Abstract
Predicting return to work in persons with traumatic brain injury has been a challenge for doctors, rehabilitation therapists and vocational counselors. Although traditional vocational rehabilitation may be beneficial to many clients, there are others who are unable to return to work through customary means. Supported employment is a method of vocational rehabilitation in which a professional staff person (a job coach) provides structured job placement services and highly individualized training at the job site in addition to ongoing services throughout the entire length of employment. This approach has been used as a last resort to treatment, but has very high success rates (50–78% success rates for those deemed unemployable by other means). Work hardening was used in the 1980s as a last resort to therapy for the industrial injured worker. However, it was found that when clients entered the program sooner, they had a greater chance of return to work than if they entered the program after a prolonged period of time, thus saving money. If the individual with a traumatic brain injury is placed in supported employment programs sooner, he may have a greater chance of return to work than if supported employment is used only as a last resort.
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