Vocational Rehabilitation Specialists Research Articles

Peer mentor contributions to an early intervention vocational rehabilitation specialist service following trauma: a qualitative study.

BackgroundPeer mentors have a role in facilitating the participation, health and well-being of people who have had a traumatic injury. Few studies have explored the involvement of peer mentors in an early intervention vocational rehabilitation (EIVR) service following trauma. ObjectiveThis study aimed to explore the experience of implementing peer support within the context of an EIVR service from the perspectives of the peer mentors themselves, the vocational therapists supervising them, and the patients that received peer mentoring. MethodsSemi-structured interviews were conducted with twenty participants from three groups: peer mentors (n=4); vocational therapists (n =3); and patients who received the EIVR intervention (n=24). Data were thematically analysed. ResultsThree themes were identified: The value of peer input in an EIVR service, The facilitators impacting the value of peer involvement as part of the EIVR service, The challenges impacting peer input as part of an EIVR service. ConclusionsThe inclusion of peer mentors early after major traumatic injury was a unique and valuable addition to the EIVR service. Offering peer support early on in rehabilitation enabled patients to gain a sense of hope for their future, and the expectation that returning to work was a realistic option. The careful selection of peer mentors, and ensuring they receive adequate preparation and ongoing supervision are vital to support their well-being during the intervention. Aiming to match peer mentors with similar injuries and work backgrounds to patients is an important contributor to the likely ongoing engagement of the mentee with the mentor.

장애인 직업적응훈련시설의 운영에 관한 질적연구: 퇴직한 직업훈련교사의 경험을 중심으로

The purpose of this study was to examine the situation and difficulties experienced by vocational training teachers in facilities before their retirement and to explore development plans. There was a purpose for research. The study participants were people who had experience working as vocational adaptation training teachers and 6 vocational training teachers who had currently retired were selected. The results were as follows. First at the perspective of the trainers, it was a workplace they chose with the goal of their own growth as professionals. Second, the trainees that the research participants met at the vocational adaptation training facility for the disabled were trainees who needed care rather than vocational training. Third, research participants complained of the burden of the user placement standard of 12 trainees per vocational training teacher and the difficulties of the reality of a shortage of vocational rehabilitation specialists. Fourth, operating standards that did not reflect on-site conditions, arduous work, and the resulting loss of direction as professionals appeared to be the process by which research participants retired. In conclusion, the current vocational adaptation training facility for the disabled serves as an institution that prepares employment through education and training for disabled people who had difficulty finding employment, but the actual users were so severely disabled that their focus was on care rather than employment. It appeared that only when the operating standards, operating system, and employee work requirements were improved will employees be able to maintain their jobs for a long period of time and operation suitable for the original purpose of operation will be possible.

Effective Teams in Vocational Rehabilitation: An Exploration of Complexities and Practice in Aotearoa-New Zealand.

Vocational rehabilitation (VR) involves complex skills, and often inter-disciplinary teams need to work effectively to meet the needs of stakeholders. Research highlights important influences on effective teamwork, including funding systems, team structure, policies and procedures, and effects of professional hierarchies. This qualitative study aimed to explore these issues in-depth including how factors interact to produce problems and solutions. We focused on identifying challenges and opportunities for VR teams working in the Aotearoa-New Zealand context which may also be transferrable to other settings. Qualitative descriptive instrumental case study involving focus groups and interviews with two VR teams (n = 14). Teams worked in musculoskeletal injury and were geographically diverse. Reflexive thematic analysis was used to analyse the data. Analysis constructed three overarching themes: Having the Power, Being Human, and VR is Not for Everyone. Achieving trusting relationships within the team was paramount. This was achieved through seeing everyone as equal, and as human. Equality within the team was particularly important for professionals that occupied different positions of power in a wider professional hierarchy. VR specialist skills (experience and postgraduate qualifications) were often under-recognised, leading them to have little power in VR decision making processes. VR professionals also experienced competing demands between client needs and business drivers. Findings offer detail of processes teams engage in to create effective team relationships and manage systemic factors to facilitate positive outcomes. Additionally, findings highlight opportunities in decision-making processes for VR medical certification that may increase job satisfaction and better utilize skills and expertise.

Proposal for an ICF-based methodology to foster the return to work of persons with disability.

