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Q - Employment and Vocation

Summary of Current Practice Figure 2.0 depicts a schematic overview of service delivery related to vocation after SCI. As indicated, the existence of, and access to, employment and vocational resources can significantly impact the nature and prospects of vocational goals and outcomes for an individual with SCI. Although most sites report availability of vocational counselling for their patients (Figure 3.0), the number of sites that employ a designated vocational counsellor is very low (Figure 4.0). Figure 2.0 Overview of EMPLOYMENT AND Vocational Service Delivery. Figure 2.0 Figure 3.0 Availability of Vocational Counseling acros 12 SCI Rehabilitation Sites. 12 10 8 6 4 2 0 Resource Available Available Onsite Serve Inpatients Number of Sites Figure 4.0 Number of Sites Emplo ying a Vocational Rehabilitation Counselor . 12 10 8 6 4 2 0 Serve Inpatients Serve Outpatients Consult within Number of Sites Vocational Rehabilitation Serve Outpatients Serve both Inpatients and Outpatients Organization Consult External to Organization Vocational rehabilitation (VR) is a multi-level process which can include medical, psychological, social and occupational activities that aim to restore work capacity, and facilitate return to work, following an injury.16 Currently, no best practices have been established in VR, specifically for individuals with SCI. However, literature suggests that VR should be individualized and integrate all clinicians, within the circle of care.17 In addition, VR may be most successful within the first six months postdischarge, where greatest adaptations to living with SCI can be made.4 Several approaches to VR (e.g., program-based, supported employment and case-coordinated) have been highlighted in traumatic brain injury literature, and show promise for individuals with SCI.18 Program-based VR involves intensive individualized work skills rehabilitation, within a structured program environment, and assisted job placement with transitional services. Supported employment VR includes immediate job placement with work site job coaching.17 Case-coordinated VR is part of the larger rehabilitation program and provides vocational counselling, pre-employment training, assisted job placement and on the job support.18 Individual (after SCI) Unable to return to pre-inury employment Able to return to pre-injury employment Vocational exploration with goal to incorporate some transferrable skills, if possible Employment counselling to assist with establishing employment goal; support regarding working with a disability/accomodating needs etc. Retraining for new goal Job development to assist with accessing hidden job market/support during job search. May utilize job trial here to test work tolerance Leisure vocation pursuits Once placed in job retention, assistance to support maintained employement Figure 3.0 180 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


Q - Employment and Vocation
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