Welcome You have joined the TBI TeleConference

1
Welcome! You have joined the TBI Tele-Conference
Online Evaluation (right click to open the
hyperlink)
2
What is a TBI?

• A traumatic brain injury (TBI) is defined as a
  blow or jolt to the head or a penetrating head
  injury that disrupts the function of the brain.
• TBI is a life long process,
• not an event

3
Post TBI Work

• Most TBI Job Seekers will try to return to their
  previous employment if the injury allows. This is
  often followed by failure, discouragement, and
  fear of returning to work. Motivation to RTW is
  high because of a desire to return to life as it
  was before injury.
• A lump in the oatmeal and a bump on the head are
  not the same. Life does not just go on.

4
Needs Created by The Silent Epidemic

• CDC estimates that at least 5.3 million Americans
  currently have a lifelong need for HELP
• 40 of TBI survivors have at least one unmet need
  for SERVICES
• Average time between injury and seeking DVR
  SERVICES is 9 years
• FUNDING and supplemental financial help
• ACCEPTANCE of self as a different person
• UNDERSTANDING of roads to success

5
What are Employment Services?

• Employment services are wages paid by the
  employer at minimum wage or higher with
  co-workers that represent the community at large
  (integrated).
• Consumer-driven employment emphasizes the role of
  the TBI Job Seeker in all phases of the
  employment process (assessment, plan development,
  job placement, training, on going support and
  periodic assessment). It is clear
  thatemployment contributes to independent living
  goals.
• Westbrook and Lumbley

6
Connecting TBI Employment

• Under a 1997 grant from NIDRR, employment
  programs were established for people whose
  employability had been reduced by TBI. This
  grant found that
• 50 of placements were with TBI survivors
  previously thought too severely injured to work,
  and that employers had to make minimal to no
  accommodations.

7
TBI - The Hidden Disability

• 95.9 of people with TBI say their number 1 unmet
  need is finding work. Corrigan et. Al., 2004
• Our job is to help TBI Job Seekers find the right
  job and keep it!

8
Negative Effects of Unemployment in General
Population

• Increased substance abuse
• Increased physical problems
• Increased psychiatric disorders
• Reduced self-esteem
• Loss of social contacts
• Alienation and apathy
• (Warr, 1987)

9
Why be employed if you have a TBI?

• To increase the quality of life for the TBI job
  seeker through paid employment
• To help the TBI job seeker find fulfillment
  through social interactions
• Off-set financial lack - Social Security
• Self confidence and cultural acceptance

10
Functional Limitations of TBI

• Memory
• Attention Span
• Stamina
• Confusion
• Concentration
• Learning
• Perception

11
More Functional Limitations

• Agitation/restlessness
• Executive Functioning issues (planning,
  organizing)
• Impulsiveness
• Coordination/balance issues
• Fatigue
• Filtering external stimuli

12
Preparation for Return to Work (RTW)

• Believe set a tone of expectation
• Individualize empower the TBI Job Seeker
• Discovery Process
• Phase 1
• Hunt for hidden and new skills
• Review records available
• Conditions, Preferences, Contributions
• Hypothesis

13
Discovery Objective
Connect with the job seeker find out what the
job seekers knowledge, skills and abilities were
pre-injury and what they are now review
assessments and records talk to those in the
know. Look to the past, assess the present, begin
to ask questions about the future.
14
Why Detailed Discovery?

15
What we believe is more important than the
truth S.R. Wood

• We are most successful if we
• strongly believe in our
• TBI Job Seekers
• employability success!

16
Work with Each TBI Job Seeker Individually

• Its not only the kind of injury that matters,
  but also the kind of head.
• Sir Charles Symonds

• Dont try to fix the survivor, change the way you
  and the survivor approaches the job search. 1st
  think of the survivor as an employable
  individual!

17
Assessments

• Phase 2 - Broad to Defined
• Use questions and start looking at answers and
  forming more questions
• Neuropsychological
• Intuition Creativity - Innovation
• Logs
• Build Confidence
• Self Discovery (Impress or Annoy?)
• Growth Increase Successes

18
Organize the Job Hunt

• Create a plan models
• -Place and Train
• -Choose, Get, Keep
• -WIT
• Put action to the plan
• -Get information from past to combine with
  present to give a future
• -Placement hypothesis
• -What will be done at each step? Who?

19
How to Develop Similar Jobs for TBI?

• Explore tasks that have worked in the past that
  may lead to current job possibilities
• Brain storm job leads that are not one of the 5
  Fs (Filth, Folding, Flowers, Fast Food Filing)
• Use creativity, innovation and intuition

20
Test Hypothesis

• Situational Assessments
• Job Shadow
• Trial Work
• Volunteering
• Do these match hypothesis or change the job
  search direction?

