Rehabilitation Plan

Rehabilitation Plan

People around the world all have different problems and range from simple to complex, and rehabilitation programs come in various types and styles. Dough Johnson, a fifty-five year old male, single, currently lives with his daughter, is seeking help through a case manager. He has worked in a factory for many years, when he recently lifted some heavy boxes and severely hurt his back. Mr. J is currently laid off from his work because he was not able to meet the needs of the job. He should be on bed rest and not active, which he is frustrating causing slight depression. He has a strong relationshop with his boss, in which he is trying to relocate to a different position in the factory. He needs to find a position where he doesn’t have to be so active and able to sit down. Prior to his meeting, the case manager Kelsey Crockett reviewed his information thoroughly. She noticed that he has only had an education level of high school, worked on a farm, car wash, and majority at a factory. He has had a history of hypertension and peptic ulcer. He currently lives with his daughter, but would like to move out soon to give her space and for her family. The doctor order Mr. J unfit for his job and needs to find a new job in result of his muscular strain in his back. He has communicated with his boss and they concluded on trying a position with machine monitoring. He was interested, but needs to continue the rehabilitation plan for him to return to work as soon as possible.

Information Needs and Questions

When meeting a client, the first thing is to write down a list of information needs regarding one client at a time. This is done in the evaluation phase, which will help obtain information about past, current, and physical functioning, psychosocial functioning, educational vocational function, and current client economic situation. In addition, the information obtained will help the rehabilitation counselor to realize what vocational objective is most appropriate for that specific client. Once the evaluation is finished, the planning phase will then take part leading the client to the best placement available.

1. Has Mr. J had any past physical functioning?

1. J has had a peptic ulcer.

2. Does Mr. J currently have any psychosocial functioning?

2. J enjoys being active, and may get depressed if lonely.

Intake Interview

Physical Factors:

1. What physical impairment are present?
2. J had complaints of acute low back pain.

2. What caused the disability?
3. J was at work doing heavy lifting when he was stuck with severe back pain.
4. How long has the client had a disability?
5. J has recently received this disability.
6. Has the client received any disability-related treatment in the past?
7. Yes, Mr. J has received past medical history involving arthritis in his fingers, and hypertension.
8. Has the client’s disabling condition become worse over the past year?
9. J’s condition has slightly become worse as he continues to work in a factory, pick up boxes, and moves his fingers all day long.
10. Is the client currently receiving any disability-related treatment?

7. Is the client taking any medication with potential side effects?
8. J. takes hypertension medication, which could cause dizziness, light headed, feeling tired, and having a headache. Mr. J’s; arthritis medication side effects could cause edema, heartburn, stomach upset, and stomach ulcers.
9. Do any recent medical test results clarify extent of physical impairment?
10. J’s; a-ray examined that he has a bulged disc in his back causing him to not be able to work.

9. How does the client’s physical disability handicap daily functioning?
10. J’s physical disability makes it difficult to be able to do daily activates along with supporting himself.

Psychosocial Factors:

1. Personal adjustment
2. Do recent psychologist test results pertain to the question of client psychological adjustment?

– Mr. J has been perceived with depression, social                                                        conflicts/withdrawal, and work problems.

1. Is there any agency or professional from whom the client is presently receiving psychological services?

1. Has the client ever received professional treatment for a personal adjustment problem?

-Mr. J goes to counseling regularly to maintain his                                         personal values and relationship skills.

1. Is the client taking any tranquilizers or sleeping pills?

–  Mr. J takes only melatonin as needed.

1. Does the client report unnecessary avoidance of work or social situations since acquiring a disability?

• J is a very active male who loves going to work and being outside. Since his back pain, it has caused him to miss a lot of work and stay in bed.

2. Relationship with family and friends
3. What is the client’s marital status?

• J is a single male.

1. Is the client living with his or her family?

• J lives with his son-in-law, daughter, and child.

1. Does the client have any depend age children?

– Yes, Mr. J has a twenty-eight year old daughter.

1. Will the most significant family members be supportive of the rehabilitation plan?

• Yes, the daughter is very excited to help her dad and start the rehabilitation plan.

1. How does the client feel about his or her home environment?

• J is very friendly and gets along well with family members.

1. How does the client get along with other members of the family?

• J is very friendly and gets along well with family members.

1. Does the client have any close friends?

• J has many friends and often getting together with them to work on things that need to be fixed. He loves being social and active.

