Skip to main content
SpringerLink
Log in

Effective Teams in Vocational Rehabilitation: An Exploration of Complexities and Practice in Aotearoa-New Zealand

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose

Vocational rehabilitation (VR) involves complex skills, and often inter-disciplinary teams need to work effectively to meet the needs of stakeholders. Research highlights important influences on effective teamwork, including funding systems, team structure, policies and procedures, and effects of professional hierarchies. This qualitative study aimed to explore these issues in-depth including how factors interact to produce problems and solutions. We focused on identifying challenges and opportunities for VR teams working in the Aotearoa-New Zealand context which may also be transferrable to other settings.

Methods

Qualitative descriptive instrumental case study involving focus groups and interviews with two VR teams (n = 14). Teams worked in musculoskeletal injury and were geographically diverse. Reflexive thematic analysis was used to analyse the data.

Results

Analysis constructed three overarching themes: Having the Power, Being Human, and VR is Not for Everyone. Achieving trusting relationships within the team was paramount. This was achieved through seeing everyone as equal, and as human. Equality within the team was particularly important for professionals that occupied different positions of power in a wider professional hierarchy. VR specialist skills (experience and postgraduate qualifications) were often under-recognised, leading them to have little power in VR decision making processes. VR professionals also experienced competing demands between client needs and business drivers.

Conclusion

Findings offer detail of processes teams engage in to create effective team relationships and manage systemic factors to facilitate positive outcomes. Additionally, findings highlight opportunities in decision-making processes for VR medical certification that may increase job satisfaction and better utilize skills and expertise.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Waddell G, Burton K, Kendall N. Vocational Rehabilitation What Works, for Whom, and When ? Vocational Rehabilitation Task Group. 2008.

  2. Stubbs J, Deaner G. When considering vocational rehabilitation: describing and comparing the swedish and american systems and professions. Work. 2005;24[3].

  3. Brunarski D, Shawb L, Doupec L. Moving toward virtual interdisciplinary teams and a multi-stakeholder approach in community-based return-to-work care. Work. 2008;30[3].

  4. Loisel P, Durand MJ, Baril R, Gervais J, Falardeau M. Interorganizational collaboration in occupational rehabilitation: perceptions of an interdisciplinary rehabilitation team. In: Journal of Occupational Rehabilitation. 2005.

  5. Øyeflaten I, Lie SA, Ihlebæk CM, Eriksen HR. Prognostic factors for return to work, sickness benefits, and transitions between these states: a 4-year follow-up after work-related rehabilitation. Journal of Occupational Rehabilitation. 2014;24[2].

  6. McKinlay E, MacKie S, Arcus K, Nelson K. Work and wellness hand-in-hand: the role of the New Zealand PATHS program nurse in improving health and employment outcomes. Rehabilitation Nursing. 2012;37[4].

  7. Sandström U, Lundborg CS, Axelsson R, Holmström I. Variation in views on clients in interprofessional work for vocational rehabilitation in Sweden. Journal of Interprofessional Care. 2007;21[5].

  8. Accident Compensation Corporation. What we do [Internet]. 2020 [cited 2022 Feb 20]. Available from: https://www.acc.co.nz/about-us/who-we-are/what-we-do/.

  9. Accident Compensation Corporation. Service Schedule For Vocational Rehabilitation Services. 2021 Jul [cited 2022 Feb 20]; Available from: https://www.acc.co.nz/assets/contracts/vrs-schedule.pdf.

  10. Ministry of Social Development. Work and Income [Internet]. [cited 2022 Feb 20]. Available from: https://www.workandincome.govt.nz/.

  11. Fadyl J, Mcpherson K, Nicholls D. Re/creating entrepreneurs of the self: discourses of worker and employee “value” and current vocational rehabilitation practices. Sociology of Health and Illness. 2015;37[4].

  12. Shaw L, Walkerb R, Hoguec A. The art and science of teamwork: enacting a transdisciplinary approach in work rehabilitation. Work. 2008;30[3].

  13. Désiron HAM, Donceel P, Godderis L, van Hoof E, de Rijk A. What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts. European Journal of Cancer Care. 2015;24[2].

  14. Cartmill C, Soklaridis S, David Cassidy J. Transdisciplinary Teamwork. The Experience of Clinicians at a Functional Restoration Program. Journal of Occupational Rehabilitation 2010 21:1 [Internet]. 2010 Jun 1 [cited 2022 Feb 20];21[1]:1–8. Available from: https://link.springer.com/article/10.1007/s10926-010-9247-3.

  15. Aust B, Nielsen B, Grundtvig G, Buchardt H, Ferm L, Andersen I, et al. Implementation of the Danish return-to-work program: process evaluation of a trial in 21 Danish municipalities on JSTOR [Internet]. Scandinavian Journal of Work, Environment & Health. 2015 [cited 2022 Feb 20]. p. 529–41. Available from: https://www.jstor.org/stable/44000303.

  16. Ståhl C, Svensson T, Petersson G, Ekberg K. The Work Ability Divide: Holistic and Reductionistic Approaches in Swedish Interdisciplinary Rehabilitation Teams. Journal of Occupational Rehabilitation 2009 19:3 [Internet]. 2009 Jun 2 [cited 2022 Feb 20];19[3]:264–73. Available from: https://link.springer.com/article/10.1007/s10926-009-9183-2.

  17. Brendbekken R, Eriksen HR, Grasdal A, Harris A, Hagen EM, Tangen T. Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention: A Randomized Clinical Trial. Journal of Occupational Rehabilitation [Internet]. 2017 Mar 1 [cited 2022 Feb 20];27[1]:82–91. Available from: https://link.springer.com/article/10.1007/s10926-016-9634-5.

  18. Hancock DR, Algozzine R. Doing case study research: a practical guide for beginning researchers. 2017.

  19. Terry G, Hayfield N, Clarke V, Braun V. Thematic analysis. The SAGE handbook of qualitative research in psychology. 2nd ed. SAGE Publications; 2017. pp. 17–37.

  20. Terry G, Hayfield N. Essentials of thematic analysis. Washington DC: American Psychological Association; 2021. 108 p.

    Book  Google Scholar 

  21. Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Education for Information [Internet]. 2004 [cited 2022 Feb 20];22[2]:63–75. Available from: https://www.researchgate.net/publication/228708239_Strategies_for_Ensuring_Trustworthiness_in_Qualitative_Research_Projects.

  22. Cozijnsen L, Levi M, Verkerk MJ. Why industrial methods do not work in healthcare: an analytical approach. Internal Medicine Journal [Internet]. 2020 Feb 1 [cited 2022 Feb 20];50[2]:250–3. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14730.

  23. Clark FA. Power and Confidence in Professions: Lessons for Occupational Therapy: [Internet]. 2010 Dec 1 [cited 2022 Mar 9];77[5]:264–9. Available from: https://doi.org/10.2182/cjot.2010.01.77.5.2

  24. Gabel S. Power, leadership and transformation: the doctor’s potential for influence. Medical Education [Internet]. 2012 Dec 1 [cited 2022 Mar 9];46[12]:1152–60. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/medu.12036.

  25. Gauld R, Ma RG. Disrupting the present to build a stronger health workforce for the future: a three-point agenda. 2018.

  26. Green B, Oeppen RS, Smith DW, Brennan PA. Challenging hierarchy in healthcare teams – ways to flatten gradients to improve teamwork and patient care. British Journal of Oral and Maxillofacial Surgery. 2017 Jun 1;55[5]:449–53.

  27. Dew A, Barton R, Ragen J, Bulkeley K, Iljadica A, Chedid R, et al. The development of a framework for high-quality, sustainable and accessible rural private therapy under the Australian National Disability Insurance Scheme. https://doi.org/103109/0963828820151129452 [Internet]. 2016 Dec 3 [cited 2022 Mar 9];38[25]:2491–503. Available from: https://www.tandfonline.com/doi/abs/10.3109/09638288.2015.1129452.

  28. Hart T, Dijkers M, Fraser R, … KCTJ of H. 2006 undefined. Vocational services for traumatic brain injury: treatment definition and diversity within model systems of care. The Journal of Head Injury Rehabilitation [Internet]. 2006 [cited 2022 Mar 9];21[6]:467–82. Available from: https://journals.lww.com/headtraumarehab/Fulltext/2006/11000/Moderating_Factors_in_Return_to_Work_and_Job.00002.aspx.

  29. Jones A, Jones D. Improving teamwork, trust and safety: An ethnographic study of an interprofessional initiative. 103109/135618202010520248 [Internet]. 2011 May [cited 2022 Mar 9];25[3]:175–81. Available from: https://www.tandfonline.com/doi/abs/10.3109/13561820.2010.520248.

  30. Breuer C, Hüffmeier J, Hibben F, Hertel G. Trust in teams: A taxonomy of perceived trustworthiness factors and risk-taking behaviors in face-to-face and virtual teams: [Internet]. 2019 Feb 17 [cited 2022 Mar 9];73[1]:3–34. Available from: https://doi.org/10.1177/0018726718818721.

  31. Terry G, Kayes N. Person centered care in neurorehabilitation: a secondary analysis.[Internet]. 2018 Jul 30 [cited 2022 Mar 9];42[16]:2334–43. Available from: https://doi.org/10.1080/09638288.2018.1561952.

  32. Brougham D, Haar J, of MRNZJ. 2015 undefined. Work-family enrichment, collectivism, and workplace cultural outcomes: A study of New Zealand Maori. search.informit.org [Internet]. [cited 2022 Mar 9];40[1]:19–34. Available from: https://doi.org/10.3316/INFORMIT.034773254783532.

  33. Moeke-Pickering TM. Maori Identity Within Whanau: A review of literature [Internet]. 1996 [cited 2022 Mar 9]. Available from: https://researchcommons.waikato.ac.nz/handle/10289/464.

Download references

Funding

First author has received research support from APM Workcare Ltd. This included contribution [$4000 NZD] towards the larger Masters Degree funding. It should be noted that L.M. was originally employed by Fit For Work Ltd at the time of data collection and the funding was taken on by APM Workcare Ltd.

Author information

Authors and Affiliations

  1. Centre for Person Centred Research, APM Workcare Ltd., Auckland University of Technology, Auckland, New Zealand

    Lisa McAulay, Joanna Fadyl & Gareth Terry

Authors
  1. Lisa McAulay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanna Fadyl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gareth Terry
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The primary author Lisa McAulay completed the research as part of a larger Master of Health Science thesis. She completed the study conception, data collection and analysis for the research. Dr Joanna Fadyl and Dr Gareth Terry supported with developing the design of the study and refining of themes during the analysis. The first draft of the manuscript was written by Lisa McAulay and this was reviewed and edited by all authors throughout the drafting process. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lisa McAulay.

Ethics declarations

Competing Interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics Approval

Ethics approval for the study was gained through the Auckland University of Technology Ethics Committee.

Consent to Participate

Written Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary Material 2

Supplementary Material 3

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McAulay, L., Fadyl, J. & Terry, G. Effective Teams in Vocational Rehabilitation: An Exploration of Complexities and Practice in Aotearoa-New Zealand. J Occup Rehabil 33, 518–527 (2023). https://doi.org/10.1007/s10926-022-10089-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-022-10089-w

Search

Navigation