Vocational Rehabilitation Research Articles

Vocational rehabilitation for Long Covid: a roadmap for recovery

Long Covid continues to impact many people’s workability; some have lived with it for years, experiencing return-to-work attempts followed by redeployment, contractual changes—even capability proceedings. For those in low-paid work or self-employment, contractual or financial insecurity, work retention options are likely to be reduced even further. New cases of Long Covid continue, and the need to support workers earlier in their trajectory with return to work as a key outcome remains crucial. Support for people with Long Covid has been lacking to date; here we introduce a practical tool that can be utilized by rehabilitation and occupational health professionals alike.

Perspectives of service providers on vocational rehabilitation for mental health service users in Namibia: a qualitative study

Purpose Chronic mental illness disrupts the ability to work, often resulting in the need for vocational rehabilitation in which occupational therapists play a role. Namibia does not have an occupational therapy vocational rehabilitation practice framework for service users with chronic mental illness. This study explored the contextual factors that should be considered for a vocational rehabilitation practice framework in Namibia. Materials and methods A qualitative collective case study design was utilized. In-depth interviews were conducted with nine mental health service providers that were purposively selected from two study sites. An inductive thematic analysis of data was done using ATLAS.ti. Results The need for collaborative advocacy for service users to raise awareness and engage stakeholders such as family members, employers and policy makers was highlighted. Vocational rehabilitation resources needed include sheltered workshops, financial resources and trained human resources. Recognition that vocational rehabilitation services are too limited to meet the needs of mental health service users. A vocational rehabilitation policy and strategy is required. Supported employment and self-employment are potential strategies that should be considered. Conclusion Vocational rehabilitation for service users with chronic mental illness is limited in Namibia and there is a need to collaboratively improve the service.

Dutch Dataset Vocational Rehabilitation for Chronic Musculoskeletal Pain: Baseline Patients' Characteristics and Program Eligibility.

Vocational rehabilitation (VR) is an intervention to improve return to work for patients with chronic musculoskeletal pain (CMP). However, a systematic overview of characteristics of referred patients or eligible for VR is lacking, which hinders comparability across studies. Objectives were (1) to describe characteristics of patients with CMP referred to and eligible for VR and (2) to identify factors that contribute to VR eligibility. This study used a multicenter, cross-sectional design. Data of self-reported questionnaires were obtained between 2013 and 2019 from care as usual of eight Dutch VR centers. Descriptive statistics were performed to describe sociodemographic, pain-related, and work-related characteristics. Logistic regression analysis was used to identify factors contributing to VR eligibility. Data sets of n = 2970 referred patients were included. The mean age was 46years and 60% were female. Low back (43%), neck (37%), and shoulder pain (34%) were most reported. 82% Worked in paid employment. The absenteeism rate was 85%, and 44% was partially absent. After multidisciplinary screening, 62.2% were eligible for VR. Persons most likely to be eligible for VR (OR < 1.20) were those having back or neck pain, whereas least eligible (OR < 0.80) were persons having pain in hand/fingers or pain in other regions, unemployed workers, and those referred by a 'other' medical specialists. All other factors contributed little or none to the model. An extensive description of sociodemographic, pain-related, and work-related characteristics is presented for patients eligible for VR. Especially having back/neck pain and being an employee were associated with higher chance of eligibility for VR.

Cognitive Accessibility of Information for Vocational Education, Support and Rehabilitation

Introduction. The article examines the problems of accessibility of professional information and intersectoral research results at three stages. Methodology and Results. At the first stage, the method of a sociological survey of disabled people (5.500 people) was used, when analyzing the results of which it was concluded that they stated the insufficient importance of education as a sphere of life (43 %) and the incomprehensibility of the information provided to them on information resources (40.2 %). The purpose of the practical second stage of the study is to develop and test the diagnosis of the availability of information for professional information (hereinafter referred to as professional information) and the need for support in obtaining advisory services for professional orientation in accessible types of work, socio–psychological, socio-pedagogical, correctional and educational services through determining the degree of cognitive safety as an objective criterion for helping people and accompanying persons with disabilities. Method: adapted questionnaire (MMSE test) as a screening tool for cognitive preservation in people of working age who applied for social services (5.915 people). The results of practical diagnostics of cognitive preservation have determined approaches to differentiating information design for the perception of information as a condition of cognitive accessibility. At the third stage, prognostic modeling of recommendations to increase the accessibility of professional information for vocational training, education and social rehabilitation, and support for the disabled was carried out. Conclusions. Taking into account functional and adaptive reserves, cognitive safety of disabled people determines the design, modeling of the subsequent design of information accessibility by levels of cognitive accessibility, which contributes to improving the quality of professional information, counseling in order to build a route of vocational education and training, including additional education or retraining.

