Willer B, Corrigan J D
Center For Research on Community Integration of Persons with TBI, Ontario Head Injury Association.
Brain Inj. 1994 Oct;8(7):647-59. doi: 10.3109/02699059409151017.
The Whatever It Takes model is presented as an extension of the medical/rehabilitation model. It is not presented as an alternative to the rehabilitation model, although it does represent an opposition to the manner in which the model is typically implemented in community-based programmes for individuals with acquired brain injury. After brain injury, medical complications persist and a strictly anti-medical model in a community-based programme is unwise. On the other hand, community-based programmes that attempt to treat the individual, or provide rehabilitation services, in the absence of careful consideration of environmental barriers or the need for natural supports, are not likely to meet the long-term community reintegration needs of the individual, and may be unjustly using up finite resources. There are numerous complications associated with living with the effects of acquired brain injury. There also is considerable complexity associated with a health-care system and reimbursement system that emphasize acute care. Given these complexities, and the strong probability that a cure for brain injury is not likely to be found within the next decade, even the most learned professionals in brain injury are likely to say that practical solutions are needed for the present. Most notable is the late Dr Sheldon Berroll, who provided so much leadership to the field, but when asked about solving the day-to-day problems for an individual, would often respond: 'Do whatever it takes'. This advice was not presented in desperation, but rather as practical guidance. We have attempted to describe the whatever it takes approach, and to provide some guidelines for its implementation in community integration programmes.
“不惜一切代价”模式被视为医学/康复模式的延伸。它并非作为康复模式的替代方案而提出，尽管它确实是对该模式在针对后天性脑损伤患者的社区项目中的典型实施方式的一种反对。脑损伤后，医学并发症持续存在，在社区项目中采用严格的反医学模式是不明智的。另一方面，在没有仔细考虑环境障碍或自然支持需求的情况下，试图对个体进行治疗或提供康复服务的社区项目，不太可能满足个体长期融入社区的需求，而且可能在不合理地消耗有限的资源。与后天性脑损伤的影响相伴而生的并发症众多。同时，强调急性护理的医疗保健系统和报销系统也存在相当大的复杂性。鉴于这些复杂性，以及在未来十年内不太可能找到脑损伤治愈方法的极大可能性，即使是脑损伤领域最有学识的专业人士也可能会说，目前需要切实可行的解决方案。最值得一提的是已故的谢尔登·贝罗尔博士，他为该领域提供了诸多引领，但当被问及如何解决个体的日常问题时，他常常会回答：“不惜一切代价”。这条建议并非出于绝望而给出。相反，它是一种切实可行的指导。我们试图描述“不惜一切代价”的方法，并为其在社区融合项目中的实施提供一些指导方针。
