Bridging rehabilitation and community living: A contextual model

This paper will describe a project that bridged rehabilitation services and client adjustment to community living for a group of individuals who sustained spinal cord injuries and were followed 6 months after discharge from rehabilitation program. The model was adapted from earlier work with community living older adults. The study used objective measurements and interviews within a randomized clinical trial to focus on the impact of an experimental intervention which used a goal oriented, client – centered model to influence client adjustment to a spinal cord injury including goals, interests, roles and habits and environmental context. This paper is focused on the data obtained through interviews. Twelve clients aged 17-50, received 8 in-house visits over a 6-8 month period of time using a model that was designed as a strategy to bridge rehabilitation services with community-living skill development, providing opportunities for clients to focus on goal development and options for new roles, behaviors and perceptions. Many rehabilitation protocols focus on evaluating changes that occur as the result of short, intense training periods but this study was scheduled over an extended period of time. In addition, 4 subjects participated in additional follow up interviews. The findings indicated modest but important life changes and increased quality of life measurement. This preliminary study indicates that extended time that affords reflection and personal development may influence compliance in home programs and accommodation to chronic disabilities.