Early integrated rehabilitation and vocational rehabilitation in 435 patients with breast cancer: A comparison between the intervention group and control group in a prospective study.

11007 Background: Return to work is beneficial both for breast cancer (BC) patients and for society. This study explored the impact of early integrated and vocational rehabilitation on sick leave and disability one year after the start of cancer treatment in BC patients. Methods: The subjects of our prospective study were 435 employed female BC patients (26-65 (mean 52) years of age), who participated in the pilot study on the individualized integrated rehabilitation in 2019-2022 and were followed for at least one year. There were 211 patients in the control group and 224 in the intervention group. The patients completed three questionnaires (EORTC QLQ - C30, B23, and NCCN): before, half and one year after the start of cancer treatment. The control group received the standard rehabilitation programme, offered to all BC patients before the start of the study. The multidisciplinary rehabilitation team reviewed the documentation of the patients from the intervention group before, half and one year after the start of treatment and recommended appropriate interventions according to the patient's needs in compliance with the institute’s new clinical pathway (psychologist, general practitioner, nutritional treatment, physical rehabilitation, kinesiologist-guided online exercises, gynaecologist, analgesia, vocational rehabilitation). Data on the patients’ demographics and needs reported in questionnaires, the extent of the disease and cancer treatment were collected. These data and the frequency of sick leave and disability retirement one year after the start of treatment in both groups of patients were analysed using the chi-square and ANOVA test. Results: The patients from the intervention group had 50 calendar days shorter sick leave compared to the control group (p = 0.002). Patients without metastatic disease from the intervention group had 52 calendar days shorter sick leave compared to the control group (p = 0.002). The intervention group treated with chemotherapy had 43 calendar days shorter sick leave compared to the control group (p = 0.029). The difference in sick leave of the group of patients who did not receive chemotherapy was statistically borderline significant (50 calendar days, p = 0.053). The patients in the intervention group had a better work ability (p &lt; 0.001) and less disability (p &lt; 0.001) than the patients in the control group one year after the start of treatment. Conclusions: One year after the beginning of cancer treatment, patients from the intervention group had shorter sick leave, better work ability, and a lower proportion of disability compared to the control group.

Initial evaluation of measurement properties of the Work Environment Impact Questionnaire (WEIQ) - using Rasch analysis

BackgroundTo provide both preventive and rehabilitative conditions in a workplace, one must understand how employees experience work demands. Such an understanding can be obtained from each individual with valid and quality-assured questionnaires. The Work Environment Impact Questionnaire (WEIQ) is a new questionnaire for measuring employees’ self-perceived work ability in relation to their specific workplace environment. The purpose of this study was to assess the measurement properties in terms of construct validity of the WEIQ.MethodsA cross-sectional survey study was conducted with 288 respondents from three different workplaces involving assisted living personnel, vocational rehabilitation personnel and personnel at a research institute. The measurement properties of the WEIQ were assessed according to Rasch Measurement Theory (RMT), including assessment of item-to-sample targeting, threshold ordering, item fit statistics, unidimensionality and reliability.ResultsItem fit, i.e., fit residuals, item characteristic curves (ICC) and chi square values, were all satisfactory, and no disordered thresholds were present after collapsing the lowest response categories. However, issues with local dependent (LD) item correlations was present in 7.6% cases, four items showed statistically significant differential item functioning (DIF), where 11% of the respondents had person fit residuals outside the recommended range of ± 2.5 and the t-test for unidimensionality did not meet the criterion of 5%. Scale-to-sample targeting and reliability (0.92) were good. LD could be resolved with testlets and at the same time maintaining fit and improving dimensionality, but then the reliability decreased to 0.82.ConclusionsThis study provides an initial validation of the WEIQ to be used for assessing employees’ self-perceived work ability. Most measurement properties were acceptable, but further exploration of LD, DIF and unidimensionality in additional work settings and with larger sample sizes is warranted.Trial registrationNot applicable.

Employment barriers questionnaire: Development and determination of its reliability and validity.

