Vocational Rehabilitation

Rating

Category: Allied Health Options

What is it?

Vocational Rehabilitation (VR) is related to improving employment opportunities by training individuals to attain skills, resources, attitudes, and expectations needed to compete in the interview process to secure and retain employment.

How does it work?

Research has found that individuals with psychiatric disorders may lack work experience, have interrupted training and educational opportunities, experience a fragmented work history, and possess very limited knowledge of the labour market and employment opportunities. VR aims to help achieve a lifestyle of independence and integration within the workplace. This is achieved through work evaluation and job readiness services, job counselling services, and medical and therapeutic services.

Is it effective?

The literature does suggest that VR is often used in conjunction with other therapies for PTSD. To date there is minimal research in the effectiveness of vocational rehabilitation as a treatment for PTSD.

Are there any disadvantages?

Only individuals considered eligible can receive VR services. Eligibility criteria requires that an individual be at least 16 years old, unemployed or under-employed, and have a physical or mental disability that results in a substantial barrier to employment, such as psychotic disorders, alcohol and other drug abuse dependence, mental and emotional disorders, attention deficit disorders, specific learning disabilities, and physical and sensory disabilities. In addition, the individual must be able to benefit from VR services. When resources are limited, individuals with the most significant disabilities are prioritised.

Where do you get it?

The Australian Government Civil Rehabilitation Scheme (CRS) website has a directory of vocational rehabilitation service providers in your local area. In addition, medical professionals that are associated with providing vocational rehabilitation assessments include occupational therapists and occupational physicians which patients are referred to by their local GP or rehabilitation consultant.

What are the evidence limitations?

Published literature and the evidence base on vocational rehabilitation is limited. Therefore interpreting this evidence should be undertaken with caution. However a study of the 'Impact of Supported Employment Versus Standard Vocational Rehabilitation in Veterans With Post-Traumatic Stress Disorder' is currently being conducted in the USA.

Recommendations

Based on the current lack of high quality evidence, VR cannot be recommended as a first-line, stand alone intervention for PTSD. It may be considered as an adjunct to other PTSD interventions, such as psychological and pharmacological interventions.

Key References

Australian Centre for Posttraumatic Mental Health 2007, ‘Australian guidelines for the treatment of adults with Acute Stress Disorder and Posttraumatic Stress Disorder. Practitioner Guide’ National Health and Medical research Council, viewed 11 December 2008,
http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/mh13.pdf

Frueh, BC, Grubaugh, AL, Elhai, JD, Buckley, TC 2007, ‘US Department of Veterans Affairs Disability Policies for Posttraumatic Stress Disorder: Administrative Trends and Implications for Treatment, Rehabilitation, and Research’, American Journal of Public Health, Vol. 97, no. 12, pp. 2143-2145.

Penk, W & Flannery, RB 2008, ‘Psychological Rehabilitation’, in Effective Treatments for PTSD, 2nd edn, ed. E Foa, T Keane & M Freidman, Guilford Press, New York, USA.

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