A Comparative Study of the Job Tasks,Functions,and Knowledge Domains of Rehabilitation Professionals Providing Vocational Rehabilitation Services in Australia and Germany

Abstract

Vocational rehabilitation services have been implemented in a number of countries to facilitate the return to work of sick and injured workers, yet little research has been undertaken to document competencies required to provide services globally. This study compared the job tasks, functions, and knowledge domains deemed important by Australian and German rehabilitation professionals working in vocational rehabilitation settings to identify common practice domains. An online survey comprising items from the Rehabilitation Skills Inventory–Amended and the International Survey of Disability Management was completed by 149 Australian and 217 German rehabilitation professionals. Items from each measure were submitted to factor analysis, using principal axis factoring as the extraction technique. Three common domains were identified: (a) vocational counseling, (b) workplace disability case management, and (c) workplace intervention and program management. Differences in skill and knowledge domains centered on the levels of specialization in vocational rehabilitation practices in each country. Ongoing transnational research is required to ensure that a “global curriculum” covers core competencies, while at the same time allowing for specialization at a local level.

Keywords

vocational rehabilitation roles and function psychosocial disability management competencies rehabilitation counseling

Countries across the globe are increasingly focusing on vocational rehabilitation services to help manage the rising social and economic costs of disability and injury. With an estimated 700 million people with disabilities worldwide and 270 million work accidents, the US$1.25 trillion costs associated with wage replacement and injury compensation are unsustainable in a globally competitive economic environment (Zimmerman, 2006). When the social costs of injury and disability are also taken into account (Dembe, 2001; Kendall & Muenchberger, 2009), including family disharmony and breakdown, social exclusion, alienation, poor mental health, and marginalization, the imperative for governments to act becomes a matter of human rights (Australian Human Rights Commission, 2005).

Vocational rehabilitation has evolved from a medically driven client-focused restoration of function to become increasingly workplace-focused and ultimately employer-driven. The original emphasis on addressing individual variables to restore function has shifted to a focus on the context, especially the workplace. For example, Blackman and Chiveralls (2011) describe “workplace (vocational) rehabilitation” (p. 537) as a complex process utilizing the workplace and emphasizing the role of the supervisor to promote successful return to work. The evolution of workplace vocational rehabilitation into disability management has taken the workplace focus a step further, becoming an employer-driven model of rehabilitation (Currier, Chan, Berven, Habeck, & Taylor, 2001).

Accompanying the growing importance of vocational rehabilitation services in addressing the fiscal and social costs of injury and disability is the need to undertake research into evidence-based models of practice. With the implementation of vocational rehabilitation policies and programs in a large number of countries, there is now an opportunity to undertake transnational research in this area. Indeed, a number of researchers have stressed the need for such research because it provides an opportunity to gain a more in-depth understanding of what vocational rehabilitation practices are effective and in which contexts (Buys, 2010; Matthews, Buys, Randall, Biggs, & Hazelwood, 2010; Rosenthal, 2003; Westmorland & Buys, 2004). Despite these calls, there have been only a small number of comparative studies that have been published over the last decade, and these have typically been undertaken in the related area of disability management. For example, a review of abstracts from three International Forums on Disability Management (a conference that brings together policy makers, employers, and researchers from across the globe) in 2006, 2008, and 2010 reveals that only 10 out of 234 presentations focused on comparing practices across countries, and of these only two involved primary data collection as opposed to using secondary data sources. Part of the reason for this is the difficulties in undertaking such research—National research grant schemes do not encourage such research, it is expensive to undertake, and there are logistical, linguistic, and contextual problems in collecting data.

One of the few comparative studies in this area (Pransky, Shaw, Loisel, Hong, & Desorcy, 2010) focused on return to work coordinators from the United States, Canada, and Australia. Defining competencies as knowledge, skills, attitudes, and behaviors, they identified eight common domains that reflected general personal characteristics (e.g., professional credibility, communication, individual personal attributes) and skill sets to address unique return to work issues (e.g., conflict resolution, administrative skills, problem-solving skills, evaluation skills, information gathering). Specific skill and knowledge requirements relevant to vocational counselors who were typically involved in both return to work and evaluating and designing-specific job accommodations included skills in work capacity evaluations, job task analysis, and integration into the worksite—tasks typical of those found in disability case management. While this was a useful study, the sample sizes were small, which may have reduced the power of the study to identify transnational differences.

The majority of vocational rehabilitation competency studies have occurred in the United States, where a number of researchers (Leahy, Chan, & Saunders, 2003; Leahy, Chan, Sung, & Kim, 2012; Leahy, Muenzen, Saunders, & Strauser, 2009; Leahy, Shapson, & Wright, 1987; Leahy, Szymanski, & Linkowski, 1993; Muthard & Salomone, 1969; Rubin et al., 1984) have documented the roles and functions of rehabilitation counselors. Rehabilitation counseling is the principal profession in the United States involved in the delivery of vocational rehabilitation and disability management services. A recent study (Leahy et al., 2012) found three major job functions that comprised job placement, vocational assessment, and career counseling; counseling, psychosocial interventions, and case management; and demand-side employment, workers’ compensation, and forensic services. It also identified four knowledge domains including job placement, counseling, and assessment; case management and community resources; individual, group, and family counseling and evidence-based practice; and medical, functional, and psychosocial aspects of disability. In the related area of disability management, Rosenthal, Hursh, Lui, Isom, and Sasson (2007) identified three main areas of practice that included disability case management; disability prevention and workplace intervention and; program development, management, and evaluation. It is therefore apparent that disability management practice draws heavily from the vocational rehabilitation skills long established in the rehabilitation counseling profession.

Australia is the only other country to undertake similar studies, due in part to the similarities between its vocational rehabilitation service delivery system and that of the United States (Biggs, 1996; Matthews et al., 2010). In a recent study, Matthews et al. (2010) identified six factors that were perceived as important to practice. These factors were vocational counseling, professional practice, personal counseling, rehabilitation case management, workplace disability case management, and workplace intervention and program management. Although there was considerable overlap between these findings and those from the United States, there were differences that could be accounted for by variables associated with the practice context such as regulatory requirements.

Of particular note in the Matthews et al. (2010) study is the conclusion that “transnational research that compares skill and knowledge sets would provide a greater understanding of the competencies required to provide such services globally” (p. 132). With the worldwide growth of rehabilitation professionals providing vocational rehabilitation and disability management services in a range of countries, including Canada (Harder, McHugh, Wagner, & Harder, 2006), the Netherlands (Reijenga, Besseling, van Ginkel, de Vos, & Zwinkels, 2003), Germany (Niehaus & Bernhard, 2006), and Sweden (Selander, 2006), the call for such research is timely. Little is known of the consistency in rehabilitation practices or of the consistency of competencies used by rehabilitation professionals in their work in these areas.

The current study is one attempt to remediate this situation by comparing the results of research on vocational rehabilitation practices across two countries, Australia and Germany. The comparative study addressed the following research question: Are there job tasks, functions, and knowledge domains that are common to effective vocational rehabilitation in Australia and Germany?

Methods

Participants

Australia

Respondents comprised 149 rehabilitation professionals (77% female, mean age = 35.42 years, SD = 11.89) recruited from two rehabilitation counseling professional associations: the Rehabilitation Counselling Association of Australasia and the Australian Society of Rehabilitation Counsellors. These organizations were chosen for recruitment because rehabilitation professionals that are members of these organizations are authorized by the various state workers’ compensation bodies to provide vocational rehabilitation services in Australia. Participants were also recruited from a major federal government employer of rehabilitation professionals: CRS Australia.

Table 1 provides the characteristics of respondents from both countries. Those from Australia reported an average of 7.63 years (SD = 6.62) of experience in industry and had been in their current job for a mean of 4 years (SD = 4.12). The sample comprised 106 (71%) rehabilitation counselors, 10 (7%) psychologists, 6 (4%) case managers, 3 (2%) occupational therapists, and 24 (16%) nurses, occupational health and safety specialists, and general counselors. Forty-three percent worked in rehabilitation agencies, 19% in insurance agencies, and the remainder in educational, private practice, and community-based settings.

Table 1.

Characteristics of the Australian and German Participants.

	Australian (n = 149)	German (n = 217)
Female (n)	77% (115)	47% (102)
Mean age (SD)	35.42 (11.89)	44.58 (7.90)
Years’ experience (SD)	7.63 (6.62)	14.75 (7.98)
Professional area	Rehabilitation counseling 71%	Public administration 43 %
	Psychology 7%	Social professions^b 13 %
	Case management 4%	Medical professions^c 20 %
	Occupational therapy 2%	Technical professions^d10 %
	Other^a 16%	Commercial professions^e 9 %
		Other^f 5 %
Employment setting	Rehabilitation agency 45%	Public sector rehabilitation 65%
	Compensation agency19%	Private sector rehabilitation 35%
	Education facilities 5.4%
	Private practice 5.4%
	Community agency 4.7%

Nursing, counseling, occupational health and safety. ^bSocial work, education. ^cMedicine, nursing, psychology. ^dEngineers, mechanics, machinists. ^eBusiness administration, finance. ^fSociology, politics, law, sports science, philosophy.

Germany

Respondents comprised 217 rehabilitation professionals (47% female, mean age = 44.58 years, SD = 7.90) recruited via the German Social Accident Insurance association, Deutsche Gesetzliche Unfallversicherung (DGUV), the umbrella association of the accident insurance institutions for the industrial and public sectors. Specific professional qualifications of participants were not sought in the demographics of the German survey; however, general professional areas were reported, as identified in Table 1. Eighty-three percent (n = 180) of participants had completed their training as a Certified Disability Management Professional. The majority (96%) identified their main activity as client work with individual counseling among their responsibilities (Niehaus & Marfels, 2010). Sixty-five percent (n = 141) worked in the public sector, mostly at the German Social Accident Insurance.

Instrument

The Vocational Rehabilitation Competency Survey (VRCS; Matthews et al., 2010) comprised 113 knowledge and skill statements relating to the diverse roles and functions undertaken by vocational rehabilitation professionals. The VRCS comprises two subscales: the first subscale captures knowledge and skill specifically in the traditional vocational rehabilitation domain (VR; n = 64) and the second includes items reflecting skills and knowledge in the related area of disability management (DM; n = 49). Items for the VR subscale were sourced from the Rehabilitation Skills Inventory–Amended 1 (RSI-I; Biggs, 1996), a revised version of the RSI (Wright, Leahy, & Shapson, 1987) validated in the Australian setting, which comprised seven subscales: vocational counseling, personal counseling, professional practice, job placement, vocational assessment, rules and regulations, and case management. Items in the DM subscale were sourced from the International Survey of Disability Management Practices (ISDMP; Certification of Disability Management Specialists Commission, 2004), which contains items representative of Levels I and II of DM practice (Currier et al., 2001; Habeck & Kirchner, 1999). Where items between measures overlapped, those most clearly describing the competency were retained. Two additional items that captured aspects of supervision and application of the professional literature to DM practice were included. Participants rated the importance of every job task item to current practice using a 5-point Likert-type scale (0 = not important, 1 = somewhat important, 2 = important, 3 = very important, and 4 = extremely important).

Forward and back translation of the VRCS was undertaken to ensure that the German version was conceptually equivalent. The translations were each undertaken independently by qualified rehabilitation professionals and back translation was undertaken by one of the researchers who had a high level of English proficiency. Translation and subsequent testing on a small group of rehabilitation professionals resulted in minor changes being made to the wording of some of the items to make it more conceptually consistent with the German rehabilitation system. Item number 84 (Utilize ergonomic principles and strategies to reduce work injury risk and to accommodate restrictions of clients) was separated out into 2 items: (a) 84a—Utilize ergonomic principles and strategies to reduce work injury risk and (b) 84b—Utilize ergonomic principles and strategies to appropriately accommodate restrictions of clients.

Procedure

Participants were recruited from the organizations most closely associated with the provision of vocational rehabilitation and disability management services in each country (see the “Participants” section) to participate in the online survey. Potential participants were emailed information about the study and a link to the survey on the study website. As the selection and invitation of participants to the study was undertaken by the individual organizations, and not the research staff, the researchers were not aware of the number of individuals who were invited to participate in the study. For further information about the procedures for each study refer to Matthews et al. (2010) and Niehaus and Marfels (2010).

