Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Psychological Risks from Transitional Duty Work

Most injured workers are in an environment where there are not true light duty positions. These positions are (often reluctantly or certainly unskillfully) created by their employer.

Such transitional duty may be sitting at a desk, inactive and bored or monitoring an entrance to the building, in public viewing but social isolation. These types of _transitional_ work place the patient at risk for two things: a. exposure to criticism by coworkers who resent the patient being paid for essentially non-productivity, and b. the patient_s own sense of humiliation at being disabled from doing his/her defined role.

I have found that injured workers, who continue (or return to) a light duty position, often become anxious and depressed. They lose faith in their employers, their coworkers and themselves. They anticipate that they will be fired, fear that they are resented, and they focus more upon their physical complaints as justification for being in that role.

However, the counterpart is that these same patients do very well in psychological care because they are holding these fears and resentments internally and are not dealing with them at home or at work.

As a result, those patients in transitional duty positions are often the most productive patients in short term psychological care.

From a physical standpoint pain and depression share much of the same biochemistry of the brain. Equally as important, they both interfere with sleep.

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