Vocational professionals aware of the stigma associated with psychiatric disability, generally exercise caution when disclosing psychiatric or disability related information to employers. However, few professionals directly address stigma or specify disclosure strategies in vocational rehabilitation plans. Integrated information tailored to vocational professionals is needed to guide this aspect of vocational rehabilitation practice. We review recent evidence with legal and ethical information relevant to vocational rehabilitation. Key elements of disclosure and stigma-countering strategies are identified which can be incorporated into the career planning, job preparation, job securing and job retaining phases of vocational rehabilitation plans.

People with disabilities comprise 19% of the Australian population. Normalisation, human rights, community-based rehabilitation and mutual obligation policies are consistent. All require broadly conceptualised services which develop the potential and capacities of people with disabilities, to enable their self-determination and social integration. There is commitment to a national platform of standards for health and environment protection. Regionally pooled funding and separate management streams for accommodation and services for the aged would facilitate coordinated and transparent management of all accommodation, health and disability funds. Elected government representatives and universities appear well placed to assist the broad, regionally planned approach to resolving community health problems which area health service managers and others have commenced.

Social skill deficits following severe traumatic brain injury (TBI) are prevalent. However, the development and provision of pro-active treatments for these deficits during rehabilitation have not kept pace with the need. Previous research described the development and presented encouraging data for community-based intensive social skills and work readiness training programs for adults with a brain injury. Brain injury residuals present similar social and vocational challenges to professionals worldwide. As such, this paper proposes these rehabilitation services may be replicated across cultures. To facilitate crosscultural replication, a training framework is shared. Australian rehabilitation counsellors may use this framework to replicate these services and contribute to the community reintegration of adults with brain injury.

Neurobehavioural symptoms, such as changes in personality, psychiatric symptoms such as depression, and behavioural changes such as increased irritability, are frequent consequences of head injury. Even in the case of mild head injuries, such symptoms may be severe enough to have a negative impact upon rehabilitation. The nature of these symptoms, mitigating factors and possible responses within a rehabilitation context are discussed.

This article describes the development and validation of a new measure of post-accident work outcome and adjustment, the Work Outcomes Coding Scale (WOCS), whose items were derived from rehabilitation indices used individually by the Workcover Authority of New South Wales. Psychometric qualities of the 4-item scale were determined using two samples of hospitalised accident survivors who returned to work following their accident. The WOCS showed excellent internal consistency, correlated moderately to highly with other measures of role functioning and had low, significant correlations with factors connected with work adjustment. Low range WOCS scores were shown to be indicative of poor work outcomes and increasing need for vocational rehabilitation interventions.

This paper explores the complexities of the role of the workers' compensation case manager working for claims agents in South Australia. It provides a brief outline of the many skills required by case managers as they deal with the worker's injury, issues of compliance, the legislation, the social and psychological aspects of the worker's claim and the treatment and management of the worker's welfare. It describes the tensions brought about by the dual nature of the case manager's role that encompasses claims processing and injury management, and the conflicts between human and organisational motivations. These findings, although imprecise, demonstrate that in order to achieve sustainable return to work outcomes, case managers need to be competent, well-trained and team players capable of acting as mediators or brokers across the stakeholders. The aim of this paper is to explore the different views of the problems and possibilities of the role of the claims/injury manager from the perspective of the major stakeholders. Some views on the redesign of the role incorporating a partnership and holistic emphasis rather than the claims processing focus are suggested.

This paper discusses issues arising from a study of referral from acute care following traumatic brain injury (TBI) in Queensland, in which aged care facilities were relied upon for the discharge of those with slow recovery after severe TBI. The discussion considers: (1) recovery following severe TBI; (2) the current policy context; (3) approaches to care beyond acute care; and (4) implications for policy and practice. In the current health care environment, with increasing pressure on scarce resources, it is critical that practitioners advocate for the dignity and care of people who sustain severe TBI and who are slow to recover.

The present study explored the current competency status of New Zealand residential mental health support workers (n = 121). Competency was assessed through the domains of skills, attitudes and perception of the work environment. Consistent with a recovery model, the National Mental Health Workforce Development Coordinating Committee (1999) put forward 10 basic core competencies that they recommended that all mental health workers should be able to demonstrate in their work practice. Skills and attitudes self-report measures were developed to assess participant performance on these competencies. In addition, a standard measure, the Ward Atmosphere Scale (Moos, 1996), was utilised to evaluate the perceived atmosphere of the participants' work environment. The aggregated results of this study appeared to show that participants were generally competent in a number of areas of work practice. However, deficiencies in critical areas of client support were identified on closer examination of the data. While superior education and training did appear to influence performance on certain competencies, some deficiencies were nevertheless reported by the more highly educated and trained participants. In addition, participants generally characterised their work settings in a negative manner such that it appears that many settings are not adhering to the philosophies of rehabilitation and recovery. Despite the identification of specific deficiencies, many participants did demonstrate a number of competencies combined with an encouraging commitment to professional growth.

This study examined the nature of the social support received by persons following spinal cord injury (SCI). Social support was assessed through use of an abridged version of the ISEL scale (Cohen et al., 1985), a self-report measure of perceived support. Seventy persons who had been living in the community at least one year post discharge from hospital provided information about four types of support received — instrumental, emotional, informational, and appraisal social support. The aim of this study was to identify whether there were any significant differences in the perceived availability of the four types of social support. Analyses revealed that overall there were significant (p < .05) perceived differences in the average availability of the four separate types of support, with Instrumental support being seen as the most available. Taken together, these findings support the usefulness of measuring separately the different types of social support perceived to be available to individuals, and thus hold important implications for the rehabilitation effort following SCI.

We examined the impact of a 27-week university-based professional training program on the self-rated skills and competencies of a group of New Zealand rehabilitation case managers. The extent to which training-related change transferred back to the workplace at both the individual and organisational level was also considered. Some pre-test/post-test increases in self-rated competencies were observed and these were maintained at 3-month follow-up. Training-related change back in the workplace was generally perceived to be in a negative direction, which highlights the fact that the relationship between the training process and subsequent skill/knowledge utilisation in the workplace is a complex and non-linear phenomenon. Some suggestions as to how research on training in rehabilitation might move forward are presented.

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.

This paper presents the results of Phase 3 of The RETURN Project, a European Study which aimed to reduce long term absenteeism in the workplace. Phases 1 and 2 have been described in detail elsewhere. The study adopted an iterative approach that explored LTA from three different perspectives: the System, the Expert and the Employer. This paper describes how the outputs of both the System and the Expert phases in combination with other tools focused on Disability Management (DM) were used to generate an interactive multi-jurisdictional assessment protocol tool for evaluating company based responses in managing employees on long term absence. The RETURN Protocol was field tested in different regulatory contexts using a company case study approach. Results of the field test carried out in six European companies are presented and the future and appropriate use of the protocol tool is discussed.