[10 years' integrated medical and occupational rehabilitation in 2d phase facilities--confirmed model or end of a trial?]

Founding of a working group of the rehabilitation facilities of the II. phase has occasioned the present study of developments in this area, as seen in particular from the vocational angle. The main emphasis is the role played by the call for integration in rehabilitation, i.e. inclusion of the disease- or disability-generated occupational problems as a vital social aspect to be considered in the treatment and rehabilitation process. For patients in residential programmes, examples are given from the sector of "occupational therapy and job family-related vocational assessment": preparatory vocational programmes, occupational analysis, vocational assessment, and individualized conditioning. Beyond medical care, the centres of the II. phase had been intended to provide "vocational adjustment services"; critical appraisal however reveals the degree of legal imprecision of this term, as well as its lacking in factual delimitation from other forms of rehabilitative measures stipulated in rehabilitation legislation. Also, the vocational functions assigned to the II. and III. phase respectively, tend to overlap more and more, at least at the conceptual level. What is therefore needed to further development of the vocational tasks and functions to be integrated in the II. phase into a direction where a need does exist and where the specific potential of these centres can be used in a meaningful and economical way: the care of most severely disabled persons for whom vocational services require a special educational emphasis.