Employment is an essential component of life as it provides income, sense of engagement and opportunities for personal development. Unemployment due to disability following an accident may have dramatic social and psychological consequences on individuals; it is thus fundamental to foster return to work of these persons. The present work was aimed to develop a methodology determining suitable jobs for people living with disability after a job-related accident. The Occupational Information Network (O*NET) taxonomy was combined with the International Classification of Functioning, Disability and Health (ICF) to match individual resources with specific job requirements. ICF Linking Rules were employed by two independent groups of researchers to associate ICF codes to O*NET skill and ability descriptors. O*NET descriptors were linked to 92 unique ICF codes. A "Criticality score" combining ICF and O*NET features to assess suitability of selected jobs for persons with disabilities was also proposed. The proposed methodology represents a novel instrument to support return to work; the capability to assess specific work-related facets through the lens of both the ICF model and O*NET taxonomy would conceivably provide vocational rehabilitation specialists and occupational therapists with a useful tool fostering job placement of workers with disability.

Evaluating effectiveness of an integrated return-to-work and vocational rehabilitation program on work disability duration in the construction sector.

ObjectiveThe aim of this study was to investigate whether an integrated return-to-work (RTW) and vocational rehabilitation (VR) program – the Work Reintegration (WR) program – was associated with reduced work disability duration in the construction sector in Ontario, Canada.MethodsWorkers’ compensation data from the Ontario Workplace Safety and Insurance Board were extracted for lost-time construction worker claims following work-related injuries between 2009 and 2015. Claims receiving referrals to RTW and VR specialists (treatments) were matched with claims receiving no referrals (controls) during the periods before and after the WR program introduction. Multivariable difference-in-differences linear and quantile regression models were used to examine differences in cumulative disability days paid during two-years post-injury between treatment and control groups before and after the program change and the difference in these differences, overall, and at different disability distribution percentiles.ResultsThe WR program introduction was associated with reductions in cumulative disability days paid for all claims but most notably among longer duration claims referred to RTW specialists (reduction of 274 days at the 90th percentile in the disability distribution) and shorter duration claims referred to VR specialists (reductions of 255 and 214 days at the 25th and 50th percentiles in the disability distribution, respectively).ConclusionsThe WR program introduction was effective in reducing cumulative disability days paid for construction worker claims but the effects varied at different percentiles in the disability distribution, as well as by specialist referral. The findings highlight the benefits of better integrated RTW and VR services to injured workers in the construction sector.

Workplace productivity loss as a result of absenteeism and presenteeism in chronic and episodic migraine: a scoping review

PurposeMigraine consists of a chronic neurological disorder with episodic attacks. Migraine prevails in people of their most productive working age, followed by difficulties at work and social functions. This scoping review aims to analyze the economic burden on a workplace due to chronic migraine compared to episodic migraine by focusing on the indirect costs of absenteeism and presenteeism and addressing the research gaps in this field.Design/methodology/approachAccording to the PRISMA Extension for Scoping Reviews, a comprehensive electronic literature search was carried out from 2010 to 2020 using the Google Scholar and Medline/PubMed databases.FindingsThe findings confirm that chronic and episodic migraine harm the workplace's productivity, escalating with the frequency of migraine attacks. Differences occur between presenteeism and absenteeism rates among chronic and episodic migraine, and higher presenteeism than absenteeism rates.Originality/valueThis review sheds new light on the indirect burden of migraine. It shows the gaps in the explored research area and the need for more targeted and extended research that could provide a deeper understanding of the workplace's hidden costs of migraine. The issues discussed are important as they can raise awareness of the interested parties, policymakers, employers and vocational rehabilitation specialists on the work disability associated with migraine.

Does Returning to Work Affect Veterans’ Disability Compensation? Veteran and VA Provider Concerns

