A vocational rehabilitation intervention for young adults with physical disabilities: participants' perception of beneficial attributes

Authors: 
Bai, M. I., Sattoe, J. N. T., Schaardenburgh van, N. R., Floothuis, M. C. S. G., Roebroeck, M. E., & Miedema, H. S.
Year Published: 
2017
Publication: 
Child: Care, Health and Development
Volume: 
43
Number: 
1
Pages: 
114-125
Publisher: 
Wiley Online Library
Background: 

This study explores the barriers and facilitators that young adults with physical disabilities experienced while finding and maintaining employment after an intervention program that supports work participation.

Purpose: 

To ascertain the participant-perceived beneficial attributes of the program and participants' recommendations for additional components.

Setting: 

Semi-structured interviews with former intervention participants, which were recorded and transcribed.

Sample: 

Young adults with disabilities (n= 19) that formerly participated in the study.

Data Collection: 

Data was extracted from the clients' charts and logged in a digital data extraction form. The following background characteristics were reviewed from the charts: age, gender, medical diagnosis, educational level and type of education.

Intervention: 

At Work' is a multidisciplinary vocational rehabilitation intervention for young people with physical disabilities. It aims to provide support for finding and maintaining regular employment after finishing post-secondary education.

Control: 

There was no control for this study.

Findings: 

Physical functions and capacities, supervisor's attitude, self-esteem and self-efficacy and openness and assertiveness were experienced barriers and facilitators for finding and maintaining employment. Improvement of self-promoting skills and disclosure skills through job interview-training, increased self-esteem or self-efficacy through peer-support, a suitable job through job placement, improvement of work ability through arrangement of adjusted work conditions and change of supervisor's attitude through education provided to the supervisor were perceived as beneficial attributes of the program.

Conclusions: 

Findings suggest that programs supporting work participation should provide real-world experiential opportunities that allow young adults with physical disabilities to develop new insights, self-efficacy and life skills.

URL: 
http://onlinelibrary.wiley.com/doi/10.1111/cch.12407/full
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Successful return to work for cancer survivors

Authors: 
Nicholas, D. B., Attridge, M Zwaigenbaum, L., & Clarke, M.
Year Published: 
2007
Publication: 
American Association of Occupational Health Nurses Journal
Volume: 
55
Number: 
7
Pages: 
290-295
Publisher: 
Europe Pubmed Central
Background: 

Advances in diagnosis and treatment has increased the 5 year survival rate among individuals with cancer. With this improvement, comes and increase in individuals who will return to work. Return to work is important in order to improve quality of life, a sense of normalcy and in terms of economic well being. The Americans with Disabilities Act (ADA) may offer legal protections to survivors both before and after treatment. Few studies have looked at return to work experiences among cancer survivors and how the ADA provisions may related to that experience.

Purpose: 

The purpose of this study is to determine factors (related to the ADA) that influence a successful return to work for cancer survivors.

Setting: 

Patients were recruited from an oncology department in a metropolitan hospital in Minnesota and a focus group was held.

Sample: 

Seven individuals attended a 2 hour focus group help at the hospital. All were female and four were breast cancer survivors. The majority were white, married and had a Bachelor's degree or higher level of education. Participants had been employed 8 to 20 months prior to diagnosis.

Data Collection: 

A focus group was help to identify common themes about health, health care, economic security, and return to work. Analysis were descriptive and qualitative. Transcripts of the group meeting were read along with moderator notes. General themes were pulled from this material.

Intervention: 

The intervention in the study included job accommodations and supports.

Control: 

There was no control or comparison condition.

Findings: 

For the majority of participant (N=5) the reason for returning to work was an essential part of their healing. All members of the group were aware of the ADA however, none had engaged in formal conversations with their employers about its provisions. Factors aiding in return to work included: job flexibility, coworker support,and health care provider support. Factors hindering return to work were: ignorance about cancer in the workplace, lack of emotional support, physical effects of cancer, and the impact of cancer on the person's priorities.

Conclusions: 

Occupational nurses have an important role to play in the return to work of individuals who survive cancer. They need to be aware of the positive and negative factors that influence return to work and understand the legal requirements such as the ADA.

