Nationwide Occupational Therapy, All Ages, All Injuries

Vocational Client Stories

18 November 2022

Vocational Client Stories

Putting vocational rehab at the heart of recovery

Through engaging clients in vocational tasks, Think Therapy 1st is supporting countless people to exceed expectations in their recovery and fulfil their goals.

With the latest employment statistics revealing that almost 2.5million people in the UK are currently out of work because of long-term health problems - an all-time record high - the focus is turning to what more can be done to support those who may be able to return to the jobs market.

One in three people in this country have a long-term condition - more than 14 million people - but after six months off, less than 50 per cent will ever return to work. Such stark statistics help to illustrate the scale of the problem.

For Think Therapy 1st, the answer - at least in part - lies in vocational rehabilitation. This approach runs throughout everything its team does, with chosen activities all geared around the client’s end goals and planning the route for them to get there.

And through vocational activities, which are fundamental to Think Therapy 1st's occupational therapy-led functional rehabilitation approach, the impact can be significant on both the mental and Rebuilding lives after physical progress of a client.

"I think it's pivotal, because without a regular productive role - not necessarily paid employment, it could be voluntary work, or caring for a relative or a child - it is very hard to rebuild your life and have a sense of purpose," says Aimee Crane, Operations Director and Occupational Therapist at Think Therapy 1st. "We all need a productive role in our lives. It’s central to our function, our identity, our social status in life, and it impacts our families and communities too. That’s why we put such emphasis on vocational activities from the earliest stages."

Early intervention is key in Think Therapy 1st approach, which follows its Specialist Rehabilitation Occupational Therapy (SROT) model and looks to support clients to achieve their goals - however ambitious or unlikely they may seem at first - by engaging them in activities so enjoyable many do not realise they are part of their rehab programme.

Rebuilding lives after serious injury

With Henry, a 21-year-old seriously injured in a motorbike accident, his goal was to return to his apprenticeship as a bricklayer. But having sustained polytrauma, manual labour seemed an unlikely task to return to.

"I first met him when he was in a hospital bed in his living room with a wheelchair next to him. He was becoming de-conditioned and losing stamina, and of course physical strength is vital in bricklaying," says Aimee.

"He had become low in mood and frustrated because he just wanted to be back with the lads and be part of that camaraderie on the building site. So we started looking at what a return to work would like, from early on in his rehab programme."

"We took everything back to basics, looking at the demands of the job and broke down each task. What are the demands cognitively, physically, emotionally? We highlighted the things that would prove a challenge for him and made a plan."

Henry’s mother had an allotment, which proved a valuable asset in the functional rehab programme Aimee devised.

"We'd be doing things like digging up vegetables, moving pallets from one side to the other, with everything geared around his bend and reach, his ability to squat and kneel, his general mobility, and lifting and carry ability. To him, it felt like he was just helping his mum with her allotment," says Aimee.

"Those movements are all needed in bricklaying, which is very repetitive, and you could be kneeling for a significant period working on one task. We tried to mimic that in the allotment and then build up his tolerance."

Having initially returned to work as a telehandler driver, a less physically demanding role, Henry’s return to bricklaying began with sessions on the ‘dummy’ building site at his college, building upon the skills and tolerance he was gaining in his Think Therapy 1st sessions. Happily, he has now returned to bricklaying full-time and has completed his apprenticeship.

"He did so well and his confidence changed massively when he could go back to work," says Aimee.  "I think the reason we got the amazing outcomes we did was because of the early intervention and early opportunity for rehabilitation.  The statistics on how many people don’t return to work after illness or injury or shocking, and you can understand how it could happen to people like Henry. But through engaging in vocational rehab at the earliest stage possible, it just shows what can happen."

The examples of life-changing levels of success are many and ongoing, with clients continuing to exceed the expectations set for them initially post-injury.

"There are so many, which is what we are all about, that’s what we want to achieve for our clients," says Aimee.

"I’m working with a client at the minute who worked night shifts in a care home before her injury; she has now gone back to work on reduced hours and is working days rather than nights. That in itself is great, but the changes in her self-esteem and confidence are huge.

We’re also seeing that in her standardised assessment scores around her psychological wellbeing. It has been a massive boost for her."

Vocational rehab - vital to recovery

Through its SROT programme, vocational tasks are at the heart of Think Therapy 1st's approach to rehabilitation. The business takes pride in how everything a client does will have some rehab benefit to them, nothing is wasted, and every activity is geared towards progress.

Returning to work can often be a key concern for clients, which is addressed by Think Therapy 1st at its initial rehab needs assessment.

Through its vocational screening, it establishes the current work status against the pre-injury status, as well as the main job roles undertaken pre-injury and the level of effort, be that physical, cognitive or psychological. This can then inform the treatment programme.

"Our therapy model is informed by the Person, Environment and Occupation model (PEO), and as part of occupation, we’re looking at that balance between self-care, productivity and leisure," says Aimee.

"We complete a vocational screening the first time we meet a client, which is very important in informing our treatment programme and understanding the client’s expectations around work. Do they think they’re going to go back to work? Is that reasonable?

There is often work to be done around their expectations and understanding of their injuries, because sometimes people won’t be able to go back to their pre-injury roles. It’s about something that matches their key strengths.

And by being able to get in there early, we can get the maximum outcomes for them."

Aimee also believes the changes to the Fit Note seen earlier this year, which enable occupational therapists to certify for their clients, has been a valuable step forward.

"For the majority of people, there may be some ways that they can get back to work with the right adjustments and changes in place," says Aimee.

"We do a work capability assessment, where we'll assess the client within the demands of their job. We’ll also assess the workplace, which could include one or two different work sites depending on what the job entails, to look at work capability and making any reasonable adjustments.

Through the change to the Fit Note, it does feel like the role of Occupational Therapy is getting the recognition it deserves. We can now make sure our clients and their employers get more detailed and tailored advice around measures that can be considered to enable a employee to return to work, including a phased return to work, amended duties, altered hours and workplace adaptations.

We come to know them well during our time with them, and are central to their rehabilitation, so we are really well placed to give this kind of assessment."

While the positive impact of vocational rehabilitation can be seen in examples like Henry’s, it is not widely used - if at all - in acute or community settings.

Aimee believes is has a much more central role to play to help rebuild lives, and particularly to tackle the issue of how to get people who could work - and want to work - back into a position to do so.

"Vocational rehab and productivity as occupational therapists, it’s what we trained to do, but in an acute setting and then in the community, it wasn’t a priority at all," she says.

"It was either getting them out of hospital safely and carry on the recovery at home, or it was looking at supporting them with adaptions and equipment. The majority of people I came across when I worked in both of those settings were already long-term unemployed - but vocational rehab could be so important in helping to address that.

At Think Therapy 1st, absolutely everything we do from the outset is about rehabilitation, which is a world away from what it is like elsewhere.

We have seen such positive results with our clients, who often don’t even know they’re doing rehab, they just see the changes to their lives and confidence."