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{{Copyvio |timestamp=20240701200513 |url=https://vra-uk.org/node/6}}

{{Short description|Occupation rehabilitation processes}}
[[File:Born a Man.webm|right|thumb|A 1964 educational film on vocational rehabilitation and [[Orientation and Mobility]] for a newly blind man, made with assistance from the [[California Department of Rehabilitation]].]]
[[File:Born a Man.webm|right|thumb|A 1964 educational film on vocational rehabilitation and [[Orientation and Mobility]] for a newly blind man, made with assistance from the [[California Department of Rehabilitation]].]]
'''Vocational rehabilitation''', also abbreviated '''VR''' or '''voc rehab''', is a process which enables persons with functional, psychological, developmental, cognitive, and emotional disabilities, impairments or health disabilities to overcome barriers to accessing, maintaining, or returning to employment or other useful occupations.{{Citation needed|date=May 2020|reason=The previous citation was incorrect}}
'''Vocational rehabilitation''', also abbreviated '''VR''' or '''voc rehab''', is a process which enables persons with functional, psychological, developmental, cognitive, and emotional disabilities, impairments or health disabilities to overcome barriers to accessing, maintaining, or returning to employment or other useful occupations.{{Citation needed|date=May 2020|reason=The previous citation was incorrect}}
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}}
}}


Vocational rehabilitation can require input from a range of health care professionals and other non-medical disciplines such as disability employment advisers, career counsellors and rehabilitation counsellors. Whilst, traditionally, the focus of vocational rehabilitation was job retention, an increased focus on an all-encompassing approach has become popular in contemporary approaches.<ref name=":0">{{Cite journal|last=Ross|first=Joanna|date=2012|title=The current state of vocational rehabilitation services|journal=Work, Health and Wellbeing: The Challenges of Managing Health at Work|publisher=Bristol University Press|pages=95–117}}</ref> Approaches differ between countries, however, due to the differing amounts of financial and political support vocational rehabilitation receives.<ref name=":0" />
Vocational rehabilitation can require input from a range of health care professionals and other non-medical disciplines such as disability employment advisers and career counsellors. Whilst, traditionally, the focus of vocational rehabilitation was job retention, an increased focus on an all-encompassing approach has become popular in contemporary approaches.<ref name=":0">{{Cite journal|last=Ross|first=Joanna|date=2012|title=The current state of vocational rehabilitation services|journal=Work, Health and Wellbeing: The Challenges of Managing Health at Work|publisher=Bristol University Press|pages=95–117}}</ref> Approaches differ between countries, however, due to the differing amounts of financial and political support vocational rehabilitation receives.<ref name=":0" />

In 2008, the UN introduced the “International [[Convention on the Rights of Persons with Disabilities]]” which provided internationally recognised rights to people with disabilities.<ref name=":8">Pechak, C., & Thompson, M. (2007). ''Disability and Rehabilitation in Developing Countries'' [Lecture]. Texas Woman’s University, Dallas, Texas. https://www.cugh.org/sites/default/files/105_Disability_and_Rehabilitation_in_Developing_Countries_FINAL_0.pdf</ref> It is often argued that this convention redefined the understanding of disability adopted by governments and further changed the way in which disability related issues were approached.<ref>{{cite journal |last1=Liasidou |first1=Anastasia |title=Disabling discourses and human rights law: a case study based on the implementation of the UN Convention on the Rights of People with Disabilities |journal=Discourse: Studies in the Cultural Politics of Education |date=2 January 2016 |volume=37 |issue=1 |pages=149–162 |doi=10.1080/01596306.2014.936928 |s2cid=144718937 }}</ref>


== Summary ==
== Summary ==
{{See also|Occupational rehabilitation}}Vocational rehabilitation varies greatly between countries.  However, it generally focuses on improvements to the socialisation, healthcare and physical and mental wellbeing of the person receiving the services.<ref name=":10">{{Cite web|title=What is Vocational Rehabilitation|url=https://clik.dva.gov.au/rehabilitation-policy-library/9-vocational-rehabilitation/91-what-vocational-rehabilitation|date=2016|website=Australian Government. Department of Veterans’ Affairs|access-date=2020-05-20}}</ref> People eligible for vocational rehabilitation generally include those with long-term sicknesses, mental health disorders, common health problems and severe medical conditions.<ref>{{Cite book|last=Waddell, Gordon.|title=Vocational rehabilitation : what works, for whom, and when?|date=2008|publisher=TSO|others=Burton, A. Kim., Kendall, Nicholas.|isbn=978-0-11-703861-5|location=[Great Britain]|oclc=241013190}}</ref> Services offered to those who are eligible commonly include financial support, psychological support and social support.<ref name=":0" /> There are a range of techniques utilised in the process of rehabilitation, including:
Vocational rehabilitation varies greatly between countries.  However, it generally focuses on improvements to the socialisation, healthcare and physical and mental wellbeing of the person receiving the services.<ref name=":10">{{Cite web|title=What is Vocational Rehabilitation|url=https://clik.dva.gov.au/rehabilitation-policy-library/9-vocational-rehabilitation/91-what-vocational-rehabilitation|date=2016|website=Australian Government. Department of Veterans’ Affairs|access-date=2020-05-20}}</ref> People eligible for vocational rehabilitation generally include those with long-term sicknesses, mental health disorders, common health problems and severe medical conditions.<ref>{{Cite book|last=Waddell, Gordon.|title=Vocational rehabilitation : what works, for whom, and when?|date=2008|publisher=TSO|others=Burton, A. Kim., Kendall, Nicholas.|isbn=978-0-11-703861-5|location=[Great Britain]|oclc=241013190}}</ref> Services offered to those who are eligible commonly include financial support, psychological support and social support.<ref name=":0" /> There are a range of techniques utilised in the process of rehabilitation, including:


