List out different team in CBR. Explain the need for team work. Describe the role of each team members in CBR.
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Finding Sources
Finding Sources
Searching PubMed
"community-based rehabilitation" AND teamwork
Searching the Web
WHO community-based rehabilitation CBR guidelines multi-sectoral team community workers roles
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https://www.who.int/publications/i/item/9789241548052
Community-Based Rehabilitation (CBR)
Community-Based Rehabilitation (CBR) is a community-development strategy that promotes rehabilitation, equal opportunities, participation, and social inclusion for persons with disabilities. It is delivered through the combined efforts of the person with disability, family, community, government departments, NGOs, and services related to health, education, livelihood, and social welfare. This is consistent with the definition in Park's Textbook of Preventive and Social Medicine.
The WHO CBR framework is multisectoral and covers five areas: health, education, livelihood, social inclusion, and empowerment. The WHO CBR Guidelines support this approach.
Teams involved in CBR
CBR does not have a fixed identical team in every area. The composition depends on local needs and available services. Common teams and members are:
- Person with disability and family team
- Community-level team
- Health and rehabilitation team
- Education team
- Livelihood and vocational rehabilitation team
- Social welfare and inclusion team
- Empowerment and advocacy team
- Government, NGO, and referral-support team
Need for teamwork in CBR
Teamwork is necessary because disability affects more than a person's physical health. It can affect mobility, self-care, communication, education, employment, income, family life, participation, and dignity. One professional cannot meet all these needs.
Importance of teamwork
- Addresses total needs: Medical, functional, educational, economic, social, and psychological needs can be managed together.
- Provides person-centered goals: The person with disability and family help set practical goals relevant to daily life.
- Ensures continuity of care: The team can provide early identification, referral, treatment, home training, follow-up, and long-term support.
- Avoids duplication and gaps: Members share information and make a coordinated plan instead of providing isolated services.
- Uses local resources: Community volunteers, schools, employers, self-help groups, and local government can be involved.
- Promotes inclusion: Teamwork helps remove barriers in school, work, transport, housing, and public places.
- Builds family and community capacity: Families learn caregiving and self-care techniques, while communities learn to reduce stigma and discrimination.
- Improves functional independence: Coordinated therapy, assistive devices, education, and livelihood support enable the person to participate in society.
A rehabilitation team approach is effective because disabilities usually involve diverse physical and psychosocial problems that require coordinated problem-solving by several disciplines.
Roles of CBR team members
| Team member | Main roles in CBR |
|---|---|
| Person with disability | Central member of the team. Identifies personal needs and priorities, participates in goal setting, learns self-care and functional skills, uses services and assistive devices, and advocates for personal rights and inclusion. |
| Family members/caregivers | Provide daily care and emotional support; encourage independence; assist in exercises, positioning, mobility, communication, and self-care; ensure follow-up; reduce overprotection and discrimination at home. |
| CBR worker/community rehabilitation worker | Identifies persons with disabilities through home visits and community surveys; performs basic assessment; teaches simple rehabilitation and self-care; counsels families; refers complicated cases; follows up at home; links people with welfare schemes and community resources. |
| Community health worker/ASHA/ANM/public health nurse | Promotes maternal and child health, immunization, nutrition, accident prevention, and early detection of disability; identifies high-risk children; provides health education; refers to primary health centre or specialist services; monitors health problems and treatment adherence. |
| Doctor/medical officer/physiatrist | Diagnoses the condition and associated complications; plans medical treatment; determines rehabilitation potential; prescribes medicines, therapy, and assistive devices; refers for specialist treatment or surgery; prevents and manages secondary complications. |
| Physiotherapist | Assesses movement, muscle power, balance, posture, walking, and pain; provides exercises, gait training, transfer training, positioning, and prevention of contractures and deformities; trains the family in a home exercise programme. |
| Occupational therapist | Helps the person become independent in activities of daily living such as feeding, dressing, bathing, toileting, cooking, and household work; recommends environmental modification, adapted tools, splints, and vocational skills. |
| Speech and language therapist | Assesses and treats speech, language, voice, swallowing, and communication problems; trains the family in communication methods; may recommend augmentative or alternative communication. |
| Audiologist/hearing specialist | Screens hearing; assesses hearing loss; recommends hearing aids and communication training; supports school inclusion of children with hearing impairment. |
| Orthotist/prosthetist | Assesses need for calipers, braces, splints, artificial limbs, footwear modifications, wheelchairs, and other mobility aids; fits devices; trains the user and maintains or repairs devices. |
| Psychologist/counsellor | Assesses emotional, behavioral, cognitive, and adjustment problems; provides counselling to the person and family; promotes coping, self-esteem, motivation, and acceptance of disability. |
| Social worker | Assesses family, financial, housing, and social problems; links the person with disability pensions, certificates, travel concessions, insurance, NGOs, and social-security schemes; works to prevent stigma, neglect, and abuse. |
| Special educator/teacher | Identifies learning difficulties; provides early stimulation and special education where required; prepares individualized education plans; helps mainstream schools make classrooms accessible and inclusive; teaches parents how to support learning. |
| Vocational counsellor/employment officer | Assesses interests, abilities, and work capacity; provides skills training, job placement, self-employment guidance, workplace adaptation, and employer sensitization. |
| Community leaders/local self-government | Mobilize local resources; promote accessible public facilities; include disability concerns in community development plans; support disability certificates, pensions, housing, transport, and livelihood programmes. |
| NGOs and voluntary organizations | Supplement government services; provide training, rehabilitation aids, outreach, education support, livelihood assistance, advocacy, and self-help group formation. |
| Disabled Persons' Organizations (DPOs) and self-help groups | Promote rights, peer support, leadership, self-advocacy, awareness, and collective action; help people access services and participate in decisions affecting them. |
| Community volunteers/neighbours | Assist with identification, home visits, transport, social support, participation in local events, and reduction of stigma; encourage inclusion in community life. |
Summary
CBR is best delivered by a multidisciplinary and multisectoral team. The person with disability and family are at its centre. Health professionals address impairments and functional limitations; teachers support education; social workers and welfare agencies address social needs; vocational personnel support employment; while community leaders, NGOs, volunteers, and DPOs promote inclusion, rights, and empowerment.
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