The high unemployment rate among people with disabilities (PWDs) can be attributed to barriers found in the work environment and demands of the job itself. Given the lack of comprehensive tools to identify these barriers, we developed the Employment Barriers Questionnaire (EBQ). The objective of this study was to develop and examine the EBQ's reliability and validity for detecting employment barriers and possible modifications to overcome them. Two stages were conducted: stage I was a cross-sectional design. Stage II included a cross-sectional and prospective design. Thirty-nine people with physical disabilities (mean age 47.21±10.78 years) were recruited, 51% of which were employed during data collection. During stage I, we developed a first version of the EBQ (EBQ.I) and evaluated its internal reliability. The EBQ.I was filled twice, one week apart to assess test-re-test reliability. Predictive validity was tested using a regression model to predict the employment status of stage II based on EBQ.I's results from stage I. In stage II, we generated a second version (EBQ.II) and tested its internal-reliability and known-groups validity, by comparing the EBQ.II's results between employed and unemployed subjects. The results showed that the EBQ.II has a high internal-reliability (α= 0.79-0.97) and a medium-large known-groups validity (-3.95≤Z≤-2.26, p < 0.05). Additionally, the EBQ.I has a high test re-test reliability (ICC = 0.85-0.94, p < 0.001) and predictive validity (β= 0.861, p = 0.033). This study has illustrated that the EBQ.II is a unique, reliable and valid tool for identifying employment barriers and modifications to address them, expected to improve vocational rehabilitation efforts.

Employer representatives' experiences of supporting employees with cognitive impairments in a digital work environment.

Digital work poses cognitive demands on all employees, but the impact is greater for employees with cognitive impairments. Digitalization also has significant implications for employer representatives as they are responsible for the work environment. However, knowledge is scarce concerning employer representatives' perspectives on identifying needs and support for employees with cognitive impairments working in a digital work environment. To describe employer representatives' experiences of work environment management with focus on employees with cognitive impairments working in a digital environment. Focus group methodology was used. Six employer representatives with work environment responsibilities participated. One overall theme "Mastering the interconnected processes in a transformative digital work environment" as well as three themes "Facilitating good digital work conditions", "Identifying needs and difficulties in work tasks among employees' with cognitive impairments" and "Pursuing knowledge and collaborations to support employees with cognitive impairments" with subthemes were identified. The themes describe employer representatives' challenges and efforts to identify fluctuating needs in employees with cognitive impairments and, also, to organize and reduce cognitive demands in the work environment to support them. Managing the challenges of an evolving digital work environment and matching individual work ability of employees with cognitive impairments in relation to cognitive demands is an ongoing process. The participants valued cooperation with employees with cognitive impairments but lacked support from expertise. The need to develop and implement a functioning support system for vocational rehabilitation to ensure a sustainable work in digital work environments is indicated.

Employment of Disabled Persons with Multiple Sclerosis in the Republic of Slovenia

Education, active involvement in the workforce, and securing employment opportunities are essential pillars for individuals with disabilities to attain autonomy and self-sufficiency. However, due to lower education levels and inherent limitations, they often face barriers in securing and maintaining employment. Enhancing their employability through various training programs and raising awareness among employers about workplace accommoda-tions is essential. Slovenian legislation facilitates this but excludes individuals without recognized disability status from disability rights. This study aims to explore the disability status of indi-viduals diagnosed with multiple sclerosis (MS) under relevant legislation. It examines Slovenian disability legislation, protection, and recognition of disability for those with MS through legislation analysis and a survey of 85 adult MS Association of Slovenia members. Findings reveal disparities in rights based on the legal basis of disability status acquisition. Those under the Vocational Rehabilitation and Employment of Persons with Disabilities Act (ZZRZI) lack disability benefits. Consolidating relevant legislation into a unified statute for disability recognition and establishing a single MS registry is proposed. Survey results indicate an 85% disability recognition rate, with 14% full-time employees, 21.2% part-time employees, 9.4% job seekers registered with the Employment Service of Slovenia (ZRSZ), and 1.2% students among respondents. No prior research exists on MS-related employment in Slovenia, suggesting the need for future studies to monitor employment's impact on health status changes, sickness absence, workplace adjustments, employment opportunities, and suitable work environments for individuals with MS.

