Entrepreneurs of ourselves: When vocational rehabilitation is career

development (and why that matters)

Dr Joanna Fadyl

Senior Lecturer: School of Clinical Sciences

Deputy Director: Centre for Person Centred Research

joanna.fadyl@aut.ac.nz

• Interdisciplinary health research centre based at AUT

• Occupational therapy, physiotherapy, psychology, sociology, speech therapy, policy, anthropology, nursing

• International level research in rehabilitation and disability.

• Understand personal experience and social context of disability and rehabilitation

• Facilitate engagement in rehabilitation and self-management of long term conditions

• Promote health, well-being and participation in a good quality of life for people experiencing disability

• Develop strategies for timely and efficient knowledge translation of evidence into practice

Director: Nicola Kayes

Deputy Director: Jo Fadyl

https://cpcr.aut.ac.nz

Vocational rehabilitation research within the Centre (Lead: Fadyl)

• Innovative inter-disciplinary research (across health &

social sciences)

• Embedded in end-user partnerships

• Examine key social and political influences on real-

world VR practices and outcomes

• Addressing both local context and international trends

Examples of recent VR research

• Work-ability Support Scale (Fadyl, McPherson, Turner-

Stokes, Schluter):

• Development of a tool for assessing work-ability in terms of the

rehabilitation, modification and/or inter-dependence

required to enable someone to work in a specific job

• Developed in NZ community context, specifically for

vocational rehabilitation practice

• Tool and resources available on Research Centre website.

• Role of societal understandings of ‘value’ in vocational rehabilitation (Fadyl, Payne, McPherson, Nicholls)

• Sociological analysis of how wider social discourses regarding

what is ‘valuable’ affect the opportunities available to

individuals going through vocational rehabilitation

• Summary of recent article in CDANZ Winter 2016 Ezine.

• Aspect of this research theme part of today’s discussion

Current social context of vocational rehabilitation

How we conceptualise work and disability in NZ society

Citizenship in the 21st century: a multitude of responsible individuals

VR: Developing and contributing selves

• Notion that work contributes to self development,

and people contribute their self to society through

work

• Vocational rehab as a preserver / restorer of this

process

Work in a ‘neo-liberal’ context

• Worker ‘value’ is complex and variable

• Not simply labour and time

• Viewed in terms of what is valued in an employment

‘market’

• Employers and workers are ‘consumers’ of work and

employment respectively.

• Jobs are less ‘secure’ and employees want opportunities

and flexibility

• ‘Employability’ rather than commitment to a specific job

that ensures continued employment

Disability reframed as qualification (value)

“So many people talk about disability as a hindrance to

working. I have found the opposite. Going to hell and

back helped me to understand other people’s pain and

has meant that in my chosen profession of Psychology I

can connect with people in ways I never dreamed”

(Lea Galvin, quoted in Verkaaik, 2009, p. 130).

“Hire them. In general if someone has a disability, you’ll

get tenacity and a strong work ethic. They’ve gone

through the process of adjusting to their disability and

working hard to minimise its impact, and that translates

to hard work and loyalty.” (Kendall Akhurst’s advice to

employers, Employers’ Disability Network, 2012b)

Disability as diversity; market responsiveness (consumers)

“A disability confident business is a more efficient, more

inclusive, forward- thinking organisation. In a tight labour

market and a competitive market- place, disability

confidence can give businesses an edge. Involving

disabled people in product development, testing and

marketing helps create products and services which

work for everyone—critical in an ageing market.

Businesses which make sure they really understand and

welcome disabled people have better reputations with

both the public and with the growing number of

companies and public sector organisations that use

diversity as a criteria for contracting and investment.”

(Workbridge, 2012)

Concepts of ‘value’ within vocational rehabilitation

Our sociological study

Conceptualising VR as manipulating worker ‘value’

• Research looking at the ways in which worker ’value’ is both conceptualised and manipuated in VR

• Discourse analysis of approaches to VR in New Zealand & categorisation according to how they view and work with worker value: • Retaining ‘value’: Identifying and addressing ‘barriers to work’ • Investing to create ‘value’(e.g. supported employment)

• Re-envisaging ‘value’ and identifying and/or creating

employment niches

Full description of study and findings available at: http://dx.doi.org/10.1111/1467-9566.12212 (publisher version - journal subscription required) or: http://aut.researchgateway.ac.nz/handle/10292/8874 (submitted version - open access)

Retaining worker ’value’

• VR largely about identifying what is preventing an individual being able

to work and addressing this through interventions

• E.g. adaptation of workplace and/or job, employer and employee education, strategy use, rehabilitation.

• Assessment of work dis/ability may focus on:

• physical function

• cognitive skills

• social functioning

• issues that affect work functioning outside job - e.g. family, emotional

• Aim of intervention to minimise or eliminate the barriers preventing the

individual being able to perform a specified job (ideally already held or

skilled and experienced to do based on work history)

• i.e. hindering their ‘value’ as an employee

• Services evaluated by how efficiently and effectively they help the

individual overcome these barriers

• Examples of measures: time until return to work; work-ability for matched job

Investing to create worker ‘value’: example of supported employment

• Supported employment approach varies across sector, distinguished by

primacy of on-the-job learning and support.

