Vocational Issues Following Traumatic Brain Injury, Part I

The Center on Brain Injury Research and Training, Teaching Research Institue, Western Oregon University
Vocational Issues Following Traumatic Brain Injury, Part 1

Paid employment is one of the most frequently cited goals for adults with traumatic brain injury (TBI) regardless of age, injury severity, or prior work experience. But it remains one of the most challenging goals to achieve; more than half of those employed pre-injury are not working five years post-injury (John Corrigan, Ph.D., 2012 NASHIA Conference). This Fact of the Matter brief is the first of a two-part series focusing on vocational issues following TBI. Part I provides an overview of this topic. Part II will review specific types of vocational services.

How do common challenges following TBI affect paid employment?

The cognitive, communication, behavioral, sensory, physical, psycho-emotional, and social changes commonly experienced following TBI can significantly affect one’s ability to effectively engage in paid employment, as illustrated by these examples:

What does current research us tell about successful employment following TBI?

A complex mix of pre- and post-injury characteristics makes it difficult to predict success in the workplace. That said, research shows that injury severity and self-awareness are two of the strongest predictors of successful employment; a severe injury and/or lack of insight into one’s deficits can make it difficult to hold down a job.

  • Other factors that affect employment include:
  • Pre-injury work history
  • Independence performing activities of daily living
  • Overall cognitive ability
  • Ability to take in and process information
  • Executive functioning (self-regulation, planning, and problem solving)
  • Emotional status
  • Social skills

What does current research tell us about the role of vocational services following TBI?

For individuals with mild injuries, clinic-based services might be enough for them to return to their existing jobs — if services are delivered early post-injury. Individuals with moderate to severe injuries are likely to require intensive, long-term services and supports. This may include changing to a less demanding job that requires a different set of skills.

What are the basic components of vocational service delivery?

Vocational Rehabilitation (VR) services are designed to help individuals with disabilities prepare for, seek, and maintain employment. Typically a case coordinator or VR counselor helps direct and support clients through the VR system. Services include, but are not limited to, the items below.

Where can I find more information?

  • Brain Injury Alliance of Oregon — www.biaoregon.org Center on Brain Injury Research and Training (CBIRT) Ask a Librarian — www.cbirt.org/ask-librarian
  • Alabama Fact Sheet: TBI work accommodations — www.nashia.org/pdf/hotopics/al_fact_sheet_tbi_accommodations.pdf
  • Hart, T., Dijkers, R. et al, (2006). Vocational services for traumatic brain injury within model systems of care, Journal of Head Trauma Rehabilitation, 21, 467-482
  • Tyerman, A. (2012) Vocational rehabilitation after traumatic brain injury: Models and services, NeuroRehabilitation, 31, 51-62.

Click here to see "Vocational Issues Following Traumatic Brain Injury, Part II."

Posted on BrainLine January 2, 2013.

This Fact of the Matter brief is used with permission from the Center on Brain Injury Reserach and Training, Teaching Research Institue, Western Oregon University. www.cbirt.org.

To contact us or receive notification of new Fact of the Matter briefs, email mch@wou.edu.

Comments (1)

I know how desperately I need voc rehab services, but I am on a waiting list as state funding was cut. I have lost 6 jobs in 5 years. Prior to my injury I had a long run as a successful professional. Now what?