Outcomes of Community Practice using the Community Approach to Participation (CAP)
The aim of this paper is to examine the outcomes of community-based intervention applying the principles of the Community Approach to Participation (CAP), outlined in the previous paper. Ten participants were selected from two private practices specialising in the community-based management of people with severe brain injuries. All participants were more than five years post injury, had long term and complex cognitive-behavioural impairments and had received intervention in their community over a period of three or more years. Each participant had unique goals and challenges so that, although therapeutic input was based on the principles of the CAP, the specific interventions provided were diverse. The outcome measures utilised in this study included the Community Integration Questionnaire, the Life Roles Checklist, and changes in the amount of weekly paid attendant care and unpaid support. In addition to these broad measures of participation, this study also used individualised clinical measures, tailored to the specific goals of each participant. The results of this study found that the overall measures of participation showed some positive change during / following the period of intervention. However, they did not capture the significant changes that had taken place in the areas of life that were the specific targets of intervention. These improvements were reflected in the individualised clinical measures. This study demonstrates the inherent challenges in selecting appropriate measures at the outset of community-based intervention as outcomes are highly specific to each individual’s needs and goals and are influenced by personal and environmental factors.
The results of this study also provide preliminary evidence that the CAP effects positive change in both overall levels of participation and function in the specific areas of daily life that are targeted by intervention.