Case Study: Nathan Brett, Part 2

As you learned in this lesson, chronic pain can have a significant psychological impact on the individual. According to the narrative report, Nathan Brett is experiencing high levels of anxiety, worry, tension, and depression.

  1. Discuss how is his injury has impacted his employment physically and emotionally.
  2. Discuss what ramifications Nathan’s psychological issues have on his specific occupation.
  3. Describe what services should be offered to help Nathan deal with the psychological issues that he is facing.

Sample response: 
Pain is a significant factor of many disabilities and may be the factor that ultimately determines the success or failure of the vocational rehabilitation plan. As you learned in this lesson, chronic pain can have a major impact on the quality of life of the individual.

According to the narrative report, Nathan’s chronic pain is having a significant impact on his quality of life. He is no longer able to golf and has difficulty fishing. He is unable to participate in sports that involve running.

The psychological reaction that Nathan is having towards his disability and pain are causing an important impact on his occupation. There are activities that he is no longer able to physically do, and emotionally, he is experiencing anxiety, worry, tension, and depression. Physically, he is unable to stand or sit for long periods of time; walk long distances (he also has difficulty walking even short distances); he has a limited ability to bend and twist at the waist; he cannot stoop, squat, or kneel; he cannot climb stairs on a repetitive basis; he has difficulty with his balance; driving long distances is difficult; cold, humid or wet environments exacerbate his pain; and noisy and stressful environments are more difficult to tolerate. He also has difficulty with reaching and is only able to lift and carry 30 pounds occasionally.

Due to his disability, Nathan is experiencing anxiety, tension, and depression. The results of his MMPI showed that he is experiencing feelings of inadequacy, inferiority, lowered self-esteem, poor self-concept and a lack of self-confidence. Results also show that he is guarded and angry and resentful of his current situation.

Nathan’s current job (as an automotive wholesale dealer) requires that he have extensive contact with the public, including buying and selling cars. The psychological issues that Nathan is experiencing may significantly impact his interactions with others, as he may be more irritable at times and may attempt to withdraw from interactions with others. Due to his depression, he may be experiencing difficulty with memory, concentration, and processing information.

Based on his narrative report, Nathan is experiencing a significant level of depression, anxiety, and an adjustment disorder. Nathan may benefit from an evaluation by a psychiatrist, in order to prescribe and manage medications that may benefit him. He should also be provided with individual counseling to help him learn coping skills. Nathan may also benefit from an inpatient chronic pain program to help him learn how to more effectively manage his chronic pain, anxiety, and depression.

To view the Vocational Worksheet for Nathan Brett, click here for the document

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