Post-injury return to work (RTW) is an important rehabilitation outcome regardless of injury type. With Spinal Cord Injury (SCI), the odds of successful RTW are lower than for the general population of work-injured. Australians living with a SCI have a higher RTW rate than many other developed countries, including the United States. Important influences on relatively higher post-injury RTW rates in the Australian context include its universal disability care policy, Australia's suite of no-fault accident insurance systems that allow for multi-faceted rehabilitation services to be provided to eligible individuals in addition to appropriate rewards for rehabilitation service providers. A combination of these systemic factors is important when delivering comprehensive rehabilitation services to those with catastrophic injuries, such as SCI. The empirical evidence on drivers of successful RTW post SCI is, however, limited in comparison to the evidence on interventions for enhanced coping following SCI. Future studies could consider the relative merits of specific RTW interventions with SCI contrasting policy and capitation systems as well as utilising study designs that take into account pre-morbid work participation and secondary health conditions.

Forty-nine injured workers were selected from a study population of 3,041 injured workers using a critical case sampling technique, to explore characteristics of workplaces and worker perceptions and attributions related to return to work status following workplace injury. The only significant differences between those who returned and those who did not return to work were satisfaction with pre-injury pay and provision of training in occupational health and safety procedures. From the in-depth structured interviews of 49 injured workers, 5 workers who failed to return to work were selected for detailed case study to further explicate the factors which contributed to unsuccessful rehabilitation. Worker characteristics, the timing and meaning of the injury to individual workers, and conflicting and unstated agendas in the occupational rehabilitation process, were all identified as critical factors which impact on return to work outcomes.

This case study analysed the expert judgments of a rehabilitation counsellor. The counsellor was given 37 accident victims' self-ratings of health, energy, daily activities, self-esteem, personal relations, financial resources and living conditions. The accident victims also rated their own overall quality of life as poor or good. The expert was required to make judgments about whether the quality of life was poor or good in each case and matched the ratings of the accident victims in 64.8% of cases. The results suggest that under conditions of uncertainty and complexity an expert may be more accurate than chance but still fail to use the properties of information to their maximum advantage.

This article explores the relevance of Carl Rogers' person-centred approach (PCA) to rehabilitation counselling. His major theoretical contribution concerning the primacy of the client's actualising tendency and the six ‘core conditions’ of the counsellor–client relationship deserves greater recognition in vocational rehabilitation. The most widely known and researched core conditions have focused upon the proverbial triad: congruence (genuineness), unconditional positive regard and empathy. However, all six core conditions are discussed with emphasis placed on recent refinements to Rogers' original theory and their importance to rehabilitation counselling. Evidenced-based research concerning the impact of PCA-oriented rehabilitation counselling is lacking. It is argued that the efficacy of PCA can be extrapolated from meta-analyses in other fields of psychotherapy and education.

Accurate measures of changes in workplace attitudes toward people with disabilities are required to determine whether employee training and other interventions are effective. This critical systematic review searched Medline, PsycInfo, Google Scholar, Cinahl, and Cochrane Collaboration for suitable instruments published between 2005 and 2015, and for those published earlier if still indicated to be in active use. In total, 13 scans were conducted. Inclusion criteria included wildcard and free text variations of workplace attitudes, adults with disabilities, and competitive employment. In total, 9 of 49 studies were selected for review. Data from each of these were categorized through the PICO model (Population, Intervention, Comparison, and Outcome), mapped within a PRISMA flow chart, and analyzed through an 18-point weight of evidence framework for empirical quality, relevance, and evidence of theoretical validity. Weight of evidence scores for empirical quality ranged from 10 to 16 out of a possible score of 18. None of the studies provided an explicit evidence of theoretical validity. Measures of responsiveness to change in workplace attitudes appear less well validated than those for single timeframes.

Risk factors associated with post-injury return to work are well documented. Less is known of the impact of PTSD on work outcomes. Information on worker and accident risk factors was obtained by survey, hospital records and personal interview with 40 road trauma survivors two years post-accident: Results suggest that while PTSD was an independent risk factor for negative work outcomes, PTSD also significantly contributed to the overall adverse impact of anxiety, depression and pain on work outcomes. The lack of improvement in work outcomes between from 12 weeks post-accident for those with PTSD indicated that early vocational interventions are critical for this population.

