Sometimes the psychological walls we build up following a spinal cord injury can be as challenging as the physical. Here SIA Case Management Vocational Specialist and CMSUK Vocational Case Manager of the Year Spencer Rathborne talks about how he works with his spinal injury clients to maximize the success of them returning to work.
It’s easy to understand why after a spinal cord injury, people feel anxious about their future particularly when it comes to returning to work or having to identify a new career if they are unable to return to their pre-injury occupation. Life changes so quickly, knocking confidence and overwhelming emotions.
As a Vocational Case Manager I search for opportunity in the problems. I know that one size doesn’t fit all, and it’s important to look at each client as an individual with their own personal anxieties, unique situations and particular ways of coping. It’s not my role to knock down those walls, it’s my role to help clients look at each brick and either throw it away or use it to build something for the future.
I’ve worked really closely with a client who sustained a spinal cord injury during a rugby game in 2010 at the age of 18. He was diagnosed with a C6 incomplete injury, experienced limited functionality in his hands and had regular UTI’s due to problems with his bladder and bowel function. When we met, his mood was low. Anxiety and depression made him quiet and withdrawn and he was disengaging with society. He lacked the independence he had enjoyed before his accident and showed symptoms of PTSD. He had returned to school and finished his A-Levels and progressed to University, but 3 months into his studying he was unable to cope and dropped out. He was trained by Back Up as a volunteer wheelchair skills trainer and was volunteering one day a month but had no previous paid work experience or weekly social activities.
Although it sounded hopeless to my client, there were bricks here we could build with. He still loved sport and in particular rugby, he had achieved good results in his A-Levels and was engaging in some voluntary activity.
First of all we had to lay the foundations. In order to maximize the chances of vocational rehabilitation being sustainable, the physiological and physical aspects of returning to work needed to be in harmony. I arranged a call between my client, myself and a psychologist and made sure a strong relationship could be reached whilst also focusing on increasing his social interactions through meaningful activities. Together we set achievable goals for the first six months to improve his confidence and made sure we were making choices that helped him grow for the future.
Understanding my client had no paid work experience, we had to take the voluntary work experience already gained and his love for sport and find opportunities to gather more. This would better inform his career pathway and allow him to gain relevant skills to transfer into paid roles. I supported him to source and then begin to volunteer with a local sports partnership for two days a week with meaningful career progression in mind. I worked closely with the company to ensure my client was challenged but not overwhelmed and was in an environment that allowed him to thrive.
In time, the company offered my client a four year workplace business degree allowing him to work and study at the same time which he proudly accepted. For the last twelve months he has been working three days a week with one day from home, attending lectures and lessons two days a week, earning a salary and gaining valuable work experience and education. I worked closely with his employer and the university to ensure he had extra time during exams, the use of a scribe, wheelchair accessible rooms and desks, extra breaks and assistive technology to aid his education. An Access to Work referral I supported my client to make, funded equipment like laptops, track pads and better accessibility into the University. Lectures were recorded in case he was unwell and support workers accompanied him for additional help he might need.
My client has said that for the first time since his injury he can see a future. Together we took a look at the walls that had built up emotionally and existed physically, taking them apart brick by brick and working over time to build confidence, opportunity and ambition. It’s been a privilege to support him through the process and hope his story inspires others to start taking down their