Back to work


People with Acquired Brain Injury should have an equally fair chance to reintegrate at work as others who have been out of work for a long time. This is the message of neuropsychologist Katinka Franken, lawyer Tina van der Linden and experience expert Ans Post. Ans is also a team member of Brain Injury Explanation.

They wrote the following article for the website of the Dutch Association for Labor experts.

The Dutch version can be viewed here.


Old level

People with acquired brain injury (ABI) often have a lack of self-awareness. Once back at work, they often do not operate at their old level. The problem is that they often do not (want) to see. Often they continue to hide behind the circumstances, "The areas that provide self-insight, areas of logical reasoning and rational estimate, those precisely are damaged," stated a labor expert specialized in clients with brain injury, in an interview in 2011 in a journal for labor experts.


Self-fulfilling prophecies

General statements about features that are common to a particular group, tend to become prejudices, which then attach themselves as "self-fulfilling prophecies”.

An example: Among young people from a particular population often criminality was found, so the police kept an extra eye on them. It was because of this that more criminality was found in this group. Because these young people were treated as a potential criminals, they tended to act like one. If one is in the approach of a person, guided by generalized assumptions (members of group X often have characteristic Y, you belong to group X, so I assume that you also have characteristic Y), hence The premise is re-amplified: expectations also shape the perception, so the expectations are confirmed – ‘I thought so'. This is a very human and recognizable mechanism.


So it is not inconceivable that an employee is welcomed back with this bias in mind in the workplace after an accident by which he or she has a brain injury. "Glad you're back, but you might not be able to function at the same level as before, and you probably don’t see it yourself".

This employee must prove immensely to negate that prejudice. It will put a considerable extra pressure on such employee, who has been out of the workplace for some time. If a person with brain injury in defense against accusations of alleged substandard performance appeals to the changed circumstances, it could easily be dismissed with a lack of self-awareness.



Conclusion: people with brain injury need to re-integrate with three types of invisible constraints: the injuries, the pressure to perform because of the prejudice about it, and the label of lack of self-awareness that is impossible to disprove. Even without brain injury a 'mission impossible'.

One of the fundamental principles of our constitutional state is: 'presumptio innocentiae': a defendant is presumed innocent until his guilt has been legally and convincingly proven.

Similarly, during the reintegration of a person with brain injury, the premise should be that he or she may ultimately operate on the old level until the contrary is proven.

With this piece, we want to emphasize that it is important to support "Judges" with careful process diagnostics and a protective, supportive and stimulating guidance. After all, everyone has the right to be judged on his or her own merits.


Recovery Process

People with brain injury must accept that the recovery process is a long way, and many will have take a step back. Recovery after brain injury can go on and on, and maybe there will come a time when someone can function again to the old level.

Give them a chance by providing good diagnostics, by giving honest feedback (psychoeducation), by providing support in counseling and keep an eye on the struggle they are to make, against the injury, against the label and the prejudices.

Katinka Franken (neuropsychologist), Tina van der Linden (lawyer), Ans Post (experience expert)