Occupational therapy interventions in facilitating return to work in patients with traumatic brain injury: A systematic review

Background: Returning to work is one of the common challenges faced by survivors of traumatic brain injury following their injury. A few reviews to date have examined the occupational therapy interventions related to return-to-work post TBI. Objective: To examine the interventions that fall under the purview of the field of occupational therapy in facilitating return to work post mild, moderate, or severe traumatic brain injury. Methods: The following databases were searched: CINAHL, Ovid, PsychInfo, PubMed, & Scopus. Fifteen articles met the inclusion criteria (articles published within the past 10 years, adults, & received rehabilitation services for return to work). The Preferred Reporting Items for Systematic Reviews and Meta Analyses was used to guide this review. Results: The most effective intervention approaches that fall under the purview of occupational therapy practice to facilitate return to work in individuals with traumatic brain injury included the use of (i) vocational and work hardening rehabilitation interventions, (ii) a multidisciplinary approach to care, (iii) mental health and cognition focused interventions, and (iv) the Model of Occupational Self Efficacy. Interventions must consider both client and work-related factors to ensure successful outcomes. Conclusions: The articles included in this review provided moderate level evidence that multidisciplinary and holistic approaches lead to successful return to work and community reintegration outcomes for individuals with traumatic brain injury. Focusing on client and work-related factors through vocational rehabilitation, cognitive and mental health interventions, and client-centered models of care is recommended to yield better return to work outcomes for traumatic brain injury survivors.