Occupational Adaptation: Perspectives of People with Traumatic Brain Injury

This paper describes a qualitative study carried out to understand the process of occupational adaptation after traumatic brain injury. Seven people, injured two to seventeen years previously, were interviewed. Transcripts were analysed using the constant comparative method, with peer review, journaling, and a member-checking group to maximize truthfulness. Participants described experiencing a change in self-identity following injury that was related to, and influenced, occupational adaptation. Self-identity and engagement in occupation were closely related. Acceptance of the new self was fundamental to successful occupational adaptation. Participants also shifted environmental contexts of doing to reflect their new persona. Reframing self-identity was thus an important aspect of participants' rehabilitation. These findings resonate with other qualitative studies with brain injury survivors, theories of occupational adaptation, and social psychological perspectives. Yet, the literature on brain injury rehabilitation rarely discusses the need to address self-identity. Occupational science can play an important role by integrating these bodies of literature.