• Based getting individual into work environment and role quickly as key to empowerment and success

• Worker not expected to be ‘work ready’ (able to do job) at time they start

employment.

• Job developer and Job coach and/or other support person aid in

balancing employer’s needs to get job done and employee’s need for

learning, experience, adaptation, strategy development

• Enable the worker to achieve job tasks and productivity with support, and develop their skills and strategies, over time being able to work towards reducing support required.

• Not required for the support to be eliminated within particular timeframe

• Aim to enable people who experience significant disability access to

mainstream jobs / workplaces

• In this model, ‘value’ discussed in reference to investment: putting

resource into creating an individual who is able to be a productive

worker from someone who previously was not contributing in this way

Re-envisaging ‘value’ and identifying and/or creating employment niches

• Focused on re- envisaging the experience of disablement as a shift in the

‘value’ that is offered in an employment market.

• Old skills and abilities may be left behind, but new ones and the ‘value’ they offer are identified.

• Process of ‘empowerment’: role of the vocational rehabilitation

practitioner is to partner with or figuratively stand behind the individual to

help them re-envisage / re-create their worker selves

• Responsibility on the individual who is experiencing disability to ‘lead’ the re-envisioning process

• Key aim not to see the disabled individual as diminished in their function

or abilities, but enhanced in different ways – offering value in a way that

may be unique

• Assumes ‘value’ is not strictly defined, and that it can be discovered or created.

Key implications for future directions at this stage of research programme

• From case study analysis:

• Engagement with vocational rehabilitation (VR) can often be

a process of embodying a different worker identity – even

when the injury or condition is not classed as ’major’.

• In our society, work identity and self identity are closely linked.

Thus, VR can be seen as a process of becoming – of

transforming one’s self.

• From sociological analysis:

• VR often characterised as purely ‘functional’ – addressing

barriers to work rather than career development – BUT many

emerging VR practices in NZ challenging this.

• Occurs across the categories discussed – all of the three

approaches to manipulating ‘value’ can vision VR as a

process of becoming

What happens when we view vocational

rehabilitation as a process of becoming?

A next stage of the inquiry …

Questions to consider as we do this exercise …

• What are the opportunities and risks associated with this

approach • For VR clients?

• For VR practitioners?

• For VR funders?

• In what ways does this approach already view VR as a

process of becoming?

• In what ways could this approach view VR as a process

of becoming and how does it change the opportunities

and constraints identified?

Example from services focused on ‘barriers to work’

Practice Some discourses that construct the practice

Some effects

Identifying barriers that are preventing a person being able to do a job and using rehab and/or environmental modification to minimize or eliminate them as part of a return-to-work plan

- Values independence and maintaining existing career capital

- Draws on discourses that injuries should be as minimally disruptive to a person’s life as possible – the more time spent out of ‘normal’ life, the greater the chance of long-term effects.

- High value placed on restoring capability and minimising disruption often do achieve these things

- Small but significant number of people experience major disruption and/or considerable changes to abilities or capability to work as they were before. In these cases, value on independence and maintenance of existing career capital can further emphasise a feeling of failure or crisis.

Example from services focused on supported employment

Practice Some discourses that construct the practice

Some effects

Practice of ‘place and train’ with long-term support. Employer engagement and employment support key activities.

- Values mainstream employment over training or sheltered employment schemes

- Draws on discourses that having disabled people in the workplace benefits an employer – ‘value’ as loyal, dedicated, used to facing challenges …

- Resists the value placed on independence in favour of inter-dependence

- Access to a jobs (and social opportunities) that a person would not normally be considered for – a way of changing what’s valuable and possible

- The value on inter-dependence as opposed to independence risks positioning a person as different or ‘other’ in a workplace – service design needs to consider how this is managed.

Example from services focused on VR as re-visioning worker ‘value’

Practice Some discourses that construct the practice

Some effects

Practice of ‘re-visioning’ what a person’s job and/or career contribution could be following change in abilities. Career guidance as main activity.

- Work is a core part of life; and that everyone faces challenges

- Utilizes discourses of diversity to resist notion that disability is different to other challenges - only one of a whole raft of possible career-changing events (and ‘normal’, could happen to anyone …)

- Job market as flexible and able to be manipulated, and employment ‘value’ as co-constructed

- Promotes and idea that services, employers, etc should see disability as one of life’s challenges rather than something out of the ordinary – promoting the valuing of a person as a ‘whole package’.

- Positions work and career as central to life

- Forward-thinking focus can obscure some of the very real negative, challenging or painful sides of this particular ‘life change’. Service design must be very mindful of this.

Moving forward: next steps in research

• Currently developing a programme of research

focused on what happens when VR is viewed as a

process of becoming, implications for practice and

policy

• Collaborative approach working with VR providers in

development and execution of the research

• Love you to express your interest – please contact me!