* assessment, appraisal, program evaluation, and research;
* assessment, appraisal, program evaluation, and research;
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*[[Medical case management|case management]], referral, and service co-ordination;
*[[Medical case management|case management]], referral, and service co-ordination;
*[[psychosocial]] interventions;
*[[psychosocial]] interventions;
* career and rehabilitation counselling, job analysis, job development, and placement services;
* career counselling, job analysis, job development, and placement services;
* functional and work capacity evaluations.<ref>{{cite web|title=Process of VR|url=http://www.vra-uk.org/node/6|publisher=Vocational Rehabilitation Association of the UK}}</ref>
* functional and work capacity evaluations.<ref>{{cite web|title=Process of VR|url=http://www.vra-uk.org/node/6|publisher=Vocational Rehabilitation Association of the UK}}</ref>


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There is a large amount of research dedicated to the development and improvement of vocational rehabilitation. Contemporary focus on vocational rehabilitation arose from an increased focus on social security systems on a governmental level.<ref name=":0" /> It is believed to be beneficial for people to return to work and to experience full integration into society, which is typically assisted by vocational rehabilitation.<ref name=":1">{{cite journal |last1=Frank |first1=Andrew |title=Vocational Rehabilitation: Supporting Ill or Disabled Individuals in (to) Work: A UK Perspective |journal=Healthcare |date=16 July 2016 |volume=4 |issue=3 |pages=46 |doi=10.3390/healthcare4030046 |pmid=27438864 |pmc=5041047 |doi-access=free }}</ref> Moreover, rehabilitation programs encourage fewer people to rely on governmental financial support by facilitating greater movement into jobs for people with disabilities who, typically, are excluded from the workforce.<ref name=":46">{{Cite web|title=jobs for people with disabilities|url=https://apm.net.au/individuals/disability-employment-services/searching-for-work|date=2020-12-23}}</ref><ref>{{Cite book|title=Vocational rehabilitation|date=2006|publisher=Springer|others=Gobelet, C. (Charles), Franchignoni, F. (Franco)|isbn=978-2-287-29745-8|location=Paris|oclc=262692000}}</ref>
There is a large amount of research dedicated to the development and improvement of vocational rehabilitation. Contemporary focus on vocational rehabilitation arose from an increased focus on social security systems on a governmental level.<ref name=":0" /> It is believed to be beneficial for people to return to work and to experience full integration into society, which is typically assisted by vocational rehabilitation.<ref name=":1">{{cite journal |last1=Frank |first1=Andrew |title=Vocational Rehabilitation: Supporting Ill or Disabled Individuals in (to) Work: A UK Perspective |journal=Healthcare |date=16 July 2016 |volume=4 |issue=3 |pages=46 |doi=10.3390/healthcare4030046 |pmid=27438864 |pmc=5041047 |doi-access=free }}</ref> Moreover, rehabilitation programs encourage fewer people to rely on governmental financial support by facilitating greater movement into jobs for people with disabilities who, typically, are excluded from the workforce.<ref name=":46">{{Cite web|title=jobs for people with disabilities|url=https://apm.net.au/individuals/disability-employment-services/searching-for-work|date=2020-12-23}}</ref><ref>{{Cite book|title=Vocational rehabilitation|date=2006|publisher=Springer|others=Gobelet, C. (Charles), Franchignoni, F. (Franco)|isbn=978-2-287-29745-8|location=Paris|oclc=262692000}}</ref>


There is a large cultural influence on approaches to disability and subsequently, disability services.<ref name=":8" /> Developed countries such as the US, UK and Australia have had systems in place for rehabilitation services for many years.<ref name=":0" /> Developing countries, however, have historically been more focused on combatting diseases and thus, have had less resources to dedicate to the development of rehabilitation programs.<ref name=":8" /> There is large amounts of stigma surrounding disability in developing countries.<ref name=":8" /> As a result, there is a lack of vocational rehabilitation programs in these countries which in turn has consequences on the economic and social development within them.<ref name=":8" /> The World Health Organisation, however, have implemented programs within developing countries in order to better establish their rehabilitation plans for people with disabilities.<ref name=":8" />
There is a large cultural influence on approaches to disability and subsequently, disability services.<ref name=":8">Pechak, C., & Thompson, M. (2007). ''Disability and Rehabilitation in Developing Countries'' [Lecture]. Texas Woman’s University, Dallas, Texas. https://www.cugh.org/sites/default/files/105_Disability_and_Rehabilitation_in_Developing_Countries_FINAL_0.pdf</ref> Developed countries such as the US, UK and Australia have had systems in place for rehabilitation services for many years.<ref name=":0" /> Developing countries, however, have historically been more focused on combatting diseases and thus, have had less resources to dedicate to the development of rehabilitation programs.<ref name=":8" /> There is large amounts of stigma surrounding disability in developing countries.<ref name=":8" /> As a result, there is a lack of vocational rehabilitation programs in these countries which in turn has consequences on the economic and social development within them.<ref name=":8" /> The World Health Organisation, however, have implemented programs within developing countries in order to better establish their rehabilitation plans for people with disabilities.<ref name=":8" />


