STIGMA& Invisible Disabilities

Think Before (& After) You Speak

asking for help!

watch outfor burnout

The Official Publication of VRA Canada

SPRING 2015

41831522

We see the lives behind our laws.

With over 40 years of litigation experience, Oatley Vigmond knowspersonal injury law. We’ve argued hundreds of cases, securedrecord settlements and have helped shape Canadian law. Yet for allour success in the courtroom, we have never lost sight of the factthat people come first. We are dedicated to serving clients acrossOntario. Contact us at 1.844.487.9040 or oatleyvigmond.com.

M E M B E R

OV ad D RehabM 8,5x11.qxp_Layout 1 2015-01-27 11:46 AM Page 1

SPRING 2015 1

Official Publication of the Vocational Rehabilitation Association of Canada

Help is the Hardest Word: Knowing how and when to admit you need help

SPRING 2015

PUBLISHED BY VRA Canada

Account Manager: Gail Kovacs 720 Spadina Ave Toronto, ON M5S 2T9 Tel: 647.346.3336 Toll-free: 1.888.876.9992 Fax: 888.441.8002 Email: info@vracanada.com Web: www.vracanada.com

Editor: Katherine Abraham

Design: Candace Morgan MCI Strategies

Advertising Sales Director: Audra Leslie Tel: 647.290.3273 audra@graymatterms.ca 1550 Bayly Street, Unit 16A, Pickering, ON L1W 3W1 Tel: 905.420.1810 www.graymatterms.ca

Rehab Matters is published four times a year by VRA Canada. The opinions expressed in this publication do not necessarily reflect the policies of the association.

PUBLICATION NUMBER: 41831522

RETURN UNDELIVERABLE MAIL TO: VRA Canada 720 Spadina Ave Toronto, ON M5S 2T9

Editorial Peer Review Committee:Robert AllenMarty BergerTamara Bilec Maria CabasSonia ClarkeDulce FelixAlex JacksonWendy NailerLynda Nolis SalvagioTheresa RichardViki ScottColleen Steiman

FEATURES

INSIDE EVERY ISSUE

CONTRIBUTORS

It’s officially spring and we’re well into another great year with VRA Canada. The transition to KMG Health Partners and Managing Matters is now complete.

Everyone is looking forward to the upcoming national conference happening in Ottawa from June 16-19. Registration information for the conference is available online at www.vracanada.com/national-conference-2015. Be sure to check it out and register now!

This issue of Rehab Matters introduces a new quarterly column by VRA Canada member Viki Scott entitled Wellness Centre. This column will feature tips and information on how to balance work with your own personal health and wellness. Read the inaugural column on page 19.

I have a new email address! Please send your Rehab Matters submissions and questions to kat.abraham@kmghp.com!

Sincerely,

Katherine Abraham Editor, Rehab Matters Magazine

Katherine Abraham, Hons. BALydia Beck, OT RegSuzanne Chomycz, PhDcBonnie Hunter, MSWLaura Kalef, OT RegKaren Michelazzi, BHSC PT, MCPATeri Pereira, BA, RRP, RVP, CVPNeetu Rishiraj, PhD, ATC, RRP

Jeff Roach, BScKinJoanna Samuels, MEd, CMF, CTDP, RRPViki Scott, RC(c), BSc, RRP, CHRM, MBA, ADR(c)Andrew Spencer, Hons. BADan Thompson, RPP, RVP, CLCPSheryl Thompson, MACP

Society News: The latest VRA developments from across Canada

A Message from the National President: Addie Greco-Sanchez

Membership Updates: The latest VRA members and achievements

CAVEWAS Corner: Changing the Landscape & Culture of the Communication Market

Wellness Centre: Compassion Fatigue: Coping with transference issues

LMS PROLINK Protector: Your questions answered

20/20/2: Answer 20 questions for 20 dollars and earn 2 CEU credits

23

121923

6

24

LETTER FROM THE EDITOR

We see the lives behind our laws.

With over 40 years of litigation experience, Oatley Vigmond knowspersonal injury law. We’ve argued hundreds of cases, securedrecord settlements and have helped shape Canadian law. Yet for allour success in the courtroom, we have never lost sight of the factthat people come first. We are dedicated to serving clients acrossOntario. Contact us at 1.844.487.9040 or oatleyvigmond.com.

M E M B E R

OV ad D RehabM 8,5x11.qxp_Layout 1 2015-01-27 11:46 AM Page 1

Shame on You? Shame on Me: Stigmatization and the invisible disability of addiction

Stigma & Disability: A deeper look

Workplace Presenteeism: And its relationship with mental health issues

Accessing the Future Now: Product reviews for adaptive technology

Watch Your Words: Why language matters

Resource Review: Reference tools to support and enhance the return-to-work decision process

What Time is the Right Time? Disclosing your disability in a job interview

4

7

9

16

15

18

20

21

2

Society News:Updates from across the country

To see news from your society in this section, please submit your updates to your

society’s representative!

Ontario

VRA Ontario has introduced a 2015 Outstanding Contribution Award within our society to recognize a VRA Ontario member who exemplifies the mandate and tenets set out for our profession by VRA Canada and VRA Ontario respectively. VRA’s membership is comprised of dynamic, hard-working, accomplished individuals who work in many industries and contribute leadership, time, and expertise within the vocational rehabilitation profession. VRA Ontario wants to recognize an outstanding professional from our society, and we are accepting submissions. The award will be presented in recognition of outstanding achievements in the field of vocational rehabilitation. This award is to be presented to

the chosen candidate at our 2015 November conference. Don’t hesitate to blow your own horn! See our website for additional information and an application form. www.vracanadaon.com/

Our website includes a recently created photo gallery of our 2014 fall conference attendees, and a promotion to encourage members to become familiar with our site and use our resources tools as an opportunity for knowledge and connection with professional services in the field.

Plans are being finalized for speakers at our 2015 fall conference to be held in Niagara Falls on November 6, 2015 at the Hilton Hotel. An update will be offered in the near future.

Saskatchewan

VRA Saskatchewan hosted a learning event in conjunction with our AGM on May 5, 2015. The learning event focussed on brain injury issues with registered psychologist Dr. Terry Levitt, and “Understanding Outcomes and Vocational Rehabilitation Interventions.” The content of this presentation was twofold: First, there was a brief overview of traumatic brain injury (TBI). Issues covered included definitions, risk factors, classification of severity, and psychosocial outcomes. Particular attention was paid to a continuum of injury severity as it relates to expectations for outcome and recovery. Second, there was a review of the most common vocational rehabilitation approach after TBI, Supported/Structured Employment. This part of the presentation focussed on the rationale for a supported employment service, review of the supported employment approach, a brief discussion of research outcomes, and case examples. The event took place from 10:00 AM to 11:30 AM at the Saskatchewan WCB Office in Saskatoon. AGM and lunch followed.

Manitoba

Spring is in the air, even in Winnipeg!

The Manitoba board is planning an educational session for later this year. The topic will be “Directed Job Search for Persons with Personality Disorder.”

We are looking forward to working with the new VRA national support team for all our future electronic registration and workshop needs.

There are a number of Manitobans planning to attend the national conference in Ottawa this year; we look forward to seeing everybody there!

SPRING 2015 3

It’s hard to believe almost one year has passed since I assumed the role of President of VRA Canada; so much has happened. They say that change is the only constant, and our association certainly embodies that! KMG Health Partners—led by Gail Kovacs—took on the role of our marketing, communications, and public relations effective February 1, 2015, while Managing Matters began providing administrative services to VRA effective March 1, 2015.

On behalf of the board of directors, I’d like to thank MCI Strategies and Events Management for supporting VRA through our growth and changes over the years. We would not be here without the guidance and support from Naireen Lowe and Pamela Lyons, and their respective teams. We look forward to expanded horizons and fresh ideas to lead us into the next era. In the meantime, we appreciate your patience with the transition

as our supporting organizations acquaint themselves with VRA and sift through the numerous member enquiries.

The various committees, comprised of board members and member volunteers, have been hard at work meeting their goals and ensuring

our mandates are achieved. We are enhancing membership services by collaborating with other institutions, such as the Canadian Institute for the Relief of Pain and Disability (CIRPD), the Institute for Work and Health, and the Ontario Brain Injury Association, just to name a few. Our collaboration with stakeholders remains imperative to our growth and provides added value to our members.

The conference committee has lined up an excellent conference for June with a variety of speakers to ensure the ultimate learning experience, and to provide delegates with a fabulous event for continued networking. It will be a memorable conference! I look forward to meeting or seeing you again in Ottawa.