URL: 
http://whs.sagepub.com/content/55/7/290.full.pdf
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Assistive technology and computer adaptations for individuals with spinal cord injury

Authors: 
Assistive technology and computer adaptations for individuals with spinal cord injury
Year Published: 
2004
Publication: 
NeuroRehabilitation
Volume: 
19
Number: 
2
Pages: 
141-146
Publisher: 
IOS Press
Background: 

Spinal cord injury (SCI) commonly occurs when individuals are forming their vocational goals, resulting in low post-injury employment rates and higher costs to society. Individuals with SCI who are employed have improved quality of life. Assistive technology, often available at modest cost, can help individuals with SCI to compensate for functional limitations, overcome barriers to employability, enhance technical capacities and computer utilization, and improve ability to compete for gainful employment.

Purpose: 

Studies have shown that return to work for individuals after a spinal cord injury are low. Other studies have shown that individuals with SCI who are employed report a better quality of life. One barrier to returning to work is a decreased scope of work skills due to physical limitations from the SCI. The purpose of this study was to demonstrate the successful return to work of three individuals with SCI using assistive technology and computer adaptations.

Setting: 

One individual received his evaluation in an acute rehabilitation center. One individual was evaluated at his workplace. The other setting for the third case study was not specified in the article.

Sample: 

Three males with SCI ages 23, 27, and 41. All three had cervical level injuries to include C3, C6, and C7.

Data Collection: 

Each individual received a computer accommodation evaluation that guided the selection of the assistive technology.

Intervention: 

Computer accommodation evaluation by the State Vocational Rehabilitation Department by a rehabilitation engineer and occupational therapist. All individuals were provided with computer accommodations as recommended by the evaluations. Each of the three participants received individualized accommodations.

Control: 

There was no control or comparison condition.

Findings: 

Assistive technology can help individuals with SCI to compensate for functional limitations, overcome barriers to employability, enhance technical capacities and computer use, and improve ability to compete for employment.

Conclusions: 

The authors conclude that an important goal for SCI rehabilitation includes maximizing vocational potential including the evaluation and application of computer and assistive technology.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15201473
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Cognitive and emotional consequences of TBI: Intervention strategies for vocational rehabilitation

Authors: 
McDonnall, M. C., & Cmar, J.
Year Published: 
2006
Publication: 
NeuroRehabilitation
Volume: 
21
Number: 
4
Pages: 
315-326
Publisher: 
IOS Press
Background: 

Traumatic Brain Injury (TBI) negatively impacts successful return to work for many individuals. Training individuals to use effective interventions to compensate for common deficits like attention, memory and executive functioning post injury should improve return to work outcomes.

Purpose: 

The purpose of this study was to describe examples of effective cognitive rehabilitation strategies through the use of 3 case studies and a review of literature. Professionals in the field need this type of information to better serve individuals with TBI who are returning to work.

Sample: 

The study sample included three people with TBI.

Data Collection: 

Various scales were used to measure improvements specifically related to the cognitive ability that was being treated (i.e.. attention deficits, memory problems, executive deficits) in each of the 3 case studies.

Intervention: 

The intervention was individualized cognitive rehabilitation interventions for four individuals with traumatic brain injury.

Findings: 

There are numerous strategies that can be taught to individuals after TBI to help them compensate for common cognitive deficits (ie. attention, memory, executive functioning). Therapists must understand the possibilities and be able to implement specific interventions for each person and be able to use effective teaching strategies to train the individual. It is also important to be aware of ways to support a person who is particularly "challenging" by becoming aware of ways to improve social behaviors and self awareness.

Conclusions: 

Intervention strategies must be individualized. Other considerations include considering the nature and degree of the disability and environmental context. Therapist must be able to think outside the box and use creative problem solving to assist individuals with TBI with using strategies to improve employment outcomes.