Whilst it is a popularly used form of intervention throughout many countries, vocational rehabilitation is often criticised for being inefficient and unsuccessful.<ref name=":6">{{cite journal |last1=Murphy |first1=Lesley |last2=Chamberlain |first2=Elaine |last3=Weir |first3=Jim |last4=Berry |first4=Alister |last5=Nathaniel-James |first5=David |last6=Agnew |first6=Robert |title=Effectiveness of vocational rehabilitation following acquired brain injury: Preliminary evaluation of a UK specialist rehabilitation programme |journal=Brain Injury |date=January 2006 |volume=20 |issue=11 |pages=1119–1129 |doi=10.1080/02699050600664335 |pmid=17123928 |s2cid=26484139 }}</ref> Furthermore, some critics claim that there is not enough emphasis placed on women with disabilities in need of vocational rehabilitation services.<ref>{{cite journal |id={{ProQuest|57813522}} |last=Stace |first=Sheila |date=1987 |title=Vocational rehabilitation for women with disabilities |journal=International Labour Review |volume=126 |pages=301–316 }}</ref>
Whilst it is a popularly used form of intervention throughout many countries, vocational rehabilitation is often criticised for being inefficient and unsuccessful.<ref name=":6">{{cite journal |last1=Murphy |first1=Lesley |last2=Chamberlain |first2=Elaine |last3=Weir |first3=Jim |last4=Berry |first4=Alister |last5=Nathaniel-James |first5=David |last6=Agnew |first6=Robert |title=Effectiveness of vocational rehabilitation following acquired brain injury: Preliminary evaluation of a UK specialist rehabilitation programme |journal=Brain Injury |date=January 2006 |volume=20 |issue=11 |pages=1119–1129 |doi=10.1080/02699050600664335 |pmid=17123928 |s2cid=26484139 }}</ref> Furthermore, some critics claim that there is not enough emphasis placed on women with disabilities in need of vocational rehabilitation services.<ref>{{cite journal |id={{ProQuest|57813522}} |last=Stace |first=Sheila |date=1987 |title=Vocational rehabilitation for women with disabilities |journal=International Labour Review |volume=126 |pages=301–316 }}</ref>


== Professionals involved ==
== Vocational rehabilitation in the United States ==
[[Occupational therapist]]s<ref name="Keough"/><ref name=Hoefsmit2012>{{cite journal |last1=Hoefsmit |first1=Nicole |last2=Houkes |first2=Inge |last3=Nijhuis |first3=Frans J.N. |date=December 2012 |title=Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review |journal=Journal of Occupational Rehabilitation |volume=22 |issue=4 |pages=462–77 |doi=10.1007/s10926-012-9359-z |pmid=22476607 |pmc=3484272 }}</ref>are the core profession in vocational rehab. The role of occupational therapists in the workplace is to facilitate individuals' ability to return to work. Occupational therapists assist their clients in reaching their maximum level of function with the aim of meeting the physical and emotional demands of their job. Occupational therapists are also qualified to make recommendations to employers on how to adapt job demands to meet the functional status of an employee in order to prevent further injury and enable productivity during occupational rehabilitation. Individual functional capacity evaluations are used to screen for [[Person-environment-work task fit|person-environment fit]]. Industrial occupational therapists use a collaborative approach involving the workers and employers to encourage a supportive work environment that empowers the worker to reach productivity and other work related goals.<ref name="Keough">{{cite journal |last1=Keough |first1=Jeremy L. |last2=Fisher |first2=Thomas F. |date=2001 |title=Occupational-psychosocial perceptions influencing return to work and functional performance of injured workers |journal=Work |volume=16 |issue=2 |pages=101–110 |pmid=12441463 }} {{subscription required}}</ref> Occupational therapy interventions in vocational rehabilitation include developing assertiveness; communication and interpersonal skills; controlling anger; and stress management, adapting environment, identification and use of compensatory strategies to enable functions within the job.<ref name="Keough" />


Other involved professionals may be [[Occupational psychologist|occupational psychologists]], [[Physiotherapist|physiotherapists]], [[Kinesiology|kinesiologists]], occupational physiologists, and [[Occupational medicine|occupational physicians]].
=== History ===

== By location ==

=== Vocational rehabilitation in the United States ===

==== History ====
The Vocational Rehabilitation Program was created in 1920.<ref name=":2">{{Cite web|title=Rehabilitation Services Administration (RSA) - Home Page|url=https://www2.ed.gov/about/offices/list/osers/rsa/index.html|last=Rhodes|first=Geoffrey|date=2020-01-23|website=www2.ed.gov|language=en|access-date=2020-05-19}}</ref> This program was created under the supervision of the [[Rehabilitation Services Administration]] (RSA) which was formed by the US government to facilitate a variety of programs for vocational rehabilitation.<ref name=":2" />
The Vocational Rehabilitation Program was created in 1920.<ref name=":2">{{Cite web|title=Rehabilitation Services Administration (RSA) - Home Page|url=https://www2.ed.gov/about/offices/list/osers/rsa/index.html|last=Rhodes|first=Geoffrey|date=2020-01-23|website=www2.ed.gov|language=en|access-date=2020-05-19}}</ref> This program was created under the supervision of the [[Rehabilitation Services Administration]] (RSA) which was formed by the US government to facilitate a variety of programs for vocational rehabilitation.<ref name=":2" />


