Objective: To illustrate the importance of environmental factors for optimi
zing return to work following traumatic brain injury (TBI) using illustrati
ve case examples. Design and Participants: Three case studies are presented
that were selected from an overall sample of 57 TBI survivors. Setting: Po
stacute, outpatient TBI rehabilitation program. Main Outcome Measures: Outc
ome was essentially descriptive and focused on factors associated with succ
essful return to work. Results and Conclusions: These case examples point o
ut the necessity of specialized treatment that not only focuses on the spec
ific strengths and weakness of the individual, but also on extant environme
ntal factors, including degree of structure or distractions that either rei
nforce or preclude optimal performance.