Vocational Rehabilitation

The importance of participating in a working role is increasingly being recognised. An independent review of scientific evidence found that work is generally good for physical and mental health and well-being, and that it can help to promote independence and full participation in society (Waddell and Burton 2006). Conversely, it has been identified that absence from work can have adverse effects on the individual and their family, employers and wider society (Black and Frost 2011).

Occupational Therapists are specialists in enabling people with health difficulties to complete activities, or occupations, which are essential to their daily living. Many people affected by health difficulties, either physical or mental, are of working age and some require specialist support to be able to return to and sustain their employment.

Occupational Therapists are uniquely placed health care professionals with core skills of task analysis, or functional assessment. Occupational Therapists provide holistic assessments to identify barriers to independent living and vocational tasks – we look at physical, psychological, social and environmental issues and identify strategies to assist people to become more independent.

Occupational Therapists can work alongside other occupational health service providers. We can use our specialist skills to helps individual to ‘stay at, return to and remain in work’ (Waddell et al 2013) and play a vital role in improving outcomes at individual and societal levels. Our key skills can help those with developmental, physical or mental health conditions to overcome barriers to engage in meaningful occupation (activity) and commence, resume or retain employment.

Occupational Therapists in vocational rehabilitation work with employers, Human Resource departments, Occupational Health professionals, Solicitors, Insurers and Case Managers.

Assessment may include the following:

A meeting with the employee to assess the difficulties experienced which may include:

Physical – range of movement, strength, tolerances.
Functional tolerances – sitting, standing, walking, lifting and carrying,
Psychological and emotional – mood, motivation, managing stress.
Cognitive – memory, planning and organising skills,
Social factors – pressures of external factors influencing work
Analysis of essential job demands
Ergonomic factors

Outcome of assessment

Barriers to the person remaining in or returning to work are identified and the Occupational Therapist can work with both the employer and the employee to identify potential solutions to enable the employee’s full participation in work activities. Solutions may include:

Negotiating reasonable adjustments such as graded hours, amended/adjusted duties and timescales with clinical reasoning.
Signposting to local services to optimise rehabilitation or information, additional treatments or support.
Providing the employee with advice and information on condition management.
Assisting the employee to develop strategies to optimise their functioning for work.
Advising employers on modifications to the work environment.
Giving information on assistive and specialist equipment that may enable the employee to complete their work role.
Formulating a return to work plan including any suggested modifications to the work role, work environment or the hours worked.
Completing an AHP Fitness Report. This provides the employer, employee and their GP with information on the practical modifications to help a person remain engaged with or return to work.

When a return to work is not feasible the OT provides information from which the employer is able to make informed decisions to manage the employee.

When a plan is agreed with the employer and employee the OT will be able to assist with its implementation. The OT will also be able to provide ongoing review as the return to work plan or work place adjustments are implemented, providing additional advice as required.

Occupational Therapists assess essential job demands alongside a person’s health to make recommendations to return to work or remain in work. We focus on functional ability and assess, analyse and solve problems. We provide advice on reasonable adjustments and on absence management. Our intervention can improve lives, prevent ill-health and injury, educate employees and employers, treat the individual and save money.

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