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By the end of the 20th century, a number of services were created to facilitate support for vocational rehabilitation.<ref name=":11">{{Cite book|title=Handbook of vocational psychology|date=1983|publisher=Lawrence Erlbaum Associates|others=Walsh, W. Bruce, Osipow, Samuel H.|isbn=0-89859-285-2|location=Hillsdale, N.J.|oclc=9441241}}</ref> In the 1980s, jobs specifically for people with disabilities were created and the idea of ‘equal access’ became more widespread.<ref name=":12">{{cite journal |last1=Bryen |first1=Diane N. |last2=Hakim |first2=Shimon |last3=Molcho |first3=Malca |last4=Newman |first4=Edward |last5=Taler |first5=Yechezkel |last6=Shouval |first6=Lea |last7=Reiter |first7=Shunit |title=The Vocational Rehabilitation Systems in Israel and in the United States |journal=Special Education and Rehabilitation / חינוך מיוחד ושיקום |date=1985 |volume=1 |issue=1 |pages=64–154 |jstor=23448362 }}</ref> The ‘Americans with Disabilities Act’ was implemented in 1990 and afforded people with disabilities the same set of rights that had historically been granted to women and marginalised groups.<ref name=":11" />
By the end of the 20th century, a number of services were created to facilitate support for vocational rehabilitation.<ref name=":11">{{Cite book|title=Handbook of vocational psychology|date=1983|publisher=Lawrence Erlbaum Associates|others=Walsh, W. Bruce, Osipow, Samuel H.|isbn=0-89859-285-2|location=Hillsdale, N.J.|oclc=9441241}}</ref> In the 1980s, jobs specifically for people with disabilities were created and the idea of ‘equal access’ became more widespread.<ref name=":12">{{cite journal |last1=Bryen |first1=Diane N. |last2=Hakim |first2=Shimon |last3=Molcho |first3=Malca |last4=Newman |first4=Edward |last5=Taler |first5=Yechezkel |last6=Shouval |first6=Lea |last7=Reiter |first7=Shunit |title=The Vocational Rehabilitation Systems in Israel and in the United States |journal=Special Education and Rehabilitation / חינוך מיוחד ושיקום |date=1985 |volume=1 |issue=1 |pages=64–154 |jstor=23448362 }}</ref> The ‘Americans with Disabilities Act’ was implemented in 1990 and afforded people with disabilities the same set of rights that had historically been granted to women and marginalised groups.<ref name=":11" />


=== Current ===
==== Current ====
Currently, a variety of federal services exist to facilitate vocational rehabilitation in the United States. The Department of Disability Services has a dedicated sect to vocational rehabilitation services where applicants are provided with a counsellor to develop an Individual Plan for Employment.<ref name=":3">{{Cite web|title=Vocational Rehabilitation Services {{!}} dds|url=https://dds.dc.gov/service/vocational-rehabilitation-services|website=dds.dc.gov|access-date=2020-05-19}}</ref> The Office of Disability Employment Policy further facilitates employment opportunities for people with disabilities.<ref>{{Cite web|title=Office of Disability Employment Policy - United States Department of Labor|url=https://www.dol.gov/odep/|website=www.dol.gov|access-date=2020-05-19}}</ref>
Currently, a variety of federal services exist to facilitate vocational rehabilitation in the United States. The Department of Disability Services has a dedicated sect to vocational rehabilitation services where applicants are provided with a counsellor to develop an Individual Plan for Employment.<ref name=":3">{{Cite web|title=Vocational Rehabilitation Services {{!}} dds|url=https://dds.dc.gov/service/vocational-rehabilitation-services|website=dds.dc.gov|access-date=2020-05-19}}</ref> The Office of Disability Employment Policy further facilitates employment opportunities for people with disabilities.<ref>{{Cite web|title=Office of Disability Employment Policy - United States Department of Labor|url=https://www.dol.gov/odep/|website=www.dol.gov|access-date=2020-05-19}}</ref>


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The US Department of Veterans Affairs offers vocational rehabilitation programs specifically for veterans whose disabilities are related to their years in active service.<ref name=":4">{{Cite web|title=VA Vocational Rehabilitation (Chapter 31)|url=https://www.va.gov//careers-employment/vocational-rehabilitation|date=2020-04-30|website=Veterans Affairs|language=en|access-date=2020-05-19}}</ref> Such programs include employment assistance, business assistance and job retention.<ref name=":4" /> All veterans are provided with a Vocational Rehabilitation Counsellor to create a rehabilitation program.<ref name=":18">{{cite journal |last1=Gade |first1=D. M. |last2=Wilkins |first2=V. M. |title=Where Did You Serve? Veteran Identity, Representative Bureaucracy, and Vocational Rehabilitation |journal=Journal of Public Administration Research and Theory |date=1 April 2013 |volume=23 |issue=2 |pages=267–288 |doi=10.1093/jopart/mus030 |doi-access=free }}</ref> These counsellors tend to dictate the success of individual rehabilitation programs, particularly through the relationship developed between the veteran and the counsellor.<ref name=":18" />
The US Department of Veterans Affairs offers vocational rehabilitation programs specifically for veterans whose disabilities are related to their years in active service.<ref name=":4">{{Cite web|title=VA Vocational Rehabilitation (Chapter 31)|url=https://www.va.gov//careers-employment/vocational-rehabilitation|date=2020-04-30|website=Veterans Affairs|language=en|access-date=2020-05-19}}</ref> Such programs include employment assistance, business assistance and job retention.<ref name=":4" /> All veterans are provided with a Vocational Rehabilitation Counsellor to create a rehabilitation program.<ref name=":18">{{cite journal |last1=Gade |first1=D. M. |last2=Wilkins |first2=V. M. |title=Where Did You Serve? Veteran Identity, Representative Bureaucracy, and Vocational Rehabilitation |journal=Journal of Public Administration Research and Theory |date=1 April 2013 |volume=23 |issue=2 |pages=267–288 |doi=10.1093/jopart/mus030 |doi-access=free }}</ref> These counsellors tend to dictate the success of individual rehabilitation programs, particularly through the relationship developed between the veteran and the counsellor.<ref name=":18" />