Sincerely,

Addie Greco-Sanchez President, VRA Canada

Addie Greco-Sanchez President

Lesley McIntyre Past President

Audrey Robertson Director, British Columbia Society

Shelley Longstaff Director, Alberta Society

Ralph Schultz Director, Saskatchewan Society

Lisa Borchert Director, Manitoba Society

Wanda Yorke Director, Ontario Society

Leeann Tremblay Director, Quebec Society

Ann Maxwell Director, Atlantic Society

Paul Holtby Representative, CAVEWAS

Jac Quinlan CVRP Liaison to VRA

Sharon Smith VRA Liason to CVRP

National OfficeVRA Canada 720 Spadina Ave Toronto, ON M5S 2T9

Tel: 647.346.3336 Toll-free: 1.888.876.9992 Fax: 888.441.8002

Email: info@vracanada.com Web: www.vracanada.com

Welcome to Your Rehab Matters Magazine

SPRING 2015

A Message from the National President

Addie Greco-Sanchez, President

VRA Canada // Vocational Rehabilitation Association of Canada2014/2015 Board of Directors

“Thanks to MCI Strategies & Events Management Inc.

for supporting VRA Canada over

the years”

4

To the World Health Organization (WHO), the term disability encompasses three areas: impairments in body function or structure; activity limitations; and restriction from participating in life situations due to some kind of issue. In Canada, substance addiction, either confirmed or perceived, is deemed a disability under the Canadian Human Rights Act and provincial human rights acts (2). The Act states that employers have a duty to accommodate substance dependent individuals as long as the accommodations do not place undue hardship on the employer or place other workers or members of the general public at risk, similar to other disabilities. Interestingly, even with this designation the federal disability tax credit is only available to individuals suffering from a concurrent disorder, such as depression or schizophrenia, in addition to addiction. Under the 1990 Americans with Disabilities Act (ADA), individuals in recovery from substance addiction are classified as disabled and employers have a duty to accommodate. However, the ADA makes it clear that individuals in active addiction are not automatically granted the same entitlements. This can be confusing for both employers and employees.

There is a residential treatment centre on Vancouver Island that is treating the disease of addiction and the residence’s patients. A comparison of addiction to other diseases—like cancer—is used to help patients understand that addiction is not merely due to a lack of willpower but is a progressive disease

with potentially fatal outcomes. Like cancer, addiction is medically diagnosed and then treated by the patient engaging in some form of recovery program (i.e., group therapy and 12-step programs). The patient may go into remission but relapses can occur, resulting in potentially more treatment or, failing treatment, death. Patients may remain abstinent and in recovery for years at a time, then relapse for myriad reasons. Similarly, a cancer patient may be deemed cancer-free only to have malignant cells reemerge years later.

Addiction can certainly be considered an invisible disability. The individuals I encounter as a group facilitator at the same Vancouver Island outpatient treatment centre, as well as in my work as a vocational professional, do not look like the caricature of the stumbling alcoholic or raving drug addict unfairly stigmatized in film and television. They are

military personnel, health care professionals, lawyers, small business owners, upper level managers, retirees, chefs, and salespeople. Some are also unemployed, having lost their jobs due to their addictive behaviour or a choice to leave an occupation that would threaten their recovery. They are friendly,

intelligent, introspective, and frequently stubborn. If you met any of these individuals on the street or in your workplace, chances are you would never know their struggles with what has been deemed a cunning and baffling disease.

At the treatment centre, I have numerous opportunities every day to talk with the patients where our conversations naturally steer onto the topic of work. I began to realize how intrinsically tied employment and addiction are. The employment environment may allow easy access to addictive substances; the field of medicine is a primary example. A work environment may also encourage use with long hours, unrealistic expectations, or by fostering a casual attitude towards substance abuse. Some industries encourage employees to engage in addictive behaviours with clients to encourage sales, and some occupations are just hazardous and exciting enough to stimulate the pleasure pathway in the brain—the same brain region implicated in addiction—priming the brain for the use of addictive substances.

At the centre’s outpatient facility, the topic of work continues to emerge: How can I get my boss to trust me again? How do I tell coworkers where I have been for two months? How do I now deal with work stress without turning to my addictive behaviour? How do I navigate social events with clients and coworkers where alcohol is present? Should I disclose my addiction to potential

Shame on You?Shame on Me: Stigmatization and the invisible disability of addictionBy Sheryl Thompson, MACP

“Old stigmas persist even in the face of scientific evidence”

SPRING 2015 5

addicted man as a work colleague and 61.5 per cent, the alcohol addicted man. These negative perceptions persisted even if respondents were informed addiction is a brain disease, demonstrating old stigmas persist even in the face of scientific evidence.

The team of van Boekel et al (8) noted in general that individuals suffering from addiction are viewed as dangerous, unstable, and blamable for their addictions. This stigmatization impedes vocational and other life opportunities, and decreases overall quality of life. Half the respondents in the study indicated substance-addicted individuals should be subjected to vocational restrictions and barred from holding positions in public office and teaching. Unfortunately, per Luoma et al (5), stigmatization that stems from one’s association with a stigmatized group, in this instance the addicted population, leads to self-stigma or shame associated with the addiction and self-imposed barriers to employment.

Matthew D. Graham (4) indicated in his very comprehensive 2006 article on vocational counselling and addiction that vocational counsellors are not immune to stigmatizing behaviours similar to the general population, as we receive the same messages from the media, see the same destruction to lives, and have the same personal experience with the disease. As vocational professionals, it is important to explore and challenge any biases and fears we may hold towards clients with substance abuse or addiction disorders. We should also consider our level of competency with this disability and how to move from understanding to action. Sprong et al (7) noted individuals who are disabled are two to four times more likely to be abusing or addicted to substances than the non-disabled population, and that in the US 25-50 per cent of vocational rehabilitation clients have a substance abuse disorder. These statistics indicate it is also highly likely we will encounter, or have already encountered, substance abuse and addiction in the population we assist here in Canada.

Past stigmatization may discourage a client from mentioning any current or historical substance abuse or addiction issues, leaving out a key piece of the client’s biopsychosocial history. Research indicates a lack of addiction competency, insufficient time to comprehensively assess a client due to a large

employers? As a vocational practitioner, I also had questions: How does a client explain the large gap in his or her resume after a year off while engaging in treatment and recovery? How does one tactfully arrange for job site accommodations, such as an extended lunch break to attend a lunchtime recovery meeting, without disclosing the individual is in recovery? What is the best way to answer a potential employer who queries why the client left his or her last position if his or her departure was related to the addiction?

To answer these questions, I use the disease model. If I were working with a client who was off work for an extended period of time for treatment and recovery from cancer, would I advise the client to disclose this to potential employers to explain the gap in his or her resume? If the client is engaging in chemotherapy treatments and needs an accommodated schedule to attend appointments, how would I negotiate this with the employer without disclosing the client’s illness? Would I advise a client to inform potential employers he or she had cancer but is in remission now? Would I counsel the client to disclose he or she left his or her previous position due to an inability to meet job demands as a result of symptoms from cancer or the side effects of chemotherapy?

Realistically, comparing cancer and addiction is like comparing apples and elephants. In my experience, cancer elicits compassion where addiction elicits distrust. In a recent study, Meurk et al (6) polled the Australian public on their perceptions of addiction after presenting participants with two scenarios: A man addicted to alcohol and a man addicted to heroin. Eighty-two per cent of respondents indicated discomfort with having the heroin-

caseload, variable use of addiction screening instruments, and inconsistent corporate guidelines when working with addicted individuals, all of which can impact a vocational professional’s ability to identify this invisible disability, potential barriers to employment, and issues that may threaten placements (i.e., absences and poor job performance).

Individuals with a history of substance addiction are a particularly challenging group to assist vocationally, as the addiction may have interfered with: engagement in post-secondary education or training programs; development of basic computer literacy; development of a strong work history; movement beyond low skill, low pay employment; development of aptitudes and behaviours needed to successfully function in a work environment; development of self-esteem; and establishment of a healthy and supportive network of friends and family. Behaviours associated with addiction may have also resulted in a criminal record that may be a barrier to some types of employment (i.e., working with children). Additionally, if the client chooses to be transparent about his or her addiction history, finding an addiction-friendly employer may prove challenging. Potential employment sites must be thoroughly vetted to determine environmental or personal triggers that may lead to relapse (stressful environments or environments where drugs and/or alcohol are readily accessible for business or social reasons).

For individuals in recovery from addiction, the positive outcomes from employment are tremendous. Employment has proven to reduce isolating behaviours that lead to using, encourages abstinence, provides legitimate income and stable housing, increases the individual’s standard of living, imparts feelings of empowerment and self-efficacy, reduces self-stigmatization, improves interpersonal relationships, and increases self-esteem and overall life satisfaction.

Employment should be a part of any successful treatment plan but opinions on when to introduce vocational services are mixed. Conventionally, services should not be introduced while a client is actively engaged in his or her addiction, as this will likely be an unproductive, frustrating, and discouraging experience for both service provider and client.

“Vocational counsellors are not immune to stigmatizating

behaviours similar to the general population”

6

Sheryl Thompson, MACP, is a vocational consultant with Vocational Solutions Inc. in Vancouver, BC and a group facilitator for Edgewood Vancouver Addiction Services. She is particularly interested in the complex relationship between addiction and employment.

Some vocational rehabilitation programs may delay services until the individual has attained a specified period of abstinence while some evidence suggests introducing vocational services in conjunction with treatment can promote treatment completion.

Other research indicates returning an addicted individual to work post-treatment should not be rushed, as the risk of relapse is high, especially during the first year of recovery when the individual is settling in to his or her new lifestyle of meetings, support groups, friendships, and activities. Individuals receiving long-term disability (LTD) benefits may be less willing to engage in employment activities out of fear benefits will be discontinued once any kind of employment is obtained, adding increased stress that may lead to relapse. As with any return to work plan, a personalized strategy that takes into consideration the client’s unique circumstances should be developed in conjunction with the client and his or her treatment team to enhance the client’s chances of success.

