Article Details

Research Database: Article Details

Citation:  Shames, J., Treger, J., Ring, H. & Giaquinto, S. (2007). Return to work following traumatic brain injury: Trends and challenges. Disability and Rehabilitation, 15 (29), 1387-1395.
Title:  Return to work following traumatic brain injury: Trends and challenges
Authors:  Shames, J., Treger, J., Ring, H. & Giaquinto, S.
Year:  2007
Journal/Publication:  Disability and Rehabilitation
Publisher:  Taylor & Francis Ltd
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Systematic review / meta-analysis

Structured abstract:

Background:  A large number of individuals with moderate to severe traumatic brain injury (TBI) have permanent impairments that impact community reintegration including employment. The implications are not only financial but also relate to the person's future quality of life. The existing literature reveals a range of return to work rates and patient variables that impact the person's likelihood to return to work after TBI.
Purpose:  A review of the current research should help guide rehabilitation professionals in their efforts to manage patients with TBI with returning to work.
Setting:  This study is a systematic review. The included studies were undertaken in various locations and settings.
Study sample:  The sample consisted of multiple studies involving individuals with traumatic brain injury.
Intervention:  Within the review of literature a number of interventions are described. This includes post acute brain injury rehabilitation (PABIR), residential neurobehavioral programs, residential community re-entry programs,outpatient programs which emphasize interventions to improve self awareness, social skills, coping mechanisms and community re-entry programs that focus on vocational and social reintegration.
Control or comparison condition:  There were no comparison or control conditions.
Findings:  The community and work entry programs vary in content, intensity and length, and depend on the availability of funding and skilled staff. PABIR programs combine the disciplines of behavioral and cognitive treatment. In general they address several issues which impact a person motivation to return to work. A tool to evaluate and monitor self awareness, the awareness Questionnaire is available for clinical use. Another commonality of these programs is good working alliances between patient and staff and patients and families. Eagerness and readiness to return to work are also significant factors that may be impacted by compensation issues. Successful programs use a supported employment (SE). SE includes job placement, on the job training and other interventions as well as long term follow along. Costs associated with supported employment appear to be a good investment and job retention rates are reported at over 70%. More research is needed.
Conclusions:  Due to the complexity of the TBI, individuals with TBI should go through a continuum of care. Return to work efforts should include identification of individuals who are at risk for failure with RTW, coordinated and structured effort by a rehabilitation team and employers to manage problems associated with TBI as in PABIR or SE approach; and efforts to increase the availability of these programs. Systematic and integrated efforts are needed to improve outcomes for individuals with TBI.

Disabilities served:  Traumatic brain injury (TBI)
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Interventions:  Supported employment
Outcomes:  Employment acquisition
Return to work