Abstract-This article compares the methods of a randomized multisite clinical trial of evidence-based supported employment with conventional vocational rehabilitation among veterans with spinal cord injury (SCI). The primary hypothesis is that, compared with conventional vocational rehabilitation (i.e., standard care), evidence-based supported employment will significantly improve competitive employment outcomes and general rehabilitation outcomes. The secondary hypothesis is that evidencebased supported employment in SCI will be more cost-effective than standard care. The current article describes the clinical trial and presents baseline data. The present sample includes 301 veterans with SCI, which includes paraplegia (50%), high tetraplegia (32%), and low tetraplegia (18%). Baseline data indicate that 65% of this sample of employment-seeking veterans with SCI had never been employed postinjury, despite the fact that nearly half (41%) had received some type of prior vocational rehabilitation. These rates of unemployment for veterans with SCI are consistent with the rates reported for community samples of persons with SCI. Forthcoming outcome data will provide much needed insights into the best practices for helping these veterans restore vocational goals and improve overall quality of life. Clinical

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The purpose of the present study was to investigate predictors of competitive employment after a spinal cord injury (SCI) among veterans. This study retrospectively examined return to work after SCI, types of jobs held, and variables that were associated with return to work. The present sample included 238 veterans receiving healthcare at one of several Veteran Affairs Medical Centers. Data were obtained through subject interviews and chart extraction. Subjects were also administered the Veterans RAND 36-Item Health Survey (VR-36), Quick Inventory for Depressive Symptomatology -Self Report (QIDS-SR), and Craig Handicap Assessment Reporting Technique (CHART). Results revealed that 34.5% of our study sample was employed at some point after SCI. Employed subjects had significantly higher scores on two of the CHART subscales (Mobility and Occupation) than unemployed subjects, but there were no significant differences among subjects on the QIDS or the VR-36. Receipt of social security benefits was a significant disincentive for employment, but receipt of Veterans disability benefits was not. Education, gender, ethnicity, level and severity of injury were not significant predictors of employment status after SCI, after controlling for demographic variables. Clinical implications of these findings may be that vocational rehabilitation interventions that focus on rapid re-entry to the workforce using existing skill sets may maximize post-SCI employment.