Neuro-behavioural changes after acquired brain injury: The role of the occupational therapist; the interventions they use and why

Introduction: Almost half of the people living with acquired brain injury experience behavioural changes, yet there is lack of clarity both in the literature, and through major stakeholders internationally, regarding how occupational therapists contribute to neuro-behavioural rehabilitation and what their role is in this context. Methods: This study answers the research question: What do occupational therapists perceive as their role in behavioural rehabilitation with adults living with acquired brain injury, and what treatment approaches, if any, are they using to promote occupation? A national, qualitative, bounded case study design using semi-structured interviews was used to explore what the role of the occupational therapist is in neuro-behavioural rehabilitation across subacute brain injury units in Australia. Findings: Four themes were identified which provide clarification on the role of the occupational therapist in neuro-behavioural rehabilitation: You change the task, you change the environment, change the person; build a safe rapport; the sensory stuff is huge and, finally, owning how we think. Conclusion: This bounded case study provides insight into how occupational therapists perceive their role and the interventions they use to promote occupational engagement. The lack of recognition of the occupational therapist role is a barrier to providing appropriate neuro-behavioural rehabilitation. This case study identified sensory approaches, building safe rapport and adapting the environment as the main interventions used in neuro-behavioural rehabilitation by occupational therapists.