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6.6.5 Psychosocial rehabilitation case study: Karen - Mindfulness / meditation classes

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Last amended 
13 April 2017

Karen has an accepted back condition. She has been struggling with back pain as a result of her injury and is becoming hesitant to undertake any physical activity as she is frightened that she will hurt herself. She also becomes very anxious when she is in pain. Karen's mobility has become limited and she is finding it increasingly difficult to share in activities such as walking that she used to do with her friends. Her pain is creating a barrier to her being able to move forward towards her rehabilitation goals. Her goals include becoming more engaged with her local community, learning strategies to help her manage her pain more effectively, and beginning to explore options for employment.

Karen has heard about a local 12 week meditation course, using mindfulness and meditation techniques. Karen has a friend who has found these techniques helpful in managing pain, and is keen to participate. The rehabilitation provider has confirmed details about the classes and the expertise of the instructor and has liaised with Karen's GP. The instructor has confirmed that alternative seating or lying positions can be used during the classes. The provider has also suggested a brief intervention counselliing program to assist Karen to learn techniques and strategies to manage her pain more effectively and to increase her coping skills.

Can this request be approved?

Criterion: Is the activity or intervention.....Example: mindfulness / meditation classes
This table outlines issues to consider when determining whether an activity is reasonable

1. … likely to achieve progress towards an agreed rehabilitation goal?

Karen's goals include reducing her back pain. Meditation, together with a brief intervention counselling program, may assist her to manage her pain more effectively. Karen is hoping that after learning these strategies and skills, she will feel more confident in starting to consider her options for returning to employment.

2. …likely to be effective?

Meditation and mindfulness techniques have been found to be helpful in assisting with pain management and reducing anxiety. Karen is also keen to extend her social network and is hopeful that participating in these classes will assist with that.

3. … appropriate for the client given their medical restrictions?

Karen's GP raised concerns about Karen's ability to sit on the floor during classes. The provider has confirmed with the instructor that Karen can sit on a chair, or lie on the floor, while practicing the meditation techniques.

4. … likely to improve, or at least not impair, their independent functioning?

The course includes a series of simple exercises that students are expected to undertake at home, so that they build their skills. Karen is keen to attend classes on a weekly basis, and to meet the out of hours course expectations.

5. … time-limited rather than a long-term or ongoing activity?

The course runs for 12 weeks. Karen will have the option to continue the course after this time, on a self-funded basis.

6. … cost-effective in relation to other equally effective interventions or arrangements?

The cost of the course is comparable to other similar courses in Karen's local community. An audio presentation is provided to assist with out of hours practice, which is covered through the course fee.

7. … in line with community standards and expectations?

Yes. Meditation is a commonly undertaken activity in the community. Mindfulness and meditation are being increasingly used to assist with the management of anxiety and pain.

8. . … unlikely to compromise the client’s personal safety?

The instructor is aware of Karen's physical limitations and has provided assurance that her needs can be accommodated.

9. … in line with the client’s preferences?

Yes. Karen has practiced yoga in the past (prior to her service injury) and found the breathing techniques that she used there, were helpful.

10. ... any other relevant matters?

Brief intervention counselling has been included on Karen's psychosocial rehabilitation plan. It is hoped that this will help Karen build her coping skills, and develop strategies to help her manage her pain more effectively. Mindfulness and meditation will complement what Karen will learn through this intervention.

Outcome: The Mindfulness / Meditation classes were approved and included on Karen's psychosocial rehabilitation plan.