Approaches to Vocational Rehabilitation After Traumatic Brain Injury: A Review of the Evidence

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,