URL: 
http://content.iospress.com/articles/neurorehabilitation/nre00329
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work

Authors: 
Siporin, S. and Lysack, C.
Year Published: 
2003
Publication: 
Health Education Research
Volume: 
18
Number: 
2
Pages: 
207-215
Publisher: 
Oxford University Press
Background: 

In England, policy developments in the field of mental health are stimulating interest in employment for mental health service users as a means of mental health promotion. To date, research that might assist in increasing employment rates amongst this group has focused largely on the question of which service users are most likely to benefit from vocational interventions and, more recently, on models of vocational support. Less is known about how employers can assist people in their transition or return to work.

Purpose: 

This study draws on the accounts of 17 employment project clients to identify workplace factors that were associated with job retention. Specific objectives were:
(1) To identify a sample of employment support service users who had retained open, competitive employment for 12 months or longer.
(2) To identify a sample where employment had broken down after a period of less than 12 months employment.
(3) To explore the experiences of both groups from their own perspective.
(4) To explore the perspectives of the other key individuals involved, including employment project workers and workplace managers.
(5) To identify factors associated with the success or breakdown of supported employment on the basis of the accounts obtained.

Setting: 

The study was conducted at five project sites in England. Of the five projects, two were based in geographically and demographically diverse areas of outer London (Projects A and B), one operated in a semi-rural area of southeast England (Project C), and one in an urban area of the southeast (Project D). The fifth project (Project E) was based in a Midlands city.

Sample: 

Clients of the five projects who had current or recent experience of open employment were invited to a meeting at their project where the research and what would be involved was explained. As a result of the meetings some clients decided not to take part because they had not disclosed their mental health problems at work, while others who were currently employed had not yet been in their job for a year. These clients therefore withdrew from the study. In total, 10 male clients and seven female clients did take part. Eleven clients had been able to retain open employment for 12 months or longer, while the other six clients jobs had ended within 12 months for reasons they themselves saw as problematic.

Data Collection: 

With participants permission, the interviews were tape recorded and transcribed verbatim. A staged analysis was then carried out. Initially, each job was treated as a case and the 17 cases were divided into jobs that had been retained and jobs that had broken down. Data relating to each case (i.e. the client‚, project worker‚ and manager‚ accounts of a job) were then grouped under broad categories according to whether they related to employment support, workplaces or service users personal circumstances. Data within each category were analysed to generate subcategories within each main category, e.g. workplace factors relating to managers, colleagues and conditions of employment. These were then compared across cases in order to identify those factors that were associated with job retention and job breakdown. As noted earlier, in this article we focus on clients accounts of those factors relating to the workplace.

Intervention: 

Since the aim was to explore clients perceptions of their employment experiences, a semi-structured interview schedule was developed to enable each participant to tell the story of the job concerned from its beginning in the assessment and preparation stage leading up to the job, through its development to its end or to the present time in the case of ongoing jobs. The schedule explored key events during each stage of the job, including client first meetings with their manager and colleagues, their induction, and subsequent significant developments identified by participants themselves. Throughout the interview, participants feelings and attitudes, their accounts of factors which had either positive or negative effects, and their views about what else might have been helpful were explored. Questions were also included to obtain background data, including clients employment and mental health history. The interviews varied in length from 40 min to just over 3 hour.

Control: 

There was no control or comparison condition.

Findings: 

Specific adjustments such as flexibility about working hours, work schedules and job tasks emerged as crucial in enabling clients to deal with the effects of medication, and to regain stamina and confidence. Over and above these, however natural supports of a kind from which any employee would arguably benefit were equally important. In this respect the main themes revolved around training and support to learn the job, supportive interpersonal relationships at work, workplace culture, and approaches to staff management. Themes from the findings might equally provide a productive focus for workplace health promotion more generally, using organization development approaches.

Conclusions: 

On the basis of this study, four organizational initiatives in particular might help to ensure that workplaces are mentally healthy, both for mental health service users starting or returning to work, and for other employees:
Ensuring that a formal period of induction, of sufficient length, is routine practice for all new employees. For many jobs, induction will need to include formal training geared to the employee‚ pace of learning, opportunities to observe colleagues work and the explicit identification of sources of support for tackling problems that arise.
Embedding attention to employees ongoing development in routine workplace practice through formal supervision and appraisal procedures.
Team building aimed at creating a welcoming workplace where difference is accepted and employees strengths are valued.
Training and other learning opportunities, e.g. action learning sets, for managers, covering mental health and safety at work, team building, and individual staff management. Opportunities to explore the boundaries between a friendly, supportive approach and ensuring that work is completed would be particularly valuable, as would training in techniques for providing constructive criticism for employees.