<h3>Research Objectives</h3> To examine Department of Veterans Affairs (VA) provider and Veteran perceptions of how return to work (RTW) may impact disability compensation benefits for Veterans with traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD). <h3>Design</h3> Interview data collected between 2014-2021 on vocational rehabilitation services for Veterans with TBI or PTSD from 4 separate cross-sectional studies were aggregated. We created a secondary dataset that focused on references to RTW and disability compensation and conducted a thematic analysis. <h3>Setting</h3> VA medical centers (VAMCs). <h3>Participants</h3> 23 Veterans with TBI with or without comorbid PTSD at 2 VAMCs and 66 providers across 32 VAMCs participated. Provider categories included psychiatrists, psychologists, social workers, and vocational rehabilitation specialists. <h3>Interventions</h3> None. <h3>Main Outcome Measures</h3> Interview responses regarding perceptions on RTW and disability compensation. <h3>Results</h3> Both VA providers and Veterans perceived that many Veterans with TBI and/or PTSD want to RTW, but that the potential for reduction of disability compensation among those who do is a barrier. VA providers were concerned that RTW would be associated with a decrease in disability compensation and that symptom management difficulties would lead to job loss. Options that Veterans considered when deciding to RTW included: finding a job where wages/benefits are sufficient to replace any lost disability compensation, working part-time to remain under the income threshold that triggers benefits reduction, or not pursuing employment. <h3>Conclusions</h3> Disability compensation can replace income lost due to difficulty sustaining gainful employment, but perceptions held by Veterans or VA providers may disincentivize RTW. RTW can improve health and functioning among Veterans with TBI and/or PTSD. Systems-level efforts to coordinate disability compensation protections for an extended period after RTW may offer Veterans the psychological safety to pursue employment. <h3>Author(s) Disclosures</h3> None.

A Role for OT Collaboration With Vocational Rehabilitation Specialists Providing Individualized Community-Based Services to Younger Rural Veterans?

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. An in-depth description is provided of the implementation of the Veterans Health Administration’s Rural Veterans Tele-Rehabilitation Initiative in supporting development and expansion of individualized community-based vocational services to rural veterans with disabling conditions. Promising practices and opportunities for OT collaborations with vocational rehabilitation specialists were identified. Primary Author and Speaker: Consuelo Kreider Contributing Authors: Zaccheus J. Ahonle, Jennifer L. Hale-Gallardo, Gail Castaneda, Kimberly Findley, and Sergio Romero

Barriers and Facilitators to Employment: A Comparison of Participants With Multiple Sclerosis and Spinal Cord Injury

ObjectiveTo compare self-reported barriers and facilitators to employment among employed and unemployed participants with multiple sclerosis (MS) and spinal cord injury (SCI). DesignCross-sectional study using self-report assessment obtained by mail or online. SettingMedical university in the southeastern United States. ParticipantsParticipants (N=2624) identified from either a specialty hospital or a state-based surveillance system in the southeastern United States, including 1234 with MS and 1390 with SCI. All participants were aged <65 years at the time of assessment. InterventionsNot applicable. Main Outcome MeasuresSelf-reported barriers and facilitators to employment. ResultsOverall, the MS participants reported more barriers, particularly stress, cognition, and fatigue, whereas those with SCI were more likely to report not having the proper education and training, resources, transportation, and attendant care. Follow-up analyses broken down by employment status indicated that several barriers and facilitators were significantly related to diagnosis for either employed or unemployed participants, but not both. Among those employed, participants with SCI were more likely to report they could not do the same types of jobs as they could pre-SCI and those with MS were more likely to state that they did not know much about jobs for people with disabilities (no differences were noted for these variables among unemployed participants). Unemployed individuals with SCI were more likely to report that the jobs for which they were trained were not accessible. ConclusionsThe primary barriers for individuals with MS revolve around the condition itself, whereas the barriers for SCI appear to be more related to modifiable factors. Vocational rehabilitation specialists need to identify diagnostic-specific barriers to promote employment outcomes.

A Study of Enhance Vocational Rehabilitation Specialists’ Job Competencies in Community Rehabilitation Centers -Focusing on an Need Analysis

