Getting motivated: long-term perspectives on engaging in community-based programs after acquired brain injury

BACKGROUND: Low motivation is a common problem after acquired brain injury (ABI) and can persist for years after injury. Little is known, however, about perspectives of motivation with respect to engaging in the community, many years after ABI. PURPOSE: To explore the client with ABI perspective of motivation and engagement in individuals based in community ABI programs. METHOD: Interpretive description methods were utilized. Semi-structured interviews were conducted with 21 individuals with an ABI. FINDINGS: Participants felt that both internal factors, such as feelings of hope, and external factors, such as social support, influence levels of motivation to engage. When positive internal and external motivators were enhanced, and negative internal and external motivators reduced, this gave rise to a sense of choice and control, which led to increased engagement. IMPLICATIONS: Fostering positive aspects of rehabilitation and increasing choice and control may promote engagement. External motivators, such as reducing repetitiveness and promoting peer support, are motivators that community and clinical settings can implement relatively easily, whilst internal motivators such as attitudes toward therapy may need to be addressed continuously to enhance motivation and engagement.