What Does It Take to Get Somebody Back to Work after Severe Acquired Brain Injury? Service Actions within the...

Area of Science:

• Neurorehabilitation
• Occupational Therapy
• Vocational Rehabilitation

Background:

• Limited understanding of vocational rehabilitation (VR) service actions for individuals with severe acquired brain injury (ABI).
• The Vocational Intervention Program (VIP) scale-up offered a chance to analyze VR service delivery for severe ABI.
• Seventy-two participants with severe traumatic brain injury (TBI) were included.

Purpose of the Study:

• To analyze the intensity and profile of service actions in VR programs for severe ABI.
• To compare intervention levels between pathways for returning to pre-injury employment (FastTrack) and new employment (NewTrack).
• To examine differences in service actions between Disability Employment Service (DES) and private VR providers.

Main Methods:

• Analysis of documented service actions (hours and minutes) using an adapted Case Management Taxonomy.
• Comparison of intervention intensity between FastTrack (n=27) and NewTrack (n=50) pathways.
• Assessment of service delivery by DES and private VR providers for individuals with severe TBI.

Main Results:

• The NewTrack pathway required significantly more intervention time (35h 30min) than the FastTrack pathway (25h 5min).
• Case coordination was the most frequent service action, accounting for over 40% of total time for both pathways.
• Disability Employment Service providers spent more time on engagement, assessment, planning, and emotional support compared to private providers.

Conclusions:

• Vocational rehabilitation for severe TBI is intensive, with case coordination being a primary component.
• The NewTrack pathway demands greater intervention intensity, highlighting the complexity of supporting new employment.
• Provider type influences the profile of VR service actions, with DES providers offering more comprehensive support.