Objectives: To determine whether a nonmedical Transitional Living Program can effectively improve functional outcomes in a group of adult survivors of traumatic brain injury (TBI). Hypothesis: Nonmedical Transitional rehabilitation can effectively improve functional outcomes and provide a cost- effective alternative to traditional custodial care facilities for adult survivors of traumatic brain injury. Participants: A consecutive group of 27 TBI survivors at an average of 4.5 years postacute rehabilitation. Methods: Participants were administered the Community Integration Questionnaire (CIQ) on admission to and on discharge from the Transitional Rehabilitation Center of Helen Hayes Hospital, a nonmedical residential program providing social, behavioral, vocational, and psychotherapeutic services. Duration of subject participation ranged from 30 days to 1 year. Results: At discharge, program participants showed significant increase over initial scores in all subscales of the CIQ. These subscales assessed home integration, social integration, productivity, and job/school performance. In addition, participants were able to sustain scores and showed a slight increase in work/productivity scores 6 months postdischarge. Conclusions: The Transitional Rehabilitation Center model can improve community reintegration outcomes for a group of traumatic brain injury survivors averaging more than 4 years postinjury. This model can thus provide a cost-effective alternative to traditional custodial care facilities.

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