Maintaining a stepped approach to care

The intent of a 'stepped' or 'stepped care' approach is to use the appropriate resource at the right time. Early and timely appropriate assessment, management and review are vital, as is the awareness of factors known to increase the risk of delayed recovery, such as red flags, yellow flags and problems associated with the return to work process.

Health providers should implement a stepped care approach, reviewing progress against expectations and applying simple, appropriate measures in a progressive, stepped up manner.

Simple interventions, positively expressed information, and reassurance may be all that is required. Examples of simple interventions are:

• providing information and advice, including clear information about the symptoms the worker is experiencing and the rationale for the treatment approach, information about the role of 'passive' and 'active' treatment, and positively expressed expectations about recovery and return to work, at the first appointment
• encouraging active forms of treatment, emphasising in a practical way the importance of staying active to restore function and prevent disability
• encouraging the injured worker to return to normal (pre-injury) activities, including returning to work, and their social and recreational pursuits, as soon as possible – where clinically appropriate (ie, no red flags or serious underlying pathology has been identified)
• providing information and support to undertake self-management activities