Original research| Volume 99, ISSUE 2, SUPPLEMENT , S14-S22, February 2018

Supported Employment for Veterans With Traumatic Brain Injury: Provider Perspectives

  • Terri K. Pogoda
    Corresponding author Terri K. Pogoda, PhD, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Building 9, Office 218, 150 S Huntington Ave (152M), Boston, MA 02130.
    Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA

    Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA
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  • Kathleen F. Carlson
    Center to Improve Veteran Involvement in Care and National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR

    Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
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  • Katelyn E. Gormley
    Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA
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  • Sandra G. Resnick
    New England Mental Illness, Research and Clinical Center, VA Connecticut Healthcare System, West Haven, CT

    Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Published:August 04, 2017DOI:



      To identify any pilot and nonpilot site differences regarding current (1) provision of supported employment (SE) to veterans with traumatic brain injury (TBI); (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE.


      Mixed methods cross-sectional survey study.


      Veterans Health Administration SE programs.


      Respondents (N=144) included 54 SE supervisors and 90 vocational rehabilitation specialists.


      Not applicable.

      Main Outcome Measures

      Web-based surveys of forced-choice and open-ended items included questions on SE team characteristics, communication with polytrauma/TBI teams, and experiences with providing SE to veterans with TBI history.


      SE was provided to veterans with TBI at 100% of pilot and 59.2% of nonpilot sites (P=.09). However, vocational rehabilitation specialists at pilot sites reported that communication with the polytrauma/TBI team about SE referrals was more frequent than at nonpilot sites (P=.003). In open-ended items, suggestions for improving SE were similar across pilot and nonpilot sites, and included increasing staffing for vocational rehabilitation specialists and case management, enhancing communication and education between SE and polytrauma/TBI teams, and expanding the scope of the SE program so that eligibility is based on employment support need, rather than diagnosis.


      These findings may contribute to an evidence base that informs SE research and clinical directions on service provision, resource allocation, team integration efforts, and outreach to veterans with TBI who have employment support needs.


      List of abbreviations:

      CWT (Compensated Work Therapy), IPS (individual placement and support), SE (supported employment), SMI (severe mental illness), TBI (traumatic brain injury), VA (Department of Veterans Affairs), VHA (Veterans Health Administration)
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