Ever wondered what’s it’s like to have a psychologist onsite at your workplace?

Authors: Axis Psychology Team

You might have already considered the benefits of having someone you know and trust to help support your team and to cope with personal and professional challenges that can arise.   

Axis occupational health psychologists can support team members and leaders at any stage of the mental health continuum. We work to elevate human potential by increases the capability of organisations and wellbeing of employees. Through our onsite psychology services, our clinicians are located at the workplace, increasing their accessibility and familiarity for employees. 

An employee’s mental health is just as integral to their productivity and wellbeing as their physical health.  Workplace health and safety legislation now requires organisations to meet a duty of care to prevent psychosocial hazards and psychological injuries in the workplace. Onsite psychology can assist companies to meet their duty of care, improve performance and support retention in the workplace.

Axis employs a continuity of care by providing psychological services by a clinician who is familiar with the workplace context and the unique challenges the workforce faces, therefore providing a well-rounded solution to employee mental health and wellbeing.  

Customised Psychology Services

Axis psychologists provide customised services which can include the following preventative and responsive initiatives: 

  • Working with leaders to increase their confidence in responding to workers experiencing psychological distress 
  • Leader workshops to build capability and competence to support their team and create a positive culture 
  • Facilitation of collaborative and supportive early intervention  
  • Providing confidential counselling support to workers 
  • Running health promotion seminars to support positive behaviour change   
  • Education to destigmatize mental health in the workplace.  
  • Assessment and education about psychosocial hazards 
  • Tailored workshops and focus groups to improve overall workplace culture  
  • Mental health coaching  

Not only does the organisation benefit from the provision of psychological services, but employees who access the service can do so free of cost and without a referral, generally obtaining an appointment more rapidly than they would within the community. Onsite clinicians destigmatise the use of psychological services and promote psychosocial safety within the workplace. This is due to both the familiarity between the team and the provider, and also the modelling of employees utilising the service. 

Please feel welcome to contact us if this is a service you would like to know more about!  

Psychosocial impact on Musculoskeletal disorders.

Author: Stacey Farmer

Musculoskeletal disorders are a significant source of lost work time. You would be right in thinking that occupational physical activity can be responsible for injuries sustained within a workplace, but what about other causes, like stress, depression, anxiety or other social factors that may be related to work or day to day life? These psychosocial risk factors are just as important, and therefore need to also be considered as a potential risk for developing workplace injuries. After all, we’re human beings, not just bodies. We are not separate from our thoughts and emotions, but instead are a whole complex but wonderful package.

But what do we mean by the term ‘psychosocial’?

This is the interrelation of social factors and individual thought and behaviour. There can be many psychosocial hazards within an organisation. These can include high working hours and workloads, low levels of job control, time pressure, pace of work and poorly defined work roles. Factors such as whether the worker is able to freely communicate with management, feel valued, have positive relationships with supervisors and colleagues and work within a positive health/safety culture can influence a worker’s psychosocial risk.

Research into the influence of psychosocial impacts.

There is a growing body of research looking at the influence of psychosocial impacts on musculoskeletal workplace injuries. For instance, research has found that stressful psychosocial work environments can increase risk for back pain among workers. Employees who reported high job intensity demands, job dissatisfaction and high job scheduling demands were more likely to report back pain than those who did not have these stressors. Other factors such as low job control and effort-reward imbalance especially can be associated with pain located anywhere throughout the body, not just isolated to back pain.

What about psychosocial stressors?

While it is great that preventative strategies within the workplace are focusing on factors such as ergonomic risk factors, what about these psychosocial stressors? They are just as important as the physical stressors, and, some may argue could have more of an influence, depending on the person and their scenario. As physiotherapists, we are good at reducing physical stressors within the work environment. Imagine if we were just as good at reducing the psychosocial stressors in conjunction. This is where working with a psychologist within a team can be very beneficial.

Although there is a fair bit of work to be done in this area, we here at Axis believe in treating the worker as a human being – as a whole person that comes not only with just a physical injury, but maybe other factors in their life that are contributing to their current situation. Taking into account someone’s biology, psychology, and social factors is imperative to having a positive outcome for the worker and we take great pride in being able to do this when working with our workers.