Analysis

Knowledge and skill sets deemed important by rehabilitation professionals in each country were identified using factor analyses utilizing principal axis factoring as the extraction technique on items in each subscale. The Kaiser−Guttman rule of Eigenvalue greater than 1 and Cattell’s scree test (Cattell, 1966) were applied. In the analysis, factor loadings equal to or greater than .40 were retained and used to identify the underlying factors. The mean importance values of the resulting factors were used to determine the level of importance of the factors to current practice and Cronbach’s alphas were calculated to document the internal consistency of items in each factor.

Although the samples were relatively small for factor analysis, there are a number of authors who have argued that there are more aspects to factor stability than participant-variable ratios. These aspects include the number of items per factor and magnitude of the factor loadings (Guadagnoli & Velicer, 1988; MacCallum, Widaman, Preacher, & Hong, 2001; Tabachnik & Fidell, 2007). The appropriateness of the approach for use in the current samples was verified with the Kaiser−Meyer−Olkin (KMO) measure of sampling adequacy, which for the Australian and German VR subscales was .89 and .85, respectively, and for the Australian and German DM subscales was .88 and .88, respectively. All KMO measures exceeded the acceptable level of .5. Bartlett’s test of sphericity was significant for both VR subscales—Australia: approximate χ²(2016) = 7622.81, p < .0001; Germany: approximate χ²(2016) = 6494.35, p < .0001—and for both DM subscales—Australia: approximate χ²(1176) = 5092.88, p < .0001; Germany: approximate χ²(1225) = 5475.11, p < .0001—indicating the factorability of the matrices.

Comparisons between results from the analysis of the Australian and German data sets were undertaken to determine common competencies used by rehabilitation professionals in each country. Resulting factors from the VRCS in each country were examined to determine areas of convergence and divergence.

Results

Participants

The Australian sample was significantly younger (t = 8.62, df = 364, p < .001) and had a significantly higher proportion of women than the German sample (χ² = 32.0905, df = 1, p < .001; see Table 1). The almost equal split in gender in the German sample is typical of rehabilitation professionals that complete their training as a Certified Disability Management Professional (Niehaus & Marfels, 2010). The German rehabilitation professionals had significantly more years’ experience working in vocational rehabilitation services than their Australian counterparts (t = 9.60, df = 364, p < .001).

Major Knowledge and Skill Areas

The factors arising from the analysis of the VRCS subscale data in each country appear in Table 2. Analysis of the Australian and German data sets revealed three common factors, one from the VR subscale, Vocational Counseling, and two from the DM subscale, Workplace Disability Case Management and Workplace Intervention and Program Management. The Australian data revealed three additional factors from the VR subscale: Professional Practice, Personal Interactions and Counseling, and Rehabilitation Case Management. Brief descriptions of all factors are provided in the appendix.

Table 2.

Main Competency Domains Resulting From Principal Axis Factor Extraction and Varimax Rotation on the Vocational Rehabilitation Competency Scale.

Australia	Germany
1. Vocational counseling	1. Vocational counseling
2. Workplace disability case management	2. Workplace disability case management
3. Workplace intervention and program management	3. Workplace intervention and program management
4. Rehabilitation case management
5. Personal interactions and counseling
6. Professional practice (advocacy)

When compared with the Australian data set, Germany had a larger number of items that did not have factor loadings of .40 or greater following analysis (identified by a dash; see Table 3) suggesting that many of the items did not relate to current practice by German rehabilitation professionals who participated in this study. A small number of items in each country’s analysis loaded on different factors, but these were not of a significant number to impact identification of the common knowledge and skill areas. Computations of Cronbach’s alpha showed that there was high internal consistency for each of the three uniform domains in both data sets (see Table 3).

Table 3.

Australian and German Factor Loadings > .40 for Principal Axis Factor Extraction on the VR and DM Subscales of the VRCS.

