Skip to main content

Theoretical Applications of Positive Psychology to Vocational Rehabilitation After Traumatic Brain Injury

Journal of Occupational Rehabilitation volume 26, pages 20–31 (2016)Cite this article

Abstract

Purpose Traumatic brain injury (TBI) produces broad-reaching and often persistent challenges that impact an individual’s ability to engage in vocational productivity. Return to work (RTW) rates after TBI are markedly poor and the efficacy of current TBI vocational rehabilitation (VR) practices is unclear. Positive psychology, the practice of fostering positive emotions and traits, offers novel approaches that might enhance the effectiveness of existing TBI VR practices. This article assesses the potential relevance of positive psychology principles and practices to VR for clients recovering from TBI. Methods A literature search was conducted using the database resources of a large university hospital, including PubMed, ProQuest, PsycINFO, and Web of Science. Content from this search was reviewed and synthesized, including literature on VR for TBI, vocational applications of positive psychology, and general rehabilitation applications of positive psychology. Results Ten guiding principles for positively-informed TBI VR are proposed. Specific positive psychology measures and interventions for improving emotional, social, and cognitive functioning are identified and discussed as they might be applied to TBI VR. Conclusions Theoretically, positive psychology principles and practices appear to be well suited to improving VR outcomes for individuals with TBI. In addition to examining the feasibility of incorporating positive psychology techniques, future research should examine the impact of positive psychology interventions on RTW rates, job satisfaction, job stability, and other vocational outcomes. With additional investigation, positive psychology measures and interventions may prove to be a beneficial compliment to existing VR practices.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

£ 29.95

Price includes VAT (United Kingdom)
Tax calculation will be finalised during checkout.

References

  1. Corrigan JD, Selassie AW, Orman JA. The epidemiology of traumatic brain injury. J Head Trauma Rehabil. 2010;25(2):72–80.

    Article  PubMed  Google Scholar 

  2. Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2004. Report No.: 68.

  3. Schretlen DJ, Shapiro AM. A quantitative review of the effects of traumatic brain injury on cognitive functioning. Int Rev Psychiatry. 2003;15(4):341–9.

    Article  PubMed  Google Scholar 

  4. Dikmen SS, Corrigan JD, Levin HS, Machamer J, Stiers W, Weisskopf MG. Cognitive outcome following traumatic brain injury. J Head Trauma Rehabil. 2009;24(6):430–8.

    Article  PubMed  Google Scholar 

  5. Hesdorffer DC, Rauch SL, Tamminga CA. Long-term psychiatric outcomes following traumatic brain injury: a review of the literature. J Head Trauma Rehabil. 2009;24(6):452–9.

    Article  PubMed  Google Scholar 

  6. Temkin NR, Corrigan JD, Dikmen SS, Machamer J. Social functioning after traumatic brain injury. J Head Trauma Rehabil. 2009;24(6):460–7.

    Article  PubMed  Google Scholar 

  7. Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil. 1999;14(6):602–15.

    Article  CAS  PubMed  Google Scholar 

  8. Yasuda S, Wehman P, Targett P, Cifu D, West M. Return to work for persons with traumatic brain injury. Am J Phys Med Rehabil. 2001;80(11):852–64.

    Article  CAS  PubMed  Google Scholar 

  9. O’Neill JH, Hibbard MR, Brown M, Jaffe M, Sliwinski M, Vandergoot D, Weiss MJ. The effect of employment on quality of life and community integration after traumatic brain injury. J Head Trauma Rehabil. 1998;13(4):68–79.

    Article  PubMed  Google Scholar 

  10. Johnstone B, Mount D, Schopp LH. Financial and vocational outcomes 1 year after traumatic brain injury. Arch Phys Med Rehabil. 2003;84(2):238–41.

    Article  PubMed  Google Scholar 

  11. Dikmen SS, Temkin NR, Machamer JE, Holubkov AL, Fraser RT, Winn HR. Employment following traumatic head injuries. Arch Neurol. 1994;51:177–86.