The importance of seeking care early

Author: Sue May Wong

The truth is asking for help can be difficult for many of us. It is human nature to put up with pain and discomfort until one day we receive a wake-up call. A wake-up call is an event people refer to when a person acknowledges that their current behaviours are no longer serving them, and changes need to be made. In the physio realm, it often presents as a situation where the person is no longer able to fully participate in their usual life activities such as work or sports due to a pain or injury. As a physio, I often see patients in the clinic who have put up with their pain for months, sometimes even years before they decide to visit the physio. And this can sometimes have a larger impact on your wellbeing than it would’ve otherwise.

To explain this further, I’d like to share with you a story about my client. Julie presented to the clinic to see me after sustaining a left foot injury at work 6 months ago. She didn’t think too much of it at the time and continued her role as a cabin crew member. As the months progressed, the pain in her left foot progressively worsened and spread from her foot to her knee, lower back and both hips.

Due to the injury, she was unable to work for 6 weeks and this took a toll on her mentally, emotionally and financially. In the first few weeks she barely left her apartment as it was difficult for her to walk and stand for long periods of time. She was unable to participate in her usual sporting and social activities and was finding previously routine tasks like going to the shops difficult. Financially, she was struggling to keep up with the bills.

This story highlights how seemingly minor injuries can develop into chronic persistent injuries that require more time, resources, and energy to manage. Not only did Julie have to dedicate more effort and time to rehabilitating her injury but she also had to also face the mental, social, and financial impact of managing a chronic injury.

So, what can you do to minimize the impact of an injury on your overall wellbeing?

Here are a couple of simple tips:

  • Modify or minimize any activities that aggravate the pain. If it is related to work tasks, speak to your manager or the onsite physiotherapist for further advice on modifying your work duties.
  • If pain worsens or persists for a few days despite modifying your activities, book in an appointment with a physiotherapist to get expert advice on how you can manage your symptoms.

The key take away is that recognizing the signs and acting early will save you a lot of time, effort, mental and financial resources in the long-term. Personally, I believe that taking ownership of your health and wellbeing is an act of love. When you feel good in your body, you can show up at your best and be present for your loved ones.

My favourite author Jay Shetty once said, “If we don’t make time for our wellness, we will be forced to make time for our illness”.

The next time you sustain an injury, I hope this article inspires you to take prompt action.

 

 

 

Basics of office ergonomics for injury prevention.

Author: Joanne Browne

Ensuring an adequate working space in the office that promotes ergonomic and user-friendly engagement is nothing new – for decades now workforces have been stationed at desks operating computers for 7-8+ hours per day. As computer technologies continue to evolve and more of the workforce than ever is now working at least in part from home, ensuring you are appropriately stationed to prevent injury remains a crucial component of occupational health.

The basics of an office ergonomics are well-established. Your chair should offer adequate lumbar support and be positioned at a height that allows you to sit comfortably with your feet resting on the floor, or on a foot rest with the hips and knees roughly at 90 degree angles. Rather than being sat bolt upright, having a slight decline in the backrest means less fatigue in your trunk muscles as the day progresses. You should be able to easily access your desk, which should be positioned to allow your forearms to rest comfortably in a near parallel position, with the keyboard and mouse within easy reach. To avoid neck or eye strain, ensure the monitor(s) you use are positioned directly in front of you, approximately arms’ length away from your face, with the top of the screen roughly at eye level.

Many offices now are fitted with sit to stand desks. This can help promote regular change in position, but prolonged standing can cause fatigue and soreness as much as prolonged sitting so make sure to vary your posture regularly throughout the day.

Even with the perfect desk set-up, you may still develop discomfort throughout your day. The best thing you can do to prevent this is to take regular breaks away from your desk to stretch and move your body. Think about ways to habitually take 1-2 minute breaks throughout the day – grabbing a drink, walking to speak to a colleague rather than sending an email, or just standing and doing a quick stretch! If you struggle to remember to move you could set a timer every 30 minutes that reminds you to change your position. Find what works for you and try to stick with it!

If you develop pain or experience other concerning physical symptoms associated with work, a physiotherapist can assist you to identify what might be causing this and work with you to find management and prevention strategies.

 

R U OK? Day: A Psychologist’s Take on Mental Health Awareness

Author: Tahlia Baumann

In an era where mental health is gaining well-deserved recognition, initiatives like R U OK? Day have emerged as powerful tools for promoting open conversations about mental wellbeing. This annual event, held on the second Thursday of September, encourages a simple yet profoundly important question: “Are you okay?” As a psychologist, I have had the privilege of witnessing the evolving landscape of mental health awareness, with initiatives like R U OK? Day at the forefront. However, I appreciate the positive changes this initiative has brought while also recognizing the need to critically evaluate the obstacles we continue to face in promoting good mental health.

 

Recognising the Accomplishments of R U OK? Day

Destigmatizing Mental Health Issues. R U OK? Day is a powerful force in destigmatizing mental health struggles. By openly discussing the topic, individuals are more likely to seek help when they need it. This day acts as a catalyst for normalizing conversations around mental health, making it easier for people to share their experiences without fear of judgment.

 

Encouraging Open Communication. This initiative promotes communication and connection, urging people to check in on their friends, family, and colleagues. It creates a supportive environment where individuals feel comfortable sharing their feelings and experiences.

 

Early Intervention. Promptly addressing mental health concerns can lead to early intervention and treatment, a principle well-established in psychology. R U OK? Day encourages individuals to acknowledge their feelings and reach out to others, potentially preventing issues from escalating into more severe mental health conditions.

 

Promoting Empathy and Compassion. By asking, “Are you okay?” we cultivate empathy and compassion towards one another. It reminds us that everyone faces challenges, and showing care and concern can make a significant difference in someone’s life.

 

Raising Awareness. R U OK? Day’s extensive media coverage and social media campaigns draw global attention to mental health issues. This heightened awareness can lead to increased funding for mental health services, reduced stigma, and improved support systems.

 

Exploring the Ongoing Obstacles for the Mental Health Field

Scratching the Surface. While a great starting point, R U OK? Day can potentially miss the nuances of mental health. People may feel compelled to ask the question without truly understanding its complexities. To address this, education on mental health issues must accompany the initiative so that those asking the question can provide support if the answer is ‘no’.

 

Pressure to Appear Okay. On R U OK? Day, there can be pressure to appear fine, even when we might be struggling. Some individuals may respond with a casual “I’m fine” to avoid revealing their true feelings. It’s important to emphasize that it’s okay not to be okay and to provide resources for those who need help.

 

Lack of Ongoing Support. R U OK? Day is a single-day event, and some argue that it doesn’t provide sufficient ongoing support for those dealing with mental health issues. While it raises awareness, a more comprehensive approach is needed to ensure individuals have access to the help they require beyond this one day.

 

Symbolic Inclusion. There’s a risk that some organizations or individuals may participate in R U OK? Day to appear socially responsible without a genuine commitment to mental health support. Encouraging year-round initiatives and providing resources for those eager to learn more is vital.

 

Need for a Holistic View. While R U OK? Day primarily focuses on personal conversations, mental health issues also exist in workplaces, schools, and broader communities. It’s important to expand the conversation to address mental health concerns in all areas of life. Additionally, R U OK? Day primarily emphasises individual-level interactions. As part of a holistic approach to mental health, we must also address systemic and environmental factors that contribute to mental health challenges. True progress requires changes at these broader levels to create environments where mental wellbeing can thrive.

 

What do we Need to Move Forward?

As a psychologist, I truly believe that R U OK? Day plays a pivotal role in advancing mental health awareness and breaking the silence surrounding discussions about our wellbeing. By encouraging open conversations and promoting empathy, it has helped change the way society views and addresses mental wellbeing. However, we also must acknowledge its limitations and use this day as a stepping stone for more comprehensive, year-round efforts to support mental health awareness, education, and intervention. Ultimately, the pros of R U OK? Day outweigh the cons, but continuous efforts are necessary to ensure lasting positive change in our approach to mental health.

 

De-mystifying Mindfulness

Author: Sarah Hartley, Axis Senior Psychologist

 

What is mindfulness and can it assist in managing workplace stress?

Mindfulness has become somewhat of a buzz word or wellness trend in modern society, so what’s the big deal? Is it all it’s hyped up to be? In this article we take a look at the core components of mindfulness and how it relates to both general and workplace wellbeing.

