Guest Edited by Paul Wehman, PhD
The Traumatic Brain Injury & Work Re-Entry edition of Brain Injury Professional covers the main complexities and issues associated with individuals with brain injury encounter as they attempt to go back to work.
Full message from the Editor
Work is a critical part of adult life. Employment brings financial independence, socialization, a
sense of purpose, and opportunity for personal growth. Therefore, disruption to employment
following a traumatic brain injury (TBI) negatively impacts many life areas beyond simply
employment status. Unfortunately, individuals with TBI experience substantially higher rates
of unemployment than individuals without disabilities and are faced with difficult decisions
about how, when, and where to return to work. While some individuals with TBI will resume
employment at a previous position, others will need to consider pursuing work in different
departments within the same company or in another industry altogether. The return to work
process is different for each individual as some may be ready soon after injury while others
may have a longer term, chronic disability and thus require more medical intervention before
work becomes a possibility. The take-away message from this special “return to work issue”
is that employment is possible and desirable for most patients with TBI. Approximately 30
years ago it was next to impossible to find articles documenting meaningful competitive
employment outcomes for individuals with long term TBI, yet, over time this has changed.
We increasingly know that patients with TBI can successfully return to work through use of
vocational supports and services.
This issue of Brain Injury Professional focuses on detailing the scope of the issue of
unemployment for individuals with TBI along with presenting employment interventions that
promote successful return to work for both military and civilian populations. The first article
by Dr. Dillahunt-Aspillaga and colleagues presents an overview of current research on the
status of employment for Veterans with TBI. She includes important descriptions of services
such as vocational case management, cognitive rehabilitation, vocational rehabilitation
counseling engagement, and supported employment all with or without increased utilization
of assistive technology, which show promise as effective interventions.
Next, my colleagues and I present a complimentary article to Dr. Dillahunt-Aspillaga’s article
by describing how Service Members and Veterans who have extensive polytrauma injuries
are able to receive employment supports through the U.S. Department of Veterans Affairs
The remaining two papers by Dr. Koch and colleagues, and Dr. Whittenburg and colleague
focus on an array of interventions available to both civilian and military populations through
state Vocational Rehabilitation agencies. These include services focused on assessment, onthe-
job support, and intervention models such as supported and customized employment.
In particular, customized employment is an emerging practice with wide implications for
individuals with TBI because it focuses on working with employers to create positions that
mutually benefit the employer and the individual with TBI.
Finally, an interview from the perspective of a Vocational Rehabilitation Counselor who has
worked to return Veterans with TBI to employment is included. In the interview, Cynthia
Young offers insight into some of the struggles and successes Veterans with TBI experience
during the process of regaining employment.
Work offers a variety of benefits. Moving forward, there needs to be more research on the
therapeutic impact of return to work on TBI. It is absolutely essential that such studies be
conducted in the years ahead in order for physicians, psychologists, parents, patients and
policymakers to understand the full benefits of work and to make return to work a priority.
To view the full PDF of this edition, click here.