    Article  CAS  PubMed  Google Scholar 

  12. Corrigan JD, Cuthbert JP, Harrison-Felix C, Whiteneck GG, Bell JM, Miller AC, Coronado VG, Pretz CR. US population estimates of health and social outcomes 5 years after rehabilitation for traumatic brain injury. J Head Trauma Rehabil. 2014;29(6):E1–9.

    Article  PubMed  Google Scholar 

  13. Kreutzer JS, Marwitz JH, Walker W, Sander A, Sherer M, Bogner J, Fraser R, Bushnick T. Moderating factors in return to work and job stability after traumatic brain injury. J Head Trauma Rehabil. 2003;18(2):128–38.

    Article  PubMed  Google Scholar 

  14. West M, Targett P, Crockatt S, Wehman P. Return to work following traumatic brain injury. In: Zasler N, Katz D, Zafonte R, editors. Brain injury medicine. 2nd ed. New York: Demos Medical Publishing; 2012. p. 1002–21.

    Google Scholar 

  15. Lezak M. Assessment of psychosocial dysfunctions resulting from head trauma. In: Lezak M, editor. Assessment of the behavioral consequences of head trauma. New York: Alan R. Riss; 1989. p. 113–43.

    Google Scholar 

  16. Dawson DR, Schwartz ML, Winocur G, Stuss DT. Return to productivity following traumatic brain injury: cognitive, psychological, physical, spiritual, and environmental correlates. Disabil Rehabil. 2007;29(4):301–13.

    Article  PubMed  Google Scholar 

  17. Johnstone B, Vessell R, Bounds T, Hoskins S, Sherman A. Predictors of success for state vocational rehabilitation clients with traumatic brain injury. Arch Phys Med Rehabil. 2003;84(2):161–7.

    Article  PubMed  Google Scholar 

  18. Haffey WJ, Abrams DL. Employment outcomes for participants in a brain injury work reentry program: preliminary findings. J Head Trauma Rehabil. 1991;6(3):24–34.

    Article  Google Scholar 

  19. O’Neill JH, Zuger RR, Fields A, Fraser R, Pruce T. The Program Without Walls: innovative approach to state agency vocational rehabilitation of persons with traumatic brain injury. Arch Phys Med Rehabil. 2004;85(S2):68–72.

    Article  Google Scholar 

  20. Heinemann AW, Sokol K, Garvin L, Bode RK. Measuring unmet needs and services among persons with traumatic brain injury. Arch Phys Med Rehabil. 2002;83(8):1052–9.

    Article  PubMed  Google Scholar 

  21. Saltychev M, Eskola M, Tenovuo O, Laimi K. Return to work after traumatic brain injury: systematic review. Brain Inj. 2013;27:1516–27.

    Article  PubMed  Google Scholar 

  22. Chestnut R, Carney N, Maynard H, Mann N, Patterson P, Helfand M. Summary report: evidence for the effectiveness of rehabilitation for persons with traumatic brain injury. J Head Trauma Rehabil. 1999;14(2):176–88.

    Article  Google Scholar 

  23. da Silva CE, Blalock K, Allen CA, Chan F, Rubin SE. Life skills and subjective well-being of people with disabilities: a canonical correlation analysis. Int J Rehabil Res. 2004;27(4):331–4.

    Article  Google Scholar 

  24. Seligman ME, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5–14.

    Article  CAS  PubMed  Google Scholar 

  25. Herzberg F. The motivation to work. 2nd ed. New York: Wiley; 1959.

    Google Scholar 

  26. Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;13(6):803–55.

    Article  Google Scholar 

  27. Smith EJ. The strength-based counseling model. Couns Psychol. 2006;34(1):13–79.

    Article  Google Scholar 

  28. Fleming AR, Del Valle R, Kim M, Leahy MJ. Best practice models of effective vocational rehabilitation service delivery in the public rehabilitation program: a review and synthesis of the empirical literature. Rehabil Couns Bull. 2013;56(3):146–59.

