Vocational intervention and support following job placement for persons with TBI

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Previous research on vocational rehabilitation after traumatic brain injury (TBI) has suggested that coaching and other services provided following job placement are particularly important for successful work re-entry in this population. Methods ofdefining and measuring these services are needed to estimate more precisely their effects on vocational outcomes. In this study we developed a measure of the type, amount, and location of post-placement interventions that could be completed by treaters in“real time”. Treatment was measured prospectively for 6 months after job placement for 65 people with moderate to severe TBI treated at 5 TBI Model System centers. Centers were found to differ substantially in the amount and location of treatment provided
following job placement; centers providing more intensive treatment and treatment at the workplace also served more severely impaired clients at a longer interval after injury. Within centers, participants’ cognitive speed and emotional distress predicted
certain aspects of amount and type of treatment provided. Three-fourths of the sample were still working at the placement job after 6 months. Due to the confounding between case mix and treatment variables, unique effects of treatments on outcomes could
not be determined.

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