1. Is the client satisfied with his or her social life?

• J was satisfied with his social life, but since his back pain it has limited a lot of what he is able to do

1. How does the client fill the hours of the day?

• J fills his day with working at the factory four times a week from 7 am- 3pm, helps around the house, and hangs out with his friends.

1. Would the client’s family be willing to relocate geographically for him/her to acquire work?

• No, because the family lives close enough to work that Mr. J can walk.

Educational-Vocational Skills Development Factors:

1. Educational history:
2. How far did the client go in school?

• J only has a high school diploma.

1. What did the client like or dislike about school?

• J was not a fan of school, and was never motivate enough to continue his education.

1. Why did the client leave school (graduate other)?

• J did not go to college because he was content with working in a factory the rest of his life and was not motivated to further his education.

1. If the client did not complete high school, has he/she passed a high school equivalency exam?

-N/A

1. Has the client received vocational training that has prepared him or her to enter particular occupation?

• In high school, Mr. J took a vocational training in construction, but realized that he wanted to work in a factory instead. He mentioned how construction is a secondary option if he ever would like a change later in life.

2. Work history:
3. What were the last three jobs held by the client?

• J previously worked on a farm, car wash, and now has worked at a factory for thirty plus years.

1. For each of those jobs, determine the following items:
2. Weekly earnings

Farm- $430.50, Car wash- $360, Factory- $560

1. Length of employment.

Farm- 5 years, Car wash-4, Factory- 31

• Time since job held.

Mr. J is currently working at the factory.

1. Aspects of the job performed well and poorly by the client.

Mr. J performed the job well when he was able to                 move around quickly and able to multi-task from                one thing to another. He performed the job                                     poorly when he was concentrating more on his                                  back and not his work.

1. Aspects of the job liked most and least. Why?

Mr. J was very hardworking and loved                                                                                  going to work. He enjoyed working for his                                                                company for so many years and felt important.                                                                     He loved having a set schedule, working four                                                               days a week, and felt like he could fully support                                                                himself.

1. Reasons for termination of employment.

Mr. J was first laid off from work and would                                                                        reevaluate his health roughly a month later.

1. Prior to onset of disability, were there any significant interruptions in work history? Why?

• Yes, Mr. J had a previous history of a peptic ulcer, which made him miss two weeks of work.

1. Is the client presently unemployed? If yes, for how long?

• Yes, Mr. J has recently been unemployed for a week.

1. Has the client been employed since acquiring a disability?

• J has not returned to work since acquiring his recent disability

Economic Factors:

1. What is the client’s primary source of support?

Mr. J primary source of support is his twenty-eight-year-old daughter.

2. Does the client have other sources of support?

No.

3. Does the client have any unpaid debts of significant size?

No.

4. What is fixed living expenses, such as medication costs, cannot be reduced?
5. Does the client have a Workers’ Compensation case pending?

Yes, Mr. J has Workers’ Compensation case pending.

6. Is the client receiving or has the client applied for welfare or SSI benefits?

No.

7. Does the client have any medical insurance?

Yes.

8. Is the client concerned about his or her economic situation?

Yes, Mr. J is concerned about his economic situation because he wants to return to work so he can move out of his daughter’s house.

9. What minimal level of earning from work must the client receive?

The minimum level of earning from work is minimum wage, but Mr. J has worked his wage up throughout the years.

List of Questions for Medical Evaluation

Pertaining to Chronic Back Pain

1. What is the current severity of Mr. J’s severe back pain?
2. Are any conditions in Mr. J’s life exacerbating his daily routines?
3. To what extent will Mr. J’s back pain become more sever over the next 5 years? 10 years?
4. Are there specific work conditions that Mr. J should avoid?
5. Are there any immediate, intermediate, or long-term medical treatments that will improve Mr. J’s back?
6. What level of stability should Mr. J reach before returning to work again?

Pertaining to Hypertension/Peptic Ulcer Condition:

1. What are the medical recommendations for Mr.J’s regarding high blood pressure and peptic ulcer?
2. Are there specific work conditions that Mr. J should avoid due to high blood pressure and peptic ulcer?

List of Questions for Psychological Evaluation

Client name: Doug Johnson

Synopsis of Intake Information:

Physical: Mr. J has physical had a history of a peptic ulcer and hypertension. He is very hard working and loves being active, which helps his endurance working in a fast-passed factory. He is currently unable to work because he strained his back lifting heavy weight at work. He is currently taking Vicodin every 4-6 hours.

Psychosocial: Mr. J has frequent episodes of depression throughout the day because he is in pain and lying in bed because of the pain. He hates not being active and able to work. He was treated many years ago with counseling because of marital difficulties.

Educational and Vocational: Mr. J is hoping to return to his factory job, but maybe a different position is available with less activity. His education level is completing high school. He has worked on a farm (short-term), car wash (short-term), and factory (long-term). He is currently laid off because of his back.

Economic: Presently supports himself and has no financial support. Will apply for public assistance but also needs work to pay living and medical expenses.

Vocational: Mr. J is currently communicating with his boss to see if there are less physical jobs available at the factory and he can switch positions.

Tentative objectives:

Rehabilitation Services: Mr. J needs to start seeing physical therapist and occupational therapist to help strengthen his back muscles in order to be more independent. He also will be visiting a psychologist one day a week to help with his depression and loneliness.

Vocational: Mr. J will be learning new job skills as he will hopefully be transitions to a different position within his company.

Referral Questions:

Physical (Neurological) Functioning

1. How is Mr. J responding to his back pain? Is it causing increased depression and loneliness?
2. What information has he received about the prognosis of his condition?

Psychosocial Functioning

1. Does Mr. J have an emotional disorder? If so, what?
2. How will Mr. J cope with the stress of working and not working?
3. What conditions precipitate Mr. J’s depression?
4. Is Mr. J’s emotional state stable enough for him to return to work? If no, how long will it take before he is ready for work?
5. Does Mr. J see himself able to transition to a new position and succeed?
6. What type of treatment is suggested for Mr. J’s depression?
7. What type of treatment is suggested for the loneliness in Mr. J is experience?

Intellectual Functioning:

1. Does Mr. J have the intellectual capacity for a different work position?
2. Are Mr. J’s aptitudes compatible with those required for the new position?

Vocational Interests and Goals:

1. Are Mr. J’s vocational interests consistent with the new position?

Job analysis, functioning assessment or work conditions plan

1. Job Entry-Level: Machine Operator
2. Tasks
   1. Run high-speed machine tools
   2. Highly skilled
   3. Perform complex operations on different tools
   4. Flexibility
3. Traits
   1. Mathematic skills
   2. Multi-task skills
   3. Detail oriented
4. Environmental Conditions
   1. Monitor machine, may cause a little stress on the body, but sitting down will help.
5. Physical demands
   1. Must be able to follow directions, head, speak English, read, write, good body movement
6. Aptitudes
   1. Intelligent
   2. Learn quickly
   3. Communicate easily with
7. Training Necessary
   1. Graduated high school
   2. Interested
   3. Experience with the company and field

Information-Processing Summary Form

Name: Doug Johnson

1. Potential vocational goals suggested by consideration of evaluation data:
   1. Most optional: Machine Operator (Already suggested by client _ X_ Yes, __ No

Supporting evaluation data:

Physical: Mr. J enjoys be active and has the endurance of long hour shift. A machine operator often sits, which is good for his back because he can’t stand for long hours anymore.

Psychosocial: Mr. J has an adjustment disability with muscular strain in his lower back. He has a history of hypertension and peptic ulcer. His emotional stability can vary depending on his back pain. He is a very friendly guy, but has had depression in the past. He lives with his daughter, and she is his primary source.

Educational – vocational: Mr. J has had previous training in the factory for many years, but a machine operator is new. He enjoys working with people or things and is capable of use simple tools. He may need additional support for computer skills and simple mathematics.

Special considerations: Needs financial assistance

1. Second: Store Clerk (already suggest by client __Yes _ X _ No)

Supporting evaluation data:

Physical: See most optimal goal.

Psychosocial: See most optimal goal.

Educational-vocational: Was open minded about being a store clerk. He demonstrated capability of using a cash register. Has perfect verbal, numerical, and clerical perception aptitudes for position. Very outgoing and friendly to public.

Special considerations: See most optimal goal.

2. Services needed to achieve vocational goal:
   1. Most optimal: Machine Operator

Physical: Medical maintenance, machine maintenance, support hoes.

Psychosocial: Personal psychologist, Physical therapy, Occupational therapy

Educational-vocational: Training in mathematics and on-the-job training.

Special considerations: Financial counseling

1. Second: Store Clerk

Physical: See most optimal.