This study investigated the rehabilitation and services needs, rehabilitation goals and barriers of individuals with brain injury (n = 81, males = 59%, females = 41%, age range 18 to 87), and their family members (n = 19; females = 75%, age range 18 to 65), (ethnicity = white = 89%). Data were collected using a survey instrument and focus group interviews. A descriptive analysis of the quantitative data was conducted, while content analysis was used to analyse the qualitative data. Results suggest that individuals with brain injury and their families experience many unmet needs across the domains of employment, independent living, financial resources and housing. Family involvement was found to be important to community participation after brain injury.

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

This study explored the subjective experiences of rehabilitation services undergraduate students in a short-term job shadowing experience. Experiential reflections of 61 undergraduate rehabilitation services students (females = 91 per cent, age range 18–22 for 77.5 per cent of sample) from a midsized state university in the USA with a brief job shadowing assignment were gathered utilising reflection journals and analysed through Interpretative Phenomenological Analysis. Four interrelated themes emerged: encouragement to enter case management professions, field experience based definition of case management, appreciation of time management in case manager role, and application of related course material learned in the classroom. Results from the study suggest a brief job shadowing experience does improve students’ career exploration, understanding of aspects of a typical career for undergraduate rehabilitation graduates, and how to connect course material to the field.

Adebate is emerging regarding the best way to ensure the timely and efficient return to work (RTW) of workers who have become long term absent (LTA) for health reasons. Elements of this debate center on the roles of the individual, the rehabilitation agent, the employing organisation and the rehabilitation and reintegration system. Recent years have seen the emergence of new approaches to managing LTA, mostly focusing on disability management and on amendments to welfare and rehabilitation systems. This paper discusses these trends in the light of a 6-year research programme carried out in Ireland, involving both national and transnational studies which have sought to identify the key elements of successful LTA policies and practices. It also reviews recent international work in the area in order to assess the relative importance of systemic, organisational and individual factors in ensuring timely and effective LTA policies and practices.

Burnout is an occupationally based syndrome that develops as a result of prolonged and cumulative stress. The experience of burnout has been documented in detail in a variety of human service professions. The purpose of this article is two-fold: to provide an alternative theoretical perspective on the development of burnout, which suggests it is not stressors per se that are responsible for burnout development; and, to use this alternative perspective as an explanation for burnout in the context of another human service profession — humanitarian work. Using the passion for activities notion conceptualised by Vallerand and colleagues (2003), it is explained how a lack of self-determination and autonomy leads to the development of an obsessive passion for an activity. Obsessive passion is linked to a variety of adverse cognitive and affective outcomes. This is then applied to the domain of humanitarian work, and it is suggested individuals with an obsessive passion are more likely to suffer adverse outcomes and consequently develop burnout when working in humanitarian crises. Some suggestions for future theoretical and empirical investigations regarding the relationship between obsessive passion and burnout are provided.

Narrative reflexivity was investigated as a potential mechanism of therapeutic change during a 12–18 month trial of Metacognitive Narrative Psychotherapy for people diagnosed with schizophrenia. Participants were nine adult clients (8 male, 1 female) aged between 25–65 years (M = 44, SD = 12.76) with a diagnosis of schizophrenia consistent with DSM-IV criteria and seven female provisional psychologists aged between 25–29 years (M = 26.8 years, SD = 1.47 years). Recovery and narrative reflexivity were measured at three time points using the Recovery Assessment Scale (RAS) and the Narrative Processes Coding System (NPCS). Results were reported descriptively due to limited sample size (n = 9). The majority of clients (n = 7) reported an increase in recovery over the course of treatment. For six clients, an overall increase in recovery was associated with an increase in narrative reflexivity. This study provides preliminary support for narrative reflexivity as a potential mechanism of therapeutic change in the psychotherapy of people diagnosed with schizophrenia.

The present study sought to investigate the current levels of psychological wellbeing in three immigrant groups to New Zealand. In addition, we sought to determine whether aspects of the acculturation process were related to mental health outcomes. This is a cross–sectional study from the fifth wave of annual in-depth interviews with three groups of recently arrived skilled immigrants from India, the People's Republic of China and South Africa. Interviews focused on international contacts and the migration of relatives and friends, housing, language, qualifications and employment, and social participation. Participants were also asked about health difficulties, homesickness, and whether they felt settled in New Zealand. The SF-36 Health Status Questionnaire (Ware, 1997), assessed the respondent's functional status and wellbeing in relation to four health concepts: vitality, social functioning, role limitations due to emotional health, and general mental wellbeing. The immigrant group differed significantly from the New Zealand population on only one of the four mental health scales, Vitality, with immigrants reporting higher levels. Different acculturation factors were found to predict different mental health subscales in regression analyses. Gender, home contact and health difficulty explained 22% of the unique variance in Vitality; employment status and health difficulty explained 18% of the variance in Social Functioning; health difficulty significantly contributed to the explained variance (14%) in the Role limitations due to emotional health subscale; gender, home contact and health difficulty explained 27% of the variance in the Mental Health subscale. There was little evidence for lower levels of psychological wellbeing for the three immigrant groups compared to the general New Zealand population, nor for differences between the three groups. However, results highlight the importance of differential predictors in the understanding of psychological health in migrant groups.

