GTB "We go to work". Belgium

Belgium, GTB.

Outreach to inactive people due to a disability and/or health problem

Summary

GTB is a specialised service provision and counselling service for people with work disabilities or health problems. GTB promotes job integration into the labourmarket, empowering persons with special needs and supporting companies to employ persons with special needs.

GTB reaches inactive people with no obligations to go to work but who have complex thresholds to overcome. The job coach is presented with this client and invites them to participate on empowerment actions as a pathway to a suitable job. The GTB’s job coach must work together with health, welfare professionals and of course with the client to reach the same perspectives on goals and pathways to follow.

The personal situation of the participants is mapped according to the methods of strength-oriented coaching and being present. The GTB’s outreach coach meets with the potential client who want to test work wishes/options for several days in the partner’s organizations, no obligations from the client at this stage is needed.

  • Module 1. Information session followed by an individual discussion with the GTB outreach coach if needed.
  • Module 2. At the partner’s organisation place GTB's outreach coach and experienced expert provide group sessions with clients focusing on their professional wishes, interests and possibilities.
  • Module 3. A Wellness Recovery Action Plan (WRAP): In a group setting a wellness / work recovery action plan is drawn up by partner organization together with GTB’s outreach coach. 
  • Growth in personal competences such as motivation, coping with stress, creation of a personal network is also measured using the ICF-core set on vocational reintegration.

Factbox

Mission: job mediation for vulnerable persons due to health problems and/or disabilities 

Foundation year: 2008

Legal type: NGO

Principal area of activity: job mediation

Total number of employees: 504

Annual turnover: € 26M

Average number of service clients in the whole organisation:11 440

Geographic area of activity of the organization: Flanders/Belgium

Target group / service users:  working age (17-65 y.o.); all types of disabilities or health problems where there is a need for greater or alternative coaching as regular public employment services or job coaching organisations can foreseen

by GTB-outreach coach that is active in care teams who deliver rehabilitation services, for inactive persons of working age in a rehabilitation program or activity/day care centres and with no direct perspective on return to work
Apart from specific medical diagnosis (chronic pain - physical rehabilitation - psychological vulnerability - oncology – rheumatism etc.), GTB see processes of coping by the patient in the field of pain, fatigue, loss of concentration and memory and psycho-social difficulties. Clinicians coach these coping processes by relating to dreams and fears to achieve maximum quality of life. Too little is the domain of "work" involved in this coaching; nevertheless, the perspective on workable work can have important therapeutic effects because the patient has more self-confidence and more social contacts. This strengthens the person’s motivation to focus on rehabilitation and to take back control of their quality of life.

It is precisely on 'whether or not to work' that patients, practitioners, employment mediators, employers, advisers and doctors are at risk of falling into dogmas. Work is all too often an all or nothing story (and only starts after rehabilitation), while by providing insights and inspiring coaching, the patient (already at the start of inactivity) can gain perspective on reasonable adjustments, learning opportunities, growth jobs, job crafting etc. The patient acquires insights by objectifying their possibilities and capacities, by examining what they really dream of and what prevents them from going for this, knowing about support options. By properly documenting this at the right moments in the treatment and by focusing on strong mutual communication - in which the customer is central - all actors achieve supported treatment goals and results in job coaching and mediation. The advisory and occupational physician have a documented treatment file in which job (re)integration is a topic so that they become partners in the process instead of remote decision makers.

With the outreach project, GTB aim to reach patients in the phase 'before they are ready to take steps to work' and we go for collaboration / interaction with GTB and the treating hospital team. Due to the outreach project, the GTB-outreach worker is present in the team, bringing the perspective on work into the treatment goals and sets up inspiring coaching with patients to this end. Conversely, practitioners, together with the patient, provide the GTB employee with these insights that are important to make decent working feasible. GTB systematically improve quality of action by measuring outcomes quantitatively and qualitatively. GTB’s impact analysis is based on the Theory of Change, the Self-Determination Theory and the insights on New Authority.

A We Go To Work worker is a seeker, inventor, divider and doer. Someone who dares to "jump" together with the customer, together with the partner organization and together with the We Go To Work colleagues.

A We Go To Work worker thinks and acts "outside of the box". They are knowledgeable in regular mediation work of GTB and are a specialist in IPS work (Individual Placement and Support) and at the same time can use their professional knowledge with some reluctance and hesitation.

A We Go To Work worker feels a strong bond with GTB and enjoys working embedded in, together with  

and from a partner organization. They quickly "sense" the expectations of a partner organization, manages to behave accordingly and combines this with the heart and soul of GTB and the We Go To Work assignment.

An outreach methodology is based on: The Theory of Presence / Baert; Solution based coaching /Korbinsky; New Authority /Hame; The ICF-coreset on job integration/WHO_VDAB. The Supported Employment Principles/EUSE.

Procedure to reach

a client

At outreach GTB, the worker meets the client in their context, so instead of the client having to come to GTB’s job mediation offices they go to client at their rehabilitation hospital, day care or activation centre, at home etc. It’s very important that ‘work’ comes as quick as possible in the form of the rehabilitation process, so the GTB-outreach worker becomes part of the care-team and together they organise individual or group information sessions about possibilities and make a work recovery action plan. Peers are actively involved in the outreach actions.
Service’s start after the disability is acquired Returning to meaningful work as quickly as possible is an important element of quality of life. Statistics shows that after 4 months without employment only 40% of people return to work. GTB actively invites persons in rehabilitation to reflect on work-possibilities and help to bring their goals into the rehabilitation process.

