Members of the armed forces who were injured during service or are suffering from post-traumatic stress disorder often struggle with returning to civilian life and employment. Many have significant needs for quality vocational rehabilitation programs. The problem of low employment rates for injured service members has only become more urgent with the wave of veterans with disabilities returning from Iraq and Afghanistan — the largest in a generation.
Unfortunately, there is limited evidence about what interventions are effective in helping veterans successfully reenter the workforce and their communities. Veterans with disabilities often have low self-esteem and motivation, significant depression, and a belief that their disability precludes them from gainful employment. Researchers at the U.S. Department of Veterans Affairs (VA) have suggested that these attitudinal barriers to employment and beliefs about disability may have as big an effect on disabled veterans’ ability to return to work as do their actual physical or mental conditions.
With the passage of the Americans with Disabilities Act of 1990, the Ticket to Work and Work Incentives Improvement Act, and improvements in medical and psychological care, people with disabilities are more able than ever to fully engage in the workplace and achieve independence and community integration. However, unless the psychological factors underlying work disabilities are addressed, return-to-work efforts for people with disabilities are unlikely to be fully successful. The VA has expressed interest in testing new and innovative programs that might resolve the underlying psychosocial factors which contribute to work disability, with the goal of improving employment and community integration for veterans.
The Progressive Goal Attainment Program (PGAP) is the first disability program that is specifically designed to target the psychosocial risk factors of disability. A 10-module program designed to incrementally increase participants’ activity levels and change daily routines to be consistent with holding employment (for example, waking up at a regular time), PGAP also tries to reduce participants’ perceptions of disability and to help them better manage pain and discomfort. Current research evidence, including from MDRC’s Accelerated Benefits Demonstration, suggests that PGAP could be an important service for veterans with disabilities.