Psychological Service Utilization and its Impact on Return to Work in Vocational Retraining Centers: A Cohort Study

Abstract

Purpose

Vocational retraining centers in Germany provide retraining for adults who are unable to continue their previous occupation due to health conditions. In addition to education and training, the centers provide support services, including the psychological service that assists rehabilitees in maintaining or regaining their mental stability. This study investigated which socio-demographic, health-related, and rehabilitation-related factors are associated with return to work (RTW) and examined the use of the psychological service and its association with RTW.

Methods

Data consisted of administrative data and service records routinely collected at one vocational retraining center. A total of 1187 individuals who began vocational retraining between 2016 and 2018 were analyzed. Logistic models predicting RTW and including interaction terms were used.

Results

Several factors were associated with RTW (Nagelkerke's Pseudo-R² = 0.173), including socio-demographic factors, e.g., age (OR 0.96, 95% CI [0.93, 0.98]), health-related factors, e.g., number of diagnoses (OR 0.85, 95% CI [0.77, 0.93]), and rehabilitation-related factors, e.g., discontinuation of training (OR 0.24, 95% CI [0.15, 0.38]). The proportion of women, rehabilitees attending boarding school, and rehabilitees pursuing a career in the commercial and administrative sector was higher among frequent users of the psychological service compared to non/occasional users. The proportion of rehabilitees diagnosed with ICD F was also higher among frequent users, as was the number of diagnoses. Moreover, an interaction was found between absence and psychological service utilization on RTW.

Conclusion

The analysis of routinely collected data in a vocational retraining center is suitable to investigate individual-level factors associated with RTW. The interaction suggests a compensatory effect, i.e., that frequent use of the psychological service mitigates the negative effect of absence on RTW.