Building research capacity through partnerships: Spinal Cord Injury--Vocational Integration Program Implementations and Outcomes inaugural meeting

Abstract

INTRODUCTION Innovative integration of vocational rehabilitation (VR) services into the healthcare continuum for veterans with spinal cord injury (SCI) was the focus of the inaugural meeting of the Spinal Cord Injury--Vocational Integration Program (SCI-VIP): Implementations and Outcomes project, held in Dallas, Texas, November 29 through December 1, 2005. The project is funded through the Department of Veterans Affairs (VA) Office of Research and Development, Rehabilitation Research and Development (RRD Charles McGeough, MS, National Marketing Director for VA Psychosocial Rehabilitation and SCI-VIP Coinvestigator; and Lance L. Goetz, MD, SCI-VIP Coprincipal Investigator. As the original concepts behind the SCI-VIP evolved, the project also benefited from the guidance of Anthony Campinell, PhD, VA Central Office, Director for Therapeutic and Supported Employment Services, and the advisement of well-informed VR clinicians in the field from VA's Compensated Work Therapy (CWT) Programs. RR&D Service considered this new program a timely and fast-developing approach to the lack of effective VR in SCI rehabilitation as we face new challenges in providing services to newly injured, often young, veterans. Recognizing the importance of finding solutions rapidly, RR&D Service supported the simultaneous development and evaluation of the program through a multisite study. The study documents the implementation of the program and provides a vehicle to efficiently inform clinicians, researchers, and administrators of the best methods for providing these necessary rehabilitation services. Thus, the study embodies a true marriage of research and development by evaluating outcomes of an intervention while it is still in development. CONVENTIONAL VOCATIONAL SERVICES Traditionally, veterans with SCI who are interested in returning to work are referred outside the VHA SCI centers to VR providers who may not have expertise in SCI. This involves referrals to state VR providers, and services vary widely depending on funding support and caseload volume. Outside referrals often do not achieve desired outcomes because (1) they involve general VR services that are not specifically suited to persons with SCI, (2) their systems are difficult for a person with SCI to access, and (3) they lack supported employment services for patients with SCI after they return to work. SPINAL CORD INJURY--VOCATIONAL INTEGRATION PROGRAM The SCI-VIP is a new method of service delivery that integrates VR services into the SCI continuum of healthcare by including a specially trained VR counselor (VRC). The VRC works within two disciplines, SCI and CWT, to provide highly individualized vocational services in a coordinated fashion within the context of the SCI healthcare team. While using a similar approach to VA's CWT Program's evidence-based supported employment (SE) model, the SCIVIP offers VR services by merging the expertise and resources of two distinct treatments teams, a novel approach to VR within the healthcare system. The CWT Program has proven over the years to be a successful approach to employment for veterans with severe mental disabilities, homelessness, and substance abuse by employing best practices, including rapid job-seeking, assertive engagement, ongoing assessment, and regular follow-along supports. …