The use of occupational therapy in work rehabilitation has diminished over the last 20 years. Therapy resources have been diverted to the acute sector as a response to the pressure within National Health Service trusts to achieve early discharges. Occupational therapy in the United Kingdom has therefore suffered a loss of facilities and of therapists experienced in returning injured or ill employees to work. This contrasts with the development of occupational therapy in work rehabilitation abroad.
Occupational therapists, through their education and training, have the potential to develop the necessary skills to assess and treat injured employees to return them to work. There exists a significant number of employees at work and absent from work with musculoskeletal problems, who need the services of occupational therapists specialising in work rehabilitation.
The aim of this article is to provide an overview of the current status of work rehabilitation, to give an example of a therapist-led work rehabilitation intervention with a client and to demonstrate the unique role that occupational therapy played in assisting in the client's return to work.
Occupational therapists can play a major role in the work rehabilitation process through the assessment and rehabilitation of clients for a return to work (Gibson and Strong 2003). The challenge facing the occupational therapist is identifying if the client's current functional abilities are a suitable match for the demands of the job. Ideally, the occupational therapist should assess the demands of the job that the client is required to perform as well as completing an assessment of the client's work abilities. The purpose of this opinion piece is to highlight to occupational therapists the importance of job analysis in all specialties within vocational rehabilitation and to illustrate the process used by the occupational therapists in the Occupational Health and Safety Advisory Service.
The early management of ill or injured workers, including occupational therapy, could help to reduce the costs and minimise the negative consequences of sickness absence. In an occupational health service that employed an occupational therapist, 37% (92) of the workers referred to occupational therapy over a 3-year period had been absent for more than 6 months. The occupational therapist was keen to examine the reasons that employees were not referred earlier and a questionnaire was sent to the human resource advisers who contracted with this service. The results of this small-scale survey suggest that referrals are delayed by several factors, including poor awareness of the skills of occupational therapists, poor awareness of the effectiveness and cost-effectiveness of therapy and confusion over the different skills that occupational health professionals have.
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