Work Practice

OT and Work – Intervention models

Mavindidze Edwin
MOccTher (Advanced OT)
BSSc. (Sp.Hons) MnE
BSc. (Hons) OT
Reflections
Session objectives
• By the end of this lecture the student should be able to
• Define and review vocational rehabilitation services
• Identify and apply various work intervention models
• Compare and contrast characteristics and application of various work
intervention models
• Evaluate various work intervention models
Vocational Rehabilitation
Vocational rehabilitation
• The occupational therapist has had multiple roles in
vocational rehabilitation
• Screening of the client to • Work adjustment services
determine work potential;
to develop job readiness
• Evaluation of the client's
abilities;
capacities and deficits related
to work such as in the motor, • Design and fabrication of
sensory integrative, cognitive, assistive devices to enable
psychological and social the client to function in a
components of performance; work setting;
• Prevocational assessment of
• Task analysis of jobs in
interests, learning abilities,
work tolerance, interpersonal actual work settings.
skills
Interventions
• Return-to- work program • Work conditioning
• Sheltered Workshops • Work hardening
• Clubhouses • Work simplification/Energy
• Supported employment conservation
• Social enterprises • Worker compensation and injury
assessment
• Reasonable accommodation
• Volunteer services
• Ergonomics
Return-to-work
• 1. The workplace has a strong commitment to health and safety,
which is demonstrated by the behaviours of the workplace parties.
• 2. The employer makes an offer of modified work (also known as
work accommodation) to injured/ill workers so they can return early
and safely to work activities suitable to their abilities.
• 3. RTW planners ensure that the plan supports the returning worker
without disadvantaging co-workers and supervisors.
Return-to-work
• 4. Supervisors are trained in work disability prevention and included
in RTW planning.
• 5. The employer makes early and considerate contact with injured/ill
workers.
• 6. Someone has the responsibility to coordinate RTW.
• 7. Employers and health-care providers communicate with each other
about the workplace demands as needed, and with the worker’s
consent.
Sheltered Workshops
• A sheltered workshop (SW) provides persons with mental and/or
physical disabilities a working environment specially designed to
accommodate the limitations arising from their disabilities, in which
they can be trained to engage in income-generating work process,
learn to adjust to normal work requirements, develop social skills and
relationships and prepare for potential advancement to supported/
open employment where possible.
Sheltered Workshops
• It is a welfare-oriented service without an employer/employee
relationship between the workshop operators and the sheltered
workers.
• Non-competitive employment settings intended to provide many of
the positive benefits of a work atmosphere for individuals with
disabilities.
• A longstanding model of vocational rehabilitation, sheltered
workshops strive to provide a protected work environment while
developing vocational competency and providing behavioural
interventions if needed (Siporin, 1999).
Sheltered Workshops
• Zambuko
• RESCU Sheltered Workshop
• Abilities Sheltered Workshop
• Sunshine Zimbabwe Project
• Kapota School of the Blind
• Emerald Hill School of the Deaf
• King George VI
• Jairos Jiri
• Homefields Centre
Supported Employment
• “Supported employment can be characterized as paid work in
integrated work settings with on-going support for individuals with
disabilities in the open labour market. Paid work for individuals means
the same payment for the same work as for workers without
disabilities” – World Association for Supported Employment.
Supported Employment
• Supported employment is competitive work in an integrated work
environment that is consistent with the strengths, resources,
priorities, concerns, abilities, capabilities, interests, and informed
choice of the individual
Supported Employment
1. Competitive employment in an integrated setting with on-going
support services for individuals with the most severe disabilities.
a. For whom competitive employment has not traditionally occurred of whom
competitive employment has been interrupted or intermittent as a result of a
severe disability and
b. Who; because of the nature and severity of their disabilities, need intensive
supported employment services from the designated state unit and extended
service after transition in order to perform this work or
2. Transitional employment for individuals with the most severe
disabilities due to mental illness.
Supported Employment
• The steps taken as part of supported employment comprise the
following:
1. Assessment
2. Job finding
3. Job analysis
4. Job matching
5. Job coaching.
Supported Employment
• The nature of support offered is determined by the needs of the
worker, or by the particular supported employment program.
Support could include:
1. Job advocacy such as advocating for a participant at the job site
with employers, co-workers and customers
2. Non-job advocacy, for example, advocating for a participant, but
not related to work, with parents, landlords, case managers,
therapists, school personnel, bank personnel, doctors, etc.,
evaluation such as analysing a person’s employment potential by
interviewing him or her, reviewing records, communicating with
guardians or involved agencies, and observing the individual in
real or simulated work settings
Supported Employment
3. Training, for example, money handling, grooming, use of
transportation, or the management of symptoms
4. Program development, including developing person-centered
instructional plans such as behavioural intervention programs
5. Transportation
Reasonable accommodation
• A reasonable accommodation is a modification or adjustment to a
job, the work environment, or the way things usually are done that
enables a qualified individual with a disability to enjoy an equal
employment opportunity.
• An equal employment opportunity means an opportunity to attain
the same level of performance or to enjoy equal benefits and
privileges of employment as are available to an average similarly-
situated employee without a disability
Reasonable accommodation
• Potential reasonable accommodations include making existing
facilities accessible, job restructuring, part-time or modified work
schedules, assistive technology, providing aides or qualified
interpreters, changing tests or policies, and reassignment to a
vacant position.
• The reasonable accommodation obligation also extends to the
benefits and privileges of employment, such as employer-
sponsored training, services, and social functions.
• Employers to provide accommodations that pose an "undue
hardship" (defined as significantly difficult or expensive)
Work conditioning
• Work conditioning is an intensive work-related, goal-oriented
conditioning program designed specifically to restore systemic
neuromuscular functions, including joint integrity, mobility, and
muscular performance (including strength, power, and endurance),
motor function (motor control and motor learning), ROM and
cardiovascular/pulmonary functions.
• The objective of a work conditioning program is to restore physical
capacity and function to enable the patient/client to return to work.
Work hardening
• Work hardening programs use real or simulated work activities and
progressively graded conditioning exercises that are based on the
individual’s measured tolerances, to restore physical, behavioural,
and vocational functions.
• Work hardening programs address the issues of productivity, safety,
physical tolerance, and work behaviours.
Work simplification
• Performance of the steps comprising a work in a manner that is least
expensive (in terms of effort, money, and time) and consistent with
the objective of the work.
• Work simplification is defined as the use of equipment, ergonomics,
functional planning and behaviour modification to reduce the physical
and psychological stresses on the body of activities at home or work
• Includes energy conservation techniques
Work Compensation and injury assessment
• An injury at work can have significant consequences for your personal
and professional life. Workers’ compensation laws in WA aim to
minimise the impact of a workplace injury by ensuring injured
workers are fairly compensated while they are unable to work, and
assisted in their return to work following an injury.
• Revise NSSA Act.
Ergonomics
• Lifting
• Seating
• Work place environment
• Equipment
• Occupational disease issues
• Stress Management