Chapter One

In this first chapter we want to start the process of demystifying what vocational rehabilitation (VR) is, and move forwards with a shared understanding of the activities and interventions which may come together under its umbrella. We also want to reflect on how we might draw on existing knowledge sources, some of which will already be very familiar to occupational therapists, in order to begin working towards creating a uniquely occupation-focused perspective of work and VR.

As we do so, let us remind ourselves that the essence of occupational therapy (OT) is built on a belief in the necessity and value of occupations. Each of us strives, throughout our life, to achieve a balance of meaningful and purposeful work, rest, self-care and leisure activities. Of all the occupations in which we engage across our lifespan, work arguably occupies the most central position. Work provides us with a significant life role that accounts for up to a third of the life of an average adult. Furthermore, the links between work and health, well-being and longevity, have already been well-argued (Wilcock, 1998). Despite this understanding, far too few occupational therapists in the UK today, ask the 'work question', even when they have clients who are of working age. Fewer still are involved, to any great extent, in addressing the actual work or employment needs of their clients. People outside of the profession could be forgiven for questioning why occupational therapists don't deal with, perhaps, the most commonly recognised occupation.

But all this is changing. A growing recognition of the po