=== Criticisms ===
==== Criticisms ====
Of people who suffered traumatic brain injury and used vocational rehabilitation services in the state of Missouri, only 17% were successful in their employment at the time of their case closure.<ref>{{cite journal |last1=Johnstone |first1=Brick |last2=Vessell |first2=Ron |last3=Bounds |first3=Thomas |last4=Hoskins |first4=Sue |last5=Sherman |first5=Ashley |title=Predictors of success for state vocational rehabilitation clients with traumatic brain injury |journal=Archives of Physical Medicine and Rehabilitation |date=February 2003 |volume=84 |issue=2 |pages=161–167 |doi=10.1053/apmr.2003.50098 |pmid=12601645 }}</ref> Furthermore, only 20.5% of the United States labour force is made up of people with disabilities and on average they are paid about 37% less.<ref name=":13">{{cite journal |last1=Tansey |first1=Timothy N. |last2=Dutta |first2=Alo |last3=Kundu |first3=Madan |last4=Chan |first4=Fong |title=From admiration of the problem to action: Addressing the limited success in vocational rehabilitation of persons from diverse racial and cultural backgrounds |journal=Journal of Vocational Rehabilitation |date=22 August 2016 |volume=45 |issue=2 |pages=117–119 |doi=10.3233/JVR-160816 |doi-access=free }}</ref> Vocational rehabilitation further tends to cater to advantaged communities, with people from disadvantaged backgrounds less likely to reach out for vocational rehabilitation services and are furthermore, less likely to be found to be eligible.<ref name=":13" />
Of people who suffered traumatic brain injury and used vocational rehabilitation services in the state of Missouri, only 17% were successful in their employment at the time of their case closure.<ref>{{cite journal |last1=Johnstone |first1=Brick |last2=Vessell |first2=Ron |last3=Bounds |first3=Thomas |last4=Hoskins |first4=Sue |last5=Sherman |first5=Ashley |title=Predictors of success for state vocational rehabilitation clients with traumatic brain injury |journal=Archives of Physical Medicine and Rehabilitation |date=February 2003 |volume=84 |issue=2 |pages=161–167 |doi=10.1053/apmr.2003.50098 |pmid=12601645 }}</ref> Furthermore, 20.5% of people with disabilities enter the United States labour force and on average they are paid about 37% less.<ref name=":13">{{cite journal |last1=Tansey |first1=Timothy N. |last2=Dutta |first2=Alo |last3=Kundu |first3=Madan |last4=Chan |first4=Fong |title=From admiration of the problem to action: Addressing the limited success in vocational rehabilitation of persons from diverse racial and cultural backgrounds |journal=Journal of Vocational Rehabilitation |date=22 August 2016 |volume=45 |issue=2 |pages=117–119 |doi=10.3233/JVR-160816 |doi-access=free }}</ref> Vocational rehabilitation further tends to cater to advantaged communities, with people from disadvantaged backgrounds less likely to reach out for vocational rehabilitation services and are furthermore, less likely to be found to be eligible.<ref name=":13" />


=== State agencies ===
==== State agencies ====
There are different agencies in the US that run VR programs, including the following:<ref>{{Cite web|title=State Vocational Rehabilitation Agencies|url=https://askearn.org/state-vocational-rehabilitation-agencies/|language=en-US|access-date=2020-05-22}}</ref>
There are different agencies in the US that run VR programs, including the following:<ref>{{Cite web|title=State Vocational Rehabilitation Agencies|url=https://askearn.org/state-vocational-rehabilitation-agencies/|language=en-US|access-date=2020-05-22}}</ref>
{{Incomplete list|date=June 2022}}
{{Incomplete list|date=June 2022}}
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|[[Missouri Department of Elementary and Secondary Education]], Vocational Rehabilitation
|[[Missouri Department of Elementary and Secondary Education]], Vocational Rehabilitation
|3024 Dupont Circle, [[Jefferson City, Missouri|Jefferson City]]
|3024 Dupont Circle, [[Jefferson City, Missouri|Jefferson City]]
|
|-
|[[Oregon Department of Human Services]], Vocational Rehabilitation<ref>{{Cite web|title=Oregon Department of Human Services : Vocational Rehabilitation Services|url=https://scvrd.net/|website=Oregon Department of Human Services : Vocational Rehabilitation Services|language=en-US|access-date=2024-05-23}}</ref>
|500 Summer St NE, E87, [[Salem, Oregon|Salem]]
|
|
|-
|-
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|}
|}


== Vocational rehabilitation in the United Kingdom ==
=== Vocational rehabilitation in the United Kingdom ===

=== History ===
==== History ====
Vocational rehabilitation has been in practice in the UK since the early 1900s.<ref>Vocational Rehabilitation Association. (2007). ''Vocational Rehabilitation Standards of Practice.''</ref> However, initially it was simply seen as a measure taken after the individual had received the necessary medical treatment.<ref name=":1" /> In 1946, the ‘Egham Industrial Rehabilitation Centre in Surry’ became open for public use, following the Second World War.<ref name=":5">{{Cite web|title=Disability, Rehabilitation and Work {{!}} Historic England|url=http://historicengland.org.uk/research/inclusive-heritage/disability-history/1945-to-the-present-day/disability-rehabilitation-and-work/|website=historicengland.org.uk|language=en|access-date=2020-05-19}}</ref> In 1951, the National Health Service (NHS) had primary control over rehabilitation services, offering a variety of programs.<ref name=":5" /> However, in the 1980s, the recession in the UK saw a decline in focus on vocational rehabilitation.<ref name=":0" /> The NHS shut down many of their rehabilitation service centres which consequently led the Department of Employment to take over responsibility for rehabilitation services.<ref name=":1" />
Vocational rehabilitation has been in practice in the UK since the early 1900s.<ref>Vocational Rehabilitation Association. (2007). ''Vocational Rehabilitation Standards of Practice.''</ref> However, initially it was simply seen as a measure taken after the individual had received the necessary medical treatment.<ref name=":1" /> In 1946, the ‘Egham Industrial Rehabilitation Centre in Surry’ became open for public use, following the Second World War.<ref name=":5">{{Cite web|title=Disability, Rehabilitation and Work {{!}} Historic England|url=http://historicengland.org.uk/research/inclusive-heritage/disability-history/1945-to-the-present-day/disability-rehabilitation-and-work/|website=historicengland.org.uk|language=en|access-date=2020-05-19}}</ref> In 1951, the National Health Service (NHS) had primary control over rehabilitation services, offering a variety of programs.<ref name=":5" /> However, in the 1980s, the recession in the UK saw a decline in focus on vocational rehabilitation.<ref name=":0" /> The NHS shut down many of their rehabilitation service centres which consequently led the Department of Employment to take over responsibility for rehabilitation services.<ref name=":1" />


