An Examination of the Influence the Broader Insurance-Based Rehabilitation Context has on the Experience of Work Stress Among Rehabilitation Professionals

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Kendall, Elizabeth

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Buys, Nick

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The phenomenon of work stress is ubiquitous and has been the source of considerable attention over the past few decades. Work stress is a common problem in human services, particularly in the area of rehabilitation. The prevalence of this problem for rehabilitation has, however, been fuelled over the last two decades by the rapid growth of the insurance-based rehabilitation sector in Australia. The expansion of this sector has created a major market for rehabilitation practitioners. Using a qualitative research paradigm, the current study examined the insurance-based rehabilitation context in Australia. Specifically, this study explored the influence of this context on the experience of work stress for rehabilitation professionals. Although attempts to account for work stress usually focus on the qualities of the individual and organizational factors, the current study has responded to the call in occupational stress literature to examine this phenomenon at a broader, contextual level. Twenty-five rehabilitation professionals were asked to provide visual representations to illustrate their experience of the insurance-based rehabilitation work context. Interviews were conducted with each participant to elicit a more in-depth understanding of this experience. The findings revealed that the insurance-context appears to be characterized by inconsistency, chaos, confusion, and a strong focus on profit and cost effectiveness as depicted by the themes Maelstrom, Co-dependent Liaisons, Implosion of Responsibility, Legislative Pluralism, External Trumping and Greed. The deleterious influence of this context on rehabilitation professionals manifested in several ways as represented by the themes Impotence, Cynicism, Going Through the Motions, and Betrayal. A metaphor of a virus was used to provide a context for understanding how rehabilitation professionals were infected by the stressors inherent in the unhealthy contextual environment of the insurance sector. The results of this study have important implications for informing future policy, practice and research within the rehabilitation industry. Clearly, the health of the insurance sector needs to improve to ensure the well-being of rehabilitation professionals such as those who participated in this study. Improved health of this sector must include a greater respect for the profession of rehabilitation. Also crucial to the improved health of the sector is consistency in legislation and procedures that underpin rehabilitation. In addition, rehabilitation professionals must accept responsibility for enhancing their core competencies if they are to inoculate themselves against the harmful influence of the broader insurance context. Strategies to inoculate rehabilitation professionals against the infiltration of these contextual stressors must include an understanding of business administration and policy. Finally, the findings suggest that unless the health of the sector and the rehabilitation professionals improve, poor rehabilitation outcomes are likely to continue to plague the insurance industry and the experience of work stress and turnover among rehabilitation professionals will remain unacceptably high.

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Thesis (PhD Doctorate)

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Doctor of Philosophy (PhD)


School of Human Services

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work stress

insurance-based rehabilitation

human services



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