Transitional Living Programs (TLPs) have been a standard component of traumatic brain injury (TBI) rehabilitation services for over two decades. The twofold aim of this study was to describe a TLP service model, and to examine the efficacy of standardised TBI-specific outcome scales for TLPs. A consecutive series of 50 residents admitted to the TLP over an 18-month period were administered a number of outcome measures at both admission and discharge. Mean duration of PTA for the sample was 60 days and average length of stay was 7 weeks. Measures included the Sydney Psychosocial Reintegration Scale (SPRS), the Mayo-Portland Adaptability Inventory (MPAI), the Brain Injury Community Rehabilitation Outcome (BICRO) scales and the Assessment of Living Skills and Resources Scale (ALSAR). Results showed significant improvements in the global scores for the SPRS, MPAI and ALSAR from admission to discharge. In contrast, a number of the BICRO scales exhibited floor or ceiling effects. Correlational analysis found moderate to strong associations between the SPRS, MPAI and ALSAR across a number of functional domains. Results to date show promise in identifying measures that are able to detect change over the course of a TLP admission. The findings lay the foundation for ongoing research into the effectiveness of such programs.

The aim of this study was to examine the clinical practice of a community team that is one component of the statewide, government-funded, specialist Brain Injury Rehabilitation Program for New South Wales, Australia. The 467 clients served by the community team of the Brain Injury Rehabilitation Service at Liverpool Hospital, Sydney during the calendar year 2000 were identified and their use of clinical services described. A random sample of 50 clients from this group was studied in further detail, with specific reference to the type of therapy interventions they received. This was compared with the therapy interventions received 2 years later, in 2002. A total of 8046 occasions of service (OoS) were recorded for the 467 clients during 2000, with a median number of 8 OoS per client. All disciplines contributed to this number, with case managers providing the largest number of OoS (n = 2734). Between 65–75% of clients attended medical clinics and received services from case managers, with between 15–30% of clients receiving services from allied health disciplines. The random sample received a median of 9 OoS during 2000, and a median of 3 therapy interventions per client. Therapy interventions pertaining to living skills were addressed in 66% of the group, interpersonal relationships in 54%, and occupational activity in 44%. Although the community team continued to provide a comparable number of OoS in 2000 and 2002, 56% of the random sample had been discharged by 2002. There were significant group differences between those who were discharged and those who remained in the service. Additionally, for those who remained in the service, there was a significant reduction of OoS and therapy interventions between 2000 and 2002. The data were used to draw together a model of clinical practice of the community team.