Few injured workers truly want psychological care due to social embarrassment and cultural bias, but of those who seek care, it important to determine how much care is needed._
There are three factors to consider:
a. Has anyone separated injury related problems from problems in personality development?
b. Are the problems chiefly or solely financial and marital?
c. Has the patient been informed as to the limited scope of care related to injury?
Frequently, what I see is that the initial exam itself resolves the bulk of the patient_s problems. Often, they want nothing more than to verbalize their anger, resentment and fear. While they believe that they want care, after venting their frustrations in the initial exam, those emotions dissipate. They do not pursue care for more than one to two visits. As indicated, this is a very frequent outcome.
For those who do wish to pursue care, as long as visits are held to once every 2+ weeks (or even monthly), few visits are required (or desired by the patient). The problems emerge when someone begins seeing these patients 1-2 times per week (!) and delving into longstanding problems in their family, their addictions, and their interpersonal problems.