P.115 The national impact of traumatic brain injury on labor markets: a canada-wide observational cohort study of post-injury employment and personal income loss

Background: Employment and personal income loss after traumatic brain injury (TBI) is a major source of post-injury stress and barrier to societal reintegration for affected patients. We sought to quantify the labor market implications for tax-filing adult TBI survivors. Methods: We performed a matched difference-in-difference analysis using a national retrospective cohort of working adult TBI survivors injured between 2007-2017. Linear and logistic mixed effects regressions were used to estimate the magnitude of personal income loss and proportion of patients displaced from the workforce in the three post-injury years (Y+1 to Y+3). Results: Among 18,050 patients identified with TBI, the adjusted average loss of personal annual income was $-7,635 dollars in Y+1 and $-5,000 in Y+3. An additional -7.8% individuals were newly unemployed compared to the pre-injury baseline. For mild, moderate, and severe TBI subgroups, income loss was $-3354, $-6750, and $-17375 respectively in Y+3; the proportion of newly unemployed individuals in Y+3 was 5.8%, 9.2%, and 20% lower than baseline. We estimated 500 million dollars of incurred labor markets losses related to TBI in Canada. Conclusions: This work represents the first national cohort data quantifying the labor market implications of TBI. These results may be used to inform post-injury care pathways and vocational rehabilitation.

Cost of out-of-hospital cardiac arrest survivors compared with matched control groups

IntroductionSocietal costs of out-of-hospital cardiac arrest (OHCA) survivors may be extensive due to high health care utilization and sick leave. Knowledge of the costs of OHCA survivors may guide decision-makers to prioritize health resources. AimThe aims of the study were to evaluate the costs of OHCA survivors from a societal perspective, and to compare these costs to the costs of individuals with non-cardiac arrest myocardial infarction (MI) and individuals with no cardiac disease (non-CD). MethodsFrom the Danish OHCA Registers, survivors, with a cardiac arrest between 2005–2018 were identified. Each case was assigned one MI control and one non-CD control, matched on gender and age. Based on register data, costs of healthcare utilization, sick leave, vocational rehabilitation, disability pension and other social benefits one year before event and five years after, were estimated. ResultsIn total 5,646 OHCA survivors were identified with associated control groups. The mean costs for OHCA survivors during the 6-year period were €119,106 (95%CI: 116,297–121,916), with €83,472 (95%CI: 81,392–85,552) being healthcare costs. Mean costs of OHCA survivors were €49,132 higher than the MI-control group and €100,583 higher than the non-CD control group. ConclusionsTotal costs of OHCA survivors were considerably higher than costs of MI- and non-CD controls. Hospital costs were highest during the first year after event, and work inability during the second to fifth year with sick leave and later disability pension as main burdens.

Promoting quality career pathways for individuals with disabilities through the public vocational rehabilitation program

BACKGROUND: Career Pathways initiatives in Vocational Rehabilitation (VR) have emerged as a crucial strategy for enhancing quality employment outcomes among individuals with disabilities. This paper conducts a comprehensive examination of the integration of Career Pathways within VR, emphasizing its significance in aligning vocational goals with evolving labor market demands. OBJECTIVE: Drawing from the innovative Career Pathways initiatives introduced by the Rehabilitation Services Administration (RSA), this paper addresses the RSA Career Pathways Demonstration Initiatives from 2015 to 2019 alongside the ongoing Disability Innovation Fund-Career Advancement Initiative Model Demonstration Project. The paper also discusses the strengthening of Career Pathways through the development of high-quality Individualized Plans for Employment and program evaluation. METHODS: This study utilized a modified exploratory case study approach to examine past and present career pathways initiatives in state VR agencies. Data were gathered from publicly available documentation and archival records, focusing on 12 cases from two national initiatives: the RSA Career Pathways Demonstration Initiatives (2015–2019) and the Disability Innovation Fund-Career Advancement Initiative Model Demonstration Project (2021–2026). RESULTS: The study reveals a substantial, positive impact on employment outcomes for individuals with disabilities through Career Pathways in VR programs, facilitated by the integration of adaptable pathways, individualized planning, and program evaluation.

The COVID-19 pandemic’s influence on employment outcomes of veterans enrolled in VA healthcare vocational rehabilitation

BACKGROUND: Employment has been shown to be the fourth most commonly reported need for veterans and their families, and unemployment rates have ranged from 1–69% dependent on the mental health diagnosis. Complications from the COVID-19 pandemic have had a significant impact on psychological functioning, and social isolation has led to increased psychiatric symptoms. Vocational rehabilitation is an intervention provided to Veterans in an attempt to remove barriers to employment while also increasing involvement in gainful work activity. OBJECTIVE: The purpose of the current study was to examine the impact that COVID-19 has had on employment rates at discharge for veterans with mental health disorders participating in a VHA vocational rehabilitation program. METHODS: An outcome-based, summative program evaluation design was used to assess the quality of Veterans served (2016-2021) at a vocational rehabilitation program served at a medical center located in VISN 12 of the U.S. Department of Veteran Affairs. RESULTS: Findings showed that veterans with Bipolar and Psychosis were less likely to discharge with employment (not considering COVID-19). CONCLUSION: No significant meaningful differences existed in employment rates when comparing pre/post March 2020 (official start of COVID-19 pandemic) for veterans with psychiatric diagnoses.

