Back2Work Early Intervention Vocational Rehabilitation program
Research background
The Back2Work Early Intervention Vocational Rehabilitation program commenced in 2016 and aims to deliver vocational rehabilitation services to people who have sustained spinal cord injuries, prior to their discharge from hospital. The program capitalises on participants’ readiness to consider their vocational goals sooner than has been traditionally supported in primary rehabilitation settings. Back2Work’s implementation in the Queensland Spinal Injuries Unit has been expertly delivered by Spinal Life Australia’s team of vocational rehabilitation counsellors, twith funding from the Motor Accident Insurance Commission (MAIC) and support from The Hopkins Centre, Menzies Health Institute Queensland, Griffith University and Metro South Health. Since the program’s inception, Back2Work has assisted 207 people with their vocational journeys (114 engaged as research participants).
The evaluation of the Back2Work program has also generated six peer-reviewed publications, five national conference presentations, and a PhD graduate, Dr Julia Bloom.
Early Vocational Rehabilitation After Serious Injury or Illness: A Systematic Review
Vocational rehabilitation to empower consumers following newly acquired spinal cord injury
Investigating employment following spinal cord injury: outcomes, methods, and population demographics
Integrated services and early intervention in the vocational rehabilitation of people with spinal cord injuries
Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury
Exploring the ‘status quo’in vocational rehabilitation and employment outcomes following spinal cord injury
The project concluded Phase 1 and moved into Phase 2 in March 2020, with funding up to February 2023. Learnings from Phase 1 highlighted the need for a longer follow-up period to better support and capture participants’ vocational journeys beyond their discharge from hospital. This extension of the project will also allow us to strengthen our data collection and better support the effectiveness of early intervention vocational rehabilitation in promoting both employment and wellbeing after spinal cord injury.
The last 12 months
The last 12 months have brought major challenges, and we are only beginning to understand the scope of the impact of the pandemic on the vocational lives and general wellbeing of this population. In terms of how the project is delivered, lockdowns in the Spinal Injuries Unit meant a rapid shift to telehealth services and all the pitfalls implied in such service delivery. Clinicians worked hard with participants to keep vocational journeys on track, pursuing vocational dreams in the face of the significant challenges that the pandemic wrought on the world of work. Recruiting new participants also proved difficult as the pandemic brought to bear new pressures on top of those that participants face during this time in their lives.
Nonetheless, participants have continued to express their appreciation for the support of the Back2Work clinicians during this strange and anxious time. It is a testament to the skills of the Spinal Life Australia rehabilitation counsellors delivering the program that participants have continued to engage and make vocational gains.
Outcomes so far
Phase 1 results underscored the utility of the program in both promoting employment outcomes and supporting participants’ wellbeing. As would be expected, employment participation decreased dramatically immediately post-injury, however at 12 months post hospital discharge almost half (43%) of participants had returned to vocational activity and at 24 months post-discharge the Back2Work paid employment rate was 50%. This is a very positive finding given the comparison rate of approximately 30% return to work for spinal cord injured populations generally.
The most common return to work pathway was via the pre-injury employer, with 90% of participants who returned to work by 6 months, and 70% who returned by 12 months, returning to their pre-injury employer. Employment status was related to both psychological distress and life satisfaction, with employed participants being more satisfied and less distressed than their unemployed peers.
The qualitative data highlights the impact of Back2Work in promoting a positive attitude and expectancy towards returning to work or study. Participants repeatedly emphasise Back2Work as playing an important role in opening vocational possibilities, promoting positivity, confidence and optimism, and instilling hope. These findings also affirm the specialist vocational rehabilitation knowledge and services provided by the Back2Work rehabilitation counsellors as having a complementary role in supporting participants’ mental health at a time when it can be challenged.
Significance
The Back2Work Early Intervention Vocational Rehabilitation Program has been successful in improving employment outcomes for people with newly acquired SCI. The project has reinforced that people are often ready to engage in vocational conversations soon after injury, underscoring the need for vocational support in the primary rehabilitation space. Given the outcomes of lower reported psychological distress and higher life satisfaction for those who had returned to work, Back2Work has also demonstrated potential for broader positive impact on the lives of people with SCI and their families.
Dr Vanette McLennan, the lead project researcher states, 'The Back2Work program is proving to be an important source of hope and motivation for people pursuing vocational goals after SCI, and an extra network of support at a time when wellbeing can be most challenged.'
She says, 'The program itself is one of only a small number in Australia and New Zealand providing people with early, innovative approaches to vocational rehabilitation and return to work support after spinal cord injury. It signifies a shift in thinking and practice following serious injury and a growing sense of the value of work in people's recovery.'