    Article  Google Scholar 

  29. Kreutzer JS, Kolakowsky-Hayner SA, Demm SR, Meade MA. A structured approach to family intervention after brain injury. J Head Trauma Rehabil. 2002;17(4):349–67.

    Article  PubMed  Google Scholar 

  30. Duckworth AL, Steen TA, Seligman ME. Positive psychology in clinical practice. Annu Rev Clin Psychol. 2005;1:629–51.

    Article  PubMed  Google Scholar 

  31. Lopez S, Synder C, editors. Positive psychological assessment: A handbook of models and measures. 1st ed. Washington, DC: American Psychological Association; 2003.

    Google Scholar 

  32. Parks A, Schueller S, editors. Wiley-Blackwell handbook of positive psychological interventions. Chichester: Wiley; 2014.

    Google Scholar 

  33. Peterson C, Seligman ME. Character strengths and virtues: A handbook and classification. Washington, DC: American Psychological Association; 2004.

    Google Scholar 

  34. Asplund J, Lopez S, Hodges T, Harter J. Technical report: Development and validation of the Clifton StrengthsFinder 2.0. Princeton: The Gallop Organization; 2007.

    Google Scholar 

  35. Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction with Life Scale. J Pers Assess. 1985;49(1):71–5.

    Article  CAS  PubMed  Google Scholar 

  36. Pavot W, Diener E, Colvin RE, Sandvik E. Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures. J Pers Assess. 1991;57(1):149–61.

    Article  CAS  PubMed  Google Scholar 

  37. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70.

    Article  CAS  PubMed  Google Scholar 

  38. Crawford JR, Henry JD. The Positive and Negative Affective Schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. Br J Clin Psychol. 2004;43:245–65.

    Article  PubMed  Google Scholar 

  39. Hanks RA, Rapport LJ, Waldron-Perrine B, Millis SR. Role of character strengths in outcome after mild complicated to severe traumatic brain injury: a positive psychology study. Arch Phys Med Rehabil. 2014;95(11):2096–102.

    Article  PubMed  Google Scholar 

  40. Lopez SJ, Ciarlelli R, Coffman L, Stone M, Wyatt L. Diagnosing for strengths: On measuring hope building blocks. In: Synder CR, editor. Handbook of hope theory, measures and applications. San Diego: Academic Press; 2000. p. 57–85.

    Google Scholar 

  41. Bolier L, Haverman M, Westerhof G, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013. doi:10.1186/1471-2458-13-119. Accessed 1 Mar 2015.

  42. Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J Clin Psychol. 2009;65(5):467–87.

    Article  PubMed  Google Scholar 

  43. Clifton D, Harter J. Strengths investment. In: Cameron K, Dutton J, Quinn R, editors. Positive organizational scholarship. San Francisco: Berrett-Koehler; 2003. p. 111–21.

    Google Scholar 

  44. Black B. The road to recovery. Gallup Manag J. 2001;1(4):10–2.

    Google Scholar 

  45. Müller R, Gertz K, Molton I, Terrill A, Bombardier C, Ehde DM, Jensen M. Pilot testing a positive psychology intervention in individuals with chronic, disability-related pain. Arch Phys Med Rehabil. 2014;95(10):E9–10.

    Article  Google Scholar 

  46. Andrewes HE, Walker V, O’Neill B. Exploring the use of positive psychology interventions in brain injury survivors with challenging behaviour. Brain Inj. 2014;28(7):965–71.