When returning a client to work, a multi-disciplinary approach is helpful. Graham (5) recommends vocational counsellors work in tandem with the client’s addiction counsellor to create a supportive and transparent relationship where the client feels free to share any challenges in his or her recovery, whether

vocational or addiction specific. Gaining some knowledge of 12-step and self-help recovery programs, such as SMART, would provide the vocational counsellor with the tools to engage in informed discourse about recovery matters that may interfere with vocational success.

Successfully completing treatment and engaging in a strong recovery program is no guarantee against relapses. Statistics indicate it is more likely than not that those in recovery will relapse at some point. Establishing new behaviours and habits takes time and interruptions due to relapse(s) can occur. In this instance, Graham (4) advises that vocational services should be suspended to allow room for the client to refocus on his or her recovery program.

For clients with little work experience returning to the workforce post-treatment, Duffy and Baldwin (3) recommend taking a youth-centric approach and introducing training, education, or volunteer employment to build the client’s

To view references for this article, visit our website www.vracanada.com/media.php

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

resume and job skills, as one would with a teenager or young adult new to the job market. Identifying and focusing on the client’s strengths is important to foster confidence and a strong therapeutic alliance throughout the return-to-work process. Bartlett et al (1) note the important role of those in the helping professions in the care of addicted individuals. If treated with any level of contempt, mistrust can form and assistance may be rejected. We have the opportunity as vocational professionals to help, support, and encourage those who have long been stigmatized, overlooked, and shamed.

Let us be a light that guides and not a darkness that hides.

“The positive outcomes to

employment are tremendous”

MEMBERSHIP UPDATESNew MembersAmanda SaavedraBrenda Uy AlindoganCatherine LauCindy Darlene LukeyDaniel James DavidsonDebbie NelsonElmira IbragimovaErin Jacqueline RyanFrances Lesley HopkinsFrancoise HacheHelen GoutosHusein Nazarali AliInba MurugesanInna AvshalomIslam MiftariJenna BeaumontJoseph Purves-SmithJulie Barrette-CairnsKathryn Mary RyanKelsey WarnickKevin Paul WitmerLianne Stephensen

Linda Yi-Chi LinLindsay Marie BurkatskyLisa FortnerLisa SmilekLonda DanielMarc SolishMartine Oliveira Mirra Ann LefortMuneeza AkhtarNathalie LandryPamela Beth ZukerPatricia ChrisPieter Van den BergRenuka GoodapatiSara FatehifarShawna WilliamsSheryl Lynne SmaleSyed Aamir IjazValerie Mason

New RRPAdelaine ThomasAmelie Degorce

Andrea QuackenbushBrian MartinCandace YakeCara KirkhamCassandra JonesCatherine BanduraChristopher SeguinDaniel CohenDebbie DesgagneDerek LoDeshpal GrewalDonika MadjirovaDoris VernonEd WoelkElmira IbragimovaErin BuxtonFrancois ParadisHarjit DhaliwalInna AvshalomIslam MiftariJeanette MorriceJeanine ReemstJeannie Lazure

Jennifer Da SilvaJessica DozoisJocelyne HardyJulie ScrivienerJulien BourqueKaren PoirierKarlie KhanKathryn Mary RyanKeith ChambersKelly BaurerKelly KarrKelly VolkLana CullisLaura DerkachLaura ReschLauren MartinLianne CharleboisLisa LivingstonLori SteacyLynn SenechalMarc-Andre DufourMichelle GrahamMirra Lefort

Muneeza AkhtarPamela ZuckerPascal SiroisPatricia SullivanPatrick CortesiPieter Van Den BergPinder DaSilvaPrince KattayilRaymond RupertRob AgostinoSanzana HussainShalini NalliahSheryl ThompsonStephanie HernandezStephanie JoabSue DavisSumaiya BaqeeSusan GouldSyed Aamir IjazTara CorreiaTracy DucharmeTroy Edwards

SPRING 2015 7

Help is the Hardest Word: Knowing how and when to admit you need helpBy Bonnie Hunter, MSW

Let’s face it: nobody likes to admit that they can’t handle something on their own. Why is it so hard to admit we need help? After being repeatedly clobbered by depression, I finally realized it was a skill I had to learn, or things were going to get a lot worse.

It can often feel like we are conditioned by society to keep to ourselves and not burden other people with our problems. This mentality even extends to our friends and family; we’re convinced that those who love us would be put out if we needed them, but we don’t stop to consider how we would respond if they needed us.

Ironically, this whole mess is compounded for those of us working in care-giving or community service roles. We can’t possibly get sick or sad or messed up in any way, what with saving the world all the time. We have to be strong and keep going at any cost, or certain disaster is inevitable! We will, however, give each other advice—don’t work too hard, take some time off, go see the doctor—while we continue to limp along, trying to smile.

Mothers out there are terrible at asking for help, even amid doing their nth load of laundry for the day, trying to explain math homework that resembles ancient Samarian, and keeping everyone from shoving things up their noses. And this is “after work.” For these women, there’s barely any time to sleep, much less manage the dark clouds in their minds.

Most men don’t have it much easier, either. While there are many lovely, caring men out there, that old macho ideal of masculinity is still alive and kicking. We still buy into the outdated idea of what a “real man” is: tough, strong at all times, never cries, and for some reason is often riding a horse. Sadly, this

results in a lot of men who can’t even talk about their pain, much less get the help they need.

Understanding all of this doesn’t make dealing with feelings of depression easier, but it gets better with practice and preparation. Consider specifically what you’re asking for and who you ask. How much does this person know about your situation? How much are you willing to disclose? If it causes you physical discomfort just to think about asking for help, preparation is really important. Asking someone you trust, even more so.

Then you’ve just got to do it—without a huge preamble and without apologizing. My first big depression-related request for help was brutal. After sobbing hysterically, I called my friend, sputtered around until I blurted out what I needed, and then spent 20 minutes apologizing and begging her forgiveness. Asking this of my friend was a significant favour, but she did it because she loves me and she knew I was in pain.

“You need the help more than you need to appear strong”

8

Bonnie Hunter, MSW, is a self-proclaimed HR geek and, in her spare time, a choir enthusiast known to break into song at inappropriate moments. She has been with North York Community House for more than ten years, where she is currently the Director of

Human Resources and Administration, which is much more exciting than it sounds. Bonnie has been fighting hard against depression for the last decade.

Personal injury lawyers focused on client recovery

Over 33 years experience dealing with complex accident and negligence claims including:• Brain Injury • Spinal Cord and Catastrophic Injuries• Medical Malpractice• Wrongful Death Claims

Joseph E. Murphy, QC

Giuseppe Battista, QC

J. Scott Stanley

Stephen E. Gibson

Brian R. Brooke

Alex Sayn-Wittgenstein

Angela Price-Stephens

Derek M. Mah

Irina Kordic

Kevin F. Gourlay

Leyna Roenspies

Jeffrey Nieuwenburg

Mike P. Murphy

Dianna Robertson

Bill Dick

Free consultation. You don’t pay until your claim is resolved.

Vancouver604-683-9621

Kelowna250-979-7230

Toll Free1-888-683-9621

murphybattista.com

Get your life back.

I wrestled with the guilt of asking for that favour for a long time until I realized that for her, helping me was not a hardship. I believe most of us in the same position will choose to help if we possibly can. It’s horrible to see someone you love suffering, fighting, struggling, and having no power yourself to help pull them to safety.

I’ve since had a lot more practice and have actually become quite skilled at asking for help—I know when something is beyond me, and will wildly wave my hands around, saying “Over here! I need a hand!” (There’s usually less of the literal hand-waving, but it’s a good visual.)

To sum up, here are the Big Life Lessons I’ve learned from all this:

• People feel good when they can help someone.

• We’re not necessarily afraid that people will say no; we’re afraid that by asking, we’ll seem even weaker, crazier, and more helpless than we already do. That’s the illness talking but don’t listen, it doesn’t know anything. You need the help more than you need to try to appear strong.

• You’ll feel much better for getting the support you need. When I asked for help, the world continued to revolve and no one threw rotten eggs at me for being a bad person.

• I asked for support again and again, and eventually got strong enough to be there for others. Not just to pay them back but because I can, and I know how hard it was for them to ask.

So, please give it a try: pick someone close to you and ask them for help. It’s important that we all get good at this.

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

SPRING 2015 9

2. Course of the condition: the degree to which the condition changes over time.

3. Strain on relationship(s) due to stigma: the more visible and aesthetically displeasing the condition, the more relationships(s) become strained.

4. Aesthetic qualities: how the condition affects the person’s appearance.

5. Cause of the stigma: whether the condition is congenital or acquired.

6. Peril: being associated with possible danger with the stigmatized person due to being perceived as contagious, or mentally ill, or having committed crimes.

The medical model for the term “disability” originated in 1980 when the World Health Organization (WHO) introduced a framework for working with disability using the terms impairment, handicap, and disability (16). The word disability can be used to describe mobility and/or disabilities involving the four special senses of the central nervous system: smell (CN I), vision (CN II), hearing/balance (CN VIII), and taste (CN IX). However, disability can also be used to identify invisible conditions such as diabetes, dyslexia, sleep disorders, chronic pain, mental illness, and post-traumatic stress disorder (14).