URL: 
http://her.oxfordjournals.org/content/18/2/207.full
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Quality of life and supported employment: A case study of three women with developmental disabilities

Authors: 
Staines, G., L., Blankertz, L., Magura, S., Bali, P., Madison, E. M., Spinelli, M.,Horoqitz, E., Guarino, H.,Grandy, A., Fong, C., Gomez, A., Dimun, A., & Friedman, E.
Year Published: 
2004
Publication: 
The American Journal of Occupational Therapy
Volume: 
58
Number: 
4
Pages: 
455-465
Publisher: 
The American Occupational Therapy Association Inc.
Background: 

Programs aimed at enhancing the quality of life for individuals with disabilities are on the rise. This includes work. To understand the impact of new models of vocational training, it may be instructive to look at sheltered work, the long standing model. The job coach model of supported employment helps individuals with disabilities work in the community. The case for a positive relationship between supported employment and quality of life is not well understood. Research aimed at understanding a person's experiences with supported employment and other factors that impact quality of life may identify whether or not the consumers' needs are really being met.

Purpose: 

The purpose of this study was to better understand the experience of supported employment and a wide range of other factors that affect quality of life for people with developmental disabilities.

Setting: 

The setting for the study included various employment settings where each participant worked as a member of an enclave.

Sample: 

The study included nine participants. Three women with developmental disabilities, three job coaches and either a family member or group home manager for each. All women were white, and able to make their own decisions including informed consent. The women had previously worked at a sheltered workshop and were currently working in a enclave of 8 to 10 adults that was supervised by a job coach. The most frequent type of work performed by the enclave included cleaning at various places and entry level food services.

Data Collection: 

Open-ended interviews and on site observations were used to collect data. The interviews were guided by a script and recorded. Afterwards they were transcribed. The women were also observed while working as a member of an enclave. On site field observations lasted about 2 hours. The job coaches and family members were also interviewed. The data was analyzed using a constant comparative method. All interview and observational data were reviewed and coded. Some quotes were also selected to serve as exemplars of each woman's quality of life experience.

Intervention: 

The intervention was supported employment services.

Control: 

There was no control or comparison condition.

Findings: 

The three women preferred enclave work over the workshop setting. The participants indicating satisfaction with work assignments and relationships with others in the enclave. Policies and regulations like social security, impacted quality of life.

Conclusions: 

People with developmental disabilities can and do form their own opinions when give the opportunity. Professionals must be in tune with this fact and find ways to help make sure consumer voices are heard.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15315252
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Expanding career options for young women with learning disabilities

Authors: 
Lindstrom, L., Doren, B., & Miesch, J.
Year Published: 
2004
Publication: 
Career Development for Exceptional Individuals
Volume: 
27
Number: 
43
Pages: 
43-63
Publisher: 
Hammill Institute on Disabilities
Background: 

Research indicates poor post school employment outcomes and limited career advancement opportunities for young women with disabilities. Individual and environmental barriers have culminated into limited career choices and post school employment outcomes. There has been very little research on the career decision process or variables that limit or facilitate career choice for this group.

Purpose: 

The study examined barriers restricting career choices and strategies to facilitate or expand career choice for young women with learning disabilities.

Setting: 

The study took place in multiple interview settings.

Sample: 

Participants were six young women with learning disabilities who resided a northwestern state. Three were employed in traditional (female dominated)occupations the other three were not. Earning ranged from $6.50 to $20.00 per hour.