    Article  CAS  PubMed  Google Scholar 

  47. Evans J. Positive psychology brain injury rehabilitation. Brain Impair. 2011;12(2):117–27.

    Article  Google Scholar 

  48. Synder C, Lopez S, editors. Handbook of positive psychology. New York: Oxford University Press; 2005.

    Google Scholar 

  49. Sale P, West M, Sherron P, Wehman PH. Exploratory analysis of job separations from supported employment for persons with traumatic brain injury. J Head Trauma Rehabil. 1991;6(3):1–11.

    Article  Google Scholar 

  50. Hodges T, Clifton D. Strengths-based development in practice. In: Linley P, Joseph S, editors. Positive psychology in practice. Hoboken: Wiley; 2004. p. 256–68.

    Google Scholar 

  51. Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60(5):410–21.

    Article  PubMed  Google Scholar 

  52. Marianetti O, Passmore J. Mindfulness at work: Paying attention to enhance well-being and performance. In: Linley P, Harrington S, Garcea N, editors. Oxford handbook of positive psychology at work. New York: Oxford University Press; 2010. p. 189–200.

    Google Scholar 

  53. Park K, Wilson MG, Lee MS. Effects of social support at work on depression and organizational productivity. Am J Health Behav. 2004;28(5):444–55.

    Article  PubMed  Google Scholar 

  54. Curl RM, Fraser RT, Cook RG, Clemmons D. Traumatic brain injury vocational rehabilitation: preliminary findings for the coworker as trainer project. J Head Trauma Rehabil. 1996;11(1):75–85.

    Article  Google Scholar 

  55. Gable SL, Reis HT, Impett EA, Asher ER. What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. J Pers Soc Psychol. 2004;87(2):228–45.

    Article  PubMed  Google Scholar 

  56. Seligman ME, Rashid T, Parks AC. Positive psychotherapy. Am Psychol. 2006;61(8):774–88.

    Article  PubMed  Google Scholar 

  57. Schwartz B, Ward A, Monterosso J, Lyubomirsky S, White K, Lehman DR. Maximizing versus satisficing: happiness is a matter of choice. J Pers Soc Psychol. 2002;83(5):1178–97.

    Article  PubMed  Google Scholar 

  58. Robertson IH. Goal management training: A clinical manual. Cambridge: PsyConsult; 1996.

    Google Scholar 

  59. Levine B, Schweizer TA, O’Connor C, Turner G, Gillingham S, Stuss DT, Manly T, Robertson IH. Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Front Hum Neurosci. 2011. doi:10.3389/fnhum.2011.00009. Accessed 1 Mar 2015.

  60. Linley P, Harrington S, Garcea N, editors. Oxford handbook of positive psychology and work. New York: Oxford University Press; 2010.

    Google Scholar 

  61. Azar B. Positive psychology advances, with growing pains. Monit Psychol. 2011;42(4):32–6.

    Google Scholar 

  62. Evans-Brown P, Jackson C, Knizek A, Copeland S. Motivational interviewing: emerging practice for rehab counselors and administrators. Paper presented at the Conference on Rehabilitation Education, National Council on Rehabilitation Education, Rehabilitation Services Administration, Council of State Administrators of Vocational Rehabilitation; Arlington, VA; 2011.

Download references

Author information

Affiliations

  1. Department of Physical Medicine and Rehabilitation, VCU Medical Center, Virginia Commonwealth University, P.O. Box 980542, Richmond, VA, 23298-0542, USA

    Ana L. Mills & Jeffrey S. Kreutzer

  2. Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA, USA

    Jeffrey S. Kreutzer

  3. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA

    Jeffrey S. Kreutzer

Authors
  1. Ana L. Mills
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeffrey S. Kreutzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana L. Mills.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mills, A.L., Kreutzer, J.S. Theoretical Applications of Positive Psychology to Vocational Rehabilitation After Traumatic Brain Injury. J Occup Rehabil 26, 20–31 (2016). https://doi.org/10.1007/s10926-015-9608-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-015-9608-z

Keywords

  • Traumatic brain injury
  • Vocational rehabilitation
  • Positive psychology
  • Return to work