Social Supports and Behavior 1 The Clubhouse: Addressing Work-Related Behavioral Challenges Through a Supportive Social Community

Employment remains an often cited but elusive goal for the majority of people who experience severe disability following brain injury. Two decades of outcome studies consistently report that only 20 % to 30 % of all people with severe disability following brain injury subsequently enter and sustain employment 1-5. Yet, despite such poor odds it should come as no surprise that employment remains an important goal. First, wages remain a primary means of covering the costs of living in the community. Second, compensated employment is the predominant daily activity pattern for most adults in our society. Third, work offers important opportunities for socialization, access to recreation and other avocational venues that may not otherwise be available. Research has also documented that the incidence of physical and mental illness, asocial behavior, marital problems and other distressful life events increases following job loss, even among "non-disabled " populations, but are typically rectified through the reversal of vocational mis-fortun