Task/function	Australia	Germany
Factor: Vocational counseling
Instruct a client in job search skills	0.88	0.74
Apply job market information to locating and securing employment for your client	0.82	0.78
Match client needs to job characteristics and client aptitudes to job requirements	0.80	—
Identify transferable work skills by analyzing a client’s work history and functional assets and limitations	0.79	—
Develop mutually agreed vocational counseling goals	0.79	0.41
Determine the level of intervention necessary for job placement	0.78	0.75
Counsel a client to select jobs consistent with his/her abilities, interests and rehabilitation goals	0.77	0.68
Discuss with a client job market conditions that may influence the opportunity to enter certain jobs	0.74	0.80
Determine appropriate community services for a client’s stated needs	^a	0.63
Counsel a client regarding desirable work behaviors to improve his/her employability	0.72	—
Identify educational and training requirements for specific jobs	0.70	0.61
Identify and arrange for the required training to maintain a client’s successful job placement	0.69	0.47
Provide prospective employers with appropriate information on a client’s work skills and abilities	0.67	0.73
Discuss with a client the educational and vocational implications of assessment and interview information	0.67	0.47
Use supportive counseling techniques to prepare a client for the stress of job hunting	0.66	0.80
Monitor a client in employment to determine needs for additional services	0.61	—
Interpret vocational assessment results to clients and others	0.61	0.43
Review medical information with clients to determine vocational implications of their functional limitations	0.59	—
Relate a client’s stated interests and values to vocational choices	0.55	—
Use local resources to assist with placement (e.g., employer contacts and colleagues)	0.53	—
Employ newer applications in vocational assessment including emerging technologies	0.52	—
Use assessment data to highlight a client’s ability for the purposes of rehabilitation planning	0.52	0.48
Use behavioral observations to make inferences about work personality characteristics and adjustment	0.48	—
Identify client work personality characteristics to be observed and rated on an actual job or simulated work situation	0.45	—
Select appropriate rehabilitation or educational service providers	^b	0.44
Understand claims processing procedures	^b	0.45
% Variance accounted for by factor	37.30	22.01
Internal consistency reliability (α)	.75	.92
Factor: Professional practice
Apply the results of published research to professional practice	0.70	—
Promote public awareness of rehabilitation programs	0.60	—
Actively promote rehabilitation services to businesses and organizations	0.60	—
Understand the applications of current legislation affecting the employment of people with disabilities	0.56	—
Identify and question limiting stereotypes of people with disabilities	0.56	—
Read professional literature relating to business, job markets, and so on.	0.53	—
Apply psychological and social theories to develop strategies for intervention	0.49	—
Actively seek to change employers’ biases and concerns regarding hiring people with disabilities	0.49	—
Design work situations for observing specific client behaviors	0.48	—
Negotiate with employers or union representatives to reinstate/rehire an injured worker	0.46	—
Conduct a review of the rehabilitation literature on a given topic or case problem	0.42	—
Report to referral sources regarding progress of cases	0.41	—
% variance accounted for by Factor	6.62	—
Internal consistency reliability (α)	.87	—
Factor: Personal counseling
Evaluate the client’s social support system (family, friends and community relationships)	0.72	—
Identify social, economic and environmental factors that may adversely affect a client’s motivation toward rehabilitation	0.69	—
Recognize psychological problems (e.g., depression, suicidal ideas) that require consultation or referrals	0.60	—
Determine appropriate community services for a client’s stated needs	0.59	^c
Adjust counseling approaches or styles according to cognitive and personality characteristics of your client	0.56	—
Explain the services and limitations of various community resources to clients	0.55	—
Assist a client in understanding and coping with stress	0.54	—
Determine a client’s need for individual, group or family counseling	0.52	—
Counsel a client to help him/her appreciate and emphasize personal strengths	0.51	—
Assist a client to state specific behavioral goals for personal adjustment	0.47	—
Assess the significance of clients’ disabilities taking into account medical, psychological, educational, and family status	0.42	—
% variance accounted for by Factor	5.46	—
Internal consistency reliability (α)	.91	—
Factor: Rehabilitation case management
Consult with medical professionals regarding functional capacities, prognoses, and treatment plans for a client	0.70	—
Select appropriate rehabilitation or educational service providers	0.59	^c
Understand claims processing procedures	0.59	^c
Apply the principles of appropriate rehabilitation legislation to daily practice	0.58	—
Write case notes summaries and reports so that others can understand the case	0.57	—
Interpret relevant legislation, policy, and regulations to clients and others	0.53	—
Describe regulations and procedures regarding disability determination and benefits	0.52	—
Clarify mutual expectations and the nature of the relationship with your client	0.47	—
Clearly state the nature of a client’s problem when referring him/her to service providers	0.45	—