From 2000 to 2002 the Vocational Rehabilitation Association led a government funded research project into vocational rehabilitation and how to better improve it in the UK. By 2003 nearly 2.7 million people in the UK were receiving government disability benefits which the government could not sustain.<ref name=":1" /> Such large numbers indicated the lack of vocational rehabilitation services throughout the UK.<ref name=":1" /> As a result, ‘Jobcentre’ was created to facilitate work services for disability, overseen by the Department for Work & Pensions.<ref>{{Cite web|title=Looking for work if you're disabled|url=https://www.gov.uk/looking-for-work-if-disabled|website=GOV.UK|language=en|access-date=2020-05-19}}</ref>
From 2000 to 2002 the Vocational Rehabilitation Association led a government funded research project into vocational rehabilitation and how to better improve it in the UK. By 2003 nearly 2.7 million people in the UK were receiving government disability benefits which the government could not sustain.<ref name=":1" /> Such large numbers indicated the lack of vocational rehabilitation services throughout the UK.<ref name=":1" /> As a result, ‘Jobcentre’ was created to facilitate work services for disability, overseen by the Department for Work & Pensions.<ref>{{Cite web|title=Looking for work if you're disabled|url=https://www.gov.uk/looking-for-work-if-disabled|website=GOV.UK|language=en|access-date=2020-05-19}}</ref>


=== Current ===
==== Current ====
Currently, a variety of services are in place to facilitate vocational rehabilitation. In 2005, the Department of Health released “The National Service Framework for Long-term Conditions”. The report was a part of a government plan to improve support for those with long-term health conditions<ref>Department of Health. (2005). ''The National Service Framework for Long-term Conditions.''</ref> and worked closely with improvements to the NHS, who are in part responsible for assisting those in need of vocational rehabilitation.<ref name=":14">British Society of Rehabilitation Medicine. (2003). ''Vocational Rehabilitation- The Way Forward.''</ref>
Currently, a variety of services are in place to facilitate vocational rehabilitation. In 2005, the Department of Health released “The National Service Framework for Long-term Conditions”. The report was a part of a government plan to improve support for those with long-term health conditions<ref>Department of Health. (2005). ''The National Service Framework for Long-term Conditions.''</ref> and worked closely with improvements to the NHS, who are in part responsible for assisting those in need of vocational rehabilitation.<ref name=":14">British Society of Rehabilitation Medicine. (2003). ''Vocational Rehabilitation- The Way Forward.''</ref>


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JobCentre Plus provides people in vocational rehabilitation programs with a variety of services to support their rehabilitation process. Firstly, they provide Disability Employment Advisors which supervise the process of somebody returning to and staying in the workplace.<ref name=":6"/> They also provide the Alternative and Augmentative Communication scheme to facilitate those with limited communication skills in the workplace, and the Access to Work Scheme which provides employers of people with disabilities with suitable resources.<ref name=":6"/>
JobCentre Plus provides people in vocational rehabilitation programs with a variety of services to support their rehabilitation process. Firstly, they provide Disability Employment Advisors which supervise the process of somebody returning to and staying in the workplace.<ref name=":6"/> They also provide the Alternative and Augmentative Communication scheme to facilitate those with limited communication skills in the workplace, and the Access to Work Scheme which provides employers of people with disabilities with suitable resources.<ref name=":6"/>


=== Criticisms ===
==== Criticisms ====
Only 14% of brain injury patients in the UK successfully remain at full-time work 30 months after their injury, even after the use of vocational rehabilitation services.<ref name=":6"/> Whilst a large amount of money is put into such services, the average payback period for people who successfully maintain employment is as long as 20 months.<ref name=":6" />
Only 14% of brain injury patients in the UK successfully remain at full-time work 30 months after their injury, even after the use of vocational rehabilitation services.<ref name=":6"/> Whilst a large amount of money is put into such services, the average payback period for people who successfully maintain employment is as long as 20 months.<ref name=":6" />


== Vocational rehabilitation in Australia ==
=== Vocational rehabilitation in Australia ===