Mindfulness has become popularised in the western world particularly within the last decade or so, however, similar practices have been occurring since ancient times in Eastern cultures. In a study conducted in 2019 regarding mindfulness in the workplace, Hilton et al., defined mindfulness as an “anon-religious practice that facilitates an attentional stance of detached observation. It is characterized by paying attention to the present moment with openness, curiosity, and acceptance”. Malarkey et al., (2013) defines mindfulness as a “non-judgmental, moment-to-moment awareness of physical sensations, perceptions, affective states, thoughts and imagery. It involves sustained awareness of mental phenomena which arise during waking consciousness. As a form of receptive awareness, mindfulness may create an interval of time where one is able to view one’s mental landscape, including one’s behavioural options.”

Psychologists and medical practitioners alike have utilised mindfulness in the treatment of a variety of physical and mental health disorders. In the broader community, it is often used as a tool to improve general wellbeing, increase perspective and reduce the stress of daily life.

That all sounds great, but what is mindfulness and how is it actually practiced?

There are 4 main elements to mindfulness:

  1. Choose where to place your attention (could be on something internal or external). Things that people may choose to notice are their thoughts, feelings, something in their environment, their breath or physical sensations.
  2. Keep your attention on the thing and taking in as much as you can.
  3. Notice when your attention drifts and remain non-judgemental (this is very normal).
  4. Gently redirect your attention back to where you are trying to focus.

Mindfulness Myths:

Myth: Mindfulness is just meditation. Fact: Whilst mindfulness meditations can be an aspect of mindfulness, in reality it is simply the practice of selective attention and non-judgemental, curious practice of attentional control. This may be a structured medication type activity but can be as simple as taking time to notice how your feet feel planted on the floor intermittently throughout the day.

Myth: Mindfulness is about taking time out to rest and relax and takes a lot of time. Fact: Whilst many people describe a feeling of relaxation that may be a by-product of mindful practices, the aim of mindfulness in and of itself is not actually relaxation. It is to selectively manage attention with an open, curious and non-judgemental attitude and become more attuned to the present moment.

Myth: Mindfulness is having no thoughts. Fact: Mindfulness is the practice of becoming more attuned to the present moment through curiosity and awareness of our current experience internal, external or both. As humans it is impossible to have no thoughts occurring at all as they are a critical component to our survival system. Our thoughts can move in and out of the foreground of our awareness but the catch is that we can choose where to place our attention. In fact, having thoughts is actually an important part of being mindfully aware so that we can notice when our attention may shift and tune in to our thoughts if our goal is to focus on mindfulness of thoughts.

Myth: The ultimate goal is to be mindful all the time. Fact: As humans our brains cannot remain in a “perfectly mindful” or aware state at all times. The goal of mindfulness is not to become 100% mindful or “enlightened”. The true goal is to build up the skill of directing our attention in a meaningful way to be able to be more attuned to our present experience. Our attention management is like a muscle and can be built up over time.

Myth: Only monks can truly practice mindfulness. Fact: Everyone can practice mindfulness anywhere at any time – the way the practice may look will be different for everyone and can be done individually or at a group level and include anything from self-directed moments of focused attention to structured group activities.

So, what does the research say in terms of benefits?

Hilton et al. (2009) referenced in their study that research suggests that mindfulness is linked to better workplace functioning (e.g., Harker, Pidgeon, Klaassen & King, 2016) and that cultivating resilience and mindfulness may assist in preventing psychological distress burnout and secondary traumatic stress (Glomb, Duffy, Bono, & Yang, 2011). Hilton et al., (2019) noted that “Evidence of potential positive effects is documented for the topic areas chronic illness, pain, substance use, depression, anxiety, perceived stress, somatization, cancer support, and IBS. Mindfulness interventions appear to have general benefits for a range of psychological variables and research shows effects of MBSR (Mindfulness-based Stress Reduction) on a variety of health outcomes”. In other words, mindfulness has shown promising results both for general use and use within workplace settings in the research.

Interested in learning more?

At Axis, our team of Psychologists utilise a variety of strategies and methodologies tailored to support you and your wellbeing including mindfulness-based therapies and practices. Consider booking a session today!

 

References:

Harker R, Pidgeon AM, Klaassen F, King S . Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals. Work. (2016) ;54: (3):631–7.

Hilton, Lara G. et al. ‘Mindfulness Meditation for Workplace Wellness: An Evidence Map’. 1 Jan. 2019: 205 – 218.

Glomb TM, Duffy MK, Bono JE, Yang T. Mindfulness at work. In Research. In Personnel and Human Resources Management. (2011):115–57.

Malarkey, WB, Jarjoura, D, Klatt, M. (2013). Workplace based mindfulness practice and inflammation: A

 

The benefits of exercise on sleep for rotational shift workers.

Author: Sami Smith

Rotational shift work refers to shift work where the worker will work both day and night shifts, rotating through various start and finish times to cover a 24hr time frame. For example, a worker may start work at 0200-1200 on Monday, 0400-1400 Tuesday and 0700-1700 on Wednesday… and so on. This rostering structure means workers are unable to adjust their circadian rhythm to match their ever-changing sleep and wake schedules. Chronic sleep deficiencies and these consistent disruptions to circadian rhythm increases risk of chronic health conditions such as type 2 diabetes, hypertension, metabolic syndrome and cardiovascular diseases. Inconsistent sleep also impacts on cortisol regulation (one of our body’s main adrenal stress hormones), and cortisol dysregulation impacts sleep quality. Regular physical activity helps regulate both cortisol levels and sleep.

Specifically, exercise has been shown to improve quality and quantity of sleeping shift workers and those that experience insomnia. Both acute bouts of exercise and regular exercise participation improves total sleep time, efficiency, quality and slow wave sleep length. Slow wave sleep is the deep phase of sleep that is considered the most restorative phase of sleep.

The American College of Sports Medicine (ACSM) and the Australian Physical Activity guidelines recommends that every healthy adult should engage in moderate-intensity aerobic exercise for ≥30 minutes/day on ≥5 days/week for a total of ≥150 minutes/week.

What is moderate intensity aerobic exercise?

“You could speak in sentences, but definitely not sing”

OR

65-75% of your Maximum Heart Rate (MHR = 220-age)

Examples:

  • Stair climbing
  • Light jogging on road or treadmill (Minimum 4.0km/hr on treadmill)
  • Stationary cycling
  • Brisk walking (Minimum 4.0km/hr)
  • Swimming laps
  • Cycling on flat surfaces

When?

  • For morning or day shift: Perform moderate intensity aerobic exercise a few hours before the main sleep time.
  • For night shift: Perform moderate intensity aerobic exercise during the day, a few hours before an evening nap.

Other workplace interventions that have proven to be successful for improving sleep quality in shift workers include:

  • Yoga and mindfulness practices
  • Appropriate light exposure
  • Melatonin supplementation
  • Improvements to sleep hygiene

 

References:

  1. Robbins, R., Underwood, P., Jackson, C. L., Jean-Louis, G., Madhavaram, S., Kuriakose, S., Vieira, D., & Buxton, O. M. (2021). A Systematic Review of Workplace-Based Employee Health Interventions and Their Impact on Sleep Duration Among Shift Workers. Workplace health & safety, 69(11), 525–539. https://doi.org/10.1177/21650799211020961
  2. De Nys, L., Anderson, K., Ofosu, E. F., Ryde, G. C., Connelly, J., & Whittaker, A. C. (2022). The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology, 143, 105843. https://doi.org/10.1016/j.psyneuen.2022.105843
  3. Okechukwu, C. E., Masala, D., D’Ettorre, G., & La Torre, G. (2022). Moderate-intensity aerobic exercise as an adjunct intervention to improve sleep quality among rotating shift nurses. La Clinica terapeutica173(2), 184–186. https://doi.org/10.7417/CT.2022.2414
  4. Kredlow, M.A., Capozzoli, M.C., Hearon, B.A. et al.The effects of physical activity on sleep: a meta-analytic review. J Behav Med 38, 427–449 (2015). https://doi.org/10.1007/s10865-015-9617-6
  5. Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43(7):1334-1359,
  6. https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians
  7. https://www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm

 

Workplace Exercise

Author: Brent Zelinski

 

Exercise has been described as ‘the best buy for public health’ (1). It is also arguably a key staple to any good injury prevention or rehab program in the world of onsite occupational physiotherapy. But what exactly are workplace exercise interventions good for and how effective are they? In this article we are going to explore some of the recent evidence regarding this to try and help come up with an answer and shed some light on the uses of exercise within a workplace setting.

Musculoskeletal Disorders (MSDs)

One of the primary and well-known reasons that exercise is utilised within occupational physiotherapy is for the treatment of MSDs. There have been several recent systematic reviews (the highest quality study design) conducted which aimed to analyse the effectiveness of workplace exercise interventions on MSDs. These have looked at exercise’s effectiveness on MSD in office workers (2), workers with physically demanding occupations (3) and even in workers with chronic musculoskeletal conditions (4). Over fifty individual studies in total were analysed within these reviews which overall demonstrated that workplace exercise interventions can reduce and effectively manage MSDs in both physically demanding and office-based occupations. Exercise resulted in a significant reduction of pain and symptoms and a significant improvement in functional scores. From these reviews it is also suggested that strength training in particular appears to be beneficial for all populations whereas other types of exercises such as aerobic exercises demonstrated limited evidence of a positive effect in workers in physically demanding jobs (3). While these results are very supporting of the use of exercise it must be noted that all reviews suggested that several studies included in the reviews were not of the highest quality and had high risk of bias implying that these results must be interrupted with care.

Job Related Stress

Exercise has been shown to have a positive effect on coping with general psychological stress (5). One survey conducted in the United States even demonstrated that up to 54% of people utilise exercise to reduce their personal stress levels (6). However, despite this the efficacy of reducing work or job-related stress is questionable. Two recent reviews have demonstrated that exercise has no significant effect on reducing job related stress (7-8). This may be due to the fact that job stress, by definition is mostly attributable to working conditions and that exercises general positive effect on stress may not be enough to address these factors. So, while exercise can be a part of an intervention targeting stress a more multidimensional intervention strategies should be utilised when targeting job-related stress specifically.

Work ability

Work ability describes a person’s capacity to meet demands of their occupation whilst taking into consideration their health, personal resources and the work environment (9). Poor work ability is associated with loss in productivity, absenteeism, early retirement (10), long term sickness absence (11), and may even be a predictor of mortality and disability in later life (12)! Several studies have looked at the effect of exercise on work ability in a range of different groups. Not surprisingly studies which have analysed workplace exercise interventions in workers who have MSDs and/or chronic pain showed that workplace exercise can improve work ability from 6-8% compared to those in the control groups (13 – 14). This makes sense as one main consideration in work ability is health and as we stated earlier exercise is an effective means of managing MSDs thus improving health and in turn work ability. However, it has also been shown through several studies including a systematic review (which did include interventions that weren’t solely exercise) that even in workers without MSDs that workability can be positively affected through workplace exercise (15-17).

We all know that exercise is integral to leading a full and healthy life. And while it may not be effective for everything, its effect on managing injuries and improving workability should highlight why exercise should be a mainstay intervention used in occupational health.

References:

