Occupational Therapy and Vocational Rehab · STATE VOCATIONAL REHABILITATION AGENCIES • All 50...

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Occupational Therapy and Vocational Rehab

June 3, 2020

CEU REQUIREMENTS

If you plan on requesting continuing education credits, you MUST complete all of the following steps:

1. You must have registered online for today’s session

2. Dial-in to the audio portion of the webinarPlease note that participants who “listen-in” on another participant’s line will NOT be eligible for credit.

3. Within 2 WEEKS of this session:

Complete the evaluation*

Complete the post-test & earn a passing grade*

*An email with links to the evaluation and post-test will be sentThursday afternoon (6/4/2020) by 5:00 pm ET.

**Certificates will be emailed within 4 weeks**

SPEAKERS

Dorra Blacker, CRC, LMHCRusk Rehabilitation, NYU Langone Health

Gabrielle Miskovitz, OTR/L, CHT, CLT Memorial Sloan Kettering Cancer Center

This publication is designed to provide general information on the topics presented. It is provided with the understanding that the author is not engaged in rendering any legal or professional services by its publication or distribution. Although

these materials were reviewed by a professional, they should not be used as a substitute for professional services.

AN OVERVIEW OF VOCATIONAL REHAB SERVICES

Dorra Blacker, CRC, LMHCRusk Rehabilitation, NYU Langone Health

VOCATIONAL REHAB SERVICES AGENDA

• Vocational Counseling• Return to Work — Self-Assessment Techniques• Strategies for a Career Change• Diagnostic Vocational Evaluation• Job Placement Services• Community Resources

VOCATIONAL COUNSELING

• Helping individuals with disabilities identify a realistic plan to achieve their highest vocational, academic or avocational goal

• Counseling addressing adjustment to disability within a vocational context — ”new normal”

• Return-to-work issues• Change-of-career strategies

QUESTIONS ASKED DURING COUNSELING

• Will I be able to return to my job?

• How do I know if I can go back to work?

• What if I can’t do the same job as before?

• What if I can only do part of my job?

• What accommodations do I need?

• What do I tell my employer?• What other skills do I have? • What if I don’t want to return to my job?

• Should I give up my disability benefits?

• What do I put on a resume?

CHALLENGES DEALING WITH TREATMENT; RETURN-TO-WORK ISSUES & RECOVERY

• Renewed goals• Physical and cognitive issues — “chemo brain” (cognitive deficits), fatigue, stamina

• Reasonable accommodations- ADA requests• Compensatory strategies• Financial concerns — medical benefits, long-term disability

RETURN-TO-WORK ISSUES: SELF-ASSESSMENT

• Important to know your strengths and challenges• May experience cognitive or physical deficits• Fatigue issues — may now need to work part-time, flexible hours or a home-based job, frequent breaks

• May require more structured job duties, extra time for tasks

• Reduced distraction in work environment-quieter office, closer to restroom

• Less stressful work environment• Explore consulting opportunities

CAREER CHANGE: INDEPENDENT SEARCH

• What do you want to do?• O*Net Interest Profiler — structured tool for career exploration, provided by the U.S. Dept. of Labor

• Computerized system to help identify strongest work-related interests

• Knowing interests can help decide the kinds of jobs & careers to explore

• Assists in identifying interests by responding to questions of likes & dislikes

• Interests & categories are revealed, not aptitudes or skill level

• Provides basic information to start career exploration

OPPORTUNITIES WITHIN THE SAME FIELD

• Explore opportunities within the same field that provide more accommodations needed for functional purpose

• Reach out to current contacts• Coworkers, friends & family can be valuable resources• Contact professional organizations• Think outside the box• Examine your transferrable skills

LEARNING ABOUT DIFFERENT CAREERS

• Informational interviews• Contact human resources departments• Contact friends and family• Contact professional organizations• Occupational Outlook Handbook• U.S. Department of Labor website• Take a continuing education course• Read college bulletins as to the direction the field is taking

VOLUNTEER OPPORTUNITIES• Try out a new area of interest• Gain knowledge regarding job duties• Reveals your hidden strengths• Provides socialization and networking skills• Experience and qualifications to put on a resume (under Community or Work Experience)

• Provides a future reference• Excellent environment to assess stamina/cognitive issues

• Can lead to future job leads

DIAGNOSTIC VOCATIONAL EVALUATION

• More formalized program sponsored by State VocRehab agency regarding return-to-work issues or forming a realistic vocational goal based upon skills, aptitudes and interests

Focus on:• Career development• Enhance self-awareness• Identify cognitive

processing style• Generate worker profile• Generate viable work

goals• Short-term program

• Provide academic/aptitude assessments

• Assess work stamina/endurance

• Assess cognitive status• Assess needed

accommodations and strategies

• Simulate job duties

JOB PLACEMENT SERVICES

• Job applications and telephone contacts• Writing cover letters & resumes• Finding job leads and the hidden job market• Electronic job search• Social media sites• Interviewing skills & techniques• Disclosure/non-disclosure of disability• Reasonable accommodations• Job-retention & career-enhancement strategies

CAREER INTERNSHIPS

Pre-requisites• Job goal• Appropriate work

behaviors• Job skills related to field• Job ready

Benefits• Obtain valuable work

experience and a current job reference

• Opportunity to refine and develop job skills

• Increase work stamina

STATE VOCATIONAL REHABILITATION AGENCIES

• All 50 states, the District of Columbia, and the U.S. Territories have VR agencies

• Provides services to assist eligible individuals with disabilities to obtain employment

• Helps people prepare for and obtain a job

• Provides services (i.e.,: diagnostic vocational evaluation, training and placement)

• Career counseling• Rehabilitation and

assistive technology• Other services necessary

to achieve the employment goal

REFERRALS AND RESOURCES

National Resources• Department of Labor: www.dol.gov• O*Net: www.onetcenter.org• Volunteer sites: www.idealist.org, www.volunteermatch.org• Google: State Vocational Rehabilitation Agency

– List of State VR Agencies: www.fda.gov/downloads/AboutFDA/WorkingatFDA/UCM277757.pdf• Job Accommodations: www.jan.org• U.S. Equal Employment Opportunity Commission: www.eeoc.gov

NYC Resources • ACCES-VR

• Vocational Rehab: Rusk Rehab, 212-263-6052 • Dorra.blacker@nyumc.org

Brooklyn 718-722-6700 Staten Island 718-816-4800

Manhattan 212-630-2300 Bronx 718-931-3500 Queens 347-510-3100

AN OVERVIEW OF OCCUPATIONAL THERAPY SERVICES

Gabrielle Miskovitz, OTR/L, CHT, CLTMemorial Sloan Kettering Cancer Center

OCCUPATIONAL THERAPY SERVICES: KEY TOPICS

• Posture• Home & Office Workstation Ergonomics• Tool Modifications• Cognitive Challenges• Strategies for Performance Improvement• Energy Conservation Tips

WHAT IS OCCUPATIONAL THERAPY?“… a health profession whose goal is to help people achieve independence, meaning and satisfaction in all aspects of their lives.”

“The occupational therapist’s goal is to provide the client with skills for the job of living — those necessary to function in the community or in the client’s chosen environment.”

— http://steinhardt.nyu.edu/ot/definition/

ROLE OF OCCUPATIONAL THERAPY IN CANCER CARE

“…to facilitate and enable an individual patient to achieve maximum functional performance, both physically and psychologically, in everyday living skills regardless of his or her life expectancy.”

– Penfold S, 1996

COMMON PHYSICAL ISSUES

• Shoulder pain–Impingement–Rotator-cuff pathology–Adhesive capsulitis

• Elbow pain –Lateral/medial epicondylitis

• Joint pain–Wrists–Fingers

• Dropping coins, utensils• Difficulty with fasteners• Difficulty using phone• Difficulty manipulating medications

CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY

• Numbness• Tingling• Weakness• Cramping

TREATMENT ACTIVITIES

• Theraputty• Fine Motor retraining• Sensory Re-education• Vibration

ERGONOMIC ASSESSMENT FOR WORK & HOME

• Workstation setup–Monitor–Keyboard, mouse–Phone

• Seated posture–Back support–Foot support

• Person/tool interface–What is the movement pattern?

ERGONOMIC TOOLS FOR WORK & HOME

• Keyboard and mouse

COMMON COGNITIVE CHALLENGES

MEMORY

• Lost items (e.g., keys, glasses)• General “forgetfulness”• Medications — missed doses• Forgotten conversation/interactions

MEMORY STRATEGIES

• Categorization• Context• Visualization• Verbalization

• Rehearsal• Repetition• Phone alarms

ATTENTION

• Breakdown with multi-step activities – meal preparation

• Difficulty reading the newspaper

• No longer reading books• Difficulty with activities later in

the day

ATTENTION STRATEGIES

• Avoid multitasking – One task at a time

• Challenging tasks – When energized

• Avoid distractions– Earbuds/Earplugs

• Chunking

• Outlining• Focus questions

– What is my point?– What is my plan?– What did I just read/

learn?

ORGANIZATION

• Medication management

• Community access• Household

management• Multiple work projects

ORGANIZATION STRATEGIES

• Visualize directions before community access

• Energy-conservation techniques

• Day Planner• Set time limits• Color coding

• PowerPoint presentations• Managing email• Coping with distractions• Meetings

WORK TASKS

• Practice use of software program• Immediate notes after meetings• Plan each day

– Periodic email checks– Time limits

WORK TASKS STRATEGIES

Occupational Therapy and Vocational Rehab · STATE VOCATIONAL REHABILITATION AGENCIES • All 50...

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