Vocational rehabilitation

These disorders should concern all physicians and mental health professionals for several reasons. First, mood disorders are very common and will be encountered on a daily basis in most clinical settings (see Table 3.1). Second, they disrupt life in numerous ways. During an episode of depression or mania, sleep patterns change, appetite and eating are affected, family life is disrupted, work efficiency suffers, substance abuse rates soar, and physical illness is exacerbated. Thus, comprehensive treatment of mood disorders routinely requires the work of nutritionists, social workers, family therapists, vocational rehabilitation counselors, substance abuse counselors and 12 step groups, primary care physicians, and others. 

In addition to adequate pharmacotherapy, specific forms of psychotherapy may also be indicated. These may include cognitive or interpersonal psychotherapy or various behavior desensitization and biofeedback techniques. Some patients may benefit from insight-oriented psychotherapy group, family, or marital counseling or both. Finally, in more chronic disorders, patients often benefit from vocational rehabilitation. A knowledgeable clinician realizes that these disorders do not occur in a vacuum, and, regardless of diagnosis, each patient requires an individualized treatment plan to optimize outcome. 

The goal of medication treatment is to reduce symptoms so that the person can function better and benefit more from other forms of treatment, such as individual, group, or family therapy and social or vocational rehabilitation. An important part of such therapy involves educating the patient to prodromal symptoms and effects and side effects of medications. It is also important to address patients beliefs that taking medications means they are sick (and conversely, that not taking medications means they aren t). Especially with paranoid patients, the belief that medications are a means of being controlled by others must be worked through. 

C Vocational rehabilitation May fund the purchase of an assistive device. 

Workers compensation laws provide payments for medical expenses, burial expenses, loss of wages, and impairments. Most provide payment for physical and vocational rehabilitation. Some provide for mental rehabilitation. 

Rehabilitation Expenses There are two main kinds of rehabilitation. Physical rehabilitation involves therapies intended to regain lost strength and movement. Vocational therapy involves regaining lost work skiUs or learning new skUls. Most workers compensation benefits typicaUy cover physical rehabilitation as a medical expense. Provisions vary for vocational rehabilitation. Some states require the employer to pay for vocational rehabilitation. Some laws have maximmn payments, limit the period allowed for training or limit total expenses per case. Under the Federal Vocational Rehabilitation Act, states receive federal funds to help cover the cost of retraining persons disabled in industrial accidents. 

Specific cases are categorized as temporary partial, temporary total, permanent partial, or permanent total. Other categories of benefits include retraining incentive benefits for employees who may have specific injuries. These benefits are paid for a limited period of time to aid the injured in pursuing additional education or training. Vocational rehabilitation services may be offered to employees who are eligible for permanent total disability benefits and actively participate in a vocational rehabilitation program. Survivors of employees killed in industrial accidents may be entitled to their benefits as well. 

Vocational Rehabilitation Act Amendments of 1965 (29 U.S.C. 41a(b)(4)). This act authorizes grants to assist in meeting the costs of construction of public or other nonprofit workshops and rehabilitation facilities. 

The Eederal Employees Compensation Act (FECA), 5 U.S.C. 8101 etseq., establishes a comprehensive and exclusive workers compensation program which pays compensation for the disability or death of a federal employee resulting from personal injury sustained while in the petformance of duty. The FECA, administered by OWCP, provides benefits for wage loss compensation for total or partial disability, schedule awards for permanent loss or loss of use of specified members of the body, related medical costs, and vocational rehabilitation. 

In all these matters the BGs act in close liaison with the employers, and in this respect the division according to branches of industry and common interests has proved effective. The BGs maintain, mostly in conjunction with other insurance institutions, several modern centres for vocational rehabilitation and are financing and establishing further centres. 

Of about 65 000 industrial accidents which required compensation, vocational rehabilitation after the completion of medical treatment was nec-... 

Concerns that disproportionate numbers of children with serious emotional disturbance were being removed from their communities led to the development of systems of care in the 1980s. In 1992, Congress passed the Comprehensive Mental Health Services for Children and Their Families Program which supported the development of these systems of care. A system of care is in or near the home and community. In fiilly developed systems of care, local public and private organizations work in teams with families and children to both plan and implement individualized services for each child s physical, emotional, social, educational, and family needs. Teams include family advocates and representatives fi om mental health, health, education, child welfare, juvenile justice, vocational rehabilitation, recreation, substance abuse, and other services. Systems of care have supported the use of mental health clinicians in schools, school- and community-based wraparound planning and services, and student support services (Woodruff et al., 1999). 

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