We go to work - GTB

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

In Belgium GTB, a specialised service provision and counselling service for people of working age with disabilities or health problems, has been running a project called “We go to work” since 201924 . The project is subsidised by ESF and will end in December 2023. It aims to reach through an outreach service inactive people who are hindered by an occupational disability or health issue and have a lot of thresholds to find a job.

The outreach service is a mixture of information, individual coaching and group empowerment sessions, which aims to reach patients in the phase 'before they are ready to take steps to work'. The GTB-outreach worker plays a key role, as they meet the client directly at their rehabilitation hospital or welfare participation, instead of the client having to come to GTB’s job mediation offices. The GTB-outreach worker is a specialist in mediation to work, IPS and knows the demands of employers well. As the GTB-outreach worker becomes part of the care-team and together with the client or patient they built on a work recovery action plan in order to integrate the client into the labour market as quick as possible. By providing insights and coaching, the patient can assess their capacities and interests and gain perspective on reasonable adjustments, learning opportunities, growth jobs, job crafting etc. 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. Between GTB and the care organisation there is a signed agreement with clear defined objectives. The outreach program is currently 80% financed by the ESF and 20% by the partners themselves. Service users pay nothing to join the outreach activities.

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

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.