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PGAP and Vocational Rehabilitation

People naturally experience a change in lifestyle after losing their job or primary occupation.  The longer they spend without meaningful employment, the more this becomes a problem.  Occupation helps to define who we are.  Meaningful work is therapeutic. It is what gives us the motivation to get up in the morning and to tackle the challenges that come our way.

When people can no longer work because of a disability due to chronic pain, many aspects of their life suffer as a result that goes beyond just financial loss.  For example there may be a loss of familiar routine, loss of important social contacts, and family dynamics can change for the worse.  It may lead to a deterioration of self esteem and self confidence, which can make it very hard to re-enter the workplace.

“Fifteen of the 18 studies demonstrated a beneficial effect of RTW (Return to Work) on health, either showing a significant improvement in health after re-employment or a significant decline in health attributed to continued unemployment..” Institute for Work and Health

We can help to restore an injured worker’s meaningful activity and help them get back to work through a program called Progressive Goal Attainment Program (PGAP) developed by Michael Sullivan, PhD and Ms. Heather Adams, BSW.

PGAP is an evidence-based program designed for individuals with difficulties returning to work due to pain, depression, cancer and other chronic conditions.  This 10-week disability treatment program is aimed at minimizing the impact of the person’s disability on their daily activity.  PGAP is cost-contained, time limited, and focuses primarily on function.  Psychosocial risk factors are also evaluated in the process.

“The primary objective of these interventions is to reduce psychosocial barriers to rehabilitation progress and facilitate return to work.”  Dr. M. Sullivan

Over 10 weeks, the client works with a PGAP-trained clinician who has the expertise to coach them through the program.  The client is assigned a workbook and weekly ‘homework’ to help develop skills and the habit of recording and planning his or her own activities.  Short- and long-term goals are formulated, meaningful life roles that were lost are examined, and there is a thought reaction record to help with stress and anxiety.

The program gets the client actively involved in a daily walking program and better sleep habits.  In addition, work simplification and pacing strategies are incorporated into learned pain coping techniques as the client begins to rebuild a repertoire of skills needed each day.

As a therapist helping injured workers dealing with chronic pain return to work, PGAP can be very helpful and an important component of the vocational rehabilitation process.

Written by Lisa Hung, OT and PGAP certified