=== History ===
==== History ====
The ‘Disability Services Act’ in 1986 created standards for Australians with disabilities and was later amended, in 1993, to include financial support.<ref>{{Cite web|title=Disability Services Act 1986|url=http://www.legislation.gov.au/Details/C2018C00146/Html/Text|last=DSS|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> In 2014, it became the ‘Disability Inclusion Act’ which officially recognised the human rights of people with disabilities.<ref>''Disability Inclusion Act 2014 No 41'' (NSW). Retrieved from https://www.legislation.nsw.gov.au/acts/2014-41.pdf</ref> In 2007, the ‘Disability Services (Rehabilitation Services) Guidelines’ was developed to create outlines on how to provide rehabilitation services in Australia.<ref name=":15">{{Cite web|title=Disability Services (Rehabilitation Services) Guidelines 2017|url=http://www.legislation.gov.au/Details/F2017L00695/Html/Text|last=DSS|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> In 2017, it was amended and included further guidelines on the facilitation of rehabilitation processes.<ref name=":15" /> In 1990 the Australian government created the ‘Disability Reform Package’ which improved financial support for disability related issues.<ref>{{cite journal |last1=Waghorn |first1=Geoff |last2=King |first2=Robert |date=1999 |title=Australian trends in vocational rehabilitation for psychiatric disability |journal=Journal of Vocational Rehabilitation |volume=13 |pages=153–163 }}</ref>
The ‘Disability Services Act’ in 1986 created standards for Australians with disabilities and was later amended, in 1993, to include financial support.<ref>{{Cite web|title=Disability Services Act 1986|url=http://www.legislation.gov.au/Details/C2018C00146/Html/Text|last=DSS|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> In 2014, it became the ‘Disability Inclusion Act’ which officially recognised the human rights of people with disabilities.<ref>''Disability Inclusion Act 2014 No 41'' (NSW). Retrieved from https://www.legislation.nsw.gov.au/acts/2014-41.pdf</ref> In 2007, the ‘Disability Services (Rehabilitation Services) Guidelines’ was developed to create outlines on how to provide rehabilitation services in Australia.<ref name=":15">{{Cite web|title=Disability Services (Rehabilitation Services) Guidelines 2017|url=http://www.legislation.gov.au/Details/F2017L00695/Html/Text|last=DSS|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> In 2017, it was amended and included further guidelines on the facilitation of rehabilitation processes.<ref name=":15" /> In 1990 the Australian government created the ‘Disability Reform Package’ which improved financial support for disability related issues.<ref>{{cite journal |last1=Waghorn |first1=Geoff |last2=King |first2=Robert |date=1999 |title=Australian trends in vocational rehabilitation for psychiatric disability |journal=Journal of Vocational Rehabilitation |volume=13 |pages=153–163 }}</ref>


Vocational rehabilitation is also made available to veterans in Australia, with the ‘Veterans’ Vocational Rehabilitation Scheme’ being created under the ‘Veterans’ Entitlement Act 1986’ which focused on stable employment and further, employment retention for veterans.<ref>{{Cite web|title=Veterans' Vocational Rehabilitation Scheme|url=http://www.legislation.gov.au/Details/F2016C00293/Html/Text|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> The importance of recognising not only physical but mental disabilities of veterans, however, is a recent revelation that has led to an increased focused in programs to support such disabilities.<ref>{{cite journal |last1=Cooper |first1=John A |last2=Creamer |first2=Mark C |last3=Forbes |first3=David |title=Mental health initiatives for veterans and serving personnel |journal=Medical Journal of Australia |date=October 2006 |volume=185 |issue=8 |pages=453 |doi=10.5694/j.1326-5377.2006.tb00646.x |pmid=17137438 |s2cid=34741082 }}</ref>
Vocational rehabilitation is also made available to veterans in Australia, with the ‘Veterans’ Vocational Rehabilitation Scheme’ being created under the ‘Veterans’ Entitlement Act 1986’ which focused on stable employment and further, employment retention for veterans.<ref>{{Cite web|title=Veterans' Vocational Rehabilitation Scheme|url=http://www.legislation.gov.au/Details/F2016C00293/Html/Text|website=www.legislation.gov.au|language=en|access-date=2020-05-20}}</ref> The importance of recognising not only physical but mental disabilities of veterans, however, is a recent revelation that has led to an increased focused in programs to support such disabilities.<ref>{{cite journal |last1=Cooper |first1=John A |last2=Creamer |first2=Mark C |last3=Forbes |first3=David |title=Mental health initiatives for veterans and serving personnel |journal=Medical Journal of Australia |date=October 2006 |volume=185 |issue=8 |pages=453 |doi=10.5694/j.1326-5377.2006.tb00646.x |pmid=17137438 |s2cid=34741082 }}</ref>


=== Current ===
==== Current ====
From 2006, the Australian government introduced a policy where people who were capable of seeking and maintaining employment had an obligation to do so.<ref name=":9">{{cite journal |last1=Buys |first1=Nicholas |last2=Matthews |first2=Lynda R. |last3=Randall |first3=Christine |title=Contemporary vocational rehabilitation in Australia |journal=Disability and Rehabilitation |date=24 April 2015 |volume=37 |issue=9 |pages=820–824 |doi=10.3109/09638288.2014.942001 |pmid=25039621 |hdl=10072/111400 |s2cid=207502034 |hdl-access=free }}</ref> In return countless services and financial support options are made available to facilitate the return to work.<ref name=":9" />
From 2006, the Australian government introduced a policy where people who were capable of seeking and maintaining employment had an obligation to do so.<ref name=":9">{{cite journal |last1=Buys |first1=Nicholas |last2=Matthews |first2=Lynda R. |last3=Randall |first3=Christine |title=Contemporary vocational rehabilitation in Australia |journal=Disability and Rehabilitation |date=24 April 2015 |volume=37 |issue=9 |pages=820–824 |doi=10.3109/09638288.2014.942001 |pmid=25039621 |hdl=10072/111400 |s2cid=207502034 |hdl-access=free }}</ref> In return countless services and financial support options are made available to facilitate the return to work.<ref name=":9" />


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The ‘Employer Incentive Scheme’ (Australian Government, 2016) provides financial support to employers who actively participate in vocational rehabilitation; however, such support is only available if employers comply with ‘Disability Services (Rehabilitation Services) Guidelines’.<ref name=":10" />
The ‘Employer Incentive Scheme’ (Australian Government, 2016) provides financial support to employers who actively participate in vocational rehabilitation; however, such support is only available if employers comply with ‘Disability Services (Rehabilitation Services) Guidelines’.<ref name=":10" />


