Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury

Abstract

Introduction: Following acquired brain injury, the goal of return to work is common. While return to work is supported through different rehabilitation models and services, access to vocational rehabilitation varies within and between countries, and global rates of employment post-injury remain low. The literature identifies outcomes from vocational programs and experiences with return to work, yet little is known about individuals’ perceptions and experiences regarding rehabilitation to support their vocational goals and experiences in attempting to return to work. Method: This qualitative study investigated the experiences of community-living adults with acquired brain injury (n = 8; mean age 45 years; mean time post-injury of 5.5 years) regarding their vocational rehabilitation and return to work. Focus groups and semi-structured interviews were conducted, with data analyzed via thematic analysis. Results: Participants identified negative and positive experiences with vocational rehabilitation and return to work. Five overarching themes were identified: addressing vocational rehabilitation in rehabilitation; facilitators of recovery and return to work; the importance and experience of working again; acquired brain injury and identity; and services, systems and policies. Participants also identified five key areas for early vocational rehabilitation services: education; service provision; employer liaison; workplace supports; and peer mentors. Study findings inform current and future practice and service delivery, at a clinical, service and system level.

Priorities for returning to work after traumatic injury: A public and professional involvement study

“…This was mostly negative, in a lesser, dependent role, and was interrelated with self-identity, pride and responsibility for others. Similarly to Watter and colleagues findings with people returning to work following acquired brain injury (2021), identity was a main motivator for individuals in rehabilitation, in resuming their pre-injury work status and independence. Being seen as a burden was an issue for participants.…”

“…Equally, engagement in meaningful occupational roles in the work-place provides an individual with a sense of purpose and consolidation of personal identity (Fitzgerald, 2014). Work being a major component of one’s identity is common across other trauma, including acquired brain injury, (Watter et al, 2021) and in stroke rehabilitation (Alaszewski et al, 2007).…”

Clinician perspectives of ABI vocational rehabilitation in Queensland

“…However, investigation into related areas has occurred. Australian studies have identified assessments and interventions used by specialised ABI vocational rehabilitation clinicians in an Australian Commonwealth Rehabilitation Service team (O’Brien, 2007) and ABI consumer views of vocational rehabilitation and return to work (Libeson et al, 2018; McRae et al, 2016; Watter et al, 2021). Consumer (adults with ABI) experiences with ABI vocational rehabilitation and return to work in Queensland have been investigated, identifying positive and negative experiences with public and private service providers, across areas including access to services, therapeutic interventions and supports for return to work (Watter et al, 2021).…”

“…To achieve this, the EBP-4 model (Hoffman et al, 2017) was adopted to guide investigation of the evidence base. This involved investigating: the research evidence via a systematic scoping review (Murray et al, 2021); client values and circumstances through a qualitative study examining client experiences with ABI vocational rehabilitation and return to work within the practice context of Queensland-based services (Watter et al, 2021); and clinical expertise within the practice context of Queensland-based services for ABI vocational rehabilitation through this study, which is detailed below.…”

What Does It Take to Get Somebody Back to Work after Severe Acquired Brain Injury? Service Actions within the Vocational Intervention Program (VIP 2.0)

“…The project aimed to address the low levels of RTW after TBI in NSW [ 9 ]. Significant barriers to effective RTW programs previously identified by consumers with lived experience of ABI included a lack of knowledge and understanding about ABI among the existing VR providers, linked with poor coordination between health and VR sectors [ 10 , 26 ]. The VIP 2.0 addressed these issues through establishing partnerships between brain injury rehabilitation services and VR providers and providing brain injury-specific resources and mentoring to the providers to build knowledge and skills in managing RTW after ABI [ 27 , 28 ].…”