Customized employment for transition-age youth in state vocational rehabilitation program PY2017 - PY2020: Analysis of service outcomes and related factors

BACKGROUND: Customized employment (CE) is positively correlated with competitive integrated employment (CIE) outcomes and potentially supports transition-age youth in achieving sustainable employment. OBJECTIVE: This study examines the employment outcomes and related factors for transition-age youth with disabilities who received CE services through state vocational rehabilitation agencies (SVRAs) and their vendors from program year 2017 to 2020. METHODS: Employing a combination of descriptive analysis, binary logistic and multiple regression, chi-square tests, and t-tests, the study investigates the demographics, potential barriers, and vocational rehabilitation (VR) services received by the research sample using the RSA-911 dataset. RESULTS: The sample comprised 672 individuals with a mean age of 22.30 years. The most prevalent barrier to employment among CE participants was long-term unemployment, while Supplemental Security Income (SSI) was the most common social security benefit. Furthermore, only 13.2% of transition-age youth achieved CIE status, compared to 30.1% of adults. The key predictors of employment outcomes, including CIE status, weekly earnings, and working hours were identified. CONCLUSION: The research reveals significant differences in employment outcomes between transition-age youth and adult VR consumers. These insights emphasize the necessity for SVRAs to consider a range of factors, including demographics, potential employment barriers, and the effects of various VR services, to increase the CE service effectiveness for transition-age youth.

The time is now: Increasing competitive integrated employment opportunities for all Americans with disabilities

We are pleased to share with you an important written testimony submitted for Senator Bob Casey’s Hearing in the U.S. Senate on “All Means All: Empowering People with Disabilities in Careers and in the Workplace.” This testimony was provided by Dr. Lauren Avellone, Associate Professor at the Virginia Commonwealth University –Rehabilitation Research and Training Center. This testimony took place on Thursday February 29, 2024. Her testimony focused on the positive impact of competitive integrated employment on people with high support needs working within the United States, the need to eliminate 14c certificates which enable subminimum wages to be paid to people with disabilities, and solutions for achieving greater employment outcomes for all people with disabilities who would like to obtain employment. Statement from Dr. Paul Wehman, Editor-in-Chief of the Journal of Vocational Rehabilitation

“Every day you are working you have to prove it”: Navigating the costs of work and ableism with visual impairment

BACKGROUND: People with visual impairment often need many items that their sighted counterparts do not, such as assistive devices, transportation services, and other disability-related goods and services. Acquiring these items represents a major barrier to the employment of people with visual impairment. OBJECTIVE: This study aimed to explore the nature of disability-related employment costs as they relate to engagement in the labor market of people with visual impairment. METHODS: The research consisted of a qualitative analysis of interviews and focus groups with 15 visually impaired adults from the New York metro area. RESULTS: What emerged were the costs of accessing and maintaining employment— particularly related to meeting the expectations of expediency in the modern world— in areas like communication and transportation. These costs interacted with perceived ableism in the labor market and created a climate of job scarcity and anxiety, which came at additional cost to participants who felt stuck in low-paying work. CONCLUSIONS: Further research is needed on the impact of perceived ableism and disability-related employment costs, and on decreasing barriers to programs that may ameliorate these costs, such as vocational rehabilitation services. Such research would inform policy interventions geared toward enhancing disabled people’s participation in the labor market.

Associations of Mortality Outcomes With Employment Status at Discharge From VA Vocational Rehabilitation Service Programs.

