Final paper

Running head: CASE STUDY

Final Paper: Vocational Analysis Case Study Brenna Coles B00529042 DISM 4040- Strategies for Alternative Work and Prevention Tom Stanley Dalhousie University April 5, 2012

TABLE OF CONTENTS

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CASE STUDY CASE STUDY ASSESSMENT ANALYSIS OF CLIENTS NEEDS AND INTERESTS.........................................4 IDENTIFICATION OF BARRIERS.......................................................................4 EXAMINATION OF ISSUES.................................................................................5 VOCATIONAL GOAL SETTING..........................................................................6 RECOMMENDATIONS COURSE OF ACTION............................................................................................7 RESOURCES..........................................................................................................8 RETOOLING AND RESCHOOLING STRATEGIES...........................................8 MOST PLAUSIBLE SOLUTIONS.........................................................................8 BIBLIOGRAPHY

Case Study

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CASE STUDY This case study will develop a vocational intervention plan based on the information provided in the hypothetical case of a 44 year old, male psychologist. The intervention plan will be developed by using elements of the vocational assessment and will incorporate the client into the case management process so that the intervention plan is client centered and client- tailored.

For the purpose of this case study I will name the 44 year old, male psychologist, Mr. D. Moreover, assumptions were made to develop an intervention plan for this client for example the willingness of Mr. D and the cooperation of the employer among others.

Assessment As described by Blanck & Pransky a disability “refers to the inability to perform an activity or task, reflecting an alteration in an individual’s capacity to meet personal, social, or, occupational demands because of an impairment” (p. 581). They also go on to explain the term work disability, which “refers to the effect of impairment on ability to work, either in one particular job or in a range or jobs” (p.581). They compare the differences between totally and partial disability, and in the case of Mr. D, he would be considered to be permanently partially disabled because he has “the ability to engage in some work, but an inability to perform all of the activities required...a worker has permanent inability to do some type of work, but retains the capacity for gainful employment” (Blanck & Pransky, 1999, p.581-582).

A comprehensive assessment will be performed to help determine an appropriate path for Mr. D’s personal intervention plan and will be directly related to his vocational goals. An intervention that is tailored to his needs and interests and takes into account his personal barriers will make for a better outcome. Moreover, a look at possible issues pertaining to primary and secondary prevention will be considered.

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CASE STUDY Analysis of clients needs and interests It has been made clear that Mr. D wishes to continue his work as a psychologist and in his preferred area of interest. He hopes that since accommodations were made for him before that his employer should be willing to do the same this time around. He has worked in the same field for at least 13 years taking him out of the career he is passionate and comfortable with may have detrimental psychologically, physically, economically effects and may disrupt the family unit.

Mr. D may feel a responsibility to his family, although his wife also contributes to the family income, Mr. D may have been the primary source of income. Financial stress can motivate Mr. D to get back to his regular career after his recovery to minimize the financial burden for his wife. While returning to work will give him a sense of pride and independence back since becoming a quadriplegic.

Identification of barriers Mr. D’s functional abilities have become very limited, now that he is quadriplegic he has lose the use of all his limbs. This is a challenge when working in the office setting for example when he worked from his home office he was linked by computer, fax and phone line with the school board headquarters. All of his office equipment and space would have to be specialized to help accommodate his now limited function and new electric motorized wheelchair. Cost may be an issue if his home office may have the need to be renovated to make these accommodations and wheelchair accessible.

If Mr. D is unable to return to his past career, he may become reluctant to return to work at all; his attitude will determine the intervention plan. If Mr. D is a willing motivated client this will positively impact the progress of the intervention plan. If he is not, however, this can stall

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CASE STUDY and even stop the process all together. The identification of red flags will help determine if Mr. D will be cooperative or not. The red flags that related to this specific case may include the duration of time off work, if there is not job to return to, psychological and social stress (keep in mind to look for signs and symptoms of depression and anxiety), substance abuse, missed appointments, age (i.e. closer to retirement age and slower recovery times in older age) and if there was a pre-existing medical condition (in this case Mr. D’s sensitivity to his work environment which made him sick).

Examination of issues The occupational illness that Mr. D developed when he was 41 years old to his work environment should have been properly investigated. Other employees may have been at risk for developing similar illnesses. An environmental evaluation of health hazards should have been completed perhaps on a yearly basis and employees should be made aware of all hazards. The initial a yearly environmental evaluations would be considered a primary prevention strategy in order to protect the health of the employees. If a health hazard did arise, protective measures should have been implemented in a timely matter to find a solution to the problem. Obviously there was something in the work environment that was making Mr. D very ill and it seems as though the issue was not resolvable or was ignored.

It was a bit alarming that the occupational injury that has caused Mr. D to become a quadriplegic took place at a school. Schools should be well architecturally planned so that risks of injuries are decreased dramatically. However, there may have been water or something on the floor that caused him to slip, but there is no such thing as an accident, all injuries can be prevented if primary and secondary preventative measures are implemented correctly. Again, if

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CASE STUDY employees are asked to visit schools a regular basis to perform their duties an environment evaluation should be completed for these workplace areas as well. The fact that in the case study it states that there is “inadequate wheelchair accessibility in the schools� seems almost suspicious to me because it makes me think the building must not be up to code.

Vocational goal setting The vocational rehabilitation hierarchy helps to determine what the most appropriate plan that will be best suited to returning the client to meaningful employment. The hierarchy of objectives is: 1. Return the worker to the same work with the same employer 2. Return the worker to the same (modified) work with the same employer 3. Return the worker to different work with the same employer 4. Return the worker to similar work with a different employer 5. Return the worker to different work with a different employer 6. Re-train and/or re-educate the worker. (Dalhousie University Department of

Health and Human Sciences, 2011b).

Mr. D will be at the center the entire decision making process. He will be a part of each step and will have his say. His goals and objectives for his intervention plan will be what leads the plan. Returning Mr. D to the same work with the same employer will not be possible, even if the job were to be modified, traveling to schools that are not all wheelchair accessible does not seem realistic. Moreover, Mr. D has previously expressed his desire to return to the same type of

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CASE STUDY work with the same employer, therefore the next logical step would be to return Mr. D to different work with the same employer.

Recommendations Course of action A functional assessment will be completed by a licensed practitioner to determine Mr. D’s level of ability to perform functional or work related tasks. Also, a job site analysis will be completed to determine if the new position is a right fit for Mr. D’s functional abilities. Of perhaps with the help of an occupational therapist and employer, they can help assemble productive work that fits the worker's present abilities and tasks that are meaningful to the business.

As determined by the hierarchy of vocational rehabilitation, it is recommended that Mr. D return to different work with the same employer. Although the employee was reluctant to accommodate Mr. D’s the first time by allowing him to work from home. As Mr. Ds’ case worker I would try and work with his employer and find him another position that would be suitable for his level of function and abilities. The new position will be comparable to his other one, with similar duties pertaining to him as a licensed psychologist, salary and the ability to work from his home office or perhaps in another building that will not cause an occupational illness.

Accommodations and modifications may have to be made including specialized office equipment, working hours and schedule.

Another possible alternative would be to provide Mr. D with a job shadow. This may be a practical application, “as this allows for complete freedom of choosing duties that are within the

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CASE STUDY client's capabilities” (Dalhousie University Department of Health and Human Sciences, 2012).

The downside to this alternative is the economic cost.

Resources As it states in the Sourcebook of Occupational Rehabilitation (1998) the vocational rehabilitation is a process that is a sequential service delivery, which means it is the “process of providing or coordination appropriate services as they are needed for the successful implementation of the rehabilitation plan in a timely and efficient manner” (p.346-347). Along with the case management services provide I would refer him to appropriate services and resources including occupational and physical therapy, psychological counselling, financial counsellor, recreational therapy, and adapted vehicle -handicapped driver evaluation (if appropriate).

Retooling and reschooling strategies It is not necessary for Mr. D to undergo reschooling at this time, as he is a qualified licensed psychologist. As his case worker I will advocate for my client to return him to his previous employment or a position comparable to his last. As a new quadriplegic Mr. D will have some challenges overcoming his limited functional abilities. He will have to rely on adaptive equipment and learn to maneuver the adaptive equipment.

Most plausible solutions In Mr. D’s case, his vocational intervention plan consists of returning him to a new but comparable position with the same employer. He will be working from his home office as he did before and his new position does not require any travelling. He will need the help of adaptive

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CASE STUDY equipment but will still be able to connect with the school board headquarters. He may have to have modified hours or working schedule. Mr. D will be able to access resources to help him and his family manage. He may need continual long-term therapy with an occupational or physical therapist to help him meet his vocational goals and training for the specialized adaptive equipment. Rather than Mr. D being on permanent disability and receiving disability benefits he is able to continue to work. This is a cost-efficient solution even though Mr. D cannot reach maximum productivity because time lost and loss of total productivity is kept to a minimum because he is still contributing to his best of his capabilities.

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CASE STUDY Bibliography

Blanck, P., D. & Pransky, G. (1999). Workers with Disabilities: A Conceptual and Demographic Overview. Occupational Medicine. Vol. 14, No. 3, 581-593. Hanley & Belfus, Inc. Philadelphia.

Dalhousie University Department of Health and Human Sciences. (2011a). Module 2. Disability Management 3010 Course Materials. Retrieved from: https://ilo.owl.dal.ca/.

Dalhousie University Department of Health and Human Sciences. (2011b). Module 3. Disability Management 3010 Course Materials. Retrieved from: https://ilo.owl.dal.ca/.

Dalhousie University Department of Health and Human Sciences. (2012). Module 9. Disability Management 4040 Course Materials. Retrieved from: https://ilo.owl.dal.ca/.

King, P., M. (1998). Sourcebook of Occupational Rehabilitation. Plenum Press: New York.