Work: A Better Approach to Finding Jobs after Brain Injury by Dawn Westfall, CCC-SLP

Work or a job: How to look for it after a brain injury!

Dawn Westfall

Dawn Westfall

When finding the perfect job for a person who has sustained a traumatic brain injury, most speech therapists and vocational rehab counselors look at the person’s weaknesses so she can find a job that does not require these skills. This has been a common approach in vocational re-entry for years. Although it is important not to set up anyone with a TBI for failure, basing a job search on avoiding weaknesses is often a very limiting approach. I propose a better one: Look at people’s strengths and interests, and build the job from there.

Let’s face it—we spend a lot of time at work. We also know we are better at jobs we love, and we love jobs we are good at doing. So step one is to find out the person loves. This can be accomplished by doing a comprehensive interest inventory. Next, we need to find out what she can do well and ask what strengths she has. We do this by looking at her skill sets.

Now comes the fun part, which is finding jobs that your client finds interesting and which require skills she possesses and performs well. If she was employed prior to the injury, this must be taken into consideration. Generally, it is preferable to keep people with their previous employer, since they have already established rapport and relationships with the boss and co-workers. They also have a long-term working memory of the policies and procedures.

The general rules are to return people to:

1. the previous job with the previous employer.

2. a different job with the previous employer.

3. a previous job with a different employer.

4. a different job with a different employer.

Remember, however, that these are only general rules and may change due to varying circumstances.

Once you have helped your client find a job after a brain injury that interests her and requires using her strengths, then you can begin to look at her weaknesses and how these might impact her success with employment. You should develop a list of potential problems, including physical, cognitive, emotional, and social weaknesses. Next in line is to develop a plan that works around these potential problem areas. Your client may need strategies, equipment, therapy, training, and other accommodations to help get around these issues. If there are parts of the job she is unable to perform due to these weaknesses, and they cannot be overcome, then job carving is an option. Job carving is simply identifying the aspect of the job she cannot perform and “trading” it for a part of someone else’s job she can perform well.

A Real-Life Example

I once worked with a woman who had been a receptionist for a small office prior to a significant injury to her brain. We worked diligently at getting her skills back so she could return to her previous job with her previous employer. She was not very responsive to treatment, and the chances of being able to return to that job were looking dismal. Then one day I brought in some silk flowers to put in a vase in my office. She came in and said, “May I arrange those flowers for you?”

Immediately, it struck me that this was the first time I had seen her initiate anything since starting the program. She also showed more affect than ever before. She arranged the flowers, and they looked amazing. But more importantly, she was smiling and looked quite proud of her accomplishment.

We began talking about her hobbies. I found that she loved many crafts and was skilled at them. I also found out she hated her receptionist job prior to the injury and never felt she was good at it, but she did not know what else to do for employment. We changed our approach and began looking at careers that matched her interests and skills. Then we came up with a plan to get around the potential problems.

In the end, she got a job working at a craft store and teaching classes. I am pleased to say that she went on to own a craft store and eventually had a craft show on a local television station in her home town.

This interaction taught me a lot about job placement, especially two very important facts when exploring finding a job after brain injury:

1. Focus on the person’s strengths and work around the weaknesses.

2. It is more than acceptable for people to do better after an injury than they did prior, so don’t hold them back!

About the Author

Dawn Westfall received her Master’s Degree in Speech-Language Pathology from Eastern Illinois University. She works at HealthSouth Deaconess Rehabilitation Hospital in Evansville, Indiana, where she has specialized in treating adults with traumatic brain injuries for the past 22 years. For 12 years she assisted with developing and managing a community rehabilitation program that assisted individuals with a traumatic brain injury in getting back to work, school, and living independently.


Special Collection on Brain Injury Journey

Special Collection on Brain Injury Journey

 This article is posted with permission from Brain Injury Journey – Hope, Help, Healing, Vol 1, 2014.



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