Pamela Targett

Return to Work After Traumatic Brain Injury: A Supported Employment Approach

Traumatic brain injury (TBI) is one of the most prevalent disabilities in the United States. Of the estimated 1.4 million who sustain a TBI annually, about 1.1 million are treated and released from the emergency room (Langlois et al. 2006). Another 235,000 are hospitalized, and 80,000 to 90,000 experience permanent disabilities (Langlois et al. 2006) TBI is three times more common in men than in women, with the most common causes for injury being motor vehicle accidents, falls, and violence (Greenwald et al. 2003).

Separation from supported employment: a retrospective chart review study

Abstract Purpose: The objective of this study was to examine job separations from supported employment (SE). The aim was to identify the types and nature of separations and precipitating events leading to the separation. Methods: A retrospective chart review methodology was utilized. The study was conducted in a metropolitan area in the Southeast United States by a university-based SE program. Participants were 47 SE clients who had been placed into and separated from 67 jobs. Using a coding form, information regarding the type of separation and issues that preceded the separation were recorded. Data were aggregated using descriptive statistics. Results: The largest number of separations was due to termination, followed by resignation and mutual consent of the employer and employee. The mean number of issues leading to the separation was 2.2, ranging from one to five. Only eight positive issues were found (compared to 116 negative and 20 neutral), the most prevalent being entry into an educational or training program. Common negative issues included poor work performance, attendance and punctuality problems, conflicts with the supervisor, and social and behavioral issues. Conclusions: The findings of this study illustrate the need to address job retention issues during the job development process, finding the most appropriate person-job fit and workplace culture for each client. The findings also support the need for vigilant and regular communication between the SE program and employers to intervene quickly when problems arise. Implications for Rehabilitation Separation from Supported Employment (SE) SE is an evidence-based employment practice that has been shown effective across multiple disability groups. Studying job separations can provide valuable information for improving service. Locating the best person-job fit, as well as frequent contract with employers, can help prevent unnecessary job loss.

Customer initiated supported employment

One of the recurring problems reported by supported employment participants has been an overall lack of involvement in the process. People with disabilities have reported feeling powerless within programs which offer no opportunity for choice and control. This creates a need to provide opportunities within supported employment to maximize consumer participation. The Consumer Initiated Approach to Supported Employment demonstrates how to promote full consumer inclusion. The authors provide an overview of this approach. Key model components include: customer lead assessment, customer driven job selection, individualized vocational supports and customized job retention services. The outcome data from this federally funded demonstration project are also provided.

Educational and Vocational Issues in Traumatic Brain Injury

This article describes some of the current issues related to return to school and employment for individuals with traumatic brain injury. A strong, collaborative partnership between an individuals health care providers and key stake holders is essential to a smooth transition back to school or work. Ways to improve current practices and ensure more timely and appropriate educational and employment services and supports for individuals with traumatic brain injury are described. Some recommendations on areas for future research are also offered.