Traumatic brain injury and employment outcomes: Integration of the working alliance model

Authors: Kitchiner, N. J.
Year Published 2008
Publication Work
Volume 31
Number 3
Pages 309-317
Publisher IOS Press

Polytrauma includes a complex constellation of symptoms that may involve an array of interrelated cognitive, physical, and psychological symptoms. According to the United States Veteran Health Administration, polytrauma is an injury to the brain in addition to other body parts or systems resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability. Although problems post traumatic brain injury (TBI) can be challenging many of these individuals remain employable. Rehabilitation specialists assisting persons with TBI with return to work need to understand treatment protocols that could enhance the relationship with the individuals and thereby enhance their employment outcomes.


This paper provided a brief review of the return to work literature and presented Bordin's working alliance model. A case example was used to illustrate the model.


The setting for the study was an In/Outpatient Rehabilitation Center.


The paper presents one case study.

Data Collection

The case study provides a brief overview of the meetings between the client and his rehabilitation counselor.


No comparison condition.


A treatment and rehabilitation program was developed for the individual with TBI using the Work Alliance model. This included: obtaining a neuropsychological evaluation, transitioning level of care to a day treatment program, continuing to work with his rehabilitation counselor using the Work Alliance model to construct realistic return to work plan and refer him to case manager to monitor his behavioral and psychological needs.


The model may be able to strengthen the relationship between a person with TBI and a rehabilitation specialist.

Disabilities Traumatic brain injury (TBI)
Populations Veterans
Outcomes Other
Research Design Case reports
Peer Reviewed Yes