Journal of Vocational Rehabilitation - Volume 7, issue 3
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Journal of Vocational Rehabilitation will provide a forum for discussion and dissemination of information about the major areas that constitute vocational rehabilitation.
Periodically, there will be topics that are directed either to specific themes such as long-term care or different disability groups such as those with psychiatric impairment. Often a guest editor who is an expert in the given area will provide leadership on a specific topic issue. However, all articles received directly or submitted for a special issue are welcome for peer review. The emphasis will be on publishing rehabilitation articles that have immediate application for helping rehabilitation counselors, psychologists and other professionals in providing direct services to people with disabilities.
Original research articles, review articles, program descriptions, and case studies will be considered for publication. Ideas for special topical issues are welcomed as well.
Abstract: In this article a traumatic brain injury survivor offers first hand advice to professionals on how ‘common sense and sensibility’ can go a long way in provision of vocational rehabilitation services. He also offers some tips for employment specialists.
Keywords: Traumatic brain injury, Neuromedical, Return to work, Employment
Abstract: The Rehabilitation Act Amendments of 1992 and current trends in services funded by the Act hold promise for supporting individuals with severe brain injuries who desire to return to work. This article discusses those service trends in relation to Vocational Rehabilitation consumers with brain injuries.
Abstract: Few guidelines exist for matching compensatory strategies to presenting problems. This article describes an approach used to maximize the use of compensatory strategies on a job site for individuals with traumatic brain injury participating in a supported employment program. Key components include assessing residual skills, identifying potentially effective compensatory strategies through situational assessment, and incorporating compensatory strategies into training on the job.
Keywords: Traumatic brain injury, Compensatory strategies, Supported employment, Situational assessment, Job site training
Abstract: A sample of 97 unemployed persons with traumatic brain injury receiving rehabilitation services at an urban outpatient rehabilitation center were identified. Patients were divided into two groups based on time elapsed since injury, 5–9 years and 10–35 years post-injury. Family members reported a high incidence of cognitive, motor, and emotional problems lingering well beyond the first few years postinjury. Rates of moderate and heavy drinking, psychiatric treatment, and criminal behavior were identified. Transportation, cognitive, and physical problems were described as primary obstacles to employment. Analysis revealed few differences in the occurrence of cognitive, emotional and motor problems between follow-up samples,…supporting contentions that disability is often permanent. Family members' perceptions of injury-related obstacles to work were also strikingly similar. Recommendations are made for individually tailored, holistic rehabilitation programs with long-term, proactive follow-up.
Abstract: The Clubhouse model has a long history of effective support among people who experience disability due to psychiatric impairment. However, it had not been used with other groups until its recent adaptation among people who experience disability following brain injury. The model is known for its consumer direction, community basis, and long term supports. Preliminary results indicate that the' model may also be very effective in supporting community and vocational tenure among this new group of individuals.
Abstract: Head injury survivors experience a variety of physical, cognitive, and emotional difficulties that create unique problems for return to work. The authors outline a systematic model of pre-vocational training, vocational evaluation, and job placement considerations that have proven effective over the years as a means of increasing placement and work longevity with traumatically brain injured clients. The model includes a comprehensive learning style assessment, work sample evaluation, domain specific training, cognitive remediation that emphasizes learning functional skills, supported employment, environmental engineering of the work site, and the use of prosthetic devices.
Abstract: This article provides an overview of available brain injury information online for health care professionals and consumers. An increasing amount of high quality medical information is available online, primarily via the World Wide Web. Recommendations in regard to type of Internet access and software are provided to assist the new and intermediate users. Electronic mail, proprietary online services, and Internet applications are briefly reviewed. In addition well established online resources, such as the Medline database are highlighted. The World Wide Web sites catalogued in this article have been linked to a single site, allowing ready access to these sites while…reviewing the article; Internet address: http://griffin.vcu.edu/html/pmr/trowland/brainref.html. The intended audience of the article is health care professionals, including those limited experience with computers and the Internet.
Keywords: Brain, Injury, Online, Telecommunication, Internet, World wide web
Abstract: The Virginia Survivor Council was formed to ‘ensure representation and first-hand input of survivors of head injury’ on a National level. This article provides a general overview and offers guidelines on how a similar entity could be formed. A description of the council's mission, structure, accomplishments to date and future direction is provided.
Keywords: Traumatic brain injury, Advocacy, Head injury foundation, Virginia Survivor Council
Abstract: 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.
Abstract: Cases from the Job Accommodation Network database that involved people with traumatic brain injury were examined to determine the nature of the industry, job, career progression, consequence, job function, accommodation, and ADA issues for this population. Most workplace difficulties were the result of cognitive consequences of the TBI and included remembering, organizing, learning, and planning skills. Types of accommodations related to these functional limitations are described. The employers, employees, and service providers had different issues related to implementation and interpretation of the ADA. The biggest. ADA issue for all three groups was effective performance in the workplace. For the employers,…safety concerns were also very apparent. The employees were concerned with basic ADA information about their rights and responsibilities. The service providers had fewer ADA-related issues to discuss, overall, but they asked more questions related to the use of a job coach than did the other two groups. The ADA can have a positive impact on the employment situation of people with TBI if employers, service providers, and the employees work together to find solutions.
Keywords: Traumatic brain injury, Americans with Disability Act (ADA), Accommodation
Abstract: The effects of an acquired brain injury may impede an individual's ability to achieve meaningful employment and live independently. Unfortunately, existing community-based services are often inadequate or inappropriate to meet the needs of people with brain injury. As the number of people with brain injury increases due to advances in emergency medical and surgical care, survivors, family members, and service providers seek ways to meet the needs of people with brain injury beyond the acute recovery stage. The need for effective brain injury rehabilitation services is especially critical for individuals with challenging behaviors. In Virginia, a non-aversive, community-based support team…approach known as Positive Behavioral Support (PBS) is being used with persons with brain injury. This approach, initially used with individuals with developmental and other severe disabilities, appears to have potential as an effective approach to working with people with acquired brain injury who have difficult behaviors. The first time that the Positive Behavioral Support model was utilized specifically with persons with brain injury was in 1992 when the Virginia Department of Rehabilitative Services, in collaboration with the Virginia Institute for Developmental Disabilities, a University Affiliated Program, implemented a one-year federally-funded project called PITON (‘Positive Intervention and Training Outcomes Network’). At the time of the PITON project, eighteen states including Virginia had implemented this innovative behavioral approach, mostly with people with developmental disabilities. This article provides a brief overview of the Positive Behavioral Supports approach, as well as two case studies describing the use of PBS with persons with brain injury in Virginia.
Keywords: Brain injury, Behavioral, Vocational rehabilitation services, Positive behavioral support model
Abstract: Experience and observations gathered during research conducted with a national sample of community-based rehabilitation programs are discussed. Functional vocational assessment services reported are largely based upon procedures incorporated in the Vocational Assessment Protocol (Thomas, D.F. (1994) The vocational assessment protocol. Menomonie: University of Wisconsin-Stout, Stout Vocational Rehabilitation Institute, Research and Training Center.). This protocol was used as a basis for training staff and as a profiling technique to collect information relevant to physical, behavioral and vocational aspects of persons studied. Medical and rehabilitation services specialists, consumers, and family members were used as sources of information for developing service arrangements. Information…gathered on functional abilities of 149 persons provided insights as to how functional abilities assessment can highlight strength areas and methods of compensatory strategy development. General observations and recommendations gained during the course of follow-up interactions with consumers and staff from the field sites are shared with particular focus placed upon encouraging caregivers to provide information in a functional manner related to targeted goals for independence and work. Specific suggestions are offered regarding the importance of documenting functional assets and pre-injury skills, as well as present physical, neuropsychological, and social adaptive skills. Development of flexible and responsive vocational plans is discussed, and the importance of direct access to employment and postemployment resources is stressed. The material presented focuses upon general findings and practices found to useful with minimal emphasis on data related aspects of this study.
Keywords: Functional assessment, Traumatic brain injury, Vocational evaluation, Case management of vocational issues following brain injury, Employment and traumatic brain injury rehabilitation
Abstract: Improvements in the medical and surgical management of individuals following trauma have resulted in an increased number of long-term survivors, especially among the most severely injured. Additionally, refinements in inpatient and outpatient rehabilitation programs have allowed these survivors to return to the community more often, at higher functional levels, and in some cases, with a greater likelihood of getting back to work. Unfortunately, owing to the increased severity of injury, many of these individuals have multiple medical conditions even in the post-acute phase of recovery. An even greater number of survivors have numerous motoric, cognitive, and behavioral deficits, long after…their initial injury. In order to meet the increasing demands of more severely impaired clients, health care professionals assisting brain injured individuals return to employment need to become more familiar with the specific medical issues commonly seen. This review provides a framework and practical guide to the neuromedical considerations affecting return to work in the brain injured adult.
Keywords: Traumatic brain injury, Neuromedical, Return to work, Employment