Perceived best practices with persons with mild closed head injury in the vocational rehabilitation process

Achieving meaningful employment outcomes for persons with brain injuries has historically been a challenge of the state-federal vocational rehabilitation (VR) system. Deficits related to cognition, memory, and behavior control, combined with related physical disability, often present challenges to VR counselors in terms of achieving successful employment outcomes. Of all brain injury cases, it has been estimated that up to 88 percent can be classified as mild brain injury (MBI), the majority of which represent mild closed head injuries (MCHI). With the high prevalence of MCHI, it becomes of paramount importance to identify rehabilitation service best practices for this population. However, while best practices with persons with moderate to severe brain injury have been addressed in previous research, there has been a paucity of research investigating specific rehabilitation services, best practices with those with MCHI resulting in a general lack of knowledge regarding practices perceived to contribute most to successful outcomes for persons in this population. The purpose of this study was to identify specific counselor practices that were perceived by VR counselors to be “best practices” in the vocational rehabilitation process for persons with MCHI. Three-hundred twenty-four VR counselors in the Region V states of Indiana, Michigan, Minnesota, Ohio, and Wisconsin who had consumers with a diagnosis of traumatic brain injury on their caseload responded to a mail survey in which their opinion was sought as to which practices were most important for achieving a successful outcome with those with MCHI. In general, results supported evidence in recent research that practices traditionally associated with working with persons with moderate to severe brain injury, were perceived by VR counselors to also be important for achieving a successful VR outcome when working with persons with MCHI. Implications for practice, preservice/continuing education, and future research are presented.