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Navigating Employment Pathways and Supports Following Brain Injury in Australia: Client Perspectives

  • Philippa McRae (a1) (a2), Lisa Hallab (a1) (a2) and Grahame Simpson (a2) (a3) (a4)

This study investigated the vocational rehabilitation experiences of 29 clients, up to 14 years post brain injury. Data obtained from participant interviews were thematically analysed by employment pathway (‘return to pre-injury employment’, ‘job seeking’ and ‘not worked since injury’). A total of nine themes were identified. Across all pathways, participants identified the importance of working, impact of injury and their own determination. The content for the remaining themes (understanding, adjustment, access, support, disclosure of injury, intervention) varied by pathway, reflecting the differing perspectives arising from integrating back into a familiar workplace versus seeking new employment. In conclusion, programme approaches to vocational rehabilitation need to be tailored to the individual circumstances, opportunities and support needs of people with brain injury pursuing these different pathways.

Corresponding author
Address for correspondence: Philippa McRae, Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation, Level 2, Ingham Institute of Applied Medical Research, 1 Campbell St, Liverpool, NSW 2170. E-mail:
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Access Economics. (2009). The Economic Cost of Spinal Cord Injury and Traumatic Brain Injury in Australia. Melbourne, Australia: Victorian Neurotrauma Institute
Agency for Clinical Innovation. (2013). Investigation of Vocational Programs and Outcomes for People with Traumatic Brain Injury in New South Wales. Sydney, Australia: Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation.
Agency for Clinical Innovation. (2014). Brain Injury Rehabilitation Directorate: Diagnostic Report. Sydney, Australia: Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation.
Anstey, K., Butterworth, P., Jorm, A.F., Chistensen, H., Rodgers, B., & Windsor, T.D. (2004). A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms. Journal of Clinical Epidemiology, 57, 12021209.
Australian Institute of Health and Welfare. (2007). Disability in Australia: Acquired brain injury. Bulletin no. 55. Catalogue No. AUS 96. Canberra: Australian Institute of Health and Welfare.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77101.
Brooks, N., McKinlay, W., Symington, C., Beattie, A., & Campsie, L. (1987). Return to work within the first seven years of severe head injury. Brain Injury, 1 (1), 519.
Department of Employment. (2015). Disability Employment Services: DES Monthly Data. Canberra, Australia: Department of Employment, Australian Government. Available at:
Ellingsen, K.L., & Aas, R.W. (2009). Work participation after acquired brain injury: Experiences of inhibiting and facilitating factors. The International Journal of Disability Management Research, 4, 111.
Frost, R.B., Farrer, T.J., Primosch, M., & Hedges, D.W. (2012). Prevalence of traumatic brain injury in the general adult population: A meta-analysis. Neuroepidemiology, 40, 154159.
Gilworth, G., Eyres, S., Carey, A., Bhakta, B.B., & Tennant, A. (2008). Working with a brain injury: Personal experiences of returning to work following a mild or moderate brain injury. Journal of Rehabilitation Medicine, 40, 334339.
Gilworth, G., Phil, M., Cert, A., Sansam, K.A., & Kent, R.M. (2009). Personal experiences of returning to work following stroke: An exploratory study. Work, 34, 95103.
Gracey, F., Palmer, S., Rous, B., Psaila, K., Shaw, K., O'Dell, J., Cope, J. & Mohamed, S. (2008). “Feeling part of things”: Personal construction of self after brain injury. Neuropsychological Rehabilitation, 18, 627650.
Harradine, P.G., Winstanley, J.B., Tate, R., Cameron, I.D., Baguley, I.J., & Harris, R.D. (2004) Severe traumatic brain injury in New South Wales: Comparable outcomes for rural and urban residents. Medical Journal of Australia, 181 (3), 130134.
Kreutzer, J.S., Marwitz, J.H., Walker, W., Sander, A. Sherer, M., Bogner, J., Fraser, R., & Bushnik, T. (2003). Moderating factors in return to work and job stability after traumatic brain injury. Journal of Head Trauma Rehabilitation, 18 (2), 128138.
Macaden, A.S., Chandler, B.J., Chandler, C., & Berry, A. (2010). Sustaining employment after vocational rehabilitation in acquired brain injury. Disability and Rehabilitation: An International, Multidisciplinary Journal, 32 (14), 11401147.
Medin, J., Barajas, J., & Ekberg, K. (2006). Stroke patients' experiences of return to work. Disability and Rehabilitation, 28 (17), 10511060.
Menon, D.K., Schwab, K., Wright, D.W., & Maas, A.I. (2010). Position statement: Definition of Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 91 (11), 16371638.
Nightingale, E.J., Soo, C.A., & Tate, R.L. (2007). A systematic review of early prognostic factors for return to work after traumatic brain injury. Brain Impairment, 8 (2), 101142.
Olver, J.H., Ponsford, J.L. & Curran, C.A. (1996). Outcome following traumatic brain injury: A comparison between 2 and 5 years after injury. Brain Injury, 10 (11), 841848.
Oppermann, J.D. (2004). Interpreting the meaning individuals ascribe to returning to work after traumatic brain injury: A qualitative approach. Brain Injury, 18 (9), 941955.
Petrella, L., McColl, M.A., Krupa, T., & Johnston, J. (2005). Returning to productive activities: Perspectives of individuals with long-standing acquired brain injuries. Brain Injury, 19, 643655.
Ponsford, J.L., Downing, M.G., Olver, J., Ponsford, M., Archer, R., Carty, M., & Spitz, G. (2014). Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five, and ten years post-injury. Journal of Neurotrauma, 31 (1), 6477.
Rubenson, C., Svensson, E., Linddahl, I., & Bjorklund, A. (2007). Experiences of returning to work after acquired brain injury. Scandinavian Journal of Occupational Therapy, 14, 205214.
Sabatello, M. (2014). “If you can't do it now, you're out the door:” Employees with traumatic brain injury - A case study. Work, 48 (3), 373379.
Simpson, G.K., Daher, M., Hodgkinson, A., & Strettles, B. (2016). Service utilisation, service access & unmet service needs of clients with traumatic brain injury: A comparison between urban, regional and remote populations in New South Wales. Journal of Head Trauma Rehabilitation, 31, E26–E38.
Tate, R.L., Simpson, G.K., & McRae, P. (2015). Traumatic brain injury. In Escorpizo, R., Brage, S., Homa, D., & Stucki, G. (Eds.), Handbook of Vocational Rehabilitation and Disability Evaluation: Application and Implementation of the ICF (pp. 263294). New York: Springer.
Teasdale, G.M. (1995). Head injury. Journal of Neurology, Neurosurgery and Psychiatry, 58 (5), 526539.
van Velzen, J.M., van Bennekom, C.A., Edelaar, M.J., Sluiter, J.K., & Frings-Dresen, M.H. (2009). How many people return to work after acquired brain injury?: A systematic review. Brain Injury, 23, 473488.
van Velzen, J.M., van Bennekom, C.A., van Dormolen, M., Sluiter, J.K., & Frings-Dresen, M.H. (2011). Factors influencing return to work experienced by people with acquired brain injury: A qualitative research study. Disability and Rehabilitation: An International, Multidisciplinary Journal, 33, 22372246.
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The Australian Journal of Rehabilitation Counselling
  • ISSN: 1323-8922
  • EISSN: 1838-6059
  • URL: /core/journals/australian-journal-of-rehabilitation-counselling
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