Collaborate with other providers so that services are coordinated, appropriate and timely	0.44	—
Educate a client regarding his/her rights under the law	0.43	—
Interact with a client to identify emotional reactions to disability	0.40	—
% Variance accounted for by Factor	3.96	—
Internal consistency reliability (α)	.85	—
Factor: Workplace disability case management
Monitor progress of clients with disabilities to achieve return to work goals	0.82	—
Coordinate vocational rehabilitation services for injured workers who are unable to return to their original employers	0.76	—
Assess workplace factors that impact on return to work outcomes for clients	0.74	—
Coordinate worksite and community resources to implement rehabilitation and return to work plans for clients	0.67	—
Develop written return to work plans for clients	0.67	—
Develop transitional work programs at worksites to facilitate the return to work process	0.66	—
Evaluate personal and work adjustment needs of clients	0.66	—
Coordinate functional capacity assessments for clients with restrictions and apply assessment results to demands of jobs	0.65	—
Provide career counseling services to clients	0.63	—
Communicate with treating practitioners to facilitate return to work planning for clients	0.62	—
Demonstrate an understanding of accident/injury prevention processes and practices	—	0.62
Understand employment practices within worksites and their potential impact on return to work planning	0.61	—
Provide early intervention strategies to facilitate early return to work outcomes for clients	0.60	—
Organize worksite assessments to identify suitable return to work duties	0.59	—
Understand cultural differences and how they may impact on injury/disability management programs and interventions	0.58	—
Understand medical terminology and apply medical information to case management planning and coordination	0.58	—
Identify assistive technology and worksite accommodation resources to facilitate return to work planning for clients	0.57	—
Perform job analyses to identify physical demands and other job requirements	0.57	—
Demonstrate an understanding of prominent causes of injury and disability at the workplace	^d	0.56
Respond appropriately and effectively to physical, emotional and cognitive needs of clients	0.55	—
Coordinate injury/disability management programs	0.55	^d
Utilize ergonomic principles and strategies to reduce work injury risks and to accommodate restrictions of clients	0.54	0.710.52^e
Prepare and manage a budget for the administration of an injury/disability management programs	0.45	^d
Understand the roles and function of treating practitioners in diagnosing and treating clients	0.43	—
Understand industrial relations issues and their potential impact on return to work planning for clients	0.42	0.55
% variance accounted for by Factor	37.89	12.04
Internal consistency reliability (α)	.95	.80
Factor: Workplace intervention and program management
Coordinate injury/disability management programs	^f	0.80
Conduct cost−benefit analyses of worksite injury/disability management programs	0.77	0.73
Facilitate joint worker-management collaboration at worksites to develop and implement injury/disability management programs	0.74	0.81
Develop worksite policies, procedures and guidelines for injury/disability management programs and return to work activities in organizations	0.72	0.76
Demonstrate an understanding of prominent causes of injury and disability at the workplace	0.69	^f
Provide consultation and leadership to worksite representatives and others regarding injury/disability management programs and return to work activities	0.69	0.69
Understand accident and illness reporting systems at worksites	0.67	0.57
Develop business plans and strategies for effective injury/disability management programs	0.65	0.82
Promote and market injury/disability management and return to work programs to unions, management and other stakeholders	0.63	0.68
Provide education and training to others related to worksite injury/disability management and return to work programs	0.63	0.73
Prepare and manage a budget for the administration of an injury/disability management programs	^f	0.64
Demonstrate knowledge of evidence-based practices in injury/disability management	0.57	0.55
Facilitate attitudinal and behavioral change among worksite representatives and others to support return to work goals	0.57	—
Understand use of management information systems to monitor patterns of injury and disability, costs, and service outcomes	0.57	0.71
Prepare and manage a budget for the administration of an injury/disability management programs	—	0.64
Conduct research and publish results of studies related to injury/disability management programs and return to work outcomes	0.56	0.73
Demonstrate grant and proposal writing skills	0.54	0.49
Provide the supervision of other professionals within injury/disability management programs	0.54	0.55
Promote legislation that supports injury/disability management and reintegration principles for clients	0.54	0.54
Evaluate processes and/or outcomes of injury/disability management programs	0.53	0.57
Read professional literature relating to medical conditions, injury management and rehabilitation	0.50	—
Evaluate the quality and effectiveness of rehabilitation providers and treating practitioners	0.50	—
Demonstrate an understanding of accident/injury prevention processes and practices	0.50	—
Manage health promotion and wellness programs in organizations	0.42	0.61
% variance accounted for by factor	7.38	24.43
Internal consistency reliability (α)	.94	.94

