For many people with an acquired brain injury, a primary goal may be to return to work or study. However, they may have experienced changes to their physical, cognitive, psychological and communication abilities and not yet be ready or able to work.
Some may be in a period of sickness absence from their job, whilst others may get back at work but having difficulties as a result of their injuries. Some will be keen to explore new occupational opportunities, such as volunteering or training, perhaps with a view to gaining employment in the future or because they are unable, or do not want, to return to paid employment.
What is vocational rehabilitation?
Providing the support required to enable a person with a health condition to work or study is known as vocational rehabilitation. Services are provided by the NHS, with provision varying in different areas of the UK, and by the private sector.
Vocational rehabilitation can be provided by qualified health professionals including occupational therapists, psychologists, physiotherapists, and speech and language therapists. Services vary between different providers – some may be led by one discipline, such as occupational therapy, and others will involve a team of different therapists.
Key features of vocational rehabilitation include:
- Assessment of the person’s current abilities.
- An analysis of their existing job or course to identify its requirements and demands.
- Liaison with the employer, occupational health team, and/or human resources staff, and meetings to prepare and plan for a return to work or study
- Worksite assessment where professionals from the vocational rehabilitation service visit the workplace to determine any obstacles to returning, and to identify relevant facilities. It may include assessing the performance of the person at work.
- Provision of information, education, advice and support to the employer and employee to address any issues.
- Work preparation including simulated work tasks or a period of intervention to help the person get ready for work.
How vocational rehabilitation can help
A person may have physical, cognitive, psychological and communication difficulties after a brain injury that can cause problems with work or study. Here are a few examples of how these difficulties can impact work and how vocational rehabilitation can help to address them:
A brain injury can cause problems with a person’s ability to concentrate, remember things, and plan and organise information or tasks. Vocational rehabilitation may focus on regaining particular skills which are required by the person’s work, or, if this is not possible, to help them manage and compensate for any remaining difficulties.
For example, for someone who is easily distracted by other people, noises, or lights, a busy office environment can be challenging. The therapist may therefore recommend that they sit in a quiet area of the office with an uncluttered workspace and, if appropriate, provide education to colleagues and managers about how best to support them.
If a person’s memory has been affected by their brain injury, the therapist may recommend memory aids or strategies – for example, using notebooks and calendars to write down information, meetings and deadlines; using technology to provide memory prompts; having access to written instructions and checklists on how to use any office equipment or new technology.
Some people will have physical issues that are not immediately apparent to other people such as fatigue, changes in sensation, and chronic pain. Other physical difficulties are more visible, such as needing to use a wheelchair or mobility aid. The therapist may advise on provision of equipment such as ramps, handrails and disabled parking close to the entrance of the building, or a change in the location of the person’s workspace so that they can easily access facilities such as the toilets and somewhere to eat meals. Other adjustments to increase the person’s ability to work effectively could include reducing hours, changing start or finish times, and scheduling breaks during the day.
Common challenges after brain injury include adapting to lifestyle changes, returning to work, and managing problems such as fatigue, stress, low mood and reduced confidence. Therapists can help people develop a range of strategies to help with these, at home and in the workplace.
As with any difficulties experienced after brain injury, education about its impact on the person in relation to their work can be provided to the employer, if needed, to help them put the right support in place. Having regular meetings with a supervisor or manager to discuss any issues can also be helpful for some people.
Know your rights
Employers have no legal right to know an employee’s diagnosis and employees do not have to disclose their health condition. However, employers cannot usually be held liable for failing to make reasonable adjustments if they did not know about the disability. You can find out more here: https://www.gov.uk/rights-disabled-person/employment
Here are some resources available to support both an employer and employer:
ACAS: an independent public body that provides free impartial advice to employees, employers and their representatives on workplace rights, rules and best practice. https://www.acas.org.uk/
Access to Work: a publicly funded employment support programme that aims to help more disabled people start or stay in work. It can provide practical and financial support. https://www.gov.uk/government/publications/access-to-work-factsheet/access-to-work-factsheet-for-customers
Fit for Work: offers free support to GPs, employers and employees to help those who are in work and on sick leave. https://fitforwork.org/
Cognivate’s vocational rehabilitation provision
Cognivate provides interdisciplinary vocational rehabilitation which is individually tailored to meet the needs of each client with acquired brain injury. Find out more here.