Approaches to vocational rehabilitation after traumatic brain injury: a review of the evidence

J Head Trauma Rehabil. 2009 May-Jun;24(3):195-212. doi: 10.1097/HTR.0b013e3181a0d458.

Abstract

Background: Return to work after traumatic brain injury (TBI) is an important outcome but frequently problematic to achieve. Vocational rehabilitation is commonly recommended as a means of facilitating return to work after TBI. However, there are several different approaches to vocational rehabilitation after TBI and little guidance regarding how to identify the best option for a particular context.

Objectives: To (1) identify approaches most commonly underpinning vocational interventions in TBI and (2) evaluate the evidence for effectiveness, strengths and weaknesses, and application of each approach for the TBI population.

Methods: Principles of systematic review were used for searching and critiquing articles. Findings are expressed as descriptive synthesis owing to heterogeneity of designs and outcome measures.

Results: Three broad categories of vocational rehabilitation for people with TBI were identified on the basis of models that underpin them-program-based vocational rehabilitation, supported employment, and case coordinated. The characteristics, similarities, differences, and applications of each approach are described, as are their strengths and limitations.

Conclusions: There is little clear evidence to suggest what should be considered the "best practice" approach to vocational rehabilitation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Brain Injuries / rehabilitation*
  • Evidence-Based Medicine*
  • Humans
  • Practice Guidelines as Topic
  • Rehabilitation, Vocational / methods*