Returning to work after a traumatic brain injury (TBI) is a significant milestone in a person’s rehabilitation journey. It represents not only a return to financial independence but also a restoration of identity, purpose, and social connection.
“What I want is normality. I know it [work] can’t go back to the way it was; somethings will never be the same but if I can get as close to the old normality as I can, well, that will be really good”. (Direct quote from a TBI participant).
However, for many TBI participants, re-entering the workforce is a complex and highly individualised process that requires the expertise of allied health professionals, including occupational therapists (OTs) and speech therapists. These professionals play a crucial role in bridging the gap between medical recovery and workplace reintegration by addressing cognitive, communicative, and functional challenges that may persist long after the initial injury.
Common challenges faced by individuals with TBI
- Cognitive impairments: memory loss, difficulty concentrating, and reduced problem-solving ability can impact job performance.
- Fatigue and energy management: many individuals experience mental and physical fatigue, requiring adjustments to their workload and schedule.
- Communication difficulties: issues with speech, comprehension, or processing speed may make workplace interactions more challenging.
- Emotional and behavioural changes: mood swings, frustration, or difficulty handling stress can affect workplace relationships.
- Physical limitations: mobility issues or sensory sensitivities may require workplace modifications.
One of the most significant barriers to employment following a TBI is cognitive impairment, particularly in the areas of executive function, memory, and attention.
Executive dysfunction can manifest as difficulty with planning, problem-solving, and decision-making skills that are essential for maintaining employment in most industries.
Tips for TBI participants to navigate the workplace effectively:
- Carry a small notebook or use a smartphone app to jot down instructions and reminders.
- Break tasks into smaller steps and focus on one at a time to avoid feeling overwhelmed.
Occupational therapists play a pivotal role in assessing these deficits and implementing strategies to support individuals in their return to work. Through cognitive rehabilitation programs, OTs help participants develop compensatory techniques, such as using external memory aids, task sequencing, and structured routines, to manage workplace responsibilities effectively. Additionally, they often collaborate with employers to introduce reasonable adjustments, such as modified work hours, task restructuring, or assistive technology, to create a more accommodating work environment.
Tips for TBI participants to navigate the workplace effectively:
- Set up visual or digital reminders for deadlines and important tasks.
- Take regular short breaks to prevent fatigue and maintain focus.
“Often people with TBI don’t present with obvious brain injuries, like physical disabilities do. There can be cognitive, memory or endurance/fatigue problems. Trying to go back to work without professional support is like trying to climb a mountain without a rope”. (TBI Allied Health Professional)
Speech therapists also play an essential role in supporting TBI participants, particularly those who experience difficulties with communication and social interaction. Even mild brain injuries can lead to challenges with processing information, word retrieval, or pragmatic language skills, which can affect an individual’s ability to engage in professional conversations, comprehend workplace instructions, and contribute effectively to team discussions.
Speech therapists work with participants to enhance verbal and non-verbal communication skills, employing techniques such as cognitive-linguistic therapy, role-playing workplace scenarios, and providing personalised strategies to navigate complex social interactions.
For individuals in client-facing roles, these interventions can make the difference between struggling with professional interactions and confidently engaging in their work environment.
Tips for TBI participants to navigate the workplace effectively:
- Visit your workplace and meet your colleagues before your official start date.
- Discuss any communication or workplace adjustments you may need, ensuring your team is aware and prepared to support you from day one.
Beyond direct therapy, the interdisciplinary approach to TBI rehabilitation ensures that participants receive holistic support tailored to their specific needs. Successful return-to-work outcomes following a TBI rely on early intervention, customised rehabilitation, and employer engagement.
Occupational therapists and speech therapists often work alongside vocational counsellors, psychologists, and employment specialists to provide comprehensive return-to-work plans. These plans not only focus on skill development but also address emotional resilience, fatigue management, and workplace advocacy. By integrating these supports, TBI participants can navigate the transition back to employment with greater confidence and sustainability, ensuring that individuals not only regain the ability to work but also thrive in their chosen careers, paving the way for long-term employment success and improved quality of life.
“I want a real and meaningful job” (TBI participant)
Additionally, there are several practical strategies that can help TBI participants succeed in the workplace.
- Encouraging self-advocacy by teaching participants how to communicate their needs and request accommodations can be invaluable.
- Creating a structured work environment with clear expectations, consistent routines, and designated quiet spaces can also help reduce cognitive overload. Regular check-ins between employees and supervisors can facilitate ongoing support and adjustment of job roles as needed.
Here are some additional tips for TBI participants to navigate the workplace effectively:
- Use noise-cancelling headphones or request a quiet workspace to minimise distractions.
- Stay positive and realistic.
- Practice self-care, including healthy sleep, nutrition, and stress management.
- Maintain open communication with employers and colleagues about specific support needs.
- Practice at home: for at least two weeks prior to starting, align your schedule with work hours, maintain focus for required durations and engage in physical activities like those at work.
With the right strategies and a supportive work environment, TBI participants can achieve meaningful and sustainable employment.
EmployAbility SCIA now offers a TBI Employment Program headed up by TBI expert Samantha Clay. Samantha brings a wealth of experience in providing comprehensive neurological rehabilitation services to a diverse range of clients, particularly those with spinal cord injuries and traumatic brain injuries. Her professional background includes eleven years in recreational therapy and six years in rehabilitation counselling, which includes case management.
If you are interested in finding out more information on the EmployAbility Traumatic Brain Injury Program, please contact Samantha via employability@scia.org.au