Little is known about the effectiveness of psychoeducational support groups on positive adaptation in parents and families after a child has been diagnosed with cerebral palsy. A systematic literature review adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to gain an understanding of the process of adaptation in parents with a child with cerebral palsy and the effects psychoeducational support programs have on this process. The databases searched were psychINFO, Taylor and Francis Online, PsychARTICLES, Medline and ProQuest. A total of 1083 papers were found and 19 of those papers were analysed. A narrative approach was used to synthesise the data extracted. A number of factors that influence adaption within a family after the diagnosis of cerebral palsy in a family member were identified in the review. These factors include, but are not limited to, providing appropriate and relevant information to parents and families, identifying community services and resources available to the family, assisting in the reduction of psychosocial distress, and encouraging the facilitation and collaboration of a strong parent-professional partnership throughout the process. Based on this information guidelines for psychoeducation programs for this client group were proposed.

Anecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver peer support. In this paper, we discuss how peer-based interventions might be used to supplement formal return-to-work services and contribute to positive job-seeking outcomes. We illustrate the potential of vocational peer support using a real situation involving a young adult who successfully returned to work soon after sustaining a traumatic injury. Future research should explore the inclusion of various peer support structures and formats as a component of other employment services, to help people with long-term conditions and disabilities achieve a range of vocational outcomes and to guide practice in this area.

Multiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.

The study aimed to determine various constraints faced by women with physical disabilities and their vocational rehabilitation in India. It revealed that the majority of these women belong to a lower income group. Their financial constraints hinder their treatment and education, and compel them to focus on vocational courses that will provide them with employment. It was found that there is a deficit in general coordination and a huge gap between the demands of the job market and the type of vocational courses done by the women, mainly because the vocational courses offered by the special institutes are outdated. The article concludes by stressing that successful rehabilitation of these women requires overall coordination, ranging from removing various constraints in the education system, modernisation of the vocational services according to capability as well as interest, and providing suitable vocational courses.

We examined relations between organisational perceptions (organisational commitment, organisational climate), personal evaluations (occupational self efficacy, skills/competencies) and subsequent job satisfaction (extrinsic and intrinsic) among a group of 101 New Zealand rehabilitation case managers. Analyses indicated that organisational commitment, organisational climate and perceived skills/competencies made a significant contribution to the prediction of extrinsic job satisfaction while organisational climate alone was a significant predictor of intrinsic job satisfaction. Despite a number of limitations, the findings have implications for the understanding of die occupational dynamics of rehabilitation service provision and illustrate the importance of a continued research focus on the antecedents and consequences of job satisfaction in rehabilitation professionals.

Acritical life event such as a significant work injury imposes on the individual a heavy burden in terms of suffering, social exclusion, stigmatisation, negative role transition, and emotional, and financial costs. Such events, therefore, have multi-level implications relating to the functional restoration of workers, the professional efficacy of their service providers, industry productivity and economic viability at individual, organisational, community and state levels. In accord with this viewpoint, discussions have been held with a range of the key stakeholders, including employers, workers, case managers, WorkCover personnel and vocational and medical providers from which a larger research study has been designed. This paper sets the scene for an investigation into a learning partnership approach to claims / injury management and rehabilitation that is pragmatic, timely and consistent in fundamental principles, and which links well with the treating medical experts, employers, insuring agents, workers and close family members involved.

Key stakeholders' perceptions of the role of the treating doctor, including treating doctors themselves, in the management of workplace injury and in occupational rehabilitation of injured workers was assessed via in-depth semi-structured interviews of doctors and via interviews and surveys of other stakeholders (injured workers, employers, rehabilitation co-ordinators, rehabilitation providers and insurers) in the post-injury period. A number of difficulties were identified by both doctors themselves and by other stakeholders in the treating doctors' management of compensable work injury clients. It was argued that these problems were a function of the conflict of interest that arises for various service providers within the current workers' compensation system and the polarised and adversarial nature of relationships between providers. The discussion of the underlying structural and policy problems inherent in the current workers' compensation system at various levels of practice which this study has highlighted provides a first step in attempts to resolve these difficulties in individual practitioner-client relationships.