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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.
People living with disabilities comprise the largest minority in the United States and the world. It is common knowledge that most people with disabilities are unemployed. There are governmental agencies (i.e., Rehabilitation Service Administration) that aim to help people with disabilities become autonomous and productive members of society. Services are offered through federal and state agencies (i.e., Veterans Affairs Offices, State Rehabilitation Services) which aim to empower people with disabilities through varying means including providing vocational rehabilitation counseling, helping to pay for education, or providing needed accommodations in life (i.e., school, work, home). This study examined relationships among optimism, self-efficacy, the type of disability clients possess, and clients’ satisfaction with services. No significant relationship was found between participant self-efficacy and their satisfaction with the vocational rehabilitation services they had received. However, results demonstrated that participants with higher optimism scores were more satisfied with vocational rehabilitation services, and that participants with congenital disabilities were more satisfied with rehabilitation services than were participants who acquired disabilities later in life. These findings suggest that perhaps the level of satisfaction expressed by individuals receiving vocational rehabilitation services may be influenced by whether they are optimistic or pessimistic and by whether they were born with their disability or acquired their disability later in life. In addition, the results found that participants with congenital disabilities had higher optimism scores than did participants with acquired disabilities. No relationship was found between type of disability (congenital or acquired) and self-efficacy scores of participants. Limitations, implications of findings, and suggestions for future research are discussed.