Monitor on Psychology - April 2012 - (Page 44)

Back to work The decline of access to rehabilitation services is only fueling disability and drug abuse, Blair believes. These days, injured miners typically receive physician evaluations, then medications, with no chance for vocational and psychological rehabilitation services. One now-defunct program that used to provide such services was Oasis Occupational Rehabilitation, which had branches in Morgantown, Beckley and Charleston. The program employed physical and occupational therapists, psychologists and rehabilitation counselors, who combined physical reconditioning with mental health support groups. The daily four-week, full-time program began at 8 a.m. and featured exposure-based occupational rehabilitation. In other words, if a miner was injured while “cribbing” — stacking wooden planks to hold up a roof — the program made sure he could comfortably crib again before graduating him, explained Jeannie Sperry, PhD, a psychologist who worked in its Morgantown branch with fellow psychologist Richard Gross, PhD. Sperry and Gross say that the program’s evidence-based, multidisciplinary format produced positive outcomes: For the most part, miners who measured as depressed when they began the program no longer registered as depressed after graduation. “It’s not typically the injury that stops people from going back to work,” says Sperry, director of behavioral science education for the West Virginia University department of family medicine. “It’s the shift in lifestyle and psychological issues. This program got you back on your feet.” The addition of social and psychological support to physical rehab proved potent, says Sperry. “Miners were getting up in the morning on a set schedule, hanging with their buddies again,” she says. “They got their self-worth back, and when they finished the program, they were ready to go back to the mines.” Sofa bound The support miners give each other is key because the mining community is tight, says Randy Venable, outpatient services director at FMRS Health Systems in Beckley, W.Va. But this insularity can also make them leery of “head shrinking” strangers, says Venable, who heads mining disaster response teams. “This is a tough-minded group, and they pride themselves on being self-sufficient,” says Venable. So he felt a surge of unexpected fulfillment when he connected with an affected miner right after the powerful April 2010 explosion at Upper Big Branch Mine, which killed 29 miners and spurred ongoing investigations and litigation against mine owner Massey Energy. What made the difference, he says, is that a disaster coordinator on his team talked to the miner right on the accident scene and brought him to Venable. This helped 44 establish Venable as an insider with the 40-year veteran of the mines, who sees Venable for help with post-traumatic stress disorder and the survivor guilt he feels after losing a nephew, a cousin and friends in Upper Big Branch. When working with miners, Venable says, psychologists must modify treatment methods in two important ways. First, they need to understand the mining community and what it’s like underground. Second, they need to be as frank and realistic about mining dangers as miners are. “When you deal with other types of trauma, you’ll often use cognitive restructuring to help people see that this event is unlikely to recur,” says Venable. “You can’t do that with a straight face with a coal miner.” Another cultural characteristic of miners is being actionoriented, says Blair. This is a group for whom 12-hour shifts, six to seven days a week is commonplace, and for whom constant movement is part of life, he explains. “For a lot of these guys, it’s like an unseen hand pushing you forward, and you have to keep moving,” he says. But post-injury, many miners are at risk for inertia. “It’s typical that, because you’ve been working so many hours, you have no hobbies. And now you’ve also lost your main identity as the breadwinner, and you’re just sitting doing nothing.” Contributing to this lethargy is disability-related pain, says Gross, Sperry’s former colleague at Oasis. “If there’s chronic pain, miners might cope with it by avoiding activities that could perpetuate the pain and disability. From there, they might lapse into helplessness and hopelessness — the disability mindset.” Gross, an associate professor at WVU, still sees miners with chronic pain individually in his work with the university’s pain management center. But he says the treatment is not multidisciplinary, incorporating physical and occupational therapy, which research has shown to be more effective. Traditional treatment also doesn’t include critical social support, says Sperry. “In our program, it was the miners being with their buddies every day, them encouraging each other that especially mattered,” she says. “Now that the program’s gone belly up, they’re not getting that group support. And they just don’t have that same success individually. I hope that health-care reform can help with this.” Sperry and other psychologists in West Virginia want to see funding for evidence-based multidisciplinary rehabilitation built into government efforts to improve access to health care — also a major legislative priority of APA’s Practice Directorate. In the meantime, West Virginia’s disability rolls will probably continue to swell. And, unlike Randy Mullins — who was able to tap his wife’s insurance — most injured miners will have no access to psychological or other rehabilitation services. n Bridget Murray Law is a writer in Silver Spring, Md. MONITOR ON PSYCHOLOGY • APRIL 2012

Table of Contents for the Digital Edition of Monitor on Psychology - April 2012

Monitor on Psychology - April 2010
Letters
President’s Column
Contents
From the CEO
Internship Shortage Continues
Mental Health Services Remain Scarce at Community Colleges
Apa Weighs in on the Constitutionality of Life Without Parole for Juvenile Offenders
Apa Praises Court’s Support for Equality
New Mobile App Answers Psychologists’ Clinical Questions
Nih Offers Free Web Resources for Psychologist Researchers
New and Improved Psyclink
In Brief
Government Relations Update
Time Capsule
Questionnaire
Random Sample
Judicial Notebook
Early Career Psychology
Psychologist Profile
Coal Miners’ Dilemma
The Science of Political Advertising
Science Watch
Science Directions
More Support Needed for Trauma Interventions
The Case Against Spanking
Innovative Psychology at the High School Level
Speaking of Education
Apa Divisions Reach Out to New Psychologists
New Journal Editors
A Home Base for Multiple Fields
Division Spotlight
American Psychological Foundation
Awards and Funding Opportunities
Personalities

Monitor on Psychology - April 2012

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