GUEST POST

I’d like to share with you an amazing story about Mary*.

Mary was referred to me by an expert vocational rehabilitation counselor. This rehabilitation counselor knew the impact the right kind of exercise physiology intervention could have on Mary’s return to work and life.

Mary was not getting out of bed. She was anxious in a fluctuating mood. Mary was having nightmares and poor sleep, low confidence and low self-esteem. She had been diagnosed with PTSD, adjustment disorder, and major depression. Mary was not working, and was medically unable to return to her pre-disability employment.

I worked very closely with the rehabilitation counselor during the initial stages. This streamlined, teamwork approach paved the way for the best possible recovery outcome for Mary. It was essential to work toward the same common client-centred goals, and be on the same page at all times.

The initial focus was simply getting Mary to commit to and attend appointments with me. She needed a reason to get out of bed and out of the house. Mary needed routine. Regular weekly appointments were scheduled, and Mary attended each and every one of these. These appointments consisted of a mixture of exercise and goal-setting, with planning and implementation. Exercise made up the backbone of the intervention.

But it was the process of guiding Mary to realise the translation of improved physical and mental function into daily living performance that mattered. This was achieved through education and goal-setting with Mary. A bio-psychosocial approach to all sessions was adopted. Mary’s thoughts and beliefs were subtly but surely, being challenged. It was essential that Mary use a calendar to plan and schedule her days, and schedule appointments. A daily diary was also used to record independent exercise participation and provide a motivational tool. Her increased daily living performance was measured, reviewed, and celebrated.

I made sure Mary was participating in physical activity that she enjoyed. Mary returned to athletic activities she had done in the past, and felt a sense of achievement and normality.  Mary tried new exercises she had always wanted to try, and loved them. The main thing was that exercise was a positive experience, and this translated to a positive frame of mind and sense of self. Exercise prescription and goal setting were graded, and gradually incremented as Mary progressed. Short term and longer term goals were set and her exercise routine ensured that these goals were always on target and met.

Mary recently achieved her longer-term goal of completing her first half marathon. Now she has a list of running events she would like to achieve for this year, including a full marathon. And to top it off, Mary is completely off her anti-depressant medication!

Through this customised, individualised program, and teamwork approach with the rehabilitation counselor, Mary is now investigating and attempting new vocational avenues. She is in a position, both mentally and physically, to return to an exciting new career. Mary has her life back, and is work-ready to experience the health benefits of work.

Mary hasn’t looked back. A tailored intervention was needed, not a ‘cookie cutter program’. This highlights the need to think outside the square and provide more than ‘just’ an exercise program. This was a return to work and life program, where exercise was part of the picture.

Here’s what Mary had to say:

Two years ago I started seeing Vicky at EXPHYS. I was not in a great place and struggling to get out of bed each day. After learning of my situation, Vicky put a successful strategy in place that got me moving every day and we worked on building my rehabilitation from there through a personally tailored individualised program.

Aside from the physical achievements, far and away the most significant impact this rehabilitation has had has been on my mood and my life. It has really turned my life around for the better. I feel alive again. I cannot thank you enough, Vicky, for being so supportive and understanding, for working with me during the good times and the bad, for being flexible and modifying my sessions as needed, and for having such extensive knowledge that allowed me to achieve my goals (once we worked out what they were). You really have changed my life for the better.

The benefits of exercise for mental health are irrefutable. Research indicates that exercise can:

• Have a moderate to large effect on depression and anxiety^1,2
• Improve social functioning, self-esteem and well-being²
• Improve general health, sleep and energy levels^2,3

Evidence on the dose-response relationship suggests that the key is to exercise for at least 30 minutes and three times per week². It needs to be delivered in the right way as part of the overall picture.

Translating improvements into meaningful goal achievement, such as returning to work and life activities, is the ultimate. This is a holistic approach that encompasses early intervention, bio-psychosocial factors, cognitive behavioural approach and exercise prescription – the complete package that gets results.

So much more than ‘just’ an exercise program.

Written by a special guest, Dr Vicky Phillips, PhD, Director and Principal Exercise Physiologist at EXPHYS, where you can return to work and life following injury or illness. http://www.exphys.com.au/

‘ExPhys is committed to providing high quality functional conditioning and rehabilitation.  This is obtained through a dedication to best practice using up-to-date research literature and clinical guidelines.  We participate in regular continued education programs.’

References:

[1] Rosenbaum, S., Tiedemann, A., Ward, P.B., Curtis, J., Sherrington, C. (2014) Physical activity interventions: an essential component in recovery from mental illness. British Journal of Sports Medicine; 0: 1-2

[2] Morgan, A.J., Parker, A.G., Alvarez-Jimenez, M., Jorm, A.F. (2013) Exercise and Mental Health: An Exercise and Sports Science Australia Commissioned Review. Journal of Exercise Physiology Online; 16(4):64-73

[3] http://www.beyondblue.org.au/the-facts/treatment-options/other-sources-of-support