Employee rehabilitation: trade secrets

When the Welfare Reform Act came into effect last month, it replaced Incapacity Benefit with Employment Support Allowance (ESA), requiring employees deemed fit to work in some capacity to continue their employment as a condition of receiving their full entitlement.

To enable this to happen, employers are now required to accommodate the needs of incapacitated employees, making reasonable adjustments to the workplace to support their return to work and facilitate their recovery. All of which has put more pressure than ever on HR professionals to successfully rehabilitate employees.

Why rehabilitate?

More often than not, employees in need of rehabilitation require help to overcome a fear of the workplace – be that the machine that hurt them, the customer that threatened them or the manager that bullied them.

Left unchecked, these fears can spiral into serious mental health and absence issues, with the likelihood of the employee returning to work reduced to less than 50% if they are not rehabilitated within six weeks.

Where someone has suffered from an accident or serious health concern, such as cancer or a heart attack, a failure to maintain communications with the employee and plan a successful return to work can lead to strong feelings of isolation. In some cases, once their physical recovery is complete, depression or anxiety about actually returning to work may prove even more debilitating for the employee than their original illness.

Either way, the cost of supporting an absent employee, finding and training temporary staff, dealing with negative feedback from their colleagues who have been left to pick up the slack or deal with strained customer relations, is far greater than the simple psychological interventions typically required to successfully rehabilitate someone back into work.

What measures are most effective?

Critical to successful rehabilitation is correctly diagnosing the specific issues preventing the individual from attending or performing at work. This is best conducted by an independent expert, as part of an existing return to work policy, who can work in partnership with both the employee and the employer to share the outcome of the assessment and plan the individual’s return to work.

Depending on the extent of any physical or psychological damage, this could be as simple as adjusting working conditions or hours to support recovery from an operation, to as complex as offering cognitive behavioural therapy to desensitise the employee from a machine that hurt them.

Cognitive behavioural therapy could also be used to overcome conditions such as agoraphobia that may have been triggered by an aggressive customer.

To optimise success, it is essential that you work in partnership with the specialist to support the process, for example by turning off machinery, or opening the office up after hours, to allow the employee to undergo any exposure therapy required to return them to full health.

Throughout the process, make it clear to the employee what will be happening, over what timeframe, and agree in advance how they would like to be communicated with. Ensure that this is regular enough to maintain the required levels of contact, but not so regular that it becomes overbearing or invasive.

How can you regain trust after a critical incident?

In the case of employees exposed to a traumatic incidents, such as an armed raid on the business or the death of a colleague, it’s essential that you immediately defuse the situation with everyone affected.

Rather than waiting for a disaster, such as the Buncefield oil depot explosion in West London, before equipping managers with the skills to handle the situation, consider enlisting the support of a critical incident specialist to train managers in how best to manage the aftermath of any traumatic situation before any such situation arises.

Follow-up trauma management sessions by properly trained professionals should also be provided three to 10 days after the event – depending on the severity of the incident – to ensure anyone struggling to recover is given the best change of avoiding post-traumatic stress disorder (PTSD) and other psychological illnesses that could cause the employee long-term damage.

What are the main benefits?

By responding quickly and effectively to any prolonged absence or trauma, you not only reduce the costs resulting from delayed interventions, but also reassure employees that their wellbeing matters, which in itself helps recovery.

And by listening to feedback from your employees, either directly or via a counselling support team, you can act on employees concerns and put in place measures to better protect employees in future, to actually improve employee engagement and productivity levels.

What are the consequences of not rehabilitating?

Employers that fail to rehabilitate or in some way accommodate the needs of incapacitated employees not only run the risk of falling foul of the Disability Discrimination Act (DDA), but are also likely to see health policy and insurance premiums rocket.

And by ignoring the situation, employers also risk losing healthy employees, demoralised by having to constantly cover for sick colleagues, as well as the ongoing cost of paying someone unable to attend work or only attending work, and unable to perform, to claim their ESA allowance.

Top tips



  • Communicate – maintain regular, but not intrusive, communication with any absent employee to prevent them from feeling isolated from the workplace and less inclined to want to return.

  • Diagnose – use independent psychological experts to correctly diagnose those issues limiting the ability of the employee to work or identify when there are no such issues justifying absence.

  • Rehabilitate – put in place necessary measures to support and facilitate a full and speedy recovery, ranging from use of cognitive behavioural therapy to shutting off machines for desensitisation.

  • Maintain – prevent relapses with ongoing counselling sessions to allow the employee to consolidate their learning and talk about and address any remaining issues affecting them.

  • Avoid legal action – only take someone down the route of dismissal due to absence once you have either proved they are fit to work or ensured you will not fall foul of DDA legislation.

Case study: Dealing with a customer death


When a young customer died quickly and suddenly, despite the best efforts of well-trained staff to resuscitate her, everyone was deeply distressed by the tragic accident.


The company responded quickly by putting its critical incident plan into place, providing telephone support for anyone who wanted immediate help with an opportunity to talk through initial feelings of grief or guilt with a counsellor trained in defusing – the first stage of helping someone to make sense of a deeply distressing incident. As well as helping employees deal with any subsequent flashbacks, insomnia, loss of appetite or reluctance to revisit the site of the accident, the helpline was also used by managers, keen to find out the best way of supporting particular individuals and groups.


After giving employees the required time to overcome their initial shock, so that they would be mentally receptive to accept further support, the Validium Group, which provides employee assistance programmes (EAPs) and rehabilitation services to businesses, was invited on-site to conduct a formal debriefing session. This involved a structured discussion to help employees share their individual reactions to the incident, release supressed emotions and prevent them from fixating on the worst elements alone.


The timely psychological support helped everyone affected to accept the tragedy.


A key factor was providing employees with the tools and knowledge required to support one another in overcoming their initial distress. This ensured that natural early symptoms were overcome and prevented from escalating into long-term absence and the more serious symptoms associated with post-traumatic stress disorder.

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