Facilitating return to work after major traumatic injuries through early vocational rehabilitation: Therapists' activities and perspectives.

INTRODUCTION: Early vocational rehabilitation has potential to achieve earlier return to work and mental health benefits following major traumatic injuries (spinal cord injury, traumatic brain injury and multitrauma orthopaedic injuries, including amputation), but clinicians seek guidance regarding delivery of early vocational rehabilitation. This study aimed to describe the activities and reflections of therapists within multidisciplinary teams providing early vocational rehabilitation for individuals with major traumatic injuries. METHODS: The activities and perspectives of therapists implementing early vocational rehabilitation were explored through (1) quantitative analysis of frequency and time engaged in therapy activities using an adapted Case Management Taxonomy, (2) content analysis of free-text therapist reflections of their early vocational rehabilitation sessions, and (3) thematic analysis of therapist interviews. CONSUMER AND COMMUNITY INVOLVEMENT: Participatory action research principles were used to engage key stakeholders, including peer support and advocacy groups, in guiding the development of the early vocational rehabilitation service components, associated consumer, and staff materials (e.g., interview questions), and provide ongoing monitoring and advice on the service implementation. RESULTS: The therapists responded to patients' employment concerns by providing practical and emotional support, for an average of 12 sessions, commencing on average 47 days post-injury. Core therapist activities included multidisciplinary team and employer liaison to exchange information and foster work connections, coordination, individualised work-related activities, and monitoring to promote injury management and work capacity. Therapists reflected that wide-ranging individual circumstances and injury-related and psychological barriers impacted work capacity, but positive emotional responses facilitated return to work. CONCLUSION: Early vocational rehabilitation needs to be tailored to patient presentation and circumstances, injury-related and psychological barriers, fostering hope, purpose, and employer connections.