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The workers’ compensation patient: A paradoxical cognitive-behavioral approach to rehabilitation

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Abstract

The literature indicates that whereas a wealth of interacting factors is involved, psychosocial issues are generally more important than are physical factors in predicting who will report an industrial injury and successfully return to work. However, patients have a strong tendency to maintain a focus on their physical symptoms.This somatizing tendency is fostered by the social stigma surrounding mental health needs, clinician bias against patients exhibiting emotional distress, and an adversarial industrial compensation system that challenges the integrity of patients and provides a lack of alternatives to disability. A paradoxical cognitive-behavioral treatment approach is presented that enables one to eventually address psychosocial issues by initially focusing on patient concerns about their physical condition. Five specific issues that need to be addressed for successful rehabilitation to occur are presented.The need for a consensus group to develop standardized assessment tools, treatment protocols, and outcome measures for multicenter studies is emphasized.

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  1. Presbyterian Rehabilitation Center, 120 Providence Road, 28207, Charlotte, NC, USA

    Jeffrey B. Feldman PhD

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  1. Jeffrey B. Feldman PhD
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Feldman, J.B. The workers’ compensation patient: A paradoxical cognitive-behavioral approach to rehabilitation. Current Review of Pain 2, 11–18 (1998). https://doi.org/10.1007/s11916-998-0058-6

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