  • MacAuley, D., Bauman, A., & Frémont, P. (2015). Exercise. BMJ (Online)350(18), h1416–1108. https://doi.org/10.1136/bmj.h1416
  • Tersa-Miralles, C., Bravo, C., Bellon, F., Pastells-Peiró, R., Rubinat Arnaldo, E., & Rubí-Carnacea, F. (2022). Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a systematic review. BMJ Open12(1), e054288–e054288. https://doi.org/10.1136/bmjopen-2021-054288
  • Sundstrup, E., Jakobsen, M. D., Brandt, M., Jay, K., Persson, R., Aagaard, P., & Andersen, L. L. (2014). Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized controlled trial. Scandinavian Journal of Work, Environment & Health, 40(3), 244–251. http://www.jstor.org/stable/43188015
  • Skamagki, G., King, A., Duncan, M., & Wåhlin, C. (2018). A systematic review on workplace interventions to manage chronic musculoskeletal conditions. Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy23(4), e1738–n/a. https://doi.org/10.1002/pri.1738
  • Jackson, E. M. (2013). STRESS RELIEF. ACSM’s Health & Fitness Journal17(3), 14–19. https://doi.org/10.1249/FIT.0b013e31828cb1c9
  • American Psychological Association. (2017). Stress in America: The state of our nation. Retrieved from https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf
  • De Freitas-Swerts, F. C. T., & Robazzi, M. L. do C. C. (2014). The effects of compensatory workplace exercises to reduce work-related stress and musculoskeletal pain. Revista Latino-Americana de Enfermagem22(4), 629–636. https://doi.org/10.1590/0104-1169.3222.2461
  • Park, S., & Jang, M. K. (2019). Associations Between Workplace Exercise Interventions and Job Stress Reduction: A Systematic Review. Workplace Health & Safety67(12), 592–601. https://doi.org/10.1177/2165079919864979
  • Ilmarinen, J. (2009). Work ability-a Comprehensive Concept for Occupational Health Research and Prevention. Scandinavian Journal of Work, Environment & Health35(1), 1–5. https://doi.org/10.5271/sjweh.1304
  • Van den Berg, T. I. J., Elders, L. A. M., de Zwart, B. C. H., & Burdorf, A. (2009). The effects of work-related and individual factors on the Work Ability Index: a systematic review. Occupational and Environmental Medicine (London, England)66(4), 211–220. https://doi.org/10.1136/oem.2008.039883
  • Palmlöf, L., Skillgate, E., Talbäck, M., Josephson, M., Vingård, E., & Holm, L. W. (2019). Poor work ability increases sickness absence over 10 years. Occupational Medicine (Oxford)69(5), 359–365. https://doi.org/10.1093/occmed/kqz083
  • Von Bonsdorff, M. B., Seitsamo, J., Ilmarinen, J., Nygård, C.-H., von Bonsdorff, M. E., & Rantanen, T. (2011). Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study. Canadian Medical Association Journal (CMAJ)183(4), E235–E242. https://doi.org/10.1503/cmaj.100713
  • Sundstrup, E., Jakobsen, M. D., Brandt, M., Jay, K., Persson, R., Aagaard, P., & Andersen, L. L. (2014). Workplace Strength Training Prevents Deterioration of Work Ability among Workers with Chronic Pain and Work Disability: A Randomized Controlled Trial. Scandinavian Journal of Work, Environment & Health40(3), 244–251. https://doi.org/10.5271/sjweh.3419
  • Ting, J. Z. R., Chen, X., & Johnston, V. (2019). Workplace-Based Exercise Intervention Improves Work Ability in Office Workers: A Cluster Randomised Controlled Trial. International Journal of Environmental Research and Public Health16(15), 2633. https://doi.org/10.3390/ijerph16152633
  • Oakman, J., Neupane, S., Proper, K. I., Kinsman, N., & Nygård, C.-H. (2018). Workplace interventions to improve work ability: A systematic review and meta-analysis of their effectiveness. Scandinavian Journal of Work, Environment & Health44(2), 134–146. https://doi.org/10.5271/sjweh.3685
  • Jakobsen, M. D., Sundstrup, E., Brandt, M., Jay, K., Aagaard, P., & Andersen, L. L. (2015). Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial. BMC Public Health15(1), 1174–1174. https://doi.org/10.1186/s12889-015-2448-0
  • Haufe, S., Kerling, A., Protte, G., Bayerle, P., Stenner, H. T., Rolff, S., Sundermeier, T., Kück, M., Ensslen, R., Nachbar, L., Lauenstein, D., Böthig, D., Bara, C., Hanke, A. A., Terkamp, C., Stiesch, M., Hilfiker-Kleiner, D., Haverich, A., & Tegtbur, U. (2019). Telemonitoring-supported exercise training, metabolic syndrome severity, and work ability in company employees: a randomised controlled trial. The Lancet. Public Health4(7), e343–e352. https://doi.org/10.1016/S2468-2667(19)30075-1

 

“She looks okay” – Why Stigma is the Most Disabling Feature of Chronic Pain

Author: Tahlia Baumann

Annie is 30 years old and lives with persistent pain. She uses a disability parking permit as it reduces the distance she walks to do her grocery shopping. When Annie parks in an accessibility bay, she is met with concerned looks from other shoppers. Sometimes, people approach her and tell her “You don’t look disabled, so you shouldn’t get to use that car park”.  Annie feels shameful, discouraged, and completely alone. She is less likely to return to the shopping centre and withdraws from her usual activities that keep her mentally and physically well. Annie’s story is the reality of thousands in Australia living with invisible conditions like persistent pain.

To most people, pain and how it is treated seems straightforward. We are taught that when we are in pain, we go to the doctor to get it fixed. We build our understandings of pain on common sense, where the amount of pain we feel must be directly related to the amount of damage to our body. Our automatic assumptions, normally based on our past experiences, form the foundation for how we make sense of situations that challenge our views of the world. As a psychologist who works with people living with persistent pain, a big part of my role is supporting people with these invisible conditions to manage the consequences of the automatic assumptions and judgments from other people about the legitimacy of their pain – not just from the public, but from friends, family, their workplaces, and even other health professionals.

