Towards a more integrated approach to job placement and retention for persons with traumatic brain injury and premorbid disadvantages.

Persons with traumatic brain injury (TBI) and premorbid socioeconomic disadvantages are more likely to be unemployed before and after injury. They have less access to private pay community re-entry (CR) programmes that could help them with post-TBI life adjustment, including work. They often enter publicly funded vocational rehabilitation (VR) programmes with unresolved adjustment issues that directly affect their capacity to work. Disadvantaged persons who enter VR programming without prior benefit of CR programming may still be able to work if the following methods are combined within the framework of interdependence: VR advocacy services for getting a job and related supports; CR treatment services for accepting and keeping a job. Current post-acute rehabilitation programmes that address work outcomes after TBI can be characterized as either VR programmes or CR programmes. Doing so may increase understanding of how all persons with TBI are helped to find and keep jobs.