A qualitative study exploring the implementation determinants of rehabilitation and global wellness programs for orchestral musicians

Objective: To explore the facilitators and barriers to implementation of a pilot workplace rehabilitation and global wellness program for orchestral musicians. Design: Qualitative study comprising focus groups and interviews. Setting: Workplace of conservatory and orchestral musicians and administrators. Participants: Musicians, administrators and a conductor from two professional orchestras; tertiary-level orchestral students and an administrator from a conservatory of music. Interventions: We held four focus groups and two interviews to document the perspectives of the participants concerning the implementation determinants of a pilot workplace rehabilitation and wellness program (exercises and health-related education). Meetings consisted of questions based on the Consolidated Framework for Implementation Research. Thematic content analysis was conducted using this same framework, with subcoding according to the Theoretical Domains Framework. Results: Fourteen musicians and five administrators participated. Results suggest that the implementation determinants for the pilot and future programs rely mainly on the Inner Setting, that is, what musicians refer to as ‘the music world’, specifically cultural elements such as pain beliefs (e.g. no pain no gain) and lack of resources and time (barriers). Characteristics of Individuals such as social influences amongst colleagues and beliefs about the consequences of self-care or lack thereof, and Intervention Characteristics such as complexity can be facilitators or barriers. All emerging themes have an undercurrent that lies in the Inner Setting. Conclusion: Musicians’ culture, currently a barrier, is a crucial determinant of rehabilitation and wellness program implementation in the orchestral musicians’ workplace. A focus on musicians’ workplace environment is necessary to optimise implementation and intervention impacts.

The Progressive Goal Attainment Program: A practitioner’s perspective of the implementation of the program in an Australian Workers’ Compensation setting

Recently, the Progressive Goal Attainment Program has grown in popularity as an intervention for injured workers experiencing psychosocial barriers when returning to work. This article provides an outline of the program and explores its implementation by a workplace rehabilitation provider. Data from 20 participants have been pooled to highlight typical presentations. Key features of the program and outcomes are discussed.

Long-term mental health care for people with severe mental disorders – the importance of workplace rehabilitation

SummaryWork and meaningful activity have historically played a key role in rehabilitation services for people with severe mental health problems and continues to do so today. People with long-term and severe mental disorders have low rates of employment. In the last 30 years the increasing emphasis on raising the sights of mental health services to focus on personal recovery and the importance given to social justice and to combating social exclusion has led to a focus on gaining open employment. Individual Placement and Support (IPS) has emerged as an important and evidence-based scheme for getting people with severe mental health problems into open employment. Despite the strong and consistent evidence for the effectiveness of IPS, these schemes are not widely implemented. This paper summarises the background to, and research on, IPS and possible barriers to its wider implementation.