The authors evaluated associations between employment at discharge from Veterans Health Administration Vocational Rehabilitation Service (VR) programs and suicide and other causes of death. For veterans receiving VR between October 1, 2005, and September 30, 2014 (N=78,293), proportional hazards analyses were used to test associations of employment with suicide, drug overdose, and external and natural cause mortality rates over 1 and 5 years postdischarge and through December 31, 2019. The analyses were adjusted for clinical and sociodemographic characteristics and propensity for employment. Of the veterans, 94.1% had a psychiatric diagnosis, and 35.5% were employed at VR discharge. In proportional hazards analyses, employment was associated with lower mortality rates through 1 year (suicide, hazard ratio [HR]=0.54; overdose, HR=0.70; external causes, HR=0.62; and natural causes, HR=0.51) and 5 years postdischarge (overdose, HR=0.72; external causes, HR=0.81; and natural causes, HR=0.72). Through December 31, 2019, employment was associated with lower risks for overdose (HR=0.80) and death by external (HR=0.81) and natural (HR=0.80) causes. Employment at VR discharge was associated with lower mortality risk among veterans with psychiatric diagnoses.

SOCIAL REHABILITATION OF CHILDREN AND YOUTH WITH SPECIAL EDUCATIONAL NEEDS OF MEANS OF MUSEUM PEDAGOGY

The article presents the aspects of social rehabilitation of children and youth with special educational needs that require new ways of solving them. The author notes that museum pedagogy is an effective way to solve existing problems in the social rehabilitation of children and youth with special educational needs. The purpose of the article is to theoretically substantiate the effectiveness of using museum pedagogy in the implementation of social rehabilitation of children and youth with special educational needs. The methods used to study this issue include the analysis of scientific literature on social work and museum pedagogy and its generalization. During social rehabilitation, attention should be paid to the following aspects: psychosocial support, social adaptation, vocational rehabilitation, medical care, educational initiatives, work with children and youth, and social partnership. The author believes that the model of social rehabilitation of children and youth through museum pedagogy is an innovative service in social work. Among the possibilities of museum pedagogy are interactive museum expositions, adapted excursions and programs, museum therapy, creative workshops, developmental games and exercises, inclusive groups, social interaction and the use of various technologies. Prospects for further research include the study of intersectoral cooperation with educational institutions, social services, local governments, inclusive resource centers, rehabilitation centers, medical institutions, NGOs and youth centers. It also includes studying the practical implementation of the innovative model.

Self-Perceived Interpersonal Problems Among Long-Term Unemployed Individuals, and Vocational Rehabilitation Programs (In)ability to Change Them.

Self-perceived interpersonal problems can challenge one's access to the work market, making it harder to attain and keep a job while adding to the distress of being outside of the labor market. In this study, we compared the self-perceived interpersonal problems among long-term unemployed individuals taking part in vocational rehabilitation programs (VRPs) (N = 220) with those of the general population. In addition, we examined whether their self-perceived interpersonal problems changed while taking part in the VRPs. We found that participants report significantly higher levels of self-perceived interpersonal problems as measured by the Inventory of Interpersonal Problems (IIP), especially with regard to feeling cold/distanced, socially inhibited, vindictive/self-centered, and non-assertive. The participants did not report a significant decrease in self-perceived interpersonal problems after being part of VRPs for one year. These results are relevant as they may inform interventions targeted this population aimed at increasing employability and/or individual well-being. Importantly, the findings may be viewed as a reflection of both social and individual processes. Long-term unemployed individuals' tendency to feel insufficiently engaged may reflect difficulty with keeping up with a job market in constant change.

Persistent physical symptoms and mental health problems among individuals seeking work rehabilitation

Persistent Physical Symptoms (PPS) are symptoms without a known biological cause. They are common and associated with psychological distress, work disability and unemployment. This study aimed to examine the prevalence of PPS and their association with clinical levels of general anxiety, depression, social anxiety, health anxiety or post traumatic symptoms in a work rehabilitation setting and to identify individuals within that setting that might benefit from psychological treatment for PPS. A sample of 324 individuals seeking work rehabilitation filled out questionnaires measuring PPS and mental health problems. To estimate how many service seekers might benefit from psychological treatment for PPS we identified participants who reported both PPS and psychological distress, defined as an elevated score on measures of general anxiety, depression or health anxiety. Eighty point nine percent of participants reported having one or more PPS and 61.7% reported having two or more. Those with PPS were more likely to report clinical levels of depression, anxiety and health anxiety than those without and the number of PPS was positively correlated with symptoms of depression, anxiety and health anxiety. Almost 65% of the participants were identified as having PPS, being psychologically distressed and willing to accept psychological treatment. There is a clear need for specialized treatment for PPS within vocational rehabilitation in Iceland as service seekers commonly have PPS, are psychologically distressed and are willing to accept psychological treatment. Such treatment should preferably be transdiagnostic as the prevalence of multiple PPS is high in this sample.