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The 7-step Model to Enhance Return-to-Work Outcomes

April 7, 2025 · Dr. Kristin Tugman

The experience of the inability to work due to an injury or illness is a psychological event. The psychology of disability and return-to-work may not be a diagnosable mental health condition, but it does require psychological adjustment that is critical to return-to-work success.

The disability experience can be categorized into three buckets: claims that are predictable and self-resolve, claims that are long term and permanent, and a middle bucket — claims that should be medically progressing but are not improving. The middle bucket is where the opportunity lies.

The 7 Steps

1. Validation of the illness — Shame and guilt often accompany the inability to work. It is important to validate the need for treatment and give permission to take the time away.

2. Baby steps — Incremental steps to recovery through small goals that demonstrate progress.

3. Challenge negative thoughts — Cognitive distortions often leave the person believing the condition will never get better.

4. Fears of return to work — Identify tangible fears and develop a plan for each.

5. Preventing illness relapse — Identify early warning signs and steps to take when they appear.

6. Boundaries — Identify reasonable boundaries around workload and hours to help the claimant feel prepared.

7. Work adjustment or Transitional return-to-work — When available, return incrementally over a brief period.

Conclusion

As soon as an individual experiences an inability to stay at work due to an illness or injury, there is a race to prevent the disability mindset and promote psychological adjustment.

The 7-step model can identify thought process barriers as they occur and provide a sense of security and preparedness for return-to-work success.