Recently, 215 people shared their experiences of living with chronic pain in a large-scale study exploring the effects of chronic pain stigma1. People with chronic pain reported that their pain was frequently disbelieved by others, and was attributed to drug seeking, laziness, or mental health concerns, which led to greater isolation and disability. Many also shared how stigma from others created self-stigma and feelings of worthlessness, increasing symptoms of depression and anxiety. People described how their social support had deteriorated due to cutting themselves off from friends, work, and concealing their pain from others to avoid stigma. The study also found that greater stigma was experienced by those who used more opioids, had a mental health condition, viewed their pain as organic, and were unemployed.

Annie was able to develop strategies to manage her responses to stigma and boost her self-esteem with support from her psychologist. She learned how to set appropriate boundaries with people who questioned the validity of her pain and began spending more time with people who were understanding and supportive. However, Annie’s story also shows the critical role that social factors play in the experience of chronic pain, and how making small, compassionate changes to the way we think about chronic illness can have a big impact on wellbeing. There is an old saying: “When you hear hooves, think horse, not zebra”. Sometimes in our quest for the easiest explanation, we forget about the possibility that things may not be what they seem. While maybe not our first thought, zebras are real too. Noticing, and then gently challenging some of our automatic reactions is the perfect place to start to create safer environments for people struggling with a condition that can’t be easily seen. If we carry with us this understanding, it can make a world of difference.

Axis offers a range of services to support people with persistent pain to improve their functioning and wellbeing and facilitate a successful return to work. For more information on Axis’s multidisciplinary approach to pain-management, visit https://helloaxis.com.au/ or email info@helloaxis.com.au.

 

1 Bean, D. J., Dryland, A., Rashid, U., & Tuck, N. L. (2022). The Determinants and Effects of Chronic Pain Stigma: A Mixed Methods Study and the Development of a Model. The Journal of Pain, 00(00), 1–16. https://doi.org/10.1016/j.jpain.2022.05.006

Job demands – the full story.

Author: Chris McCarthy, Psychologist | Rehabilitation Consultant

Often times when we think about the demands of our work, we think in terms of their being too many, although this is not the full story.

Demands are what make our work challenging, and therefore we feel a sense of accomplishment when we are able to perform well and achieve success in our jobs. Therefore, demands are necessary.

When the job demands (high workload, ill-defined roles, etc.) outweigh our resources (sense of autonomy, support from colleagues / supervisors, etc.) there is an increased likelihood of negative outcomes, such as issues with sleep, burnout, and increased ill-health. This is intuitive. We tend to notice this too (or those around us will!).

Whilst job demands, beyond the bounds of our ability to cope, can be detrimental to our effectiveness and overall wellbeing, there is little attention given to the impacts of low job demands, particularly in the space outside of academia.

Research has found high demands, if coupled with appropriate levels of resources can lead to greater levels of work engagement, which incorporates factors such as enthusiasm, dedication, and connectedness. But, if our work is not adequately aligned with our abilities (i.e., low job demands), then this will make us feel as though we could / should be doing more. Job satisfaction will also decline as a result. Both of these variables are highly correlated with productivity.

Speaking with someone recently triggered my deeper thinking about this topic as he spoke of going through a restructure in which his role was altered. He went from a doing a job in which he reported being challenged every day and one which utilised and stretched his capability, to all of a sudden having to do much less. Initially, he thought “this is going to be great… I’ll have less to do… I can relax more” having reported previously, that his job could be stressful at times. However, what he reported was not what he expected. He reported a significant drop in enthusiasm and energy and even a noticeable drop in his moods.

Obviously, there would be personality factors which would play a part, but I think what his story highlighted (for me at least) was the need to feel challenged at work, and feeling as though your skills and abilities are being put to good use.

Like all things in life, it is a tricky balance to find, but I think it is worth noting that it’s not all about being overworked. Being underworked poses its own challenges.

 

Sources:

Bakker, A. B., & Demerouti, E. (2007). The job demands‐resources model: State of the art. Journal of managerial psychology22(3), 309-328.

Karasek Jr, R. A. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative science quarterly, 285-308.

Sonnentag, S. (2022). Job Stress: Revisiting Karasek’s Job Demand–Job Control Studies. Organisational Psychology: Revisiting the Classic Studies, 111.