Pam Sherron

Return to work for persons with severe traumatic brain injury: A data-based approach to program development

This article presents a review of the literature on return to work for individuals with traumatic brain Injury, reported rates for and factors found to influence return to work, such as injury severity, preinjury variables, and postinjury services. The outcomes for 87 Individuals served in a support

Critical factors associated with the successful supported employment placement of patients with severe traumatic brain injury

A number of investigations have recently demonstrated the effectiveness of supported employment programmes in improving the vocational status of clients with traumatic brain injuries. The present study investigated a sample of 39 individuals participating in a return to work programme emphasizing a supported employment approach to identify key functional characteristics which differentiated successful and unsuccessful clients. Clinical ratings of employment specialists were used to identify two groups of individuals rated least and most difficult to place and maintain. Results indicated that the two groups differed markedly on key employment outcomes. Individuals rated most difficult tended to be younger, possess functional limitations such as visual and fine motor impairments, and display significant deficits in numerous work-related skills. Recommendations are made for applying these findings to assessment, placement, and training activities within vocational rehabilitation programmes for persons with traumatic brain injuries.

Return to work for persons following severe traumatic brain injury. Supported employment outcomes after five years.

Wehman P, Sherron P, Kregel J, Kreutzer J, Tran S, Cifu D: Return to work for persons following severe traumatic brain injury: supported employment outcomes after five years. Am J Phys Med Rehabil 1993;72:355–363Supported employment is a recently developed rehabilitation alternative that is being used to assist individuals with traumatic brain injury to return to work. The present study reports the results of a supported employment program that has placed 80 individuals into competitive employment during a 5-year time period. All individuals had sustained a severe traumatic brain injury; 72% of the injuries involved a motor vehicle. A mean of 6.1 years had passed since injury for all participants, who had been unconscious an average of 48 days. Neuropsychologic evaluation revealed defective cognitive functioning, which contributed to diminished employment potential. A key outcome indicator used to assess return to work capacity is the monthly employment ratio, which is computed by dividing the number of months employed during an employment phase (i.e., pre/post injury) by the total possible months an individual would have the opportunity to be employed. The monthly employment ratio increased from 13% after injury with no supported employment to 67% with supported employment services. The majority of individuals were employed in warehouse, clerical and service-related occupations. A mean of 250 staff intervention hours were required to train and provide follow-up services to program participants.

Employment outcomes of persons following traumatic brain injury: pre-injury, post-injury, and supported employment

This paper provides a prospective analysis of the pre-injury, post-injury and supported employment work histories of 20 persons who survived a severe head injury. All persons had a very limited or inconsistent work history post-injury, due to the severity of the injury. Data are presented on the placement outcomes and include factors such as wages, hours worked, months of employment and type of occupation. The supported employment model is described and the job coach approach is presented in some detail. The most significant finding of this preliminary report is that, as an aggregate group, supported employment was able to facilitate restoration of vocational capacity from pre-injury levels based on total months worked.

Return to work for persons with traumatic brain injury and spinal cord injury: three case studies

Supported employment was utilized in the vocational rehabilitation of two people with traumatic brain injury and one with a traumatic spinal cord injury. Supported employment was found to yield real work outcomes, though it required substantial amounts of money to return the three patients to relatively low-paying jobs. Funding issues are discussed.) Language: en

Computer technology in vocational rehabilitation

Survey Information was collected from 174 vocational rehabilitation facilities about current uses, desired future roles, and the perceived disadvantages and advantages of computer technology. Seventy percent of facilities reportedly used computers. Most frequently cited uses Included word processing, client training, billing, and data entry. A great majority of respondents preferred an increased role for computers. Increased roles were most desired for treatment planning, statistics, data entry, and data analysis activities. Reliability, diversity, adaptability, and increased efficiency were cited as major advantages of computer technology. The efficacy of computers in various tasks remains to be determined. However, ongoing advances in hardware and software development, as well as close communication with computer professionals about consumer needs, will enhance the overall value.

Return to Work for Patients with Low Back Pain: Two Case Studies

Dismal return to work rates and mounting disability costs in the chronic low back pain (LBP) population imply the need for innovative re-employment strategies. The supported employment approach utilizes a vocational specialist under close physician supervision. It is more proactive, less biased, and more specialized than the more traditional case management approach used by many insurance companies. Supported employment has been used extensively at our institution in the brain injured population and we have recently begun exploring its use in LBP patients. Herein, we describe the successful use of supported employment in two individuals with chronic disabling LBP.