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Beyond Therapy: Addressing Chronic PTSD and Functional Decline in a Long-Term Compensation Claimant

Ms James, a long-term Comcare compensation claimant since 2014, suffers from severe PTSD, severe anxiety, and adjustment disorder with anxious mood due to a workplace incident that led to severe psychological trauma. Since 2018, Ms James has been receiving weekly to fortnightly sessions with the same psychologist, focusing on Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Despite these efforts, there was little improvement in her symptoms, and she continued to rely heavily on a significant volume of antidepressant and anti-anxiety medication.

During the initial needs assessment conducted by ELEV8 Consulting, it was noted that Ms James’s Depression, Anxiety, and Stress Scale (DASS) scores were extremely severe, with each category scoring 36. She exhibited constant physical symptoms of anxiety, such as trembling hands and shaking legs, which were visible during meetings. Ms James reported extreme distress at the thought of returning to work, often experiencing suicidal thoughts and feeling that she would no longer be a burden on her family if she were gone.

Ms James’s daily life was severely impacted by her condition. She could no longer engage in hobbies that once brought her joy, such as sewing. Additionally, Ms James was consuming alcohol excessively, drinking 1-2 casks of wine per day, and smoking up to 10 cigarettes daily to cope with her anxiety and stress.

Tired woman sits at her desk staring at laptop screen and yawning in her loft, feeling overworked and exhausted. Person deals with burnout, stress and anxiety while juggling remote work. Camera B.

Intervention and Program Participation

ELEV8 Consulting engaged with Ms James in August 2023, aiming to support her through non-return-to-work activities. Initial efforts included setting home-based activities, small goal-setting, and exploring volunteer and work trial options. However, these attempts led to extreme distress and were not successful.

In a case conference with Ms James’s psychologist in March 2024, it was determined that a stronger focus on psychosocial goals, daily function, and physical health was necessary. The psychologist endorsed the implementation of the Vitality Voyage program, which was supported by ELEV8 Consulting and subsequently approved by the Rehab Authority. The program commenced in April 2024, maintaining Ms James’s existing treatment modalities and frequencies.

The Vitality Voyage program incorporated weekly themes, including sleep hygiene, energy management, enhancing wellbeing and mindfulness, behavioural activation, and habit stacking. Activities included virtual weekly exercise sessions, accompanied walks, regular self-guided walking, yoga, and light weight training.

Outcomes

Ms James’s post-program DASS scores showed significant improvements:

  • Depression: Dropped from 36 to 22 (Severe Category)
  • Anxiety: Dropped from 36 to 16 (Moderate Category)
  • Stress: Dropped from 36 to 22 (Moderate Category)

Comparing Ms James’s pre-program and post-program WHODAS assessments also showed significant results:

Understanding and Communicating:

  • Pre-Program: Mostly severe issues, with an overall score of 62.50%.
  • Post-Program: Improved to moderate or mild in all aspects, reducing to 45.83%.
  • Interpretation: Significant improvement in cognitive and communicative functions, suggesting effective interventions or adaptations.

Getting Around:

  • Pre-Program: Major issues primarily with getting out of the home, with a domain score of 15%.
  • Post-Program: Improvements noted, especially in walking long distances and standing, with the score increasing to 25%.
  • Interpretation: Mobility has improved, though challenges remain with getting out of the home. Continued physical therapy or mobility aids might be beneficial.

Self-Care:

  • Pre-Program: Extreme difficulty in staying by oneself and severe in eating, with a domain score of 62.50%.
  • Post-Program: Some issues remain, such as staying by oneself; however, improvements in other areas have brought the score down to 50%.
  • Interpretation: Self-care capabilities have improved moderately. Ongoing support and possibly adaptive equipment could help further.

Getting Along with People:

  • Pre-Program: Severe difficulties in making new friends and dealing with unknown people, with a score of 70%.
  • Post-Program: Slight improvement, reducing to 60%. Making new friends remains a significant challenge.
  • Interpretation: Some improvement in social interactions, though difficulties in forming new friendships suggest a need for focused social skills training or therapeutic interventions.

Life Activities:

  • Pre-Program: Extreme difficulties with household and work tasks, with a score of 84.38%.
  • Post-Program: Slight reduction to 81.25%, but significant challenges persist, especially in work-related tasks.
  • Interpretation: Minimal change; continued severe restrictions suggest that current strategies may need reassessment or that Ms James may benefit from more targeted occupational therapy.

Participation in Society:

  • Pre-Program: Significant barriers and challenges with a score of 75%.
  • Post-Program: Slight reduction to 59.38%, showing some improvement, especially in dealing with societal barriers and dignity issues.
  • Interpretation: Ms James shows increased ability to engage in societal activities, though severe issues remain in how her health affects her emotional and financial well-being.

Overall Functioning:

  • Pre-Program: A score of 64.58%.
  • Post-Program: Reduced to 56.25%.
  • Interpretation: Overall, Ms James’s functioning has improved across several domains. The reduced number of days she was totally unable to work (from 30 to 19 days) and the days she reduced activities (from 0 to 11 days) are positive signs of increased daily functioning and capacity.

In addition to the improvement in DASS and WHODAS scores, Ms James reported several positive changes:

  • She was able to complete daily activities around the house and provide for her family, which she previously felt incapable of doing.
  • Ms James successfully engaged in weekly sewing tasks and projects, activities she had been too anxious to start before the program.
  • There was a marked reduction in her daily shaking, a symptom that had persisted for over five years.

Conclusion

The Vitality Voyage program significantly enhanced Ms James’s mental well-being, resilience, and overall quality of life. Despite ongoing challenges, the program’s structured and supportive approach enabled Ms James to manage her symptoms better, improve her daily functioning, and re-engage in meaningful activities. This case study highlights the importance of tailored psychosocial interventions in the rehabilitation process for individuals with severe psychological trauma.

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Privacy and Information Storage Policy

Introduction

ELEV8 Consulting is committed to protecting the privacy and confidentiality of personal information that we collect, use, store, and disclose in the course of providing our services. This policy outlines our approach to privacy and information storage, and explains the measures that we have put in place to ensure compliance with privacy laws and best practices.

Scope

This policy applies to all personal information that ELEV8 Consulting collects, uses, stores, and discloses in the course of providing our services. This includes but is not limited to personal information about our clients, workers, stakeholders, and partners.

Purpose

The purpose of this policy is to ensure that personal information is collected, used, stored, and protected in accordance with the Privacy Act 1988 and other relevant privacy and confidentiality requirements.

Roles and Responsibilities

All employees of ELEV8 Consulting Pty Ltd are responsible for complying with this policy and ensuring the protection of personal information. The Managing Director is responsible for monitoring compliance with this policy and ensuring that all employees are trained on privacy and confidentiality requirements.

Collection, Use, and Disclosure of Personal Information

ELEV8 Consulting collects, uses, and discloses personal information only for purposes that are relevant to our services, and that have been consented to by the individuals concerned. We obtain consent through a detailed consent form that outlines the purposes for which personal information will be collected, used, and disclosed, and we review this consent annually to ensure that it remains valid and up-to-date.


ELEV8 Consulting limits the collection of personal information to what is necessary for the intended purpose, and ensures that any personal information that we collect is accurate, complete, and up-to-date. We use and disclose personal information only for the purpose for which it was collected, unless we obtain consent or are required by law to do so.
ELEV8 Consulting does not sell, trade, or rent personal information to third parties. We only disclose personal information to third parties when it is necessary to provide our services, or when we are required by law to do so.

Consent Management and Withdrawal of Consent

ELEV8 Consulting ensures that individuals provide informed and voluntary consent for the collection, use, and disclosure of their personal information. For sensitive information, such as health records, we take extra steps to obtain explicit consent. Individuals have the right to withdraw consent at any time by contacting us directly. Upon withdrawal of consent, ELEV8 Consulting will cease any further use or disclosure of the individual’s personal information unless required by law.

Information Storage and Security

ELEV8 Consulting stores personal information in a secure manner to prevent unauthorised access, use, or disclosure. We use a case management system that is designed to ensure the security of personal information. Only appropriate people have access to the case and its details, and all activity and communication related to the case are completed through the system to minimise the risk of privacy breaches.


Any personal information that we collect as part of assessments or attendance at appointments is transferred onto the case management system in electronic form, and hard copies are then destroyed to further minimize the risk of unauthorised access.
ELEV8 Consulting uses appropriate physical, technical, and administrative safeguards to protect personal information against loss, theft, unauthorised access, use, or disclosure. We regularly review and update our security measures to ensure that they remain effective and up-to-date.

