Facilitating return to work after major traumatic injuries through early vocational rehabilitation: Therapists' activities and perspectives.
Pamela Ross, Margaret Mealings, Penelope Analytis and 6 others
PMID 42601810WHAT IT FOUND
Therapists delivering early vocational rehabilitation after major trauma spent most of their time coordinating with others, giving emotional support and doing individualised work tasks, in 12 sessions of 33 minutes on average.
They said early employer contact kept work goals alive.
Key findings
01Coordinating with other services was the therapists' most frequent activity, recorded in over 51% of sessions, most often collaborating with other service providers (35.20%) and monitoring progress (35.11%).
02Therapists spent the most time on specific vocational rehabilitation activities, recorded in 32.45% of sessions, followed by emotional support and then gathering work-related information as part of assessment.
03Therapists said fostering social connection with the workplace was a key part of the job: it made return to work feel less unknown and less frightening for the patient, employer and family, and informal workplace visits gave a stepping stone for later return-to-work planning.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only three therapists were studied, and their only job was delivering this early vocational rehabilitation within the trial, so their activities and views may not match therapists who carry a mixed caseload in another service. The trial design required patients to be handed over to usual vocational providers once they were work-ready, so the therapists' role was shaped by a rule that would not apply everywhere. Therapists strongly valued in-person workplace visits and contact with rehabilitation teams, and the COVID-19 restrictions of the time limited exactly that. Only five worksite visits and eight family meetings happened, and some patients faced delayed treatment and delayed starts at work. Therapists rated their own perceptions of patients' barriers and emotions in the free-text summaries, and those views were not checked against what patients themselves reported; patients' perspectives are published separately. Only 458 of the 1051 session summaries were coded, because the team judged the themes complete at that point; the remaining 525 were not analysed. This paper reports what therapists did and thought. It does not test whether that work caused the return-to-work outcomes, which come from the separate randomised trial this study sat inside.
Declared interests
The study was funded by the Transport Accident Commission. The authors declare no conflicts of interest. The funder's requirements shaped the study design: patients had to be handed over to usual care vocational providers once they were work-ready, and nine traumatic brain injury patients who were not eligible for that continued with the trial therapists instead.
The easy way to misread this
Do not read this as evidence that early vocational rehabilitation works. It describes what three therapists did and what they believed about their own work. Whether the service changed return-to-work outcomes was measured in the separate randomised trial this study sat inside, and three therapists cannot stand in for the wider profession.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →