Late diagnosis in senior professionals - Case Study

Background

56 year old  male who had worked as a Managing Director within a large Building Surveying  organisation prior experiencing poor mental health symptoms. He advised that  employment took priority over his personal work-life balance and wellbeing.

He had also  been masking neurodiversity symptoms to allow him to achieve success in his  senior management role, however this masking had affected his health overall  and his engagement with general life. He advised that he had utilised alcohol  and developed a "work persona" as a coping mechanism pre absence  and that he had experienced panic attacks, PTSD, heightened anxiety,  psychological dysregulation and historical suicidal ideation.

These  symptoms resulted in him leaving his role to access support and he advised  that he did not feel able to return to his pre illness role, so was seeking  an alternative. After taking absence from work in 2024 he had undergone  neurodiversity testing and had been diagnosed with Attention Deficit  Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). He was  looking for support to assist him to find a suitable role to continue with,  which will allow him to manage tasks in an optimal way and prevent regression  of his symptoms.

Referral and  assessment

A brief  vocational triage assessment was completed initially, which recommended  psychotherapy, followed by a vocational redirection assessment. The purpose  of the psychotherapy initially was to provide him with support to grieve his  loss of role and to provide grounding techniques to allow him to access  further support.

He was low on  confidence and not leaving his home pre incident. He advised that he was  spending much of his day browsing the internet and avoiding his family. He  advised that he felt that he had sacrificed his position of  "breadwinner" and he did not feel that he had a purpose in life.

Intervention

He completed  an initial assessment plus 12 sessions of psychotherapy with our inhouse  psychotherapy team, which included a combination of CBT and EMDR. Midway  through this course he accessed a Vocational Redirection Assessment, which  explored his transferrable skills, symptoms and work preferences to find  suitable roles that he could explore. Following the assessment, it was agreed  that the client would work towards a qualification in Environmental Surveys,  to enable him to work as an Environmental Surveyor.

Whilst  training, it was identified that the client would need further support from  an occupational therapist with a specialism in Neurodiversity to provide him  with techniques to concentrate when completing long reports following  surveys. He advised that he experiencing difficulty with task initiation,  reduced tolerance to prolonged static tasks without sensory input, high  distractibility and mental fatigue after sustained cognitive effort.

Outcome

The client  achieved his environmental survey qualification within 12 months of starting  the course, which included 400 hours of work experience, three exams and the  sign off from a mentor.

He was  successful in finding a full role within four months of achieving his  qualification, with total absence duration of two years.

Without  vocational, psychotherapy and occupational therapy support it would be likely  that the client would remain unemployed. The whole program allowed him to be  able to access the support that he needed to reduce his mental health  symptoms and to make a return to an alternative role sustainable.

-His GAD 7  and PHQ-9 scores reduced from Severe to Minimal levels during this support.

-He was  provided with techniques to allow him to manage his neurodiversity conditions  alongside work tasks, to allow him to make notes and write reports within a  reasonable timescale.

-An  alternative role was identified, training course arranged and the client was  successful in achieving a change in role.

The  client commented that: "the multidisciplinary support received from  Innovate Rehabilitation has allowed me to bridge the gap between by pre  illness role, which I was not managing effectively and propelled me in to a  new role which I will be able to sustain in to the future. Thank you for the  support that you have provided me"

Over a three  session period, the client was provided with techniques which included  support with planning his routine, assistance with task initiation, attention  and focus support., sensory and tactile regulation support and preparation  for exposure to crowds.

This support  ran alongside the vocational consultants co-ordination, where the client was  provided with 8 hours of case management support, which included sessions on  CV writing, interview technique and sourcing suitable work experience. The  client was matched with an industry mentor during this period who introduced  him to potential employers.

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