When East meets Wests: community-based rehabilitation in Chinese communities

Purpose. Community-based rehabilitation (CBR) has been practiced in mainland China for over three decades. This study reviews the development of CBR and describes its practice in Chinese communities in order to discuss current controversies within CBR practice internationally and in the Chinese context. Method. Review of literature. Development of CBR, its principles and controversies internationally and in the Eastern world is reviewed. CBR practice in Chinese communities is examined. Results. Shifting ideology and practices mean many different activities are labelled CBR. Variation across contexts has led to many controversies, specifically: the lack of evidence to support practice; ownership of programs; conceptual differences surrounding autonomy and participation and cultural issues. Contemporary Chinese cultural values and Chinese CBR arc shaped by traditional peasant culture, traditional Chinese philosophy and socialist ideology. Conclusion. The review indicates that Western CBR concepts and philosophy cannot be directly applied to the Chinese context. An appropriate model or framework is needed to fit the unique Chinese cultural context and to guide practice in Chinese communities.