6.2.1 Case studies
Case study 1: Jessica’s nordic walking lessons
The following example shows a decision made about the appropriateness of nordic walking lessons for Jessica.
- Jessica has a back condition and no capacity for work for three months while she recovers from an operation. She is finding her rehabilitation slow, frustrating and isolating. Jessica’s provider has recommended participation in a Nordic walking group.
- Jessica’s rehabilitation provider says that the walking group will increase Jessica’s general level of exercise and community engagement by ensuring she regularly leaves the house, participates in a supervised exercise program suitable for her condition and by introducing her to new people. Regular practice between sessions will give Jessica a meaningful task to undertake while at home.
- Following the application of the decision making framework to Jessica’s individual circumstances (as shown below), one term of nordic walking lessons and hire of equipment were approved as a psychosocial activity.
CRITERION: Is the activity or intervention.....? | Example: Nordic Walking Group |
|---|---|
1. … likely to achieve progress towards an agreed rehabilitation goal? | Jessica’s goals include self-management of her ongoing pain and increasing her community engagement. Participating in this group aligns with these goals. |
2. …likely to be effective? | Jessica is motivated to improve her level of fitness, meet people and engage in a meaningful occupation for her while she cannot work. The lessons are in a group setting which will provide social contact. |
3. … appropriate for the client given their medical restrictions? | Jessica’s GP considers her back condition will be assisted by her participation. The lessons are easy to get to by bus. |
4. … likely to improve, or at least not impair, their independent functioning? | Learning a new technique, practicing and attending lessons requires self-discipline and accountability, both of which will assist with independent functioning. |
5. … time-limited rather than a long-term or ongoing activity? | Jessica understands that the lessons will be approved for a limited time period. The provider has recommended one term of lessons. |
6. … cost-effective in relation to other equally effective interventions or arrangements? | The cost of the lessons is in line with similar courses in Jessica’s area. As it is DVA policy that equipment for rehabilitation activities be hired rather than purchased – see section 6.7 of this library, this is negotiated with Jessica and her provider. |
7. … in line with community standards and expectations? | Yes, walking as an exercise is a common activity in the wider community, and the cost is affordable. |
8. … unlikely to compromise the client’s personal safety? | Attending lessons with a skilled instructor is unlikely to compromise the client’s safety as there is minimal danger involved. |
9. … in line with the client’s preferences? | Yes, Jessica has expressed an interest in learning this type of exercise. |
10. ... any other relevant matters? | Jessica previously hiked and enjoyed running, so she is likely to be motivated to learn a new technique to support her exercise. |
Case study 2: Len's guitar lessons
The following example shows a decision made about the appropriateness of guitar lessons for Len.
- Len has a back condition and no capacity for work for two months. He is frustrated by his rehabilitation progress and is becoming short-tempered with his partner. Len’s provider has recommended participation in a guitar lesson group.
- Len’s rehabilitation provider says that the group will increase community engagement by ensuring he regularly leaves the house and the practice between sessions will provide ameaningful task to undertake while at home.
- Following the application of the decision making framework to Len’s individual circumstances (as shown below), alternate psychosocial activities were identified as guitar lessons were not supported, due to the medical restrictions of the client.
- In this case, after considering the intent of the activity was to address his increasing anger management issues, ongoing pain and engagement with the community, it was negotiated with Len and his rehab provider that Len’s interest in music could be supported through participation in a men’s choir; he and his partner could attend a mental health resilience/anger management strategy course; and Len would also participate in a 6 week meditation course to see if this would assist with self-management of his pain.
