Occupational rehabilitation

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Occupational rehabilitation is the science and practices of returning injured workers to a level of daily work activities that is appropriate to their functional and cognitive capacity related to their position of which may be influenced by the severity of a worker's injuries.

Contents

Professionals involved

Occupational therapists [1] [2] 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 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. [1] 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. [1]
Occupational psychology
Physiotherapists [2]
Kinesiologist
Occupational physiologists
Occupational physicians [2]
Vocational rehabilitation

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 [3]

Approaches

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. [3] 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. [3]

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. [4]

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 [5]

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Type of therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

Industrial and organizational psychology "focuses the lens of psychological science on a key aspect of human life, namely, their work lives. In general, the goals of I-O psychology are to better understand and optimize the effectiveness, health, and well-being of both individuals and organizations." It is an applied discipline within psychology and is an international profession. I-O psychology is also known as occupational psychology in the United Kingdom, organisational psychology in Australia and New Zealand, and work and organizational (WO) psychology throughout Europe and Brazil. Industrial, work, and organizational (IWO) psychology is the broader, more global term for the science and profession.

Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles. OTs have training in the physical, psychological, and social aspects of human functioning deriving from an education grounded in anatomical and physiological concepts, and psychological perspectives. They enable individuals across the lifespan by optimizing their abilities to perform activities that are meaningful to them ("occupations"). Human occupations include activities of daily living, work/vocation, play, education, leisure, rest and sleep, and social participation.

Stress management consists of a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of improving everyday functioning. Stress produces numerous physical and mental symptoms which vary according to each individual's situational factors. These can include a decline in physical health, such as headaches, chest pain, fatigue, and sleep problems, as well as depression. The process of stress management is named as one of the keys to a happy and successful life in modern society. Life often delivers numerous demands that can be difficult to handle, but stress management provides a number of ways to manage anxiety and maintain overall well-being.

Applied psychology is the use of psychological methods and findings of scientific psychology to solve practical problems of human and animal behavior and experience. Educational and organizational psychology, business management, law, health, product design, ergonomics, behavioural psychology, psychology of motivation, psychoanalysis, neuropsychology, psychiatry and mental health are just a few of the areas that have been influenced by the application of psychological principles and scientific findings. Some of the areas of applied psychology include counseling psychology, industrial and organizational psychology, engineering psychology, occupational health psychology, legal psychology, school psychology, sports psychology, community psychology, neuropsychology, medical psychology and clinical psychology, evolutionary psychology, human factors, forensic psychology and traffic psychology. In addition, a number of specialized areas in the general area of psychology have applied branches. However, the lines between sub-branch specializations and major applied psychology categories are often mixed or in some cases blurred. For example, a human factors psychologist might use a cognitive psychology theory. This could be described as human factor psychology or as applied cognitive psychology. When applied psychology is used in the treatment of behavioral disorders there are many experimental approaches to try and treat an individual. This type of psychology can be found in many of the subbranches in other fields of psychology.

<span class="mw-page-title-main">Job satisfaction</span> Attitude of a person towards work

Job satisfaction, employee satisfaction or work satisfaction is a measure of workers' contentment with their job, whether they like the job or individual aspects or facets of jobs, such as nature of work or supervision. Job satisfaction can be measured in cognitive (evaluative), affective, and behavioral components. Researchers have also noted that job satisfaction measures vary in the extent to which they measure feelings about the job. or cognitions about the job.

<span class="mw-page-title-main">Occupational therapy</span> Healthcare profession

Occupational therapy (OT) is a healthcare profession that involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to improve mental and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in any activity that occupies an individual's time. It is an independent health profession sometimes categorized as an allied health profession and consists of occupational therapists (OTs) and occupational therapy assistants (OTAs). While OTs and OTAs have different roles, they both work with people who want to improve their mental and or physical health, disabilities, injuries, or impairments.

Ergophobia is described as an extreme and debilitating fear associated with work, a fear of finding or losing employment, or fear of specific tasks in the workplace. The term ergophobia comes from the Greek "ergon" (work) and "phobos" (fear).

A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a name for community personnel who worked in the new community mental health agencies begun in the 1970s to assist individuals moving from state hospitals, to prevent admissions, and to provide support in homes, jobs, education, and community. These individuals were the forefront brigade to develop the community programs, which today may be referred to by names such as supported housing, psychiatric rehabilitation, supported or transitional employment, sheltered workshops, supported education, daily living skills, affirmative industries, dual diagnosis treatment, individual and family psychoeducation, adult day care, foster care, family services and mental health counseling.

<span class="mw-page-title-main">Psychological intervention</span>

In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.

Occupational health psychology (OHP) is an interdisciplinary area of psychology that is concerned with the health and safety of workers. OHP addresses a number of major topic areas including the impact of occupational stressors on physical and mental health, the impact of involuntary unemployment on physical and mental health, work-family balance, workplace violence and other forms of mistreatment, psychosocial workplace factors that affect accident risk and safety, and interventions designed to improve and/or protect worker health. Although OHP emerged from two distinct disciplines within applied psychology, namely, health psychology and industrial and organizational psychology, for a long time the psychology establishment, including leaders of industrial/organizational psychology, rarely dealt with occupational stress and employee health, creating a need for the emergence of OHP. OHP has also been informed by other disciplines, including occupational medicine, sociology, industrial engineering, and economics, as well as preventive medicine and public health. OHP is thus concerned with the relationship of psychosocial workplace factors to the development, maintenance, and promotion of workers' health and that of their families. The World Health Organization and the International Labour Organization estimate that exposure to long working hours causes an estimated 745,000 workers to die from ischemic heart disease and stroke in 2016, mediated by occupational stress.