There is no standard time period the client is asked by the care team to reflect on return to work actions. By being ‘present’ as much as possible the GTB-outreach worker supports the service user with his/her internal motivations. Strengthening the internal motivation is a key point for the success of the rehabilitation. Being ‘present’ is an active process of the GTB-outreach worker through actions such as:

- Open information access points to talk about work.

- Group session on return to work.

- Storytelling information about return to work on the internal television channels.

- Individual coaching possibilities on establishing personal return to work action plans.

Continuity / integration between services Between GTB and the care organisation there is a signed agreement with clear defined objectives, the input of staff and a project steering committee in each of the 5 Flemish counties. GTB puts efforts into learning circles and will do an impact-evaluation. Based on costs/benefits calculations we can presume our stakeholders (the public authorities on unemployment benefits and sickness benefits) to invest in outreach-programs.
Staff and Resources 1 FTE ‘outreach staff’ can reach about 200 potential clients per year in outreach and guarantee that 15% of them take active steps to work by following a VET-course, a workplace training and reach paid employment.

As the activities take place on the locations of the care provider no additional infrastructure is needed.

Duration The maximum duration ‘outreach’ is 2 years.

The outreach service is a mixture of information, individual coaching and group empowerment sessions. All these actions take place at health-welfare locations in which the client is already active. On average at each location the GTB job coach is 350 hours/year available and uses 100 hours on individual coaching, 100 hours on group information and activation (10 months/year – 3 sessions/3 hours), 100 case and team consultations, 50 hours’ administration/preparation. It depends on the individual needs of the clients if he joins more the group sessions or needs more individual coaching.

Budget The outreach program is 80% financed by the ESF and 20% by the partners themselves. Service users pay nothing to join the outreach activities. The ESF-budgets are guaranteed until the end of 2022. A cost/benefit analyse must show the financial benefits for society and convince the public authorities to invest. 
Partners 18 hospitals with rehabilitation units and pain clinics which include 2 university clinics. 7 outpatient welfare centres and more than 10 activity centres involved in mental health rehabilitation. GTB is a promoter of the 5 regionals partnerships.
Other stakeholders The public employment service (VDAB) participate actively in the 5 regional project steering groups. The social partners and user-organisations are present on the board of GTB and stimulate the outreach-program. 85% of the GTB-staff are willing to employ their service outside the local job shop. In 2 regions mutuality’s / sickness insurance companies are partners and can be an influencer on the National Social Security Agency (RIZIV/INAMI).
Information campaigns Employers are not directly involved in the scope of the outreach project. GTB use the Talentoscope service model to reach employers, so that each employer interested in diversity on their work floor has the guarantee of a SPOC (Single Point of Contact). By promoting the We Go To Work project to care partners GTB facilitates the job integration as the care providers can count on specialists in job-mediation and in networking with employers.
Repeated service accessibility GTB is the structural partner of the VDAB (The Flemish Public Employment Agency) and is obliged to offer services to unemployed and workers with disabilities of working age.  GTB regularly contacts the service users to find out if all goes well or if there are some more service needs, even if the client is at work. So, the client has an opportunity to apply for service even after receiving it at once.
Monitoring The GTB outreach coach is active in the ‘care team’ of the rehabilitation service as well as in the job mediation team. So after the outreach program the trainee can access the GTB-mediator as his coach.  GTB try to ensure that this is the same person but certainly the service is based in the same team. It can be guaranteed that if necessary the monitoring can be provided systematically for 18 months after the outreach-program. Above that GTB provides after care for at least 2 years after the end of the mediation.
Direct and wider impact To gain a paid suitable job is a significant boost to the quality of life of the trainee. Also, society benefits if the employment rate is high, in Flanders the target is 78% activity rate and to realise 45% activity rate for persons with a disability. For the outreach project it must be guaranteed that 15% of the contacted persons will make further steps towards employment.

Currently it’s too early to measure the outcomes.

Success factors - Bringing in the focus on work in an outreach way within the recovery process.

- Converting theoretical insights on outreach into practical tools for field workers and job brokers, including from the theory of presence - new authority.

- The use of experiential expertise in drawing up action plans and empowerment group processes.

- Realizing good monitoring to arrive at policy recommendations. What are the main barriers that prevent steps to work and how can we respond to this?

- Strengthening the ICF as a bio - psycho - social thinking and language framework across the sectors work - care - welfare.

- Let care and welfare counsellors connect with the focus on work and job placement.

Dialogue with policy makers The social partners, the mutuality’s as well as user organisations are involved in the policy board of GTB, 5 members are also involved in the board of VDAB (PES). GTB delivers advice directly to the National Social Security organisation (RIZIV/INAMI), the Socio-Economical advisory board of Flanders and the departments of work, welfare, education.
Adaptation for other countries In Flanders there is a unique organisation structure. GTB is the largest organisation for job mediation for people with a disability or health problems and works with a connection with the public employment service VDAB. So, the welfare or care organisations don’t carry out mediation actions with employers. GTB offers employers a SPOC so that the inclusion in the labour market is well organised. An employer is not reached by a lot of job mediators asking to solve problems. On the contrary GTB uses their knowledge with healthcare providers on what competences are asked by employers and how both can act on building the capacities of a jobseeker of a worker.

This model can be integrated in other countries.

Now GTB is creating a duo partnership between the GTB-outreach coach and the care partner. Future developments include:

- Group modules for learning offered across the organizations, so that rapid starts and smooth regional distribution is possible.

- There is a central platform for video calling so that online (group) coaching is possible. The participants who are not skilled in video calling have.

- Using custom apps / new technology to improve the work and quality of life of the customers.