title: Long-term community reintegration: concepts, outcomes and dilemmas in the case of a military service member with a spinal cord injury.
abstract: OBJECTIVE
  Despite growing knowledge about medical and functional recovery in clinical settings, the long-term issue of community reintegration with a spinal cord injury (SCI) in the military context remains virtually unexamined. Thus, the U.S. Department of Defense created the SCI Qualitative Research Program to advance knowledge about service members' reintegration into civilian life. The purpose of this paper is to better characterize the long-term outcomes related to the community participation experienced and desired vis-à-vis a case study of a military veteran who suffered a service-related traumatic SCI.
  
  
  METHODS
  An in-depth anthropological interview was used with Jake, a 28-year old marine with a service-related C5/C6 SCI. Data were analyzed using content analysis.
  
  
  RESULTS
  Three significant themes were identified: opportunities for better engaging socially meaningful others may not be adequately included in so-called "client-centered" interventions; how management of the social self in inter-personal interactions and public spaces is critical to gaining broader societal acceptance; and how meaningful age normative relationships and activities are essential to establish lasting inclusive social connections.
  
  
  CONCLUSIONS
  Jake's case challenges existing models of rehabilitation predominantly focused on physical capacity building. Study findings point to the need for rehabilitation to invest more resources in efforts to address the existential and social elements of long-term social reintegration. Implications for Rehabilitation Both the veteran with SCI and their meaningful support network face challenges socially reintegrating after injury and rehabilitation. Empowering clients to envision future possibilities in terms of family, intimate relationships, and meaningful work are important to successful long-term social reintegration. Addressing the existential desires and social capacities of the individual may be as important as addressing physical functioning skills after SCI.
authors.affiliation: Institute of Gerontology, Wayne State University , Detroit, MI , USA .
authors.forename: Heather Ann
authors.initials: HA
authors.lastname: Fritz
authors.forename: Cathy
authors.initials: C
authors.lastname: Lysack
authors.forename: Mark R
authors.initials: MR
authors.lastname: Luborsky
authors.forename: Seth D
authors.initials: SD
authors.lastname: Messinger
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D062309:Community Integration; D049674:History, 21st Century; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D011788:Quality of Life; D012944:Social Support; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014481:United States
keywords: Community reintegration; military service; outcomes; rehabilitation; spinal cord injury