In 1963, people perceived as “normal” or average (those who do not possess a stigmatized attribute) believed that the stigmatized/disabled are not fully human (3; 6). In 1984, Jones et al, expanded on the above belief by affirming that people who are different cause average people to question the way they view the world, which leads to average people engaging in discriminatory activities to act on their beliefs. The average people construct a belief that enables them to rationalize that the stigmatized people may be dangerous and that they are inferior. These beliefs are often related to public perceptions prevalent at certain times (6). For example, epilepsy has historically been associated with evil and with demonic possession (6; 8).

“Concealable disabilities add

considerable stressors and psychological

challenges due to the threat of potential

discovery”

Stigma & Disability A deeper lookBy Neetu Rishiraj, PhD, ATC, RRP

Stigma was derived from the Greek word meaning “mark or puncture,” while in Latin the meaning translates into “a mark burned into the skin to signify disgrace” (3). Presently, the word stigma is used to reference a negative stereotype or reputation attached to an illness or event; stigmatizing is a process in which a social meaning is attached to behaviours and individuals (6). In 1963, Erving Goffman presented three types of stigma with specific characteristics involving:

1. Physical deformities

2. Character blemishes that can involve weak will, dishonesty, addiction or other mental illness

3. Tribal stigma based on race/religion that are usually conveyed through familial lines

Additional work by Edward Jones, et al in 1984 identified six dimensions of stigma that seem to affect interpersonal roles of individuals stigmatized (7). These six dimensions are:

1. Concealability: the extent to which a condition is hidden/visible. The authors identified concealability as playing a critical role in establishing a stigma, as visibility can produce a negative social response.

10

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

Neetu Rishiraj, ATC, RRP, PhD, received his PhD from the School of Physiotherapy, University of Otago, NZ. He founded ACTIN Health & Rehabilitation Inc. (www.actinhealth.com), a company that assists injured and chronically ill and/or in pain individuals return to optimal

personal and professional well-being. Neetu has been a part-time faculty member at various postsecondary institutions in Canada, New Zealand, and the US and a medical staff member with various national teams.

In Western societies, people are obsessed with physical perfection/appearance, which affects how others perceive and value individuals and how one feels about oneself (9). People with chronic illness/injury may have conditions that can cause their physical appearance to alter over time, or have a condition that may not be visible to others, but can be very visible and traumatic to the individual living from the chronic illness/injury (6; 13).

Goffman identified two ways that stigma can be experienced by individuals: as discredited and as discreditable. A discredited individual is one who shows visible signs of being different (12). Even though most average people do not openly stigmatize these individuals, the stigmatized people believe and behave as if their disability is insignificant and can go to great lengths to avert their condition from being a focal point and/or a distraction (6; 3). Whereas, an individual experiencing discreditable stigma will perceive their disability as being relevant. This characteristic can be lessened if the individual’s parents, peers, and/or support structure accept the disability and assist the individual with applicable coping mechanisms (15).

Due to stigma, the decision to disclose an invisible disability is vital to the life of the person living it (6; 10; 14), while people with a visible disability probably do not have an

option regarding disclosure. It is generally assumed that individuals with a hidden disability avoid the difficulties/stigma faced by individuals with a visible disability, but researchers have shown that individuals with a concealable disability also face considerable stressors and psychological challenges due to the threat of potential discovery (1; 10; 14). The Canadian government has legislation in place to protect the rights of disabled individuals; legislation such as the 1982 Charter of Rights and Freedoms prohibits discrimination on the grounds of mental or physical disability and governs relationships between a private individual and government entities. The Canadian Human Rights Act of 1985 seeks to prevent discrimination and improve access to employment, services, and facilities in all areas of federal jurisdiction. With effective legislation in place, one would presume that this relieves the strain of disclosing a disability, and may even increase the chances of the disabled individual being offered employment accommodation/social support (14). This is not the case for most people. Researchers have identified several functional factors that may hinder individuals living with an invisible disability with disclosing their chronic condition (14). These factors include:

1. Disabled individuals may still encounter potential prejudice or negative evaluations from others as there is still a social stigma attached to having a disability. This is especially true for psychological or psychiatric conditions. As such, people with invisible disabilities might be willing to conceal their conditions and forego accommodations to avoid being treated differently or negatively by others.

2. Disclosure may lead to concerns regarding the legitimacy of the disability. Colella, (2) and Paetzold et al (11) all stated: if an individual looks “normal” and requests accommodation, employers and the general population may ask if the disability is indeed genuine. Additionally, due to the potential stigma of having a disability, the person with an invisible disability may

risk being accused of being someone who is wrongly seeking personal gain.

People with invisible disabilities also have concerns regarding diagnoses by health care providers, leading to the disabilities going undiagnosed/misdiagnosed (14). To illustrate this concern, researchers pointed to the fact that diagnosing a learning disability often involves multiple assessments by various health care practitioners over an extended duration (5). Additionally, complications in a diagnosis may arise when the clinical criteria of a condition is updated/altered (14).

People with disabilities (invisible and visible, alike) should discuss their concerns with their family practitioners and seek advise/assistance in disclosing their respective disabilities to their employers. It should be the responsibility of the health care providers to assess and seek assistance from specialists when required to provide the disabled individual with a diagnosis, treatment plan, and required paper work to assist with work accommodation/return-to-work.

Employers should be aware of the unique challenges related to invisible/visible disabilities and must follow the established rules and regulation stipulated by the 1982 Charter of Rights and Freedoms and Canadian Human Rights Act of 1985.

“Diagnosing a learning disability involves multiple assessments by various health

care practitioners over an extended

duration”

To view references for this article, visit our website www.vracanada.com/media.php

MD Guidelines provides evidence based tools and protocols to make appropriate return to work and treatment decisions

The most advanced toolkit in the �eld also o�ers:

• A predictive model calculator for estimating leave durations

• Useful, highly detailed illustrations

• Clinical reference information and

crosswalks

• Recommendations for rehabilitation

and failures to recover

• Guidance on therapies, exams, tests

and surgical procedures

• An ICD-9/ICD-10 code mapping tool

ACOEM Treatment Guidelines:

• MD Guidelines includes the treatment guidelines developed by the American College of Occupational and Environmental Medicine (ACOEM)

• Treatment advice based on the work of

more than 5,000 clinicians

For more information or to schedule a product demonstration on the REED Group MD Guidelines,

please contact Ben Andrews at ben.andrews@kmghp.com or visit http://www.mdguidelines.com

With MD Guidelines, you get:

• Reliable advice on 1,150 medical conditions based on 3 million disability cases

• Recovery times that are peer- reviewed and backed by our medical advisory board

• Treatments that are independently researched and supported by leading clinicians

• CASE MANAGERS • HEALTH PROFESSIONALS • EMPLOYERS • INSURERS • LAWYERS

12

By Teri Pereira BA, RRP, RVP, CVP & Jeff Roach, BScKin

CAVEWAS CornerChanging the Landscape & Culture of the Communication Market

CAVEWAS CornerDear fellow colleagues and readers, here is our most recent contribution to CAVEWAS Corner.

As many of you know, CAVEWAS (Canadian Assessment, Vocational Evaluation and Work Adjustment Society) is a member society of VRA Canada, serving in large part to represent and support the professional and developmental needs of vocational evaluators as well as professional rehab personnel specializing in work adjustment of injured workers and the like. In this section, you will find current and candid articles authored by CAVEWAS members, non-members (and future members alike) that will share, discuss, and communicate with you developments and changes affecting our membership. Amongst them issues of best practice, professional development and designation, as well as industry trends.

We hope you continue to find the content in this section stimulating, motivating, and informative and we encourage your ongoing participation and contributions.

Enjoy!

CAVEWAS National Board Of DirectorsIf you are a CAVEWAS member and have any ideas, opinions or thoughts relevant to this section and you would like to share, discuss, and communicate them in the next issue, please contact: Jodi Webster at jodi@keyrehabservices.ca We also encourage you to join our group on LinkedIn.

I asked Jeff Roach, CEO of Sociallogical.com, for his thoughts on communication and changing landscapes/cultures of the job market and this is his response:

“My first thought would be how to make yourself easy to connect with: social media, email, phone, etc. It’s the non-fancy first step to which a lot of professionals don’t pay enough attention. Communicating to people how important that is and giving them a few first steps to take is a good idea.”

Jeff published an article in 2012 that I believe is still relevant three years later—far more relevant than the lists of articles that were published 20 years ago as innovative thoughts on emerging technologies. Very little has been written recently about the impact of advances in communication and technology and how to effectively use these resources.

Jeff asks, “If I want to find you online, can I? Five minutes of searching for my name on Google, LinkedIn, or Twitter should easily produce results that you can use to learn a bit about me; what I do; and most importantly, how to reach me. If a simple search like that doesn’t

yield results, I’m in big trouble.”

Earlier this year, Trent Seely, a member of the Employee Success team for the social media monitoring tool Radian6 who focuses on prospecting new talent and workforce development, touched on the concept of online searchability in regards to finding a new career. It’s important to point out that the same tactics apply to those of us who are constantly working to grow our network of connections and manage an online reputation to further our careers.

