Return-to-Work Site - OT Student
Tim Wolf - Occupational Therapy Student
Washington University School of Medicine, St. Louis, MO
(9/23/05) My first Level II fieldwork was at a site called the Occupational Performance Center (OPC) at the Rehabilitation Institute of St. Louis (TRISL). TRISL is a rehabilitation hospital run by Healthsouth and BJC health systems. The OPC is a Washington University facility that is run out of TRISL. The focus of the OPC is very specialized on return to work issues. In contrast to work-hardening centers that are out in the community, Washington University believed that we should target people much earlier in rehabilitation and begin to prepare them for return to work. In order to accomplish this, traditional methods of work rehabilitation had to be scaled down since the hospital did not allow for all the equipment necessary to operate a work-hardening center. Also, new and different interventions had to be explored, as the patient population now included a lot of individuals with cognitive deficits. The shift from mostly musculoskeletal injuries to cognitive rehabilitation is a deviation from traditional work-hardening centers.
At the OPC I had the opportunity to work with individuals with brain injuries secondary to stroke, motor vehicle accident, aneurysm, accident, or other traumas. Some of our other diagnoses included spinal cord injury, lupus, multiple sclerosis, amputation, and others. Our interventions are focused mainly on job simulation. We complete an in-depth interview with our clients, along with the initial evaluation. We then set up activities to simulate their job environment as the focus of treatment. One example is an attorney I was treating who had memory loss due to an aneurysm resection. We set up a mock deposition to help detect deficits related to that aspect of his work. We then work with our clients to either remediate or learn strategies to compensate for their deficits related to job function. In addition to job simulation, we explore all the other necessary functions related to working. Some examples include transportation, interviewing, general worker behaviors (e.g. timeliness and productivity), education on the Americans With Disabilities Act and other legislation, how to fill out an application, referral to other community resources, job site visits, and more.
There are many reasons why I enjoyed working at the OPC. I appreciate the fact that we had longer appointments to allow for more effective interventions. I also enjoyed the freedom we had to do almost anything necessary to help clients return to work, like going on job site visits or assisting with interviewing. It was extremely rewarding to hear back from clients when they began a new job or returned to their previous employment and know that I played a small role in that. My appreciation goes out to my clinical instructors, Mary and Sue, and my patients I worked with that summer.