CRITERION: Is the activity or intervention.....? | Example: Guitar Lessons |
|---|---|
1. … likely to achieve progress towards an agreed rehabilitation goal? | Len’s goals include self-management of his ongoing pain and increasing his community engagement. Participating in this group aligns with these goals. |
2. …likely to be effective? | Len is motivated to get out of the house, meet people and engage in a meaningful occupation while he cannot work. The lessons are in a group setting which will provide social contact. |
3. … appropriate for the client given their medical restrictions? | Len’s GP has cautioned against guitar lessons as she considers the posture will aggravate Len’s condition. The GP is supportive of other psychosocial activities. |
4. … likely to improve, or at least not impair, their independent functioning? | While learning a new technique, practicing and attending lessons require self-discipline and accountability, both of which will assist with independent functioning – they do not directly support Len’s efforts to self-manage his pain. An alternate activity may be more effective. |
5. … time-limited rather than a long-term or ongoing activity? | Len understands that the lessons will be approved for a limited time period but has indicated that he will be unable to afford lessons after the first term. The provider has recommended one term of lessons. |
6. … cost-effective in relation to other equally effective interventions or arrangements? | The cost of the lessons is in line with similar courses in Len’s area. As it is DVA policy that equipment for rehabilitation activities be hired rather than purchased, this would be advised to Len and his provider if the lessons went ahead. |
7. … in line with community standards and expectations? | Yes. Group lessons are a popular form of community engagement, and short courses are commonly used for issues identified by Len. |
8. … unlikely to compromise the client’s personal safety? | The client’s safety is unlikely to be compromised. |
9. … in line with the client’s preferences? | Yes, Len has an expressed interest in music and signing, and wishes to engage in the community further. |
10. ... any other relevant matters? | Len likes the idea of guitar lessons but is aware it will take a few years to master the skills. |
Case study 3: Paul's kayaking
The following example shows a decision made about the appropriateness of kayaking related funding for Paul.
- Paul has accepted conditions relating to both knees. He has had to undergo surgery for both knees in the past year which resulted in long recovery times and bed rest. This has affected his rehabilitation because he has found it difficult to leave the house and he has become socially isolated. Paul relies heavily on his wife to support him, particularly when he meets new people, as his self-confidence is low.
- Paul’s rehabilitation provider has identified that a beginners kayak course at a local kayak club will increase Paul’s engagement in the community, will allow Paul to undertake an activity independently and will have no impact on his knees. The provider has suggested purchasing a kayak for Paul to enable him to continue kayaking after the course has ceased.
- Following the application of the decision making framework to Paul’s individual circumstances (as shown below), the beginner kayaking course was approved for Paul. Approval was given for hiring the kayak from the club, rather than purchasing the equipment. This was funded as a psychosocial rehabilitation activity.
CRITERION: Is the activity or intervention.....? | Example: Beginner Kayaking course |
|---|---|
1. … likely to achieve progress towards an agreed rehabilitation goal? | Paul’s goals include increasing his community engagement and learning to function more independently. Taking a course to learn how to kayak aligns with these goals. |
2. …likely to be effective? | The beginner kayak course has a maximum of 6 participants per course which will provide social contact for Paul while not being overwhelming. As each person is in their own boat, Paul can interact with others at his own pace. The course occurs weekly and Paul will learn how to be more independent in social settings. |
3. … appropriate for the client given their medical restrictions? | Paul’s GP has provided approval for kayaking as it will have no impact on his knee conditions. Paul has arranged for assistance with lifting and moving his kayak to ensure his knee condition is not impacted. |
4. … likely to improve, or at least not impair, their independent functioning? | Attending the course weekly will require commitment and self-management from Paul, both of which will assist with his independent functioning. |
5. … time-limited rather than a long-term or ongoing activity? | The beginner course runs for 12 weeks and Paul understand that if he wishes to continue after this period, he will need to become a member of the kayak club himself. |
6. … cost-effective in relation to other equally effective interventions or arrangements? | The cost of the course is comparable to other kayak clubs that operate on the same river. However, it is DVA policy that equipment for rehabilitation activities is hired rather than purchased so the request to purchase a boat is declined. The kay club does offer hire of their boats – see section 6.7 of this library. |
7. … in line with community standards and expectations? | Yes, kayaking is a popular sporting activity in the wider community, and the cost is affordable. |
8. … unlikely to compromise the client’s personal safety? | Kayaking unlikely to compromise the client’s safety as the course only operates when the weather is calm and beginners must wear life jackets for the duration of the course. |
9. … in line with the client’s preferences? | Yes, Paul was involved in rowing while at school and suggested kayaking as a way to increase his social contact. |
10. ... any other relevant matters? | Paul’s brother-in-law is a member of the kayak club and this connection may encourage Paul to continue kayaking after the course is completed. |
Source URL: https://clik.dva.gov.au/rehabilitation-policy-library/6-psychosocial-rehabilitation/62-overview-psychosocial-rehabilitation/621-case-studies