Effective Vocational Rehabilitation Team Working: An Exploration of Complexities and Practice in Aotearoa-New Zealand
Background: There is limited research in the field of vocational rehabilitation (VR) in the Aotearoa – New Zealand (A–NZ) context. In the international research, there are lots of influences on how effectively VR teams can work together. These include funding systems, the structure of the team, organisational policies and procedures, and hierarchical perceptions. As the existing literature came from outside of the A-NZ practicing climate, it was unclear how transferable this international research is to A-NZ VR. It is important for policy makers, VR professionals, and organisations, to understand how a VR team can work effectively together. If a team can work well together, they are more likely to achieve positive outcomes and team members have better job satisfaction.
Design: The study had a two-stage approach employing a conceptual review of the current literature on VR teams, alongside a collective instrumental case study of two A-NZ VR teams. The focus of stage one was the type of discipline mixes (i.e. transdisciplinary, interdisciplinary or multidisciplinary), which disciplines were involved, what their roles were, and the influences on how the team operated effectively. The findings from the conceptual review informed the focus group and interview schedule for stage two, which explored the specific experiences of VR teams working in A-NZ. Stage two of the research constructed case studies of two A-NZ-based VR teams. A qualitative descriptive methodology guided the overall process, and thematic analysis was used to analyse the data.
Results: Stage one identified many similarities and differences between the systems in A-NZ and other countries, in terms of how VR is accessed and administered. Barriers and enablers to an effective team included client role within the team, team communication, shared language, team trust, hierarchical perceptions, funding, and work culture.
The findings in stage two identified some similarities and unique experiences to practicing in a VR team, in A-NZ. Participants discussed the importance of achieving trusting relationships with their team. This was achieved through seeing everyone as equal, and human. Being equal was particularly important for professionals that were seen to be at different hierarchical levels. It was identified that VR professionals’ specialist skills were not recognised, leading them to have little power in VR decision making processes. Most VR professionals experienced competing demands between client drivers and business drivers. Stage one and stage two identified trust as a key facilitator for a successful team and hierarchical perceptions as a barrier.
Conclusions: A-NZ VR teams have some unique needs from other teams described in the international literature. This is largely due to the A-NZ VR systems and how teams are set up by organisations. Unique issues identified by participants related to funding, finances, meeting key performance indicators, and the stress this caused. The concerns that were the same as international teams included the power play between all stakeholders in VR, needing trust for a cohesive team, and the impact of medical hierarchy. The present research proposed that being human was an important aspect to achieve a collaborative team. This was an insight unique to this study