Asssessment

Accurate and thorough assessment is essential for developing safe, appropriate and realistic vocational goals following TBI, accounting for the complexities of this population.   

Initial assessment in vocational rehabilitation may include assessing a client’s readiness to commence employment, determining the suitability of returning to pre-injury employment, identifying tasks and restrictions to include in a RTW plan and/ or gathering information to formulate a new vocational goal.

Initial assessment phase in vocational rehabilitation includes:

• Holistic assessment of the client’s situation, including their medical, physical, psychological, social, cultural and vocational circumstances
• An assessment of the impact of the disability, injury or health condition on the client’s life and, in particular, the effect it has on their capacity to work
• An exploration of the client’s goals and aspirations in relation to finding a job
• An assessment of the client’s abilities and skills
• An assessment of the barriers that may affect the client’s ability to participate in vocational rehabilitation and supports required to increase participation.

For most people with a new injury, assessment is completed by their rehabilitation clinician/team as a part of their comprehensive and holistic rehabilitation program.

Initial Assessment

The initial assessment involves gathering information from relevant sources, including both written reports and discussions with the client’s family, treating team and relevant others to enable a comprehensive profile to be developed to assist with vocational goal setting.   Assessment generally commences with interviewingthe client to discuss their work history and perspective of the changes resulting from injury.  Involving family members in the interview process is important to gain details the client is unable to recall, to check any discrepancies related to their view of current functioning and to gain additional information not presented by the client. 

Completion of a comprehensive initial assessment with the client helps to develop a foundation for planning the next stage of the vocational pathway.  In addition, it ensures that the client’s needs remain at the forefront of planning and momentum is maintained.

Functional Assessment

Functional Assessment in vocational rehabilitation is assessing a person’s ability to perform specific job related tasks. Tests may include lifting capacity, hand function, balance, work posture tolerance, writing and comprehension, attention to detail, problem-solving, communication skills, time management. .Some of these assessments can be completed in a clinical environment, but others may need to be assessed in the workplace.

Observation of task performanceis a key component of client assessment in brain injury rehabilitation. Observing a client performing work tasks on the job site (or simulated setting) during the planning stage of RTW may help to understand the tasks and demands of the job and the client’s functional abilities to inform the planning stage.

Workplace Assessment

Workplace assessment is completed for clients returning to their pre-injury employment.   A workplace assessment is also completed for clients starting a  work experience, work trial or new job to ensure the role is a suitable match.

This assessment includes an overview of the workplace environment, the physical, behavioural and psychological work demands, working conditions and educational requirements of the job role. A workplace assessment report sets out the assessment of these demands and conclusion about the client’s capacity to manage in this work setting, along with recommended strategies and plan. The assessment would also address the employer’s requirements and any industrial/safety/commercial issues pertaining to the RTW.  This report is usually accompanied by a ‘suitable duties plan’ that is signed by the employee, employer, vocational provider and often the medical practitioner certifying the client fit for work within the parameters of the plan.

Vocational assessment and setting goals

In cases where the client is unable to resume their pre-injury employment, a vocational assessment is usually the first step. .   This process examines the client’s interests, abilities and skills to identify vocational strengths, barriers and new job goals.  Vocational assessment may use a variety of standardised assessments or non-standardised approaches (e.g. interviews, observation) and usually results in recommendations for training, work experience or employment. 

It is important to review the job goal and plan with the client, their family and treating team to confirm suitability. The goal must be specific and drive the subsequent plans.  For example:

• To secure paid work as a gardener on a part-time basis
• To undertake a work trial as a data entry clerk to develop new skills and determine the suitability of this job role.