Note. Australian data from Matthews, Buys, Randall, Biggs, and Hazelwood. (2010)

Item loaded on Factor 3 Personal Counseling. ^bItem loaded on Factor 4 Rehabilitation Case Management. ^cItem loaded on Factor 1 Vocational Counseling. ^dItem loaded on Factor 6 Workplace Intervention and Program Management. ^eItem 84 was split into two items in the German version (see Instrument section). ^fItem loaded on Factor 5 Workplace Disability Case Management.

The total variance accounted for by each of the factors was higher in the Australian analysis than the German analysis (VR subscale: 53.34% and 22.01%, respectively; DM subscale: 45.27% and 36.47%, respectively). Table 3 shows that the factor Vocational Counseling accounted for the greatest percentage of variance in the VR subscale for both countries (37.29% and 22.01%, respectively), this factor being the only one arising from the German analysis. The dominant factor in the DM subscale, however, differed between countries. Analysis of Australian data revealed Workplace Disability Case Management as the dominant DM factor accounting for 37.89% of the variance while analysis of German data identified Workplace Intervention and Program Management as the dominant DM factor accounting for 24.43% of the variance.

The means and standard deviations of the perceived importance ratings in each country for each domain appear in Table 4. All ratings were significantly higher in the Australian data set. The relatively low perceived importance rating provided for Workplace Intervention and Program Management by German rehabilitation professionals was not expected given the high percentage of participants in this sample who had received DM training and certification.

Table 4.

Means (SD) of Importance Ratings for Common Factors in Each Country.

Factor	Australia	Germany	t, df = 364
Vocational counseling	3.26 (0.81)	2.88 (0.81)	4.40*
Workplace disability case management	3.29 (0.69)	2.54 (0.87)	9.16*
Workplace intervention and program management	3.07 (0.88)	1.92 (0.97)	11.78*

p < .001.

A closer examination of the DM items rated highly by German participants revealed that relatively few of the items that reflected direct services to injured workers were endorsed (see Table 3 Factor: Workplace Disability Case Management). Furthermore, the five endorsed items in Workplace Disability Case Management, though appearing in the grouping of typical Level II DM items, closely align with Level I organizational aspects of DM that appear in the Workplace Intervention and Program Management domain. Most of the items in the Workplace Intervention and Program Management domain were endorsed (see Table 3: Workplace Intervention and Program Management).

Discussion

The results of this study suggest that there are three common knowledge and skill areas deemed important to current practice by Australian and German rehabilitation professionals employed in vocational rehabilitation settings. These are vocational counseling, workplace disability case management, and workplace intervention and program management. As would be expected, there were more competencies identified with rehabilitation practice in Australia due to the longer term evolution of service delivery systems and legislative mandates in the area of vocational rehabilitation since World War 1 (Matthews, Buys, Crocker, & Degeneffe, 2007).

Points of divergence center on the strong focus by German rehabilitation professionals on Level I DM tasks that largely focus on organizational aspects of DM with little or no endorsement of the Level II tasks that focus on DM service delivery (Currier et al., 2001). This result was not expected because one would assume that there would be an equally strong focus on both levels of DM given the emphasis on DM certification in Germany (Bernhard, Niehaus, & Marfels, 2011). There was an equally strong focus on the service delivery aspects of vocational rehabilitation with little endorsement of the personal counseling or case management aspects. Again, this was unexpected given that the main activity reported by rehabilitation professionals was client work, rather than project work or management work. It may be that German rehabilitation professionals identify more with the traditional VR service delivery items than those in the DM subscale that reflect more recent trends in practice.

