For individuals with illness, injury and disabilities, their
condition often acts as a barrier that prevents them from accessing
Vocational rehabilitation is a process that enables individuals
with all kinds of health conditions to overcome barriers to
accessing, sustaining or returning to employment. It can be defined
as 'whatever helps someone with a health problem to stay at, return
to and remain in work' and 'is an idea and an approach as much as
an intervention or a service' (
Waddell, et al, 2008) or 'a process that enables people with
functional, psychological, developmental, cognitive and emotional
impairments or health conditions to overcome barriers to accessing,
maintaining or returning to employment or other useful occupation'
Scottish Executive, 2007).
The aim of vocational rehabilitation is to help people retain or
regain the ability to work, rather than to treat an illness or
injury. It is now widely recognised that, as well as providing
economic benefits, engaging in work or other meaningful activity
has health benefits for the individual, and can help people
recover from physical and mental illness. A review of the available
Waddell et al (2008) showed that there is a strong scientific
evidence base for many aspects of vocational rehabilitation and
there is a good business case for investing in vocational
Techniques used in vocational rehabilitation may include (
Healthy Working Lives Website):
- Provision of health advice and promotion, in support of
returning to work.
- Support for self-management of health conditions.
- Career (vocational) counselling.
- Individual and group counselling focused on facilitating
adjustments to the medical and psychological impact of
- Case management, referral, and service co-ordination.
- Interventions to remove environmental, employment and
- Job analysis, job development, and placement services,
including assistance with employment and job accommodations.
The Individual Placement and Support (IPS) 'place then train'
model is also widely used and its core principles include (Centre
for Mental Health):
- Every person with severe mental illness who wants to work is
eligible for IPS supported employment.
- Employment services are integrated with mental health treatment
- Competitive employment is the goal.
- Personalized benefits counseling is provided.
- The job search starts soon after a person expresses interest in
- Employment specialists systematically develop relationships
with employers based upon their client's work preferences.
- Job supports are continuous.
- Client preferences are honored.
In relation to the effective delivery of vocational
rehabilitation interventions, Waddell et. al. (2008) suggest the
- Working with employers, as effective vocational rehabilitation
depends on communication and coordination between the individual,
healthcare, and the workplace.
- Giving high priority to common health problems, as these
account for about two-thirds of long-term sickness absence and
incapacity benefits, and many of these conditions can be
- Intervening early before the health problem becomes harder and
more costly to tackle. Essentially, the longer anyone is off work,
the greater the obstacles to return to work and the more difficult
vocational rehabilitation becomes.
The Scottish Government recognises the importance of vocational
Co-ordinated, Integrated and Fit for Purpose, the framework for
adult rehabilitation, highlights the importance of vocational
rehabilitation and sets out a model for service delivery in
Scotland. The framework notes that rehabilitation cannot be
delivered by health services alone and that an integrated
approach across services is required. It has identified a rapid
access referral process through which individuals can secure
support and specialist advice from a dedicated vocational
rehabilitation team consisting of a range of professionals using
case management approaches.
The Scottish Government's Health
Works strategy recommends that the case management
approach to working with clients must be more widely adopted whilst
taking a whole person approach which considers wider
barriers/needs, such as, housing and money issues.