From the Professional’s Perspective

H.L. Mencken said "For every complex problem there is a simple solution that didn't work." Robert Fraser, in an article in TBI Challenge, makes the more optimistic point that for a complex problem there are many solutions that do work and in combination can be very effective. He writes:

"With the occurrence of a traumatic brain injury, the primary concern is initially securing quality medical and allied health care, but vocational issues can soon become prominent. Can the person with brain injury enter or re-enter the job market? When should this process begin? What type of employment potential exists? These are the types of questions that arise for the person with brain injury, family members and significant others."

Fraser says that although "from a historical perspective, individuals with TBI have shown relatively high unemployment rates, progress is being made" and that "with special and intensive forms of intervention, rehabilitation employment outcomes can range within the area of 50 to 80% for persons with even a severe TBI."

This is encouraging news. How can you become part of this encouraging statistic?

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Start by finding a vocational rehabilitation counselor who has worked with people who have had a brain injury. "This professional should not only understand the different aspects of the disability, but also have a firm understanding of the job market and potential access points for the person with TBI. A vocational evaluator can also be helpful in job development, on-site training and maintenance. An experienced neuropsychologist is critical in identifying an individual's brain-related pattern of assets and areas which may require intervention within the context of a specific job goal. Other allied health staff such as a speech language pathologist, occupational therapist or assistive technologist can be very helpful relative to compensating strategies, work-site modification and equipment that help the person perform effectively on the job. In true cross-disciplinary collaboration, the member of the rehabilitation team that can be most assistive in ensuring job success should be the person assuming the necessary helping role (e.g., a physical therapist may meet with a plant safety engineer in order to review the physical demands of the job or a speech language pathologist may be the best job coach for a teacher's complex work activity)."

Working with your rehabilitation counselor, evaluate yourself in relation to employment.

"A short-term or basic evaluation includes a synthesis of neurophyscological testing results, academic skills, vocational interests and work values, physical capacities and communication capabilities review, emotional and behavioral functioning data and often hands-on work samples in order to establish a vocational goal. These goals can include return to a prior job, return to a related position, returning to a new position within a firm or establishing an entirely new job goal.

Critical parts of this evaluation include clearly establishing the financial needs of the person within the context of federal and private disability subsidies and a job analysis of a prior position. Job analysis includes identifying a job's tasks and task complexity, the receptivity of a supervisor and co-worker to a person's work return, and establishing how skilled a person was on the job. In order to understand the viability of a vocational goal, a rehabilitation counselor and/or job coach can establish an actual paid or non-paid job-site evaluation as part of an extended or intermediate level of evaluation."

After the initial but comprehensive evaluation of your own status, the job site should be evaluated.

"Some individuals, even with severe injuries, may simply need to be advised by a vocational rehabilitation counselor within the counselor's office relative to job search and maintenance strategies. Others may need to be represented and brokered to the employer and/or receive some type of on-site employment support (agency-based or natural). Rehabilitation agency-based supports include one-to-one job coaching or some type of employment group or enclave with a job coach, contracted job sharing with a non -disabled co-worker, or paid mentoring through a community training consultant or a retired worker. Forms of natural support include using a supervisor or co-worker as a trainer or actually receiving some type of physical assist from a co-worker." The combination of your effort and the assistance of others will help set you up for success.

Revised: Saturday, February 23, 2002 08:42 AM