Australian Privacy Principles (APPs) Compliance

ELEV8 Consulting is committed to complying with the Australian Privacy Principles (APPs) as set out in the Privacy Act 1988. These principles govern the collection, use, storage, and disclosure of personal information.

Data Access, Correction and Protection

ELEV8 Consulting recognises the right of individuals to access and correct their personal information that we hold. We provide individuals with access to their personal information upon request, and we allow them to correct any errors or omissions that they identify.
Access to personal information must be granted on a need-to-know basis, and employees are prohibited from sharing or disclosing any personal information with unauthorised individuals.
All ELEV8 Consulting employees are required to use a strong password to protect access to ELEV8 Consulting’s information systems. All ELEV8 Consulting data is backed up regularly and securely.


Personal information is deleted or destroyed in accordance with the Privacy Act 1988 when it is no longer required, and ELEV8 Consulting ensures that all hard copies of personal information are securely destroyed.

Retention and Destruction of Personal Information

ELEV8 Consulting retains personal information only for as long as necessary to fulfil the purposes for which it was collected, in accordance with the Privacy Act 1988 and any contractual obligations. Personal information will be securely destroyed or de-identified when it is no longer required. Our retention periods vary depending on the nature of the information:

  • Client records: Retained for a minimum of seven years after the last contact or as required by law.
  • Employee records: Retained in accordance with applicable employment and taxation laws. We use secure methods for the destruction of physical documents (e.g., shredding) and digital data (e.g., permanent deletion from systems).

Notifiable Data Breaches (NDB) Scheme

ELEV8 Consulting complies with the Notifiable Data Breaches (NDB) Scheme, as outlined in the Privacy Act 1988. In the event of an eligible data breach, where there is unauthorised access to, disclosure of, or loss of personal information likely to result in serious harm, ELEV8 Consulting will:

  • Notify affected individuals as soon as practicable, providing recommendations on how they can mitigate potential harm.
  • Notify the Office of the Australian Information Commissioner (OAIC) within 30 days of becoming aware of the breach.
  • Follow our Incident Response Procedure to mitigate the breach and prevent future occurrences.

Complaints Mechanism and Escalation

ELEV8 Consulting is committed to addressing privacy-related complaints promptly and transparently. Complaints regarding our handling of personal information can be made to our Privacy Officer. We aim to:

  • Acknowledge receipt of complaints within five business days.
  • Investigate and respond to complaints within 30 business days.
  • If a complaint cannot be resolved internally, we will inform the individual of their right to escalate the matter to the Office of the Australian Information Commissioner (OAIC) for further review. Individuals may contact the OAIC through their website or by phone for more information on lodging a complaint.

Training and Accountability

ELEV8 Consulting provides ongoing training to all employees and contractors on privacy and confidentiality requirements and processes. We ensure that they understand and follow these requirements and processes to protect personal information.
ELEV8 Consulting management is accountable for compliance with privacy and confidentiality requirements. We complete a privacy and confidentiality accountability self-assessment on an annual basis to ensure that effective measures are in place and to consider continuous improvement initiatives for ongoing compliance with privacy laws and best practices.

Complaints and Enquiries

ELEV8 Consulting takes privacy complaints and enquiries seriously. We have procedures in place to receive and respond to complaints and enquiries about our privacy practices. We investigate all complaints and take appropriate measures to address any privacy concerns that are raised.

Breach Response

ELEV8 Consulting has developed an Incident Response Procedure to respond promptly to any suspected or confirmed data breaches. The Incident Response Plan outlines the steps to be taken in the event of a breach, including notification of affected individuals, regulatory bodies, and other relevant stakeholders.

Monitoring and Review

ELEV8 Consulting regularly reviews and monitors its policies and procedures to ensure they are up-to-date and effective in protecting personal information. Any changes to policies and procedures will be communicated to employees and other relevant stakeholders. This policy will be reviewed annually or as necessary to ensure compliance with the Privacy Act 1988 and other relevant privacy and confidentiality requirements.

We may make changes to this Privacy and Information Storage and Use Policy from time to time. Any updates will be posted on our website.

Conclusion

ELEV8 Consulting takes the protection of personal information seriously and has implemented policies and procedures to ensure compliance with the Privacy Act 1988. These policies and procedures provide a strong foundation for protecting personal information and ensuring ongoing compliance with privacy and confidentiality requirements.