ersonnel to provide an individualized, work-oriented activity process that helps the client return to a work environment. The whole person is assessed. Referrals are from physicians, attorneys, rehabilitation personnel, employers, educational personnel, human service agencies, insurance representatives, and self-referrals (Commission of Practice, 1986; & Hertfelder & Gwin, 1989).
Typical primary staffing for work hardening includes a multidisciplinary team which optimally has an occupational therapist, physical therapist, psychologist, and vocational specialist. Additional staff could include a rehabilitation engineer, exercise physiologist, industrial arts teacher, ergonomist, rehabilitation nurse, occupational health nurse, lay foreman, industrial hygienist, and a nutrition counselor. A ratio of one professional for every six to eight workers is recommended. Studies show that occupational and physical therapists are the primary providers of hands-on evaluation or treatment (Hertfelder & Gwin, 1989; Niemeyer, Jacobs, Reynolds-Lynch, Bettencourt, & Lang, 1994; & Wyrick, Niemeyer, Ellexson, Jacobs, & Taylor, 1991).
Unique job responsibilities for the Occupational Therapist include skills in the development and guidance of a job-specific program of graded activity for the worker, job task analysis, job station and tool modification,
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