<span class="mw-page-title-main">Occupational burnout</span> Type of occupational stress

The ICD-11 of the World Health Organization (WHO) describes occupational burnout as an occupational phenomenon resulting from chronic workplace stress that hasn't been successfully managed, with symptoms characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy." It is classified as a mismatch between the challenges of work and a person's mental and physical resources, but is not recognized by the WHO as a medical condition.

<span class="mw-page-title-main">Occupational stress</span> Tensions related to work

Occupational stress is psychological stress related to one's job. Occupational stress refers to a chronic condition. Occupational stress can be managed by understanding what the stressful conditions at work are and taking steps to remediate those conditions. Occupational stress can occur when workers do not feel supported by supervisors or coworkers, feel as if they have little control over the work they perform, or find that their efforts on the job are incommensurate with the job's rewards. Occupational stress is a concern for both employees and employers because stressful job conditions are related to employees' emotional well-being, physical health, and job performance. The World Health Organization and the International Labour Organization conducted a study. The results showed that exposure to long working hours, operates through increased psycho-social occupational stress. It is the occupational risk factor with the largest attributable burden of disease, according to these official estimates causing an estimated 745,000 workers to die from ischemic heart disease and stroke events in 2016.

<span class="mw-page-title-main">Vocational rehabilitation</span> Occupation rehabilitation processes

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.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

Occupational therapy is used to manage the issues caused by seasonal affective disorder (SAD). Occupational therapists assist with the management of SAD through the incorporation of a variety of healthcare disciplines into therapeutic practice. Potential patients with SAD are assessed, treated, and evaluated primarily using treatments such as drug therapies, light therapies, and psychological therapies. Therapists are often involved in designing an individualised treatment plan that most effectively meets the client's goals and needs around their responsiveness to a variety of treatments.

Vision rehabilitation is a term for a medical rehabilitation to improve vision or low vision. In other words, it is the process of restoring functional ability and improving quality of life and independence in an individual who has lost visual function through illness or injury. Most visual rehabilitation services are focused on low vision, which is a visual impairment that cannot be fully corrected by regular eyeglasses, contact lenses, medication, or surgery. Low vision interferes with the ability to perform everyday activities. Visual impairment is caused by factors including brain damage, vision loss, and others. Of the vision rehabilitation techniques available, most center on neurological and physical approaches. According to the American Academy of Ophthalmology, "Provision of, or referral to, vision rehabilitation is now the standard of care for all who experience vision loss.."

A psychosocial hazard or work stressor is any occupational hazard related to the way work is designed, organized and managed, as well as the economic and social contexts of work. Unlike the other three categories of occupational hazard, they do not arise from a physical substance, object, or hazardous energy.

Rehabilitation psychology is a specialty area of psychology aimed at maximizing the independence, functional status, health, and social participation of individuals with disabilities and chronic health conditions. Assessment and treatment may include the following areas: psychosocial, cognitive, behavioral, and functional status, self-esteem, coping skills, and quality of life. As the conditions experienced by patients vary widely, rehabilitation psychologists offer individualized treatment approaches. The discipline takes a holistic approach, considering individuals within their broader social context and assessing environmental and demographic factors that may facilitate or impede functioning. This approach, integrating both personal and environmental factors, is consistent with the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF).

Psychosocial safety climate (PSC) is a term used in organisational psychology that refers to the shared belief held by workers that their psychological health and safety is protected and supported by senior management. PSC builds on other work stress theories and concerns the corporate climate for worker psychological health and safety. Studies have found that a favourable PSC is associated with low rates of absenteeism and high productivity, while a poor climate is linked to high levels of workplace stress and job dissatisfaction. PSC can be promoted by organisational practices, policies and procedures that prioritise the psychosocial safety and wellbeing of workers. The theory has implications for the design of workplaces for the best possible outcomes for both workers and management.

References

  1. 1 2 3 Keough, Jeremy L.; Fisher, Thomas F. (2001). "Occupational-psychosocial perceptions influencing return to work and functional performance of injured workers". Work. 16 (2): 101–110. PMID   12441463.(subscription required)
  2. 1 2 3 Hoefsmit, Nicole; Houkes, Inge; Nijhuis, Frans J.N. (December 2012). "Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review". Journal of Occupational Rehabilitation. 22 (4): 462–77. doi:10.1007/s10926-012-9359-z. PMC   3484272 . PMID   22476607.
  3. 1 2 3 LaMontagne, Anthony D.; Martin, Angela; Page, Kathryn M.; Reavley, Nicola J.; Noblet, Andrew J.; Milner, Allison J.; Keegel, Tessa; Smith, Peter M. (9 May 2014). "Workplace mental health: developing an integrated intervention approach". BMC Psychiatry. 14: 131. doi: 10.1186/1471-244X-14-131 . PMC   4024273 . PMID   24884425. Open Access logo PLoS transparent.svg
  4. Wisenthal, Adeena; Krupa, Terry (2013). "Cognitive work hardening: a return-to-work intervention for people with depression". Work. 45 (4): 423–430. doi:10.3233/wor-131635. PMID   23676328.(subscription required)
  5. Arends, Iris; Bultmann, Ute; Nielsen, Karina; van Rhenen, Willem; de Boer, Michiel R.; van der Klink, Jac J.L. (January 2014). "Process evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders". Social Science & Medicine. 100: 123–132. doi:10.1016/j.socscimed.2013.10.041. PMID   24444847.(subscription required)