Early vocational rehabilitation improves employment outcomes for individuals with acquired brain injury


van Velzen, J. M., van Bennekon, C. A. M., van Dormolen, M., Sluiter, J. K., Frings-Dresen, M. H. W. (2016). Evaluation of the implementation of the protocol of an early intervention for people with acquired brain injury. Disability and Rehabilitation, 38, 62-70. doi:10.3109/09638288.2015.1017057


Individuals with acquired brain injury (ABI), whether traumatic or non-traumatic, experience numerous barriers reengaging in pre-injury major life roles, including employment. Laws in the Netherlands require employers and employees to work together in the return to work (RTW) process while the employee is on sick leave (up to 2 years). Early vocational rehabilitation (EVR) can assist with RTW in a timely manner, thus reducing costs to employers and loss of wages to employees. Rehabilitation experts in the Netherlands and Belgium, with input from the management team and rehabilitation professionals, established a protocol to implement an EVR intervention for inpatient and outpatient clients with ABI. The purpose of this (reviewed) study was to evaluate: (1) the feasibility of the EVR protocol in the standard rehabilitation process, (2) identify factors that facilitate and jeopardize the EVR protocol, and (3) the perceived effectiveness of the EVR protocol in facilitating RTW following ABI. The study was conducted at a Dutch rehabilitation center using a pre- and post-process evaluation. Dependent variables included: feasibility (research question [RQ] 1), promoting factors and barriers (RQ 2), and perceived effectiveness of the protocol (RQ 3). Data of 23 patients were evaluated by a team of 21 rehabilitation professionals (1 rehabilitation physician, 1 basic physician, 3 occupational therapists, 4 physical therapists, 2 cognitive trainers, 4 neuro/psychologists, 2 speech therapists, 2 social workers, 2 vocational rehabilitation specialists). A total of 34 participants (9 rehabilitation professionals, 10 patients with ABI, 9 employers, and 6 occupational physicians) completed the required pre- and post-questionnaires to be included in the study. Overall, the results were positive: two-thirds of the performance goals were reached as were one-fourth of the timing goals. All respondents cited the structured EVR protocol as a factor which promoted/facilitated the RTW process. The majority of participants (32 out of 34) perceived the EVR protocol as appropriate for facilitating RTW after ABI. The authors conclude that the EVR protocol is viable for use in standard rehabilitation to promote RTW for individuals with ABI and should be implemented and tested in other rehabilitation settings.

I SELECTED THIS ARTICLE BECAUSE it is a novel program which seems to provide evidence to support its effectiveness in RTW of individuals with ABI. Employment is a major barrier for individuals with ABI in the United States. Perhaps, adopting a successful practice from another country could help bridge that gap. 

THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was chosen by Jennifer Sánchez, Ph.D., CRC, Assistant Professor, Department of Rehabilitation and Counselor Education, The University of Iowa, and a member of Division 22’s Science Committee.