Data Collection: 

Case study methodology was used to analyze variables influencing career choices for young women with learning disabilities. Multiple sources of information were used to confirm, elaborate and verify collected information. This included interviews with all participants and 28 key informants. Additionally, data was collected through on the job observations, field notes, and review of special education and vocational rehabilitation records. A multistep process was used in the first phase of analysis. Descriptive codes were developed based on literature, research questions and initial review of data. Next interview transcripts and field notes were coded following a common scheme. Then coded data and file review information were used to outline the career decision making process for each participant by examining variables that impacted each participant's career choices. In the second phase a explanatory methods were used to explore and confirm findings for each participant. Explanatory matrices were developed that allowed comparison of information on variables across participants. Cross case analysis led to identification and verification of influences on career decision.

Intervention: 

The interventions were career exploration and counseling to improve employment outcomes for young women with learning disabilities.

Control: 

The study did not include control or comparison conditions.

Findings: 

The following variables seemed to influence initial career choices and post school outcomes for participants: gender roles, disability limitations, family and childhood experiences, early work experiences and career exploration and counseling. Gender roles and socialization influenced career choices. Disability limitations restricted career choice. Family and childhood experiences influence career choices. Early work experiences played a role in shaping career options as did career counseling and exploration. Regardless of the participants chosen occupation, the influences on career choices were similar. It was also evident that occupational choices were developed and refined over time.

Conclusions: 

Gender roles and difficulties from disability restricted career choices. Exposure to work through family experiences and employment in high school expanded career aspirations.

URL: 
http://cde.sagepub.com/content/27/1/43.refs
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Vocational reentry following TBI: An enablement model

Authors: 
Kramer, S. E.
Year Published: 
2000
Publication: 
The Journal of Head Trauma Rehabilitation
Volume: 
15
Number: 
4
Pages: 
989-999
Publisher: 
Lippincott Williams & Wilkins, Inc.
Background: 

Environmental factors are at the heart of many performance problems after traumatic brain injury (TBI). This vulnerability negatively affects the ability of the patient to generalize treatment gains made in an artificial clinic environment to more naturalistic settings like home and work. It also impacts the rehabilitation professional's ability to predict the performance of a patient in these and other real world settings. Rehabilitation efforts that make patient environmental interactions part of the treatment plan will increase generalization and predictability. Rehabilitation efforts should include data-based definitions of the environment(s) within which each individual can best function. Also important is a focus on the tasks that he or she can perform within those environment(s). When a discharge goal is to return to work, rehabilitation efforts must include: identifying job settings where enabling environments can be established and providing ongoing support to the individual in the job situation should the environment change. More research is needed on the use and benefits of an environmentally focused treatment model.

Purpose: 

The purpose of this paper was twofold. First it described a treatment program for individuals with brain injury that focuses heavily on patient-environment interactions, both during treatment and after discharge and provide illustrative case examples.

Setting: 

The interventions took place in the clinical setting and the individuals' places of employment.

Sample: 

The study examined the experiences of three individuals with TBI who received varying levels of support to return to work. More specific, they demonstrate how treatment environments were initially configured and then modified during treatment as the patients returned to work. The case studies were selected from an overall sample of 57 individuals with TBI. All three patients had extremely severe neurocognitive dysfunction.

Data Collection: 

No specific data was collected or analyzed. Three case studies illustrated three interventions to help individuals with TBI with returning to work.

Intervention: 

The three interventions were part of an environmentally focused treatment model. Preliminary steps for each involved a) contacting an employer about a patients return to work for those employed at the time of injury or if the person was not employed or does not want to return to work a job developer gets involved to develop work options in an environment where the person is most likely to optimally perform and b) a rehab staff member conducts a job site visit in order to gain an understanding of environmental factors that may impact success on the job.

The first intervention teaches a patient to structure environments. Clinic staff make an initial job site visit and may have some ongoing contact with the employer, but the patient has primary responsibility for structuring the work environment. The second intervention is reserved for a patient who is incapable of assuming primary responsibility for structuring his own environments. Therefore, the rehabilitation staff play a major role in developing an enabling environment. This makes vocational placement easier. The third intervention involves creating a highly structured work environment for a extremely compromised patient, by educating the family throughout the rehabilitation process. The family then supplies the ongoing structure and limits distractions, as necessary, to maximize the person's performance.

Control: 

No comparison condition.

