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Best practice techniques in vocational rehabilitation
Best practice techniques in vocational rehabilitation
Joy Reymond Head of Rehabilitation Services at Unum. She originally trained as a clinical psychologist in Australia and the USA and later completed an MBA. She moved to the UK in 2000 and since then has led Unum’s rehabilitation services. She is currently working with the National Institute for Disability Management and Research to introduce an international occupational rehabilitation training program to the UK and has been appointed the secretary to the International Disability Management Standards Council. She is a board trustee with the Vocational Rehabilitation Association and is also a founding member of the UK Rehabilitation Council. E-mail: firstname.lastname@example.org
Unum is the UK’s largest provider of income protection insurance. One of our key differentiators is the way we help our clients with sickness absence, including providing the practical framework required for employers to help their employees at an appropriate time return to work. This service has been developed over a number of years and as part of this, in 2001, Unum made a significant investment in recruiting more vocational rehabilitation specialists to work with our clients.
However, we found it challenging to recruit good staff; we wanted people who had the credentials, but more importantly had the right skills to work effectively with employers who needed assistance in managing the return-to-work process for their employees following a period of sickness absence. It was also key that they could work effectively and empathetically with the individual employees.
The recruitment challenges we faced were most likely due to a number of issues, including the fact that most rehabilitation professionals have a traditional clinical rehabilitation background learned from the the National Health Service (NHS) in the UK and/or occupational health training schemes. There has also been a decline in the value attached to rehabilitation in both education and the health industry over the past 20 years. This has left the industry relatively empty of suitably skilled people to pass on their skills. It was imperative that we find a solution if our service was to be effectively delivered.
Starting with an in-house training program
As we were unable to find a ready supply of skilled practitioners, our existing rehabilitation management team worked together to develop a comprehensive in-house training program. This combined in-class training over the first two to four weeks with an extensive period of mentoring by our existing staff for up to six months. The new employee could then gradually assume responsibility for a full caseload during this time.
This model has proved very successful over the past five years, resulting in the recruitment of impressive staff, some of whom have gone on to win rehabilitation awards for their work. However, the level of resourcing and amount of time required to undertake all of the training in-house encouraged us to look for alternative training schemes that would prepare rehabilitation consultants for this kind of work.
In addition, we found that the approach our clients used to manage absence didn’t always mesh with the approach to disability management that we were using. This meant that although our staff were now well equipped to effectively help employers with their return-to-work processes, employers often lacked the equivalent disability management skills that we felt were necessary to effectively manage the less straightforward cases of sickness absence in-house. We recognized this was a real opportunity to improve our effectiveness, so we set about working out what we could do to help employers become more self-sufficient in managing absence, and make best use of our services with their more complex cases.
Bringing in an international solution
During our research for an appropriate way to help our clients and train our own staff, we recognized that there were two related training needs:
training for professionals who wish to specialize in return-to-work and disability management (i.e. vocational rehabilitation specialists); and
training for related professionals – for instance in HR and Occupational Health and Safety – who have a need to understand the best approach to managing sickness absence and return-to-work.
Our scan of the programs available nationally did not find one that would achieve these aims. We therefore looked internationally for an occupational rehabilitation training program that would provide both the intellectual foundation for effective disability management and return-to-work, and the foundation practical skills to assist employees to successfully return-to-work.
Our search led to the National Institute for Disability Management and Research (NIDMAR) occupational rehabilitation training program. This was originally developed in Canada but is now offered in nine countries around the world. It takes as its foundation the International Labor Organization (ILO) Convention on Vocational Rehabilitation and Employment of Disabled Persons, and the ILO Code of Practice for the Management of Disability in the Workplace.
The course is designed to cover the full range of skills required of a practitioner who is either assisting in or advising on an employer’s return-to-work process. There are nine core “domains,” which cover the essential skills and competencies for effective disability management practice. These are then being subdivided into over 150 sub-domains. The nine core domains are set out in Table I.
These nine knowledge domains are incorporated into the curriculum of 25 modules. The modules are self-contained short courses and can be completed in a day, although some homework is also required. The program has been specifically designed to suit the needs of the practitioner. Because it is modular, students can choose to take just those modules that address their individual learning needs. Most of the modules are also free-standing and can therefore be taken in any order, at the student’s preferred pace, and are sufficiently brief that most working practitioners can attend without too much disruption to their work schedule.
The program is designed to be part of a continuing professional development program, and to be delivered by subject matter experts at universities around the country. Brunel University’s School of Health Sciences and Health Care is the first centre to introduce the training program, with additional universities expected to be ready to offer it shortly.
Rolling out the program
As the training program is rolled out, we are recommending it to our clients with an interest in improving disability management practices in the workplace. We are also finding interest among our broker community for the same reason. Students so far come from a wide variety of settings but include return-to-work coordinators and occupational health providers keen to learn the approach. And we have found this new training course useful for our own staff too, as it helps them to better understand the principles that underlie best practice in vocational rehabilitation.
Although it is very early days, we believe this will have long-term benefits for us and for the vocational rehabilitation community in general. It will serve to build a strong professional community of people who are both committed to these best practices and competent to deliver them, whether they carry the job title of vocational rehabilitation specialist, occupational health professional, case manager, or indeed HR professional.
This final group is perhaps most important of all, since it is the HR practitioner who has the most influence over return-to-work practices in an organization and can have the greatest influence on the outcome of a return-to-work process, for both employer and employee.