본 연구의 목적은 장애인복지관 직업재활 전문가의 직무수행에 필요한 역량을 파악하고, 파악된 역량을 증진시킬 수 있는 방안을 모색하는 것이다. 이러한 연구 목적을 달성하기 위해 우선, 선행연구 분석 및 전문가 검토를 통해 직업재활 전문가의 직무역량을 도출하였다. 둘째, 전국 장애인복지관 직업재활 전문가 112명을 대상으로 직무역량에 관한 설문조사를 실시하였다. 셋째, 설문조사 자료는 Borich의 요구도 공식, t-검증, The Locus for Focus Model을 적용하여 분석한 후 최종 우선순위 역량을 제시하였다. 분석결과 업체개발, 직무개발, 직업매칭, 네트워크 형성, 업체관리 등 12개의 직무역량이 최우선적으로 고려해야 할 직무역량으로 도출되었다. 이러한 연구 결과에 따른 지원방안과 시사점으로서는 첫째, 장애인복지관 직업재활 전문가의 직종개발·취업알선 역량을 극대화 할 수 있는 전문가 특강 및 워크숍 등의 로드맵 제시가 필요하고, 둘째, 직업재활 현장에서 실무가 강조되는 역량들에 대한 지속적인 교육 및 훈련의 개선이 요구되며, 마지막으로 본 연구 결과를 통해 도출된 역량과 우선순위를 활용하여 신규 직업재활 전문가 그리고 자격별로 맞춤화된 역량강화 교육이 필요할 것으로 제시되었다.The purpose of this study was to distinguish capabilities that are required for conducting rehabilitation counselors work performance and to investigate support approaches that can be beneficial in improving the recognized capabilities. To accomplish the purposes, firstly, rehabilitation counselors work capabilities were recognized by literature reviews and DACUM conferences. Second, the data collected in this study was analyzed 112 numbers, rehabilitation counselors in Community Rehabilitation Centers. Third, collected data were investigated by Borich formula, t-test and the Locus for Focus model. The recognized capabilities were ordered according to their significance. The following 12 areas were determined to be key job competencies with the highest priority: Job searching, Job development, Job matching, Building network, Company management, etc. Support strategies and implications were suggested for vocational rehabilitation specialists based on the findings. First, it is necessary to present a road map of special lecture and workshops that can maximize job development and job placement skills of vocational rehabilitation specialists in community rehabilitation centers. Second, in the field of vocational rehabilitation, there is a need for continuous improvement of training and education of competencies that emphasize pragmatism. Finally, using the competencies and priorities derived from the results of this study, customized capacity building training is needed for new employees and other professionals.

Determinants of Participation and Satisfactions of In-Service Education According to Job Characteristics of Vocational Rehabilitation Specialists

Determinants of Participation and Satisfactions of In-Service Education According to Job Characteristics of Vocational Rehabilitation Specialists

Supported Employment for Veterans With Traumatic Brain Injury: Provider Perspectives

ObjectiveTo identify any pilot and nonpilot site differences regarding current (1) provision of supported employment (SE) to veterans with traumatic brain injury (TBI); (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE. DesignMixed methods cross-sectional survey study. SettingVeterans Health Administration SE programs. ParticipantsRespondents (N=144) included 54 SE supervisors and 90 vocational rehabilitation specialists. InterventionsNot applicable. Main Outcome MeasuresWeb-based surveys of forced-choice and open-ended items included questions on SE team characteristics, communication with polytrauma/TBI teams, and experiences with providing SE to veterans with TBI history. ResultsSE was provided to veterans with TBI at 100% of pilot and 59.2% of nonpilot sites (P=.09). However, vocational rehabilitation specialists at pilot sites reported that communication with the polytrauma/TBI team about SE referrals was more frequent than at nonpilot sites (P=.003). In open-ended items, suggestions for improving SE were similar across pilot and nonpilot sites, and included increasing staffing for vocational rehabilitation specialists and case management, enhancing communication and education between SE and polytrauma/TBI teams, and expanding the scope of the SE program so that eligibility is based on employment support need, rather than diagnosis. ConclusionsThese findings may contribute to an evidence base that informs SE research and clinical directions on service provision, resource allocation, team integration efforts, and outreach to veterans with TBI who have employment support needs.

A Study on Status and Needs of In-Service Education for Vocational Rehabilitation Specialists in Community Rehabilitation Centers

A Study on Status and Needs of In-Service Education for Vocational Rehabilitation Specialists in Community Rehabilitation Centers

The attitudes of people with disabilities who participated in vocational rehabilitation and specialists towards possibilities for application of vocational training and employment models

The article deals with the attitude of people with disabilities who participated in vocational rehabilitation and vocational training specialists towards the possibilities for application of vocational training models and models of workplaces for the employment of people with disabilities in Lithuania and Ukraine. The results of an on-line questionnaire-based quantitative research are introduced. It was found out that when choosing a model of vocational rehabilitation and model of workplaces for the employment of people with disabilities in each of the countries the historical, cultural, religious aspects must be regarded and country’s development, tradition and environment as well as the completeness of the vocational rehabilitation and employment model must be assessed

In-vivo job development training among peer providers of homeless veterans supported employment programs.

