Supported Employment for Veterans with Traumatic Brain Injury: Provider Perspectives

Publication date: Available online 5 August 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Terri K. Pogoda, Kathleen F. Carlson, Katelyn E. Gormley, Sandra G. Resnick
ObjectiveIn 2006, 13 sites were provided with one-time pilot funding to provide supported employment (SE) to Veterans with traumatic brain injury (TBI) history. In 2014, we surveyed SE providers at pilot and non-pilot sites that did not receive this funding. Our objectives were to identify any pilot and non-pilot site differences regarding current: (1) provision of SE to Veterans with TBI; (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE.SettingVeterans Health Administration (VHA) SE programs.DesignMixed methods cross-sectional survey study.ParticipantsProviders included a total of 54 SE supervisors and 90 vocational rehabilitation specialists (VRSs).InterventionsNot applicable.Main Outcome MeasuresWeb-based surveys of forced-choice and open-ended items included questions on SE team characteristics, communication with polytrauma/TBI teams, and experiences with providing SE to Veterans with TBI history.ResultsSE was provided to Veterans with TBI at 100% of pilot and 59.2% of non-pilot sites (p = .09). However, VRSs at pilot sites reported that communication with the polytrauma/TBI team about SE referrals was more frequent than at non-pilot sites (p = .003). In open-ended items, suggestions for improving SE were similar across pilot and non-pilot sites, and included increasing staffing for VRSs and case management, enhancing communication and education between SE and polytrauma/TBI teams, and expanding the scope of the SE program so that eligibility is based on employment support need, rather than diagnosis.ConclusionsThese findings may contribute to an evidence base that informs SE research and clinical directions on service provision, resource allocation, team integration efforts, and outreach to Veterans with TBI who have employment support needs.



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