Niehaus and Marfels (2010) allude to the fact that vocational rehabilitation professionals employed in the public sector are required to have a detailed knowledge of the legislation and its specific application to rehabilitation. Having this knowledge implies a level of expertise in traditional VR practice for those sick or injured workers who are not able to return to work. On the other hand, practitioners employed in the private sector focus heavily on organizational aspects of DM possibly because of their professional background (e.g., medical practitioners, psychologists, technical managers) whereby they lack the training in the case management aspects of DM.

Alternatively, it may be that the current training provided in Germany does not adequately cover service delivery aspects of disability management. If this is the case then it may be that the German DM certification process does not adequately cover the intensive case management required to return people to work following a workplace injury and that changes are needed to ensure professionals are adequately prepared for service delivery in this particular sector.

What is evident from the results is that well-rounded VR professionals are increasingly involved in DM practice (Leahy et al., 2003; Matthews et al., 2010). Consequently, Australian degree programs that have always included strong VR content are now progressively including elements of DM training, a practice that is in line with the Council on Rehabilitation Education (CORE) standards that were reviewed and re-developed between 2008 and 2010 (Council on Rehabilitation Education, 2013). It is also the case that VR professionals in Germany have been increasingly involved in DM as a new area of responsibility, mainly as a result of “the legislature defining vocational rehabilitation as a managerial task that falls to the employer” (Niehaus & Marfels, 2010, p. 71). As DM is expected to grow in importance in Germany (Bernhard et al., 2011), there appears rationale and scope to develop the DM training currently provided by the DGUV into comprehensive tertiary programs in vocational rehabilitation and disability management that are relevant to its service delivery and policy context.

The identification of common skill and knowledge sets between Australia and Germany as well as differences that arise from levels of specialization that were identified in our study reinforce the importance of such transnational research. While previous research has identified a high degree of commonality in job functions among return to work coordinators (Pransky et al., 2010), including tasks typical of those found in Workplace Disability Case Management, the study was conducted between countries that have similar disability management systems. Greater value may be gained by comparing countries with disparate systems to assess the impact of the political, environmental, and legislative differences on service delivery.

Furthermore, in this age of a global workforce, rehabilitation professionals need to receive education and training relevant for the global market. Recent changes in the legislative environment, particularly that focusing on DM, point to the need to regularly assess the competencies needed for contemporary, evidence-based practice. It is likely that there will be commonalities and differences between countries, so ongoing transnational research is required to ensure that a “global curriculum” covers core competencies, while at the same time allowing for specialization at a local level.

The authors of this article therefore support Leahy et al.’s (2003, 2009) call for regular VR competency studies but would strongly recommend that this occur within a transnational agenda. Indeed CORE has recently picked up on this issue by initiating discussions with the International Rehabilitation Counseling Association to develop global standards in rehabilitation counselor education. As part of this process it was acknowledged that research is needed to define the content of these standards. This move is consistent with recent initiatives in other areas such as the Assessment of Higher Education Learning Outcomes Project, which seeks to develop learning outcomes in disciplines that are consistent across cultures, languages, and institutions (Organization for Economic Co-Operation and Development, 2013).

There are a number of limitations to this study. First, the samples in both countries were convenience samples and not randomly selected; therefore, there is the possibility that participants were not representative of the population of vocational rehabilitation professionals. Second, the instrument used has not been psychometrically validated as it was a combination of the RSI-I and the ISDMP. Further research is required to validate this measure for use in vocational rehabilitation competency studies in every country in which it is used. The psychometric properties established in one country may not hold when the instrument is translated into a different language. The sample sizes were relatively small and this raises questions about the stability of the factor solutions and generalizability of the findings. Finally, the nature of this study precluded an empirical comparison of factor scores from each country. Future research that uses an empirical approach to examine differences between countries would add certainty to the findings reported in this study.

Conclusions

Although there are commonalities in the role and function of Australian and German vocational rehabilitation professionals in areas such as vocational counseling, workplace case management, and workplace intervention and program management, there are also differences that relate to the historical development of the profession in the two countries and the legislative context. In a globalized world with an increasingly mobile workforce, further transnational research is needed to identify common and unique core competencies, from which a universal curriculum can be developed.

Footnotes

Appendix A

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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