Traumatic Brain Injury

Traumatic brain injury (TBI) is the leading cause of disability in previously healthy young adults. As a consequence, the resumption of work roles can be a difficult and protracted process, particularly for those people with neurocognitive impairments, which may compromise work performance. The introductory sections of this chapter provide an overview of the epidemiology, neuropathology and clinical profiles of TBI, with particular reference to common neuropsychological impairments and their functional consequences. Brief review is made of outcome studies of return to work after TBI and evidence for the effectiveness of a range of vocational rehabilitation programmes, including case management, supported employment and centre-based programmes. The final section of the chapter is devoted to a detailed description of the state of the field of vocational rehabilitation in TBI. The assessment process is described (including the seven-step process of Stergiou-Kita et al. 2011): work preparation, work placement (from the perspective of both the pre-injury and the post-injury employer) and post-placement support. The chapter concludes with a brief section on alternatives to mainstream, competitive employment for those people whose impairments preclude them from returning to work.