=== Criticisms ===
==== Criticisms ====
In Australia, there has been limited research dedicated to vocational rehabilitation, with most of the research coming from the United States.<ref name=":16">{{Cite journal|last1=Matthews|first1=Lynda|last2=Buys|first2=Nicholas|last3=Randall|first3=Christine|last4=Biggs|first4=Herbert C.|last5=Hazelwood|first5=Zoe|date=2010|title=Evolution of vocational rehabilitation competencies in Australia|url=https://eprints.qut.edu.au/34500/1/c34500.pdf|journal=International Journal of Rehabilitation Medicine|volume=33|issue=2|pages=124–133|doi=10.1097/MRR.0b013e3283310d30|pmid=19786880|s2cid=24962745}}</ref> Furthermore, providers of vocational rehabilitation in Australia are not required to obtain any form of certifications.<ref name=":16" /> Resultantly, the teaching of vocational rehabilitation at universities needs to be improved in order to improve the state of vocational rehabilitation in Australia.<ref name=":16" />
In Australia, there has been limited research dedicated to vocational rehabilitation, with most of the research coming from the United States.<ref name=":16">{{Cite journal|last1=Matthews|first1=Lynda|last2=Buys|first2=Nicholas|last3=Randall|first3=Christine|last4=Biggs|first4=Herbert C.|last5=Hazelwood|first5=Zoe|date=2010|title=Evolution of vocational rehabilitation competencies in Australia|url=https://eprints.qut.edu.au/34500/1/c34500.pdf|journal=International Journal of Rehabilitation Medicine|volume=33|issue=2|pages=124–133|doi=10.1097/MRR.0b013e3283310d30|pmid=19786880|s2cid=24962745}}</ref> Furthermore, providers of vocational rehabilitation in Australia are not required to obtain any form of certifications.<ref name=":16" /> Resultantly, the teaching of vocational rehabilitation at universities needs to be improved in order to improve the state of vocational rehabilitation in Australia.<ref name=":16" />


== By disability or condition ==

=== For common mental disorders ===

Many workers have an increased risk of developing common mental disorders (CMDs) in the workplace due to job stressors such as job insecurity, bullying or psychological harassment, low social support at work, employee perceptions of fairness in the workplace, and an imbalance between job demands and rewards. These CMDs may include anxiety disorders, alcohol dependence, addiction-related disorders, suicidal ideation, and depression <ref name="LaMontagne">{{cite journal |last1=LaMontagne |first1=Anthony D. |last2=Martin |first2=Angela |last3=Page |first3=Kathryn M. |last4=Reavley |first4=Nicola J. |last5=Noblet |first5=Andrew J. |last6=Milner |first6=Allison J. |last7=Keegel |first7=Tessa |last8=Smith |first8=Peter M. |date=9 May 2014 |title=Workplace mental health: developing an integrated intervention approach |journal=BMC Psychiatry |volume=14 |page=131 |doi=10.1186/1471-244X-14-131 |pmid=24884425 |pmc=4024273 |doi-access=free }} {{open access}}</ref>

A symptom of CMDs is having disorganized and deteriorated habits. Therefore, during work rehabilitation, occupational therapists and/or other rehabilitation professionals often use a graded environment, intentionally eliminating barriers to increase individuals' performance and self-esteem. An integrative approach, based on the three key disciplines of medicine, public health, and psychology, is being utilized by occupational therapists to reduce job stressors and improve the psychological well-being of employees with CMDs.<ref name="LaMontagne"/> The purpose of an integrative approach is to prevent further harm to the employee and to learn how to manage the illness through health promotion, [[occupational psychology]], positive psychology management, psychiatry, and [[occupational medicine]].<ref name="LaMontagne"/>

Cognitive work hardening programs administered by occupational therapists using the Canadian Model of Client-Centered Enablement (CMCE) improve return to work outcomes of employees who have depression. Cognitive work hardening incorporates meaningful occupations or work tasks that are graded to fit individual needs within an environment that is supportive in order to improve self-worth. Cognitive work hardening programs are individualized to promote interpersonal communication and coping skills within a real-life work setting.<ref>{{cite journal |last1=Wisenthal |first1=Adeena |last2=Krupa |first2=Terry |date=2013 |title=Cognitive work hardening: a return-to-work intervention for people with depression |journal=Work |volume=45 |issue=4 |pages=423–430 |doi=10.3233/wor-131635 |pmid=23676328 }} {{subscription required}}</ref>

The Stimulating Healthy Participation and Relapse Prevention (SHARP) approach is used for individuals with CMDs who experience many sick absences from work. The SHARP approach encompasses five steps including: listing positive and negative situations encountered in the workplace; solutions to negative situations or problems; support need for solutions; planning how to implement solutions; and evaluation of implementation <ref>{{cite journal |last1=Arends |first1=Iris |last2=Bultmann |first2=Ute |last3=Nielsen |first3=Karina |last4=van Rhenen |first4=Willem |last5=de Boer |first5=Michiel R. |last6=van der Klink |first6=Jac J.L.
|date=January 2014 |title=Process evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders |journal=Social Science & Medicine |volume=100 |pages=123–132 |doi=10.1016/j.socscimed.2013.10.041 |pmid=24444847 }} {{subscription required}}</ref>
== See also ==
== See also ==


*[[European Platform for Rehabilitation]]
*[[European Platform for Rehabilitation]]
*[[Occupational rehabilitation]]
*[[Psychiatric rehabilitation]]
*[[Psychiatric rehabilitation]]
*[[Rehabilitation counseling]]
*[[Rehabilitation counseling]]
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{{Authority control}}
{{Authority control}}


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[[Category:Vocational rehabilitation| ]]
[[Category:Vocational rehabilitation| ]]
[[Category:Rehabilitation medicine]]
[[Category:Rehabilitation medicine]]

Revision as of 08:06, 6 August 2024