Article Details

Research Database: Article Details

Citation:  O’Brien, L. (2007). Achieving a successful and sustainable return to the workforce after ABI: A client-centered approach. Brain Injury, 21 (5), 465-478.
Title:  Achieving a successful and sustainable return to the workforce after ABI: A client-centered approach
Authors:  O’Brien, L.
Year:  2007
Journal/Publication:  Brain Injury
Publisher:  Informa Healthcare
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Mixed methods

Structured abstract:

Background:  Acquired brain injury (ABI) can be caused by cerebrovascular accident, trauma (such as assault or motor vehicle accident), tumors, hypoxia, infection or degenerative conditions and is a common occurrence [1]. It may result in significant disability and, in people of working age, limit their ability to join or return to the workforce.
Purpose:  The aim of this study was to describe the services provided (including assessments, interventions and post-job placement support) and outcomes achieved by CRS Australia’s Victorian ABI team and compare and contrast this with other models.
Setting:  The study setting was a rehabilitation service organization in Australia.
Study sample:  The study sample consisted of 27 individuals with ABI who had received rehabilitation services at CRS Australia. The sample was randomly selected from cases that had been closed in the previous year with an employment outcome. Additional characteristics of the sample are not provided.
Intervention:  The intervention is described as “client-centered practice.” Each client is allocated to a Rehabilitation Consultant (RC) with whom they work one-to-one, wherever possible, throughout the duration of services. Active client involvement in the negotiation of individual rehabilitation plans is standard practice in all cases and clients are informed of their rights, responsibilities and the complaints handling mechanism at the earliest opportunity. Specific interventions are tailored to the individual and can include vocational counseling, skills training, cognitive retraining, job seeking, interview preparation, work behavior coaching, and post-employment services.
Control or comparison condition:  There was no control or comparison condition. Outcomes for the study group were compared to those of other models.
Data collection and analysis:  A data extraction method was used to audit patient information relevant to the study. Team members were also asked to indicate which of 17 vocational rehabilitation strategies they used with their clients and to rate each in terms of effectiveness in achieving a successful job placement. which of five post job-placement strategies (email to client, weekly or fortnightly phone calls to client, weekly or fortnightly phone calls to employer, support/counseling outside client’s work hours and regular scheduled workplace visits) they used and to evaluate their perceived effectiveness.
Findings:  Of the patient files audited, 42% were placed in professional, managerial, office or administrative work, two were placed in a trade-qualified job, eight were placed in semi-skilled positions, and four were placed in unskilled labor. Of the clients who had jobs to return to (n=10) all returned to their previous role or a similar job following a graded return with professional/clerical jobs figuring highly (50%; n=5). Those clients who did not have a job to return to (n=17) were placed in similar roles to their pre-injury employment, with seven placed in a professional role, six placed in semi-skilled work and four placed in unskilled labor positions. Half were employed more than 13 weeks.
Conclusions:  The CRS Australia model resulted in higher than average employment outcome rates for this population (50% working at award wage for more than 13 weeks, compared to Australian ABI population estimates of 28–46.5%). This study shows that the CRS Australia model has been successful with people with mild, moderate and severe impairment following an ABI and significantly less time-intensive and therefore less costly than other models.

Disabilities served:  Cerebral vascular accident (stroke)
Cognitive / intellectual impairment
Multiple sclerosis
Traumatic brain injury (TBI)
Populations served:  Gender: Female and Male
Interventions:  Career counseling
Compensatory strategies
Job coach
Job search and placement assistance
On-the-job training and support
Non-psychological counseling
Post-employment services
Training and technical assistance
Vocational assessment
Outcomes:  Employment acquisition
Return to work