The relationships among social support, autonomy, and vocational outcome following a traumatic brain injury

Robert Alan Katz, Fordham University


This study was designed to determine whether indicators of social support and autonomy were associated with a positive long-term vocational outcome following participation in a neuropsychological rehabilitation program. The sample consisted of 58 moderate to severe TBI survivors who were interviewed by telephone an estimated mean of 9 years and 3 months following completion of the NYU Head Trauma Program. The two dependent criterion measures were the Employability Rating Scale (ERS) and the employment stability ratio (ESR). The independent predictor variables were participant age, biological gender, preinjury level of education, length of coma, an autonomy composite measure, a social support composite measure, and the number of compensatory strategies which the participants spontaneously reported using. The predictor variables did not account for a significant amount of the variance in the dependent criterion variable ERS. An index of spontaneously reported compensatory strategy usage was the only significant predictor of ESR. Survivors who reported greater usage of compensatory strategies were also more independent with regard to transportation, performed more active leisure activities, were more likely to formulate their own compensatory strategies, and had been discharged from the program more recently. Survivors who had less family involvement were more independent with regard to home responsibilities. Descriptive data indicated several trends. The low employment rates, the small percentage of the working survivors engaged in competitive work, the low salaries the working survivors were receiving, all suggested a negative relationship between length of time since vocational rehabilitation program discharge and work status. The survivors who were able to maintain successful employment worked fewer hours per week. The participants reported significant alcohol usage. The findings of this study suggest a need for the following additions to the neuropsychological rehabilitation model: (a) periodic postprogram follow-up sessions to reinforce the usage of compensatory mechanisms, (b) family therapy sessions to help families determine when it may be beneficial to push survivors toward more independent functioning, (c) an increased emphasis on substance abuse counseling, and (d) encouragement of part-time as opposed to full-time work.

Subject Area


Recommended Citation

Katz, Robert Alan, "The relationships among social support, autonomy, and vocational outcome following a traumatic brain injury" (2000). ETD Collection for Fordham University. AAI9975352.