Findings: 

It is clear that the successful vocational re-entry depicted in these cases required close attention to each patient's specific strengths and weaknesses as they related to specific environmental factors, especially the levels and types of structure and distraction that were inherent in the environment. It seems that specialized, individualized treatment that focuses on the patients' strengths and weaknesses and on environmental factors, like the degree of structure and distractions, can enable return to work for individuals with severe TBI.

Conclusions: 

Environmental factors impact the ability of individuals with TBI to return to work. Individualized treatment that focuses on how structure and/or distractions impact work performance can be used to help individuals with TBI return to work.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/10876171
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Psychological treatment of three urban fire fighters with post-traumatic stress disorder using eye movement desensitisation reprocessing (EMDR) therapy

Authors: 
Klonoff, P. S., Talley, M. C., Dawson, L. K., Myles, S. M., Watt, L. M., Gehrels, J. & Henderson, S. W.
Year Published: 
2004
Publication: 
Complementary Therapies in Nursing and Midwifery
Volume: 
10
Number: 
3
Pages: 
186-193
Publisher: 
Elsevier
Background: 

Due to the nature of their work, which can be extremely traumatic, firefighters are at increased risk of developing mental health problems. Providing adequate mental health services can often take time, leaving the individual without supports and remaining disabled and off work.

Purpose: 

The purpose of this paper is to describe the partnership between the South Wales fire service and a NHS department of liaison psychiatry and the rapid psychological treatment provided to traumatized personnel.

Setting: 

The setting was a mental health center, in South Wales, United Kingdom.

Sample: 

This article describes three cases in which all suffered with PTSD and were treated with Eye Movement Desensitization Reprocessing therapy.

Data Collection: 

The study looks at three case studies

Intervention: 

The intervention was Eye Movement Desensitization Reprocessing therapy.

Control: 

There was no control or comparison condition.

Findings: 

All three individuals benefited from a short time in treatment and were able to return to work or work with less trauma.

Conclusions: 

Eye Movement Desensitization Reprocessing therapy appears to be a potentially useful psychological treatment for PTSD.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15279860
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Traumatic brain injury and employment outcomes: Integration of the working alliance model

Authors: 
Kitchiner, N. J.
Year Published: 
2008
Publication: 
Work
Volume: 
31
Number: 
3
Pages: 
309-317
Publisher: 
IOS Press
Background: 

Polytrauma includes a complex constellation of symptoms that may involve an array of interrelated cognitive, physical, and psychological symptoms. According to the United States Veteran Health Administration, polytrauma is an injury to the brain in addition to other body parts or systems resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability. Although problems post traumatic brain injury (TBI) can be challenging many of these individuals remain employable. Rehabilitation specialists assisting persons with TBI with return to work need to understand treatment protocols that could enhance the relationship with the individuals and thereby enhance their employment outcomes.

Purpose: 

This paper provided a brief review of the return to work literature and presented Bordin's working alliance model. A case example was used to illustrate the model.

Setting: 

The setting for the study was an In/Outpatient Rehabilitation Center.

Sample: 

The paper presents one case study.

Data Collection: 

The case study provides a brief overview of the meetings between the client and his rehabilitation counselor.

Intervention: 

The intervention was the Working Alliance Model of Rehabilitation. Some limited research has highlighted the working alliance model‚ benefit in working with participants for whom issues of inclusion, empowerment, and promotion of autonomy have become central to the definition of a healthy counseling relationship. One of the main benefits of the model is its dynamic, collaborative orientation. In essence, the sense of ownership a participant gains given the model‚ central tenet of shared power and decision making within the professional relationship provides a solid rationale for using this model in rehabilitation settings.

Control: 

No comparison condition.

Findings: 

A treatment and rehabilitation program was developed for the individual with TBI using the Work Alliance model. This included: obtaining a neuropsychological evaluation, transitioning level of care to a day treatment program, continuing to work with his rehabilitation counselor using the Work Alliance model to construct realistic return to work plan and refer him to case manager to monitor his behavioral and psychological needs.

Conclusions: 

The model may be able to strengthen the relationship between a person with TBI and a rehabilitation specialist.

URL: 
http://content.iospress.com/articles/work/wor00785
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes