Locus of control, awareness of deficit, and employment outcomes following vocational rehabilitation in individuals with a traumatic brain injury




Stroup, Elizabeth Suzanne

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Employment outcomes in persons with traumatic brain injury (TBI) are far from ideal and have serious implications for quality of life and financial well-being post-injury. Numerous potential correlates of return to work, including locus of control and awareness of deficit, have been examined in past studies with mixed findings. The current study investigated these issues in a relatively ignored segment of the TBI population—those who receive services through state-funded vocational rehabilitation programs. Thirty State of Alaska Division of Vocational Rehabilitation (DVR) clients with TBI completed comprehensive interviews, the Patient Competency Rating Scale (PCRS), the Internal Control Index (ICI), and several neuropsychological test measures. Overall time spent working decreased from 75% pre-injury to 39% post-injury. Participants with poor vocational outcomes underestimated their level of impairment on the PCRS relative to informant ratings, and generally fared worse post-injury than participants with more accurate awareness of their limitations. Locus of control and cognitive function measures did not predict vocational outcome. Given the need for DVR clients to be aware of their deficits in order to set realistic goals, vocational counselors should address awareness of deficit early in the rehabilitation process to optimize employment outcomes and allocation of resources.



Brain, Wounds and injuries