Affiliations: Moss Rehabilitation Research Institute, Elkins Park, PA, USA | Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA | Research Department, Craig Hospital, Englewood, CO, USA | Department of Cognitive Rehabilitation, JFK-Johnson Rehabilitation Institute, Edison, NJ, USA | Departments of Rehabilitation Medicine, Neurology, and Neurological Surgery, University of Washington, School of Medicine, Seattle, WA, USA
Note: [] Address for correspondence: Tessa Hart, Ph.D., Moss Rehabilitation Research Institute, 60 Township Line Rd., 2nd Floor West, Elkins Park, PA 19027, USA. Tel.: +1 215 663 6153; Fax: +1 215 663 6113; E-mail: thart@einstein.edu
Abstract: 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 of defining 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.
