Hi Mike:

In the mental health facility where I work OTs and Rehab Counsellors (they are called 
Vocational Counsellors here) do work together.  And there are certainly some turf 
issues, but it is nothing very complicated or deep rooted.  It is difficult for me to 
comment on how similar OT and Rehab Counselling are in theoretical terms.  However, OT 
focuses on more than vocational rehab in its emphasis on the all-encompassing idea of 
occupation.
As well based on my experience and the experience of some of my OT colleagues our 
emphasis on the use of standardized vocational assessments and educational assessments 
may likely make the modalities OTs use somewhat different from the assessment 
modalities that Rehab or Vocational Counsellors use.  However, in terms of vocational 
goal setting with clients there are certainly some significant similarities.

My sense of the vocational rehab role for OTs is that it is a very much neglected 
aspect of their role.  In fact I would even go so far as to say that there are 
probably a handful of  OTs out there who even perceive vocational rehab as being a 
part of the OT role.  In my opinion this neglect is unfortunate.  However, it is also 
likely that in part this may be because OTs may have a hazy idea of what exactly 
vocational assessment and
rehab consist.  I was fortunate enough to have worked closely with the OT Discipline 
Lead at my facility, and she happened to be very clear on the vocational rehab role in 
OT and has been an amazing resource person in this context.  This led me to develop a 
very different perspective of the OT role in vocational rehab.  In fact I believe that 
OTs can make a critical and qualitative contribution to vocational assessment because 
OTs look
at the functional implications of the individual's strengths and deficits, in terms of 
the job role.  I have read through some vocational assessments done by Psychologists, 
and found that they relied almost entirely on the results of the testing.  Whereas as 
an OT I look at a variety of issues like strategies to make for a safe working 
environment, graduated approaches for on-the-job training, deficit remediation, 
adaptive and
assistive devices/technologies and all of these are unique to each client.  However, 
vocational assessments done by Psychologists did not look at any of these issues, thus 
the real-world application of their recommendations was very limited in my opinion.

I also do worksite assessments from a return-to-work perspective and this has a clear 
vocational focus as well.  Needless to say a lot of this looks at the physical demands 
of a position, and how best a job incumbent could return to work with or without 
modifications to the responsibilities and the work place environment.  However, this 
aspect of the OT role takes a more physical medicine and adaptive/assistive devices 
perspective
based on issues like range-of-motion, the incumbent's physical endurance, fatigue and 
pain management.

As regards Case Management, I also wear the hat of a Case Manager in my work.  And 
this means that I enable and provide support to my client's around the management of 
their life issues.  These range from medication compliance, mental status exams, 
therapeutically influencing clients to move to more productive social roles, 
vocational/educational goal-setting, training, housing, health management, life 
skills, income and
community/socializing and leisure issues etc.

Hope this is responsive to what you wanted to know, at least from a Canadian 
perspective.

Best,

Biraj

Mr Michael Deen wrote:

> G'day All,
>
> I have noticed from numerous discussions on this list that there appears to be quite 
> a bit of role conflict between OTs and PTs in the USA.  Just wondering if there are 
> any role conflict concerns between OTs and Rehabilitation Counsellors.  I work in 
> vocational rehabilitation in Australia and although I do not feel there are any 
> issues regarding role delineation between OTs and RCs I see that our underlying 
> theory is quite similar.
>
> Do OTs in the US (and/or other countries around the world) have much to do with RCs? 
>  Do OTs in the US have much of a role in vocational rehabilitation or in case 
> management?
>
> Cheers
>
> Mike
>
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