An international program assisting people living with the impacts of protracted work-related physiological injuries is seeing success in Australia.

The Progressive Goal Attainment Program or PGAP has seen chronically injured or ill people improve movement capacity, reduce weekly benefit dependency and in 13 cases, return to work. 

Implemented by EML, in consultation with clinical psychologist McGill University Professor Michael Sullivan and PGAPworks, the project is also in collaboration with the NSW Ministry of Health and being implemented by NSW Health Recovery at Work coordinators and providers from across the state.

“We collaborate and look to empower customers to help put them back in the driver’s seat of their own recovery to maximise quality of life,” EML Member Benefits Manager Elisa Hitchens said.

Professor Sullivan’s research into the psychology of pain and disability found that the severity of a person’s symptoms is only weakly related to the severity of their disability. It pointed to the power of behavioural psychology approaches for addressing long-term disability and to support return to work.

PGAP emerged from this research.

We identified many psychosocial risk factors that were stronger predictors of disability than symptom severity,” Professor Sullivan said.

It has already made a positive difference in Canada, and the USA where it was adopted by Washington state in a region-wide strategy, for the prevention of chronic disability following injury.

“Several clinical trials have shown PGAP yields impressive return to work outcomes in work disabled individuals suffering from a wide range of debilitating health and mental health conditions,” Professor Sullivan said.

Professor Michael Sullivan, Clinical Psychologist McGill University.

More than 100 people in New South Wales with debilitating work-related injuries have been given the opportunity to participate in PGAP.

"The results are very encouraging," Ms Hitchens said.

"The program has also delivered a 22% decrease in weekly benefits associated with disability and a 26% upgrade in capacity.

"Most importantly these figures represent people who have been empowered to get their life back on track."

They include:

  • 13 people who have been able to return to work
  • 129 referrals made in NSW
  • 61 successful completions
  • 25 upgrades for an average of 23.2 hours
  • 11 workers (8.5% of all referrals) returned to pre-injury duties - which is a phenomenal impact given the health profile of suitable participants
PGAP is the only program specifically targeting non-medical or non-symptom factors in work-related disability,” Professor Sullivan said.

The program is now the most researched standardised intervention for reducing disability associated with a wide range of debilitating psychological and mental health conditions.

PGAP program design

Injured workers who might benefit from PGAP are invited to participate in an initial screening interview with a trained PGAP provider to determine suitability.

The program is delivered through weekly, hour-long appointments with trained PGAP providers over the course of up to ten weeks.

At the first appointment the PGAP provider will discuss factors that:

  • contribute to successful rehabilitation and recovery
  • the importance of engaging in activities
  • return to work and the program goals

Everyone who is considered suitable for PGAP is encouraged to watch an informative video about the program and its impacts.

The next appointments focus on developing activity goals and a structured activity schedule. These are designed to help the injured worker get back into activities that they used to be able to engage in prior to injury or illness. Activity goals are set around family, social and occupational activities like meeting up with a friend, washing dishes or taking a walk.

The provider supports the injured worker to address barriers to achieving these goals, such as:

  • fear of symptom exacarbation
  • catastrophic thinking
  • perceived injustice
  • disability beliefs

The final appointments focus on activities that facilitate return to work.

Overall, PGAP is having an impact on the lives of workers at risk of needless disability by providing them with a structured approach to recovery, ultimately helping them get their lives back.