Step 2A. Expectations about the RTW Outcome

Defining what we mean by expectation:

• The belief that something will or should happen

The worker's expectation that they will RTW, at some point, is the strongest, most robust, and most validated predictor of RTW. Worker's are more likely to purse the RTW Goal if they believe they have the ability to achieve success and that there will be a perceived positive outcome for them by achieving that goal.

Step 2 Questions: Step 2A RTW Expectations (Step 2A) and Step 2B. Concerns about RTW are subject to change with context

The dictionary definition: "A strong belief that something will happen or be the case in the future" , and the Psychology Today definition: "Beliefs, anticipations, or standards regarding future events, actions, or outcomes, often based on past experience, social norms, and desires".

Jason used the analogy of a crystal ball or fortune teller to illustrate the concept: the question is essentially asking the worker to predict their future in relation to work. He outlined the types of expectations relevant to return to work:

• Realistic expectations - based on probability of return to work
• Unrealistic expectations - such as hoping to be completely pain-free before returning
• Unrealistically negative expectations - catastrophic thinking about the future
• Unmet expectations - when what the worker expected (e.g., a safe workplace, employer support) did not happen, leading to perceived injustice

Jason explained why the question is asked broadly first: it allows the worker to respond in whatever way they interpret it, which can reveal beliefs, anticipations, and standards that a narrow question would miss. If the worker does not understand the broad question, the case worker should then narrow it to a simple yes/no:

• "Do you see yourself going back as a house cleaner?"
• "Do you see yourself re-entering the workforce?"

Jason also clarified the difference between wanting and expecting: wanting belongs in Step 1, while expecting is a prediction of a future state. He noted that conditional expectations (e.g., "I'll return to work when I'm pain-free") are important to identify because they reveal what the worker believes must happen first.

Jason used a relatable personal example involving Katie's nieces and nephews at a restaurant to illustrate how expectations are formed based on past experience, beliefs, and anticipations, and how an expectation violation occurs when reality does not match the prediction.

Key Insight: The case worker should walk away from Step 2A with a clear sense of whether the worker sees a future that includes work. Anything less than a clear "yes" to returning to the workforce is a flag that requires follow-up because this remains an open gap that needs to be addressed in a subsequent interaction.