Psychosocial: See most optimal.

Educational-vocational: Training in mathematics, on-the-job training.

Special considerations: See most optimal.

3. Vocational goals expressed by the client that appear to be inappropriate based on evaluation data. Discuss.
   1. Jobs requiring lengthy periods many days a week, standing, rigorous physical demands, and lifting should be viewed with caution.

Goal Setting

Primary Objective:

Mr.J’s primary goal is to transition from working hands on in the factory to a machine operator. This is a big transition, but he is will to train and learn new skills to perfection. This new position is to relieve some of his back pain at work.

Intermediate Objectives

1. Physical Goals
   1. To decrease severe back pain at work
      1. Make appointment with primary doctor
      2. Ask doctor about:
         1. Therapist
         2. Mechanical bed
         3. Conditional of muscular strain
      3. Psychosocial Goals
         1. To be active and be able to see his friends regularly
         2. To be able to control his depressive thoughts and actions
      4. Educational-Vocational Goals
         1. To obtain the machine operator position
         2. Learn the back ground and become knowledgeable about the position
         3. Return back to work within the next couple weeks for financial support

Balance Sheet

 Goal Analysis: Doug Johnson

IPE: Doug Johnson

Individuals name:                   Case: MSB132                        SSN:4044-249-3655

Address: 2439 Sturbridge, MI 49521             Telephone:123-897-0098

Email:DJ1@hotmail.com

I have participated in developing this plan and agree to its terms and conditions:

Clients name:                                                              Counselor’s name:

Vocational goal: I have chosen the employment goal of Machine Operator

1. Steps required to reach my vocational goal: I would like to start training as soon as I’m allowed and would like services and support for my health and financial needs.
2. Counselor’s plan justification
   1. Vocational handicap: Mr. J is limited in the number of hours on his feet and must not lift heavy things. He needs to have a comfortable chair that he can sit on while working the machine to decrease pain in his back and maintain correct posture. His present disabilities allow him to only work 3 three out of the week for 5 hours. He needs to work in area that involves people and is not a closed space.
   2. Vocational objective: Machine Operator. With occupational and physical therapy Mr. J should be able to strengthen his back muscles and return full time back to work. His endurance will last longer and he will be more versatile through his work. With only an education of high school, he may need some refreshment and training on mathematics with the new position.

3. Services provided Responsibility for payment

DRS    Client  Other

1. Diagnostic evaluation
   1. Medical examination for physical

Disability                                                         X

1. Psychological disability X

• Vocational evaluation X

1. Counseling guidance:
   1. Personal counseling
      1. Decrease depression episodes X
      2. Move out of daughter house (January)         X
   2. Training:
      1. Machine Operator X
         1. On-the-job Training
         2. Mathematics
         3. Work the machine
         4. Documentation
      2. Restoration:
         1. Medical services, Rehabilitation

Institute of MI                                                            X

1. Monitor hypertension
2. Monitor previous peptic ulcer

1. Training material:
   1. Job shadows to experience hands on X
   2. Books relating to his job
2. Maintenance and transportation:
   1. Enable Mr. J assistance with expenses X

while in training

1. Tools, equipment, and licenses: X
2. Placement (job placement and follow-up) X
3. Other

4. Client responsibilities: I will report to rehabilitation and training programs, successfully complete the machine monitor position.
5. I will apply for other benefits to support my employment such as:

Comments:

Agreed to by the client (signature) ___Doug Johnson__             Date: 10/10/2017

Agreed by counselor (signature) __Kelsey Crockett__                 Date: 10/10/2017

Client representative or witness __Lilly Johnson__                      Date: 10/10/2017

References

Healthline Media. (2017). Peptic Ulcer. In Healthline . Retrieved from

http://www.healthline.com/health/peptic-ulcer#overview1

Net Industries and its Licensors . (2017). Machine Operator and Tender Job Description, Career as a Machine Operator and Tender, Salary, Employment – Definition and Nature of the Work, Education and Training Requirements, Getting the Job Read. In State University. Retrieved from http://careers.stateuniversity.com/pages/567/Machine-Operator-Tender.html

Rossler, R. T., & Rubin, S. E. (2006). Case Management and Rehabilitation Counseling (fourth

ed.). Austin, TX: PRO-ED

Study.com. (2017). What is vocational training?. In Study.com. Retrieved from

http://study.com/vocational_training.html