Two community practitioners collaborated with the University of Puget Sound Occupational Therapy program and submitted the following clinical question: “What bio/psycho/social factors have been identified to hinder and/or facilitate successful return to work in addition to traditional work hardening/conditioning intervention for adults?” A literature review discovered 47 articles ranging from systematic reviews, descriptive, qualitative, outcome, and experimental studies. Evidence was synthesized by two reviewers into a critically appraised topic (CAT). Numerous facilitating (job satisfaction, employment accommodation, social support, multidisciplinary approach) and hindering factors (social isolation, depression, pain, self-perceived disability) were identified affecting one’s ability to return to work after various diagnoses.

Due to the lack of literature on interventions addressing the biopsychosocial factors specifically for vocational rehabilitation, another literature review was conducted for the knowledge translation portion of the project. This review resulted in 22 additional articles addressing effective interventions to alleviate pain and/or depression, used by various healthcare professions. The researchers provided a document with detailed flow charts to the community practitioners summarizing the findings. Satisfaction surveys were administered to both collaborators to assess their professional opinion about the potential use of these interventions in their settings. Further research should explore the effectiveness and applicability of the interventions identified in this study in vocational rehabilitation.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

George Tomlin, PhD, OTR/L, FAOTA

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound