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Murray A, Watter K, McLennan V, Vogler J, Nielsen M, Jeffery S, Ehlers S, Kennedy A. Identifying models, processes, and components of vocational rehabilitation following acquired brain injury: a systematic scoping review. Disabil Rehabil 2022; 44:7641-7654. [PMID: 34606380 DOI: 10.1080/09638288.2021.1980622] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Acquired brain injury (ABI) is a complex injury which impacts engagement with worker roles. Return to work (RTW) rates for individuals with brain injury are low and those who do RTW often report job instability. Vocational rehabilitation (VR) can improve RTW rates and job stability; however, service provision is varied, and no gold standard has been identified. METHODS A systematic scoping review of the literature was completed to explore research activity in VR for individuals with ABI to address the following three questions: what models have been identified to underpin VR in ABI? What clinical processes have been identified to guide provision of VR in ABI? What components of VR have been described and/or recommended in the ABI literature? RESULTS The number of included articles was 57. From these articles, 16 models, nine process steps, eight components, and four service delivery components were identified that were utilised in provision of ABI VR. Implications for practice are discussed. CONCLUSIONS Key processes and components of ABI VR have been identified across a range of models and apply to clients at all phases post-injury. Findings may be used to inform service provision across a range of time points and support clinicians in their delivery of VR to adults with brain injury.Implications for RehabilitationPeople with acquired brain injury (ABI), even severe injury, can be successful with return to work (RTW) when provided appropriate supports.A wide range of models, interventions, and service components have been identified in the literature which can be used to guide clinical and policy development in ABI vocational rehabilitation.Vocational rehabilitation for individuals with brain injury involves a complex interaction of factors, and consideration should be paid to not only the person and their abilities but also job demands and the environment (physical, social, cultural).Vocational rehabilitation services should be accessible and timed to maximise chances of a successful RTW, provided by a coordinated interdisciplinary team and should involve active stakeholder engagement.
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Affiliation(s)
- Alena Murray
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
| | - Kerrin Watter
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
| | - Vanette McLennan
- Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia.,School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - Jessica Vogler
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
| | - Mandy Nielsen
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
| | - Sarah Jeffery
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
| | - Shelley Ehlers
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia
| | - Areti Kennedy
- Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Brisbane, Australia.,Division of Rehabilitation, The Hopkins Centre, Metro South Health & Griffith University, Brisbane, Australia
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van Markus-Doornbosch F, Meesters JJ, Volker G, Ijzereef WA, van den Hout WB, Vliet Vlieland TP, de Kloet AJ. The outcomes of a vocational rehabilitation and mentorship program in unemployed young adults with acquired brain injury. Work 2022; 72:553-563. [DOI: 10.3233/wor-210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Persons with disabilities are at risk for unemployment with negative long-term consequences. OBJECTIVE: This study aimed to explore the process and outcomes of a novel vocational rehabilitation (VR) program based on the concept of mentorship. METHODS: Observational, retrospective study including unemployed young adults with acquired brain injury (ABI) taking part in a VR program including assessment, training, individual counselling and mentor support from volunteering professionals. Adherence to the program and work status were registered and at follow-up all patients were invited to complete a general questionnaire and EuroQol 5D. RESULTS: 49 patients started the program, with 41 completing the follow-up. Median age was 31 years and 19 were male. Median duration of the program was 8 months. At follow-up, 9 patients had acquired paid employment, 7 with the support of a mentor; 6 of whom were bothered by health problems at work. Nine patients left the program prematurely, with insufficient financial support for continuation being the primary reason for withdrawal (n = 6). CONCLUSIONS: A VR program including a mentor may be a promising program for patients who are unemployed at onset of ABI. Lack of financial support to complete the program and concurrent health problems were found to hamper the process and outcomes of the program, respectively.
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Affiliation(s)
| | - Jorit J. Meesters
- Department of Innovation, Quality and Research, Basalt Rehabilitation, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerard Volker
- Department of Innovation, Quality and Research, Basalt Rehabilitation, The Hague, The Netherlands
| | - Wil A. Ijzereef
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - Wilbert B. van den Hout
- Department of Biomedical Data Sciences – Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Thea P. Vliet Vlieland
- Department of Innovation, Quality and Research, Basalt Rehabilitation, The Hague, The Netherlands
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Arend J. de Kloet
- Department of Innovation, Quality and Research, Basalt Rehabilitation, The Hague, The Netherlands
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Bennett K, Dillahunt-Aspillaga C, Lasley C, Trexler LC, Schmeeckle W, Walker-Egea C, Gonzalez CM, Trexler LE. Traumatic brain injury vocational rehabilitation counselor competencies: Implications for training and practice. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The Administration for Community Living (ACL) TBI State Partnership Program grants support states by providing funding to build capacity and infrastructure to support and maintain a system of services and supports to maximize the independence, well-being, and health of persons with traumatic brain injury (TBI). A Transition and Employment (T&E) workgroup identified competencies needed by Vocational Rehabilitation Counselors (VRC) to support people with TBI to obtain and maintain employment. OBJECTIVE: To: (1) identify self-perceived VRC TBI competence and (2) inform individual state VR training activities and competency goals. METHODS: A self-assessment online survey was employed. RESULTS: A total of 269 VR professionals across four states completed the VRC Self-Assessment between December 2020 and February 2021. The T&E workgroup identified TBI competencies across four domains (1) brain injury medical and rehabilitation, (2) employment, (3) state and local systems, resources, and service coordination, and (4) national systems, research and best practice. The results by TBI competency and the overall score for all participants show that state and local systems, resources, and service coordination is the highest area of competency, placing them close to the proficient level of knowledge. CONCLUSIONS: Future VR education and training opportunities may be informed by the results of this study.
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Affiliation(s)
- Keri Bennett
- Program Director for Acquired Brain Injury, Nebraska VR, Nebraska Department of Education, Kearney, NE, USA
| | - Christina Dillahunt-Aspillaga
- Rehabilitation and Mental Health CounselingProgram, Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Carla Lasley
- Program Director of CommunityServices, Nebraska VR, Nebraska Department of Education, Lincoln, NE, USA
| | - Laura C. Trexler
- ACL Grant Clinical Program Manager, Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
| | | | - Connie Walker-Egea
- Senior Social and Behavioral Researcher, Department of Child and Family Studies, College of Behavioral andCommunity Sciences, University of South Florida, Tampa, FL, USA
| | - Cristina M. Gonzalez
- Doctoral Student, Counseling and CounselorEducation, University of Florida, Gainesville, FL, USA
| | - Lance E. Trexler
- Consulting Rehabilitation Neuropsychologist, Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
- Department of Physical Medicine andRehabilitation, Indiana University School of Medicine, Indianapolis, IN, USA
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