Vocational Rehabilitation in Spinal Cord Injury: What Vocational Service Activities Are Associated with Employment Program Outcome?

Top Spinal Cord Inj Rehabil, 2015 · DOI: 10.1310/sci2101-31 · Published: January 1, 2015

Spinal Cord Injury Occupational Health Rehabilitation

Simple Explanation

This study investigates which specific vocational rehabilitation (VR) services are most effective in helping veterans with spinal cord injury (SCI) return to work. The research focuses on a model called evidence-based supported employment (EBSE), which integrates vocational services into clinical care. The findings suggest that actively engaging veterans in job seeking and providing on-the-job support are more effective than general job preparation counseling.

Study Duration

12 months

Participants

81 Veteran participants with SCI

Evidence Level

Randomized, controlled trial, secondary analysis

Key Findings

1
Participants obtaining competitive employment received a greater variety of vocational services per week.
2
Job development, job placement, and employment follow-up were more likely to occur for those who obtained competitive employment.
3
Vocational counseling was less likely to occur for participants who obtained competitive employment.

Research Summary

This study examines the relationship between specific vocational activities and employment outcomes for Veterans with SCI undergoing evidence-based supported employment (EBSE). The study found that while the amount of time spent on vocational services was similar, those who obtained competitive employment received a greater variety of services per week, particularly community-based activities. The authors conclude that action-oriented, community-based services like job development, job placement, and on-the-job support are more effective than traditional, office-based vocational counseling for Veterans with SCI.

Practical Implications

Program Design

Vocational programs for individuals with SCI should prioritize action-oriented, community-based services like job development and on-the-job support.

Service Delivery

Integrate vocational services with ongoing medical rehabilitation care, ensuring close collaboration between vocational providers and the clinical team.

Policy Shift

Move away from prevocational activities and focus on rapid job finding and community-based support for individuals with significant disabilities like SCI.

Study Limitations

1
Data on vocational services were extracted from clinical progress notes, and there is no interrater reliability available for the tool.
2
The sample size may limit the ability to detect significant clinical and demographic predictors of competitive employment.
3
The analysis was restricted to the EBSE group, potentially limiting the generalizability of the findings.

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