This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record

An Analysis of Structural Relationship between factors of Vocational Rehabilitation Practicum and the Specialty of Would-be Vocational Rehabilitation Specialists

An Analysis of Structural Relationship between factors of Vocational Rehabilitation Practicum and the Specialty of Would-be Vocational Rehabilitation Specialists

Job satisfaction of Department of Veterans Affairs peer mental health providers.

Department of Veterans Affairs (VA) peer specialists and vocational rehabilitation specialists are Veterans employed in mental health services to help other Veterans with similar histories and experiences. Study objectives were to (a) examine job satisfaction among these employees, (b) compare them to other VA mental health workers, and (c) identify factors associated with job satisfaction across the 3 cohorts. The study sample included 152 VA-employed peer specialists and 222 vocational rehabilitation specialists. A comparison group included 460 VA employees from the same job categories. All participants completed the Job Satisfaction Index (11 aspects and overall satisfaction ratings). Linear regression was used to compare job satisfaction and identify its predictors among the 3 cohorts. Job satisfaction was fairly high, averaging "somewhat satisfied" to "very satisfied" in 6 (peer specialists) and 9 (vocational rehabilitation specialists) of the 11 aspects and overall job ratings. Adjusting for length of employment, age and gender resulted in no significant group differences with 2 exceptions: White peer specialists were less satisfied with pay and promotion opportunities than vocational rehabilitation specialists and comparison-group employees. Across all cohorts, shorter length of time employed in the job was associated with higher job satisfaction. The high job satisfaction levels among the 2 peer cohorts suggest support for the policy of hiring peer specialists in the VA. Furthermore, the results are consistent with those of the nonveteran samples, indicating that integrating peer providers into mental health care is possible in VA and non-VA settings.

Protecting Ourselves from Harm: Voices of Aging Farmers.

Senior farmers suffer the highest fatality risk of any age group in agriculture. The purpose of this exploratory study was to develop a "voice" for senior farmers by examining aging farmers' and their families' perspectives of farm work, associated injury risks, and methods to decrease those risks. Focus groups and personal interviews were used to collect data from 81 participants across seven U.S. states. The findings reflect the collective and verified voice of the study group. The Health Belief Model was applied and revealed differences between farmers and their family members; however, the need and desire to continue self-directed work was ubiquitous. Seniors reported external risks, while family members were more likely to name risks associated with the health of the senior farmer. Both groups cited stress as an injury risk. Posing risk to others was the trigger point for senior farmers to make behavior changes. Family members reported uneasiness in initiating safety conversations. Adaptation of existing interventions for self-assessment of risk was rejected. Use of the popular farm press and respected local resources were desired as avenues for safety education. Humor and stories were highly regarded. Interventions should be tailored for the target audience. These new insights into the risk perceptions of senior farmers and their families may result in more appropriate actions by health professionals, extension staff social workers, vocational rehabilitation specialists, and others who work with farm populations.

Mental health and quality of life among veterans employed as peer and vocational rehabilitation specialists.

The study compared employment experiences, mental health recovery, and quality of life among peer specialists and vocational rehabilitation (VR) specialists hired by the U.S. Department of Veterans Affairs (VA), the VR specialists under the Homeless Veterans Supported Employment Program. Employment characteristics associated with mental health recovery were examined. The study was a national, observational survey of 152 peer specialists and 222 VR specialists across 138 VA health care systems in 49 states. The survey, administered over the Internet, included measures describing participant characteristics, employment factors, mental health, and quality of life. The two cohorts were compared by using t tests or chi square tests. Multiple regression analysis controlling for participant characteristics was used to identify employment factors associated with mental health and quality of life. Peer specialists were more likely than VR specialists to share recovery stories, serve as a role model or mentor, and advocate for veterans. Activities by VR specialists tended to focus more narrowly on job skills. Overall, after adjusting for multiple comparisons, the analysis found high levels of mental health and average quality of life for both cohorts, with no significant differences between the groups. Satisfaction with amount of supervision was consistently associated with aspects of mental health recovery, including work-related and helping-related quality of life, for both cohorts. The results highlight the value of work and the importance of supervision in realizing both the adoption of recovery-oriented services and the promotion of mental health in a community of veterans serving each other.

Facilitators and barriers to employment among veterans with spinal cord injury receiving 12 months of evidence-based supported employment services.

Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment. The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program. Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups. Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes. Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes.