Identifying models, processes, and components of vocational rehabilitation following acquired brain injury: a systematic scoping review

Abstract

Purpose

Acquired brain injury (ABI) is a complex injury which impacts engagement with worker roles. Return to work (RTW) rates for individuals with brain injury are low and those who do RTW often report job instability. Vocational rehabilitation (VR) can improve RTW rates and job stability; however, service provision is varied, and no gold standard has been identified.

Methods

A systematic scoping review of the literature was completed to explore research activity in VR for individuals with ABI to address the following three questions: what models have been identified to underpin VR in ABI? What clinical processes have been identified to guide provision of VR in ABI? What components of VR have been described and/or recommended in the ABI literature?

Results

The number of included articles was 57. From these articles, 16 models, nine process steps, eight components, and four service delivery components were identified that were utilised in provision of ABI VR. Implications for practice are discussed.

Conclusions

Key processes and components of ABI VR have been identified across a range of models and apply to clients at all phases post-injury. Findings may be used to inform service provision across a range of time points and support clinicians in their delivery of VR to adults with brain injury.

Implications for Rehabilitation

• People with acquired brain injury (ABI), even severe injury, can be successful with return to work (RTW) when provided appropriate supports.

• A wide range of models, interventions, and service components have been identified in the literature which can be used to guide clinical and policy development in ABI vocational rehabilitation.

• Vocational rehabilitation for individuals with brain injury involves a complex interaction of factors, and consideration should be paid to not only the person and their abilities but also job demands and the environment (physical, social, cultural).

• Vocational rehabilitation services should be accessible and timed to maximise chances of a successful RTW, provided by a coordinated interdisciplinary team and should involve active stakeholder engagement.

Keywords:

• Vocational rehabilitation
• brain injury
• models
• rehabilitation
• return to work

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This project was supported by a Seed Grant from The Hopkins Centre (2018). We acknowledge the support of the Acquired Brain Injury Transitional Rehabilitation Service for their support of this study.