21
Assessing a Person with TBI

• Awareness of injury in a functional sense
• Functional and verifiable knowledge of strengths
• Functional and verifiable knowledge of areas
  where supports may be needed (weaknesses)
• Risk taking to develop new skills or verify
  existing skills
• Planned exploration in the community setting to
  assist in learning process

22
Identifying Vocational Goals Expectations

• Concentrate on individuals interests and
  preferences
• What kind of work is the individual interested in
  doing?
• What type of work at home or in the community has
  the individual done pre-injury? Post-injury?
• What are the familys work expectations?
• What are the individuals existing skills and
  support needs?
• What support does the individual use now?
• What is the individuals ability to learn new
  skills?
• What teaching strategies seem to work best?

23
Community Based Assessments

• Actual community work settings (e.g. internships,
  volunteer work, job shadowing, trial work)
• Identifies interests in job duties
• Analyzes work environment/culture
• Identifies skills
• Determines individuals responses to training
• Identifies support needs
• Helps determine a feasible vocational direction,
  explore career options, and to provide
  opportunities to enhance self-determination
  skills

24
Cognitive Supports

• Determine learning style written, verbal,
  demonstration, combination.
• Allow individual to set up own work station
• Reduce distractions in work area
• Allow for white noise sound machines or music
• Divide large assignments into smaller tasks
• Make daily to do lists
• Use calendar or electronic organizer
• Schedule weekly meetings with supervisor
• Use watch or pager with time capability
• Tape record meetings
• Allow additional training time
• Provide written checklists
• Provide environmental cues to assist memory for
  location of items (labels, color coding, bulletin
  boards)
• Post instructions

25
Summary of Supports

• Use lists to compensate for memory (pocket
  notebook or appointment book or listings where
  particular tasks or behavior should occur)
• Use individual auditory or visual cues (tape
  recorded messages or instructions, different
  colored containers or files).
• Accommodate endurance levels and stress tolerance
  by sequencing tasks
• Use physical adaptations (trays, jigs, electric
  staplers, rubber band holders, laminated work
  materials)

26
Summary of Supports (cont.)

• Summary of Supports
• Schedule reminders (voice mail message, pager,
  alarm clock)
• Stop watch for time management
• Scheduled rest breaks to prevent stimulus
  overload
• Supportive phone calls before and after work
• Role playing job situations
• Mentoring by a co-worker
• More frequent evaluation by supervisor

27
Pass GoCollect 200
Placement
28
Works Impact on Confidence

• There is marked correlation between
  recovery/return to work (RTW) and low confidence
  caused by lack of acceptance of changes caused by
  TBI. Often TBI Job Seekers feel they are a
  different person who isnt welcomed or liked.
  Acceptance of and coping with the new self may
  take months, years, or never entirely occur.
• This step in rehabilitation is often the
• most fundamental.

29
TBI Employment Self Esteem

• Employment enhances a persons self esteem and
  contributes to quality of life.
• Relationship
• Productivity
• Socialization
• Employment can help in counteracting the
• TBI Job Seekers Crisis of Identity

30
SelfEsteem Compensations

• Get a job that has the high probability of
  success!
• Model positive attitude behavior
• Coach Job Seeker on how to interact socially with
  ice breakers, etc. and practice these skills for
  likeability
• What has worked? Review log
• Self-esteempay rate job prestige

31
Baggage from TBI

• TBI Job Seeker may come
• with low self esteem
• Assessed and heard diagnosis
• Heard they are marginal or less than pre-injury
  in many areas
• Little validation in medical system
• Feelings of fear, low energy, overloaded
  synapses, and hopelessness

32
You Can Do It!

• You as the Employment Consultant can most help
  the TBI Job Seeker by
• Giving them the empowerment to choose, inclusion
  in all choices, cultivate commitment and charm,
  then place them in a job.
• ENCOURAGE CHEER THEM ON!

33
Dont Give Up

• Trying but failing is okay
• failing to try is not.
• All jobs and employees experience
• shortfalls and setbacks it is all part of
  quality employment!

34
Start Stop - Continue

• This information has a short shelf life
• What will you start doing?
• What will you stop doing?
• What will you continue doing?

35
Resources

• TBI Net, Wayne A. Gordon, The Mount Sinai
  Medical Center, Vocational Rehabilitation, TBI
  The Power of Networking, March 2002.
• National Certificate in Employment Services
• Laura Owens, Ph. D., University of
  Wisconsin-Milwaukee

36
DONT FORGET
37
More upcoming CTAT audio trainings

• June 26, 2008- Getting Ready to Write The
  Beginning of a Successful Grant
• July 10, 2008- A Little Magic for your Meetings
• August 7, 2008- Coaching Skills for Supervisors
• Sept. 11, 2008- Planning and Accountability Made
  Easy
• www.ctat-training.com

38
Make Each Day Your Masterpiece
For attending a CTAT training! Joe
Lewis jlewis_at_denveroptions.org Please fill out
our online evaluation form at http//www.ed.uiuc.e
du/illinoisrcep/activities/eval_conf.htm