There is a lot of talk about search engine optimization (SEO), content creation, and socializing online to grab attention so your target customers can find you and become interested in you. But what if a customer already knows who you are and wants to develop a more interactive relationship? Can they find you and connect with you?

We Meet Our Needs in Different Ways

This won’t come as much of a shock, but most people don’t look for people or businesses in the phone book any more. Organization-based business directories that are isolated from the mainstream services like Google+ Local or

SPRING 2015 13

Excellence in Rehabilitation & Employment Services

Est. 1990

Expert Opinions & Assessments l MVA l CPP l LTD l WSIB

Contact US 416-297-9373 www.rehabnetwork.ca 4151 Sheppard Ave. E. Toronto, M1S 1T4

Principals

Frank Martino, CEOHon. BA, RRP, CCRC, CVP

Carmille Bulley, PresidentRRP, CCRC, CVP

416-297-9373 www.rehabnetwork.ca

REHABILITATION NETWORK CANADA INC.

Teri Pereira, BA, RRP, RVP, CVP, has more than 23 years of experience as a rehabilitation consultant to auto insurers, disability insurers, and WSIB. She is on the board of CAVEWAS.

REHAB MATTERS

ED

ITO RIA L C O M M

ITT

EEAPPROVED

LinkedIn are of limited value. People who want to find you will go first to the tools that have given them the best results in the past, and it’s been a long time since the Yellow Pages has been the trusted resource it used to be.

Google is still the most popular choice for finding information and should bring up something about you that will allow the searcher to connect

with you. Is it your LinkedIn profile? Your about.me page? Your business website? A news item you were featured in? Whatever it is, how many more clicks will it take the searcher to send you an email or find your phone number?

A “social search” is a search that looks for

keywords or user accounts on any of the online social networks (Google now being one of them with Google+). On Twitter you can find users, as well as any time a user has been mentioned in an individual tweet. From there, you can post about users and they (along with anyone else who’s looking) can see it, or you can send private “direct messages” to someone if you are both already following each other.

On LinkedIn, a successful search may require a variety of identifying elements to find the person you’re looking for. For example, there are 87,990 people on LinkedIn with my name John Smith. The addition of a photo, business name, location, and industry are all listed in the search results to help narrow down the hunt for the right John Smith. Once you’ve found who you’re looking for, click on his profile and send him a message.

Google+ and Facebook are very similar in that people tend to be a lot less diligent about keeping their profiles complete and current on those channels. This may not be ideal since Facebook currently has the largest population of any social network, and a Google+ profile is, not surprisingly, most likely to be found in a Google search.

“If a simple online search for you doesn’t yield

any results, you’re in trouble”

Non-Existent: Cannot Be Found or Connected With

A large, international consulting company conducted a high level audit of its 30 regional leaders using a 10-point, non-scientific scale (based on a few measuring scales like Klout and PeerIndex) to give a sense of where the company was at in terms of online presence. At the top end of the scale was “10: Thought Leader—someone who has a large, niche audience and whose content is often amplified and trusted.” At the bottom end of the scale was “0: Non-Existent—cannot be found or connected with.”

From this senior group of consultants in a company dependent entirely on the strength and reputation of their employees, not one person scored above “2: Observer—accounts on three networks with little to no activity.” It isn’t until 4 on the scale that profiles are strong enough to allow people to connect easily. Consider the challenges a business like this will face in the coming years as online reputations are increasingly important and their greatest asset—their people—has no online reputation to speak of.

It’s Not Social but It’s A Start

Simply getting accounts and not using them is not good for business. People won’t want to connect with you on a social channel if it is obvious that you don’t use it. However, having complete, up-to-date profiles with options for visitors to connect with you directly is an open door for those who know already that they’d like to talk to you, and that’s a great start.

Jeff Roach, BScKin, graduated from the University of New Brunswick. He started CITAHEALTH in Vancouver, specializing in employee fitness programs He returned to St. John, New Brunswick and became an internationally successful entrepreneur with Sociallogical.com.

HEALTHCARE CENTRE

I want to stay in my own

home.

Canada Cares is a not-for-profit that supports, celebrates and recognizes family and professional caregivers.

canadacares.org

Help us find this year’s National Caregivers.Tell us about outstanding

family or professional caregivers in your life. Regional awards for Western, Northern, Central and Atlantic Canada.

ADDITIONAL AWARDS:

To find out more and enter to win visit canadacares.org Contest closes September 18, 2015.

B521

Caring Communities

In partnership with

Caring Communities

Caregiver Friendly

Workplace Award

In partnership with

INSPIRATION, INFORMATION AND OPPORTUNITY FOR CANADIANS WITH DISABILITIES

Caring Communities

In partnership with

Caring Communities

Caregiver Friendly

Workplace Award

In partnership with

INSPIRATION, INFORMATION AND OPPORTUNITY FOR CANADIANS WITH DISABILITIES

Canada Cares2015 Awards

Canada Cares2015 Awards

FOR CAREGIVERS FOR COMMUNITIES FOR EMPLOYERS

Caring Communities

In partnership with

Caring Communities

Our Funding and Current Sponsors:

®

LIVINGSOLUTIONS

Perfect Productsfor People Who Care

livingcaresolutions.com

CARE

Media partners: n Caregiver Solutions n Today’s Kids in Motion n Rehab & Community Care Medicine n INSPIRATION, INFORMATION AND OPPORTUNITY FOR CANADIANS WITH DISABILITIES

© 2

015

Can

ada

Car

es R

esou

rce

Net

wor

k

B521 CC FlyGuy Ad 9 X 10 7-8_2015_Ad.indd 1 4/10/15 1:16 PM

SPRING 2015 15

Mr. Easton LaChappelle

At the 2015 Consumer Electronic Show (CES) in Las Vegas, Nevada, Easton LaChappelle, a 19-year-old inventor and entrepreneur, offered his innovated prosthetic technology to the open market.

He had been working on his innovative prosthetic technology for five years, when he was inspired by a young girl who had a prosthetic limb. LaChappelle was astonished that for $80,000, the functionality of the limb was restricted to only opening and closing. In his initial designs, he used Lego for support, fishing line, small plane motors, and electrical tubing for the fingers to create a rudimentary prototype that performed a lot more functions than simply opening and closing. He did all that when he was only 14 years old.

Since then, LaChappelle has accomplished much more, including working with NASA when he was just 17 years old. Following his high school graduation, LaChappelle established his own company called Unlimited Tomorrow, where he is literally trying to change the world. Rich Stewart, one of LaChappelle’s test subjects, had been using the conventional hook limb and was blown away by LaChappelle’s thought-controlled technology that enables the user to perform intrinsic hand functions, like picking up a light bulb without damaging it. According to LaChappelle, the technology uses 12 different channels of the brain.

Panasonic’s Washer/Dryer

Completing all the steps of doing laundry can be one of the daily activities that non-disabled people take for granted. Transferring clothes from a washer to a dryer can be difficult for someone with limited hand-function, limited upper extremity strength, or limited endurance due to the excess weight of the wet laundry.

In 2009, Panasonic developed a single front-loading machine that does both jobs of washing and drying clothes.

It comes complete with an angled drum to make it easier to load and unload your clothes. As an added bonus, the washer/dryer is also extremely energy efficient because it uses a heat pump instead of a heating element to dry the clothes. The washer/dryer saves more than 20 gallons of water per load compared to a traditional top-loading washer by simply tilting the washing cylinder. Similarly, the tilting allows the washer/dryer to create the same depth of water as a top-loading washer with a significantly decreased volume of water. The decreased water usage also saves on electricity, with less energy required to heat the smaller amount of water.

Panasonic’s washer/dryer is commercially available in Japan but it will not be available to North American customers until a sufficient demand is demonstrated. The washer/dryer is part of a number of “green” products offered by Panasonic, including hybrid car batteries.

Accessing the Future Now Product reviews for adaptive technology By Dan Thompson, RRP, RVP, CLCP

LaChappelle could have sold the rights to his technology, he could have kept the information close to his chest but he decided to release the designs and software for his 3D prosthetic arm to the entire world by making it open-sourced. LaChappelle wants to have his technology shared with as many people as possible so others can build on what he had started.

LaChappelle’s technology offers far greater intrinsic hand function than conventional prosthetic limbs, and the beauty of his prototypes are that they were developed for only $350! It’s no wonder he was quoted as saying “prosthetic manufacturers are very nervous!”

Dan Thompson, RRP, RVP, CLCP, has, over the course of his lengthy career, dedicated himself to improving the quality of life of others with disabilities.

To view references for this article, visit our website www.vracanada.com/media.php

“LaChappelle wanted to share

his technology with as many people as

possible”

16

Presenteeism is defined as a productivity and performance-related issue when individuals are present at work despite being ill (3). It is a relatively new construct and a major issue in the workplace. It has been associated with decreased productivity at work, increased short-term disability leaves, errors in judgment, work-related accidents, interpersonal problems, and greater job turnover (1; 6; 8). It is also related to increased costs to the company (9). Presenteeism can be measured in different ways depending on the workplace, but typically “normal productive output” for an individual is first determined prior to the impairment, followed by a comparison with their estimated current level of functioning (12). It can be challenging to quantify presenteeism as it may be difficult to discern how much an illness affects one’s performance, especially if the illness was present when hired (12). Level of

impairment due to presenteeism may vary as well depending on the type of occupation (8).

Presenteeism is commonly reported in individuals with children and workers with lower wages (2). It is also more likely to be reported in workers with poor overall health and those who have difficulties setting limits when confronted with excessive demands (2). There are strong similarities between risk factors of presenteeism and mental health issues, including stressful life events and poor coping skills. While presenteeism can apply to a variety of situations, including potentially invisible ones like chronic pain, it is frequently reported in workers with mental health issues.

Presenteeism due to mental health issues may be associated with more productivity rather than absenteeism from migraines or seasonal allergies (5). In fact, it is more likely to be

reported by workers receiving mental health services, while absenteeism is more likely to be reported by workers being treated for a physical illness, like a heart condition (10).

“A recent study reported almost 40 per cent of

Ontario workers would not tell their managers if they

were experiencing a mental health issue”

Workplace PresenteeismAnd its relationship with mental health issuesBy Suzanne Chomycz, PhDc

SPRING 2015 17

Although presenteeism itself is not a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, it still describes a pattern of behaviour common in a group of individuals that have clear negative impacts on their occupational functioning. Depending on the nature and severity of the presenteeism, it may negatively influence an individual in other aspects of his life, such as financial or social functioning. Therefore, it is a valid and legitimate concern in the workplace for both the company and the workers themselves.

In order to prevent and manage presenteeism in the workplace, it is critical for research in this area to develop further. The majority of literature in this area has investigated presenteeism in the context of mood disorders, demonstrating that depression can negatively affect one’s ability to work (1; 11). It is also associated with greater absences, inability to handle the current workload, decreased work speed, and impaired ability to meet simultaneous demands (5).

Attempts to measure presenteeism have been made with several psychometric measures being developed to evaluate presenteeism in mood disorders and productivity in the workplace. For example, the Lam Employment Absence and Productivity Scale (LEAPS) (7) is a 10-item self-reporting measure of work functioning and impairment in clinically depressed individuals. Several of its items inquire about presenteeism. Although there is conflicting evidence as to whether self-report measures of presenteeism are actually unbiased, it is nevertheless evidence of increased interest in this area of research. Future studies are required to investigate how presenteeism may be displayed in different occupations and in individuals with different mental health issues. Likewise, while there are numerous studies on clinical intervention strategies for depression and other mental health concerns, there is much less literature examining specific interventions in the workplace targeting presenteeism due to mental health issues and monitoring of workplace outcomes.

Another approach for dealing with presenteeism involves increased efforts towards workplace health promotion to maximize performance. For example, instituting a workplace wellness program or

monitoring for potential work overload may be considered. Managers should promote open communication around mental health concerns in order to reduce stigma. This is critical, given that a recent study reported almost 40 per cent of Ontario workers would not tell their managers if they were experiencing a mental health issue (4). Organizational policy should be reviewed to reevaluate attendance management practices (6). Lastly, identifying presenteeism should be recognized as a preventative strategy, given that it may subsequently lead to longer periods of decreased productivity, and eventually absences or termination if not addressed.

Suzanne Chomycz, PhDc, works as a psychometrist in the vocational rehabilitation field in Thunder Bay, Ontario. She is in her third year of the PhD program in Clinical Psychology at Lakehead University. Her dissertation is investigating personality and motives related to substance

use in undergraduates. She also has strong research interests in program evaluation and cultural issues relevant to vocational assessments and intervention.

To view references for this article, visit our website www.vracanada.com/media.php

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

18

Reflect on these sentences and underlined words:

• “My boss is acting like a psycho about these reports”

• “My work schedule is retarded this week”

• “I was such an alcoholic this weekend, I drank so much”

What is being communicated? What do these words really mean and how may they impact others? Could these words be replaced by more thoughtful adjectives? Why is this important?

According to the Mental Health Commission of Canada (2014), one in five Canadians experience mental health problems in their lives, and this number is on the rise. One way mental health challenges differ greatly from physical health challenges is that mental health is invisible—you might never know the person you are talking to is experiencing mental health issues. Stigma plays a part in making mental health challenges invisible, as individuals may try to hide difficulties to avoid being labelled or discriminated against. As a result, you never know the experiences of someone you are talking to. One way to decrease the stigma is to change the language we use every day. It is important to be mindful and respectful of others by using person-first terminology and sensitive language.

Person-first terminology refers to the language used to describe an individual. For example, instead of saying “she is schizophrenic,” the person-first terminology would suggest you say “she is a person with schizophrenia.” Consider using neutral terms,

like “experiencing a mental illness,” or “a person who has a mental illness diagnosis.” This person-first terminology highlights that the individual is a person first, and should not be labelled mainly by their illnesses. Although this terminology aims to respect individuals, it is always important to be mindful of the language people use to describe themselves.

Everyone has a different view on appropriate language so we encourage you to actively listen, reflect, and ask others if your language/terms are appropriate.

Sensitive language refers to being conscious and purposeful about the language you are using. This is applicable to everyday communication as you never know what others are going through and what that experience is like for them.

Common examples of terms to reflect on:

• “Struggling”—Individuals with mental illness are often portrayed to be “struggling” with their disease. While some people living with mental illness may identify this way, others may feel that their illness is a part of who they are. It is up to them to determine how they describe their experience with their illness. Saying someone is “struggling” with a mental illness implies a negative

Watch Your WordsWhy language mattersBy Lydia Beck, OT Reg, & Laura Kalef, OT Reg

experience and this may not be the case for everyone.

• “Crazy”—You might be familiar with using this word to describe most matters of your life. “My week has been crazy!” “That bus ride was crazy busy.” “My mother is acting crazy about planning this wedding.” But why do we use this word? Does crazy mean bad? Or good? The term crazy has been used historically to label people with mental illness and may have a negative connotation. Consider how this may make others feel when you use this word. Is it the most appropriate word choice? Is there another way you can describe your experience?

• “Depressed” or “OCD” (or any other physical or mental health diagnoses)—These are other terms that are often heard in everyday conversation and in the media: “I am so depressed, I am having a bad hair day,” “You are so organized, you are so OCD.” Depression and OCD are diagnosed mental illnesses and should be taken seriously. If you were talking to someone who has experienced one of these illnesses and told them how depressed you felt because of a sad movie you watched, how do you think this would make them feel? A diagnosis of depression is more than just being sad for a moment. Is that the most appropriate choice of language? Are there other words you can use to describe these feelings?

We know that it is difficult to change your language overnight, but by being mindful of the words you use and making purposeful choices, you can perpetuate a positive

“Be cautious of how your words

may impact those around you”

Laura and Lydia are registered occupational therapists and the co-founders of L&L Consulting, focused on improving mental health in the workplace. Visit their website at www.corporatementalhealth.ca. If you have any questions or comments, feel free to reach out to us at info@corporatementalhealth.ca.

According to Dr. Charles R. Figley, there is a cost to caring. Professionals who listen to clients stories of fear, pain, and suffering may feel similar fear, pain, and suffering because they care. Sometimes we feel we are losing our sense of self to the clients we serve. Those who have enormous capacity for feelings and expressing empathy tend to be more at risk of compassion stress and/or burnout.

A comprehensive review of the empirical research on symptoms of burnout identified five categories of symptoms:

1. Physical Symptoms: fatigue and physical depletion/exhaustion; sleep difficulties; specific somatic problems, such as headaches, gastrointestinal disturbances, colds, and flu.

2. Emotional Symptoms: irritability, anxiety, depression, guilt, sense of helplessness, anger, sadness, hypersensitivity, loss of confidence, decreased self-esteem.

3. Behavioural Symptoms: aggression; callousness; pessimism; moodiness; changes in appetite; defensiveness; cynicism; substance abuse, such as caffeine, nicotine, alcohol, etc.

4. Work-Related Symptoms: quitting a job, poor work performance, procrastination, work avoidance, obsession with details, setting perfectionist standards, absenteeism, tardiness, misuse of work breaks.

5. Interpersonal Symptoms: perfunctory communication with, mistrust in, and/or isolation from friends and family; intolerance; inability to concentrate/focus and/or withdrawal from clients/coworkers; dehumanizing clients; intellectualizing clients

Components of Prevention

1. Personal Development: self-care including exercise, healthy eating, proper sleep, life balance, relaxation, investing in creative expression, obtaining professional/clinical assistance, etc.

2. Skill Development: assertiveness training, stress reduction techniques, time management, interpersonal communication, professional subject matter training, etc.

3. Professional Development: seek professional/clinical support; colleague mentorship; incorporate “risk of burnout” framework into regular case management meetings, peer review, transfer file; establish primary and secondary counsellor model to high risk files, etc.

Wellness CentreCompassion fatigue: Coping with transference issues

portrayal of people with mental health diagnoses, ultimately reducing stigma and being sensitive to those with whom you communicate. One strategy to use is to imagine everyone has an invisible disability of some kind—reflect on your language to ensure you are being sensitive to others. Consider what your invisible disability is—what would cause you to have an emotional response?

We all say things like the examples we’ve shared in this article, but we encourage you to reflect on your language every day and be cautious of how your words may impact those around you. We have reworded the examples in the introduction to be more sensitive. What do you think?

• “My boss is acting like a psycho about these reports” > “My boss is taking these reports seriously”

• “My work schedule is retarded this week” > “My schedule is busy this week”

• “I was such an alcoholic this weekend, I drank so much” > “I drank a lot this weekend”

Changing your language may seem like a small task, but it can make a big impact in reducing stigma around mental health.

Let’s keep talking about mental health in a sensitive and respectful way.

Wellness Centre is a quarterlycolumn prepared by Viki Scott.

To view references for this article, visit our website www.vracanada.com/media.php

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

20

As a registered physiotherapist, I am often asked what tools and resources are available to support sound decision-making and to enable safe and sustainable return-to-work.

Professionals working in the vocational rehabilitation, disability management, and return-to-work fields have access to a variety of resources, including technology solutions that provide evidence-based guidelines to support the decision-making process.

Online reference tools used by professionals to guide the process include:

•Reed MD Guidelines (Reed Group Medical Disability Guidelines)

•ACOEM (American College of Occupational and Environmental Medicine Practice Guidelines)

•ODG (Official Disability Guidelines)

All three are used to assist professionals to determine the expected timeframe for return-to-work, select evidence-based treatment, offer options for workplace accommodation or modification, and use the International Classification of Diseases in their data source.

The following is an overview of the key features of each reference tool:

Reed MD Guidelines

•Development of the Reed Guidelines more than 30 years ago helped to establish an evidence-based benchmark for the treatment and management of both occupational and non-occupational disabilities.

•The guidelines use the ICD-9/ICD-10 codes as their diagnostic basis and are built on objective medical evidence.

•Information that incorporates user-provided data from more than 5 million actual disability cases and provides access to aggregate data.

•Each topic includes a clinical description, information on diagnosis and prognosis,

Resource Review:Reference tools to support and enhance the return-to-work decision processBy Karen Michelazzi, BHSC PT, MCPA

treatment and rehabilitation options, disability durations, and return-to-work accommodations.

•Additional tools include a predictive model calculator for estimating leave durations, detailed illustrations, clinical reference information, and an ICD-9/ICD-10 code mapping tool.

ACOEM

•The ACOEM treatment guidelines were developed by the American College of Occupational And Environmental Medicine to provide treatment advice on a wide range of health conditions.

•ACOEM offers treatment evidence that is outcome-based and is primarily based on original research articles, not reviews.

•Covers medical, psychosocial, and functional outcomes of injured workers.

•ACOEM is not prescriptive, i.e. the professional still makes the ultimate decision, but it offers evidence-based treatment options based on best practice and the work of more than 5,000 clinicians.

ODG

•It was developed by the Work Loss Data Institute 20 years ago.

•The ODG provides evidence-based disability duration guidelines.

•It offers additional support tools, including the comorbidity calculator, UR Advisor, and Drug Formulary.

All three reference tools have been evaluated with the Appraisal of Guidelines Research Evaluation (AGREE) instrument, incorporate the ICD-9/ICD-10 diagnostic tools, and offer web-based online access. As Reed MD Guidelines now incorporate the ACOEM Treatment Practice Guidelines, it offers the benefits of both these applications. The Reed MD Guidelines also allow for the examination of aggregate data, providing users with an

effective tool for trend tracking to support broader decision-making and reporting.

These applications are used by a broad range of professionals—including case managers, HR professionals, health professionals, and claims managers—not only to guide the decision process, but also to document each individual’s claim/case and to ensure that information is both secure and highly accessible. Depending on the complexity of the individual case, additional clinical reference information and illustrations on the diagnosis and/or disability assist professionals to formulate a plan that is evidence-based and defensible, and can be particularly useful if it involves a subject area in which they do not have personal expertise. The ability to access aggregate data is a powerful tool that can also help to identify trends in diagnosis or disability. Professionals can subsequently use this data to generate credible reports for their clients and customers that support effective policy decisions, and that can lead to improved outcomes for lost time and absence.

All stakeholders involved in the delivery, procurement, and receipt of services increasingly expect an evidence-based approach throughout the decision-making process. As professionals in the field, we now have a number of tools available to support and enable the process, which can elevate both the quality and outcomes for service delivery.

Karen Michelazzi, BHSC PT, MCPA is a registered physiotherapist who has been working in the rehabilitation and disability field for more than 25 years. Karen is the owner and CEO of KMG Health Partners, an international rehabilitation and disability management

company established in 1996 to deliver education and consulting services to organizations and professionals in the field. She can be contacted at Karen.michelazzi@kmghp.com.

SPRING 2015 21

What Time is the Right Time?Disclosing your disability in a job interviewBy Joanna Samuels, MEd, CMF, CTDP, RRP

One of the most challenging aspects of the job search process for people with disabilities is dealing with disclosure at the job interview. Deciding whether to disclose an invisible or hidden disability at the interview can be very stressful. There are pros and cons of disclosing. Hoff, Gandolfo, Gold, and Jordan (1) present the following information and suggestions to help job seekers with the hidden disability make this decision.

Evaluate the risks of disclosing

Analyzing the risk factors of disclosing from the employer’s point of view is a critical step for all job seekers. You take a chance that you may not be hired; you may be labelled and face discrimination. Unless your invisible disability could put you or someone else at risk, telling an employer about it is a matter of personal choice. If safety is an issue, you’ll need to disclose your disability at an appropriate time. If you do decide to disclose, consider the following questions before you move ahead: Will this information help or hurt your chances of getting or keeping the job? How will the interviewer react? If you have

your disability under control, is there a reason to disclose? Do your coping strategies allow you to meet the job requirements? And if you know you can’t perform some of the duties of the job description because of your disability, would disclosure help you get the job?

Benefits of disclosing

If a company is federally regulated (like banks, telecom, transportation) they have employment equity requirements. These firms are interested in diversity. They seek to recruit and hire candidates with disabilities. Therefore, it might be good to disclose that you have a disability (you don’t need to mention what it is) in an application, resume, cover letter, and job interview. Sometimes employers value your openness and how you overcome your disability. Also, the employer can provide accommodations if you disclose. Information interviews, networking, and finding a mentor in your field are strategies to learn as much as you can about the company and its culture so you can make an informed decision regarding disclosure at the interview.

Stay positive

In the interview, focus on your abilities, skills, experience, and enthusiasm that you will bring to the job, not your limitations. Describe what you can do for the company, rather than what you can’t do. Also, prepare for the job search by identifying employers and companies that also focus on your abilities and strengths. Make sure your skills and experience are a good match for the role and that the work meets your needs. For example,

“Unless your invisible disability could put you or someone else at risk, telling an employer about it

is a matter of personal choice”

22

if you like having the option to work from home, apply to companies and organizations that offer this possibility. Figure out what you need to succeed at a job and in your career.

You can always disclose later

In an interview, if you don’t disclose your disability, the employer won’t know that you will need accommodations. If you do get the job, you can discuss accommodations with the hiring manager providing you are qualified for the job. Keep the discussion positive and be very clear as to what you require to assure the employer (and yourself) that you will be a most competent and professional employee. Hoff et al write, “Generally, it is best to begin by disclosing only to those who need to know. This allows the individual to form relationships prior to disclosure and helps diminish stigma.”

Disclose during the job interview

Be concise and prepared to explain the gaps in your resume whether or not you decide to disclose. For example, “For the last three years, I’ve been dealing with a medical issue, but it’s under control now and I’m ready to work.” Legally, the interviewer can only ask questions about your disability that relate directly to the requirements of the job. It is illegal to ask any other questions (personal or professional) about your disability.

Job developer or job coach support

If you are working within a supported employment program for people with disabilities, your assigned job developer and job coach will handle the disclosure and accommodations in advance with their employers prior to and during the placement (paid or unpaid). Once again, it is important for all job seekers with disabilities to understand their disabilities and accommodations. Being able to articulate this information to both the agency support staff and employer in a clear and concise way will make for a more successful and sustainable placement.

REHAB MATTERS

ED

ITO RIA L C O M MIT

TE

EAPPROVED

To view references for this article, visit our website www.vracanada.com/media.php

When dealing with disclosure in job interviews, it is important that clients with an invisible disability remember that each job interview and situation is different. Job seekers with disabilities will require an analysis as to the benefits and risks of disclosing, and its impact on the final decision—the job offer.

Regardless of your barriers or disabilities, employers are looking for the most qualified candidate who is the best fit with the workplace culture and team whether or not the individual has a disability. As renowned speaker and author on employment and disabilities Richard Pimentel (2) explains to employers, “There are no good jobs for people with disabilities in your company; but there is a good person with a disability for every job in your company.”

Joanna Samuels, MEd, CMF, CTDS, RRP is a job developer, job coach, and facilitator at JVS Toronto. Her expertise is providing customized employment support services and job search skills training to unemployed and underemployed clients

from diverse communities. She also helps employers with recruitment, selection, and diversity. Joanna is a certified Life Skills Coach, certified Personality Dimensions Facilitator, and part-time instructor at George Brown College.

“Describe what you can do for the company, rather than what you

can’t do”

SPRING 2015 23

LMS PROLINK ProtectorThe LMS PROLINK Protector is your direct source for insurance related tips and information.

