Professionalisation of the occupational clinician: towards a competence profile

In 2020, Belgian figures show 470,000 people were on long-term incapacity. This is twice as much long-term incapacity as 15 years ago. Moreover, considering also short-term incapacities, the cost, estimated in 2010 at 4.7 billion euros, rose to 8.6 billion euros in 2019, i.e. an increase of 7% each year. Indeed, a survey conducted by a Belgian mutual insurance company (2021) [1] among 5 602 people shows 56% of respondents consider their work is (partially) responsible for their incapacity. Among those, 36.8% attribute their incapacity to burnout or mental illness, such as depression or anxiety. These figures highlight work-mental disorders constitute a major issue. This is confirmed by health professionals who reported more patients expressing work suffering. They are facing new disorders requiring new skills.
We aim to explore an innovative competence profile in the area of occupational health psychology, and especially in the diagnosis and follow-up of burnout or other work-related psychological disorders. This Belgian project launched in 2019 [2] was funded by the Minister of Social Affairs and Public Health as part of the new burnout initiatives, more particularly that related to the creation of a training program and networking device in occupational clinic.
The competence profile was developed according to the needs identified among health professionals:
The first need is being able, as occupational clinicians, to self-evaluate and identify the necessary relevant training for their own formation. The second one is checking if their practices are appropriate in the area of occupational health psychology. The next one refers to having a guide to create a training program for both first-line prevention actors (i.e, occupational physician, general practitioner, prevention counsellor) and second-line health professionals (i.e, occupational clinicians). The fourth need was enhancing recognition of the role of the occupational clinician and to protect the activities involved in occupational clinic.
Regarding the methodology, 12 focus groups were conducted by 2 animators and transcribed by 2 observers. 19 practitioners were divided into 3 groups of 6-7 practitioners and each group took part in 4 sessions. The objective was to highlight the behaviours implemented in critical situations (e.g. through a clinical case). In order to collect the behaviours, we chose different methods as the nominal group [3], the SPC (Sens-Process-Content) method [4] and the focus group method [5] with the critical incident technique [6].
Concerning the results, we first realized a qualitative analysis, based on the SPC method, which give us 521 behaviours. Secondly, a categorization of these behaviours was carried out with a group of 5-6 occupational clinicians. Finally, based on this categorization, a coordinator and a researcher realized the competence profile. The validation of the profile was based on an iteration process of reviews conducted by all the experts including in this project (project coordinators, psycho-pedagogue, occupational clinicians, scientific committee with representatives of different Belgian universities, pilot committee).
This competence profile includes seven skills: therapeutic setting (e.g. legitimacy, professional confidentiality), communication (e.g. with the worker, the health professionals, the prevention actors), network (e.g. how to develop and mobilise the network), diagnosis (e.g. anamnesis, tools, differential diagnosis), follow-up (e.g. work on resources, on demands), return-to-work (e.g. preparation for the return-to-work or for a professional transition) and sensitization (e.g. of the worker, of the hierarchical line). Furthermore, according to the competence profile for occupational psychologists (Wopsy, 2019), these skills are divided into some objectives that include behaviours and abilities. Then, the competence profile was linked to a variety of resources.
We also focus on the reflections in terms of practical and pedagogical scopes, the ethical and deontic position of occupational clinicians and the relevance of our competence profile as a guideline for health professionals practising or not yet as occupational clinicians.
This presentation will be relevant for the congress due to its contributions concerning the continuing professional development, skills training, the mental health at work and therapeutic interventions, among other things.