The experiences of occupational therapists regarding returning clients with traumatic brain injury to work through the utilisation of the Model of Occupational Self-efficacy

Abstract

Traumatic brain injury (TBI) is a major public health concern which mostly affects the economically viable population. In addition, the Code of Good Practice as described in South African Labour Law serves as a guide for employers to encourage equal and fair opportunities for employees with disabilities. However, despite the presence of this policy, as well as other legislation, research has shown that individuals with TBI are failing to return to work. The Model of Occupational Self-Efficacy (MoOSE) was developed as a client centered approach to return individuals with TBI to work. The aim of the current study was to explore, and describe the experiences and perceptions of occupational therapists who have used the MoOSE in the vocational rehabilitation and return to work process of clients with TBI. The participants in the study were selected by means of purposive sampling and semi-structured face-to-face interviews were conducted on a monthly basis for three months with 10 occupational therapists. The semi-structured interviews were used to gain insight into and explore the perceptions of the occupational therapists who have used the MoOSE in their vocational rehabilitation programmes with clients who have suffered TBI. The findings of the study were analyzed by means of thematic content analysis. The outcome of this study was aimed at finding ways to enhance / improve the model when it is used in the vocational rehabilitation process with people who have suffered TBI. Informed consent was obtained from the research participants and confidentiality of their information was maintained. Data was collected by means of semi-structured interviews which were audiotaped and transcribed. Transcriptions were analysed by using constant comparative methods of data analysis which resulted in categories, which reflected the purpose of the study being created. The analysis of transcripts was done using Microsoft Word. Results were then divided into themes and discussed holistically. Four themes emerged that answered the research question. Theme one described how client related factors impacted on the implementation of the MoOSE. Theme two explored the therapist related factors that impacted on the implementation of the MoOSE while theme three discussed how characteristic of the model impacted on the vocational rehabilitation and return to work process. The participants appreciated the clear four stages of the MoOSE and the dynamicity of the model. Theme four described how the job market and employer perceptions impacted on the return to work process. Recommendations were then discussed that could further improve the model and the implementation thereof. Recommendations included adding a motivation component to the MoOSE, involving family members in the rehabilitation process and therapist reflection as a means to foster client-centered practice. Other recommendations were aimed at addressing policy issues which interferes with the return to work process and encouraging interdisciplinary collaboration in the vocational rehabilitation of individuals with TBI.