For more information on LMS Prolink and VRA Canada’s insurance program, visit www.lms.ca/vracanada.

As an employer, how do I know if my employees are experiencing a mental health issue?

According to the Mental Health Commission of Canada, there are approximately 7,000,000 Canadians (20% of the population) managing a mental health issue (an “invisible disability”) in their day-to-day lives. In other words, it is reasonable to assume that 1 in 5 of your employees is experiencing a mental health problem. However, many people with mental health problems and mental illness often experience stigma—negative attitudes and the negative behaviours they produce. Stigma spreads fear and misinformation, labels individuals, and perpetuates stereotypes. A 2008 Canadian Medical Association study cited in the “Mental Health Strategy for Canada” found that only 23 per cent of Canadians would feel comfortable talking to their employer about a mental illness. This suggests that the number of people affected by mental health issues is likely even higher than official tallies show due to a significant proportion of silent suffering.

What can be done to reduce stigma in the workplace?

Reducing stigma requires a change in behaviours and attitudes toward acceptance,

respect, and equitable treatment of people with mental health problems and mental illnesses. This happens by understanding that mental illness is not anyone’s choice and recovery is possible with appropriate treatment and supports. As an employer, you can reduce stigma by leading with compassion and regarding mental illness and problems on the same plane as visible disabilities at the workplace.

The Mental Health Commission of Canada offers the “National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard)” as a voluntary set of guidelines, tools, and resources focused on promoting employees’ psychological health and preventing psychological harm due to workplace factors. For a free and downloadable copy of The Standard, visit www.mentalhealthcommission.ca/English/issues/workplace/national-standard.

What is an “EAP” and how can it contribute to well being at the workplace?

Employee Assistance Plans/Programs (EAPs) are offered by many employers to provide an immediate and short-term solution to mental health issues at work and in other parts of life. An EAP is a confidential,

short-term, counselling service for employees with personal problems that affect their work performance. An EAP can be sourced from an insurance broker and while it bears an upfront cost to an employer to attain, an economic case can be made for EAPs because of the strong correlation between mental health and work performance. For example, a study funded by Arete Human Resources Inc. and conducted by APAS Laboratory found that before counselling, 66 per cent of individuals had performance issues that created an economic loss to their employer averaging $1,063 per month, or nearly $13,000 per year. After EAPs, only 29 per cent had performance issues, with a lower average loss of $612. In fact, following EAP use, a 74 per cent reduction in employer costs related to poor work performance was observed.

How much does an EAP cost?

The cost of an EAP varies greatly based upon plan design (depth of services, etc.) and demographics of a company’s employees (age, family status, etc.). There is no cost to attain a customized EAP proposal from an insurance brokerage, such as LMS PROLINK.

To have your insurance questions answered by the pros, submit them to kat.abraham@kmghp.com

24

1. What does Trent Seely say is an important factor when setting out to find a new career? A: Personal online searchability B: Refined resume C: Practical experience D: Networking

2. A person with an invisible disability is obligated to reveal it in a job interview. A: True B: False

3. According to the Mental Health Commission of Canada, how many Canadians experience a mental health issue in their lifetime? A: 1 in 25 Canadians B: 1 in 10 of Canadians C: 1 in 5 of Canadians D: All Canadians

4. Whose research identified six dimensions of stigma? A: Erving Goffman B: Edward Jones (et al) C: Adrienne Colella D: R. L. Paetzold (et al)

5. According to the World Health Organization, what does the term disability encompass? A: Impairments in body function or structure B: Activity limitation C: Restriction from participating in life situations due to some kind of issue D: All of the above

6. What is presenteeism? A: Employees who work above and beyond scheduled hours B: The practice of involving oneself in every project and event C: People continuing to go to work despite being ill D: All of the above

7. How might someone help prevent symptoms of burnout? A: Personal development B: Skill development C: Professional development D: All of the above

8. What is the term used to describe being conscious and purposeful about the words you use? A: Sensitive Language B: Politically Correct C: Deliberate Cautiousness D: Linguistic Mindfulness

9. What is a “social search”? A: The act of scanning a room at a social function B: How to find people to connect with for networking purposes C: A search that uses keywords or user accounts on any online social network site D: The act of crowd-sourcing for informal answers

10. In the early 1960s, people believed that stigmatized or disabled people were not fully human. A: True B: False

11. Easton LaChappelle created a prototype for a thought-controlled prosthetic limb, how many channels of the brain are engaged during its use? A: 5 B: 7 C: 10 D: 12

12. What type of companies have employment equity requirements? A: Banks B: Telecom C: Transportation D: All of the above

13. In which groups is presenteeism most commonly reported? A: Parents and workers with lower wages B: Executives and CEOs C: Small business owners D: Contract workers and shift workers

14. How might a work environment encourage addictive behaviour? A: Unrealistic expectations B: Long hours

C: Engage in casual use of addictive substances to encourage sales D: All of the above

15. Which social media network has the largest online population? A: Twitter B: Facebook C: LinkedIn D: MySpace

16. What type of person is more at risk of compassion-related stress and/or burnout? A: People in similar situations as those they are counselling B: People who have previously experienced burnout C: People with an enormous capacity for feelings and expressing empathy D: People without adequate training

17. To whom does Hoff et al recommend you disclose an invisible disability? A: Hiring officers B: All management and supervisory positions C: Cubicle mates and coworkers with whom you share space/equipment D: Only to those who need to know

18. How many times more likely are people with disabilities to abuse substances than people without disabilities? A: 4 to 6 times more likely B: 2 to 4 times more likely C: 10 times more likely D: No more likely

19. Presenteeism is more likely to be reported in people with physical illnesses over people with mental illnesses. A: True B: False

20. What condition was historically associated with evil and demonic possession? A: Schizophrenia B: Narcolepsy C: Tourette Syndrome D: Epilepsy

The answers to the following questions are derived from the content within this publication. Each question has a CEU value of 0.1. If all questions are answered correctly, you will receive two CEU credits, for a total of eight per year. In order to participate in this unique offer, you may go online to www.vracanada.com and fill out the required information and questionnaire online. Alternatively, you may fill out the form and complete the quiz below and mail them, along with a cheque in the amount of $20 addressed (plus applicable provincial taxes) to VRA Canada. CEU quizzes from previous issues may be completed at any time; there is no expiry date. To complete previous CEU quizzes please login to www.vracanada.com. Good Luck!

for20

$

Name _________________________________________________ VRA Number ________________Email _______________________________

Visa/MC number and expiry date (if not paying by cheque) ___________________________________________________________________

Mailing address: VRA Canada, 720 Spadina Ave, Toronto, ON M5S 2T9

Cut h

ere

Cut h

ere

Cut h

ere

Cut h

ere

Cut h

ere

Pay $20 and receive 2 CEU credits

based on a 100% score.

MATTERCREDENTIALS

Choosing a personal injury lawyer is one of the most

important decisions an injured person will make.

Help your client ask the right questions:

Is the lawyer?

• selected by peers for inclusion in Best Lawyers in Canada

• rated 5 out of 5 AV Preeminent - Martindale Hubbell

• selected by peers for inclusion in Lexpert, Canada’s Legal Lexpert Directory

• a Director or Past President of the Ontario Trial Lawyers Association

• a Certified Specialist in Civil Litigation

C

M

Y

CM

MY

CY

CMY

K

VRAPublication_Summer 2014_CredentialsMatterAd(Final).pdf 1 2/6/2015 9:13:51 AM

To the Automotive Training Centre;

My name is Chad Williams. I was an injured worker when Worksafe and I decided that the Dispatching and Transportation Operations program at the Automotive Training Centre would be a good fit for my situation.

At first I was hesitant, as I had no experience in this industry. Being out of school for 20 years, I wasn’t sure of what to expect from adult

learning. The professional staff at ATC was very helpful to me, and understood where I was coming from and what my goals were, and helped me to achieve them.

Both of the instructors, Jerry Virtanen and Lawrence Candiago have a wealth of knowledge and understanding of the transportation and trucking industries, and are able to pass that along to their students. With the education that I now possess, I am now working full time as Head Dispatcher for a major trucking company in the lower mainland. This would not have been possible for me without my training here at ATC, and without the level of teaching and value of the materials taught here.

I would like to thank the staff at the Automotive Training Centre for helping me rejoin the workforce, and to succeed in the Dispatching field.

Sincerely, Chad Williams, Graduate

Providing Education Since 1985

www.lovecars.ca

CAMPUS LOCATIONSTORONTO, ON SURREY, BC MONTREAL, PQON: 1.800.458.7473 BC: 1.888.546.2886 PQ: 1.877.725.6026

you can change your life!

Imagine Your Future…

WE HAVE MANY EMPLOYMENT OPPORTUNITIES!In less than 6 months your client can be trained and qualified for their new career! Many of our graduates start working immediately.

Automotive Service Operations SpecialistThis program combines the skill sets from our Automotive Service Consultant, Auto body Collision Estimator, and Parts & Warehousing programs to provide a complete automotive service education for someone looking for advancement opportunities in this industry.

Dispatching & Transportation OperationsThis program will prepare you for the seamlesss entry into the transporation industry.

Compliance & Safety SpecialistThis program fully prepares you to enter the transportation industry as a Compliance and Safety Officer.