A programme of intervention for substance abuse following traumatic brain injury.

This article describes a pilot programme initiated in 1991 to address the problems of substance abuse among persons who have experienced traumatic brain injury (TBI). The model of treatment is community-based, using an interdisciplinary staff with expertise in TBI, vocational rehabilitation, and substance abuse treatment, to support and enhance existing services in the client's own community. The primary method of intervention is resource and service coordination. Six principles that serve as the underpinnings of the model are described, as are core and supplemental services and staffing patterns. Innovative components of the programme include the theoretical model of changing addictive behaviours used to guide treatment, and the development of community teams to facilitate a coordinated and integrated approach. The programme has relatively low start-up costs and can serve both urban and rural populations. Clinical experience and initial programme evaluation results suggest that substance abuse and vocational rehabilitation goals can be effectively attained using this model of service delivery.