Profiling the work-hardening therapist: education and experience.

The American.!oumal of' Occupational FhemjJ)' W ork.hardening concepts and techniques originated in occupational therapy (West & McNary, 1956). Occupational therapy's use of activity as a primary modality and its activity analysis of the phYSical and psychosocial components of an occupation substantiate its involvement in work-hardening programs (Harvey-Krefting, 1985). The profession's philosophy toward work and worker-related activities (American Occupational Therapy Association [AOTA], 1989) uniquely qualifies its presence in return-to-work programs. Growth of rrivate sector vocational rehabilitation, changes in workers' compensation laws, and increasing COSts of vocational rehabilitation have incurred the demand for occupational therapy services (Matheson, Ogden, Violette, & Schultz, 1985). These changes have also facilitated the introduction of new terminology, technology, and program formats into occurational therapy practice. Occupational therapy involvement and leadershir in work programs parallel the growth of specialized workhardening services The AOTA Work Programs Special Interest Section (WPSIS) documents a sevenfold increase in membership from 1985 (400 members) to 1990 (2,771 members), which constitutes the largest increase in any practice section during that time (Niemeyer, 1989; Wyrick et al., 1991). Current trends analysis reveals that work-hardening services are being provided in both traditional and nontraditional settings, including hospitals, rehabilitation centers, vocational evaluation centers, physical therapy private practices, occupational therapy private practices, industries, physician and physicians' group practices, and universities. Programs reflect diversit\' nor only in location but also in staffing patterns, eqUipment, range of services, and practice philosophy (Wyrick et al., 1991). Who are these pioneers contributing to the exransian and diversification of work-hardening practice' What level of education and experience do they bring to the practice' How was their specialized knowleclge, particularly in consulting with industry (e.g., prevention, ergonomic assessment, preplacement screening) and inuus, trial rehabilitation (e.g., functional capacity evaluation, work hardening) acquirecl? The answers to these questions provide a basis for an examination of the training needs of therapists practicing and preparing for [xacpce in this area.