Community integration is often cited as the ultimate aim of rehabilitation. However, outcome studies show that following severe traumatic brain injury (TBI), many people do not return to valued life roles or reach previous levels of integration within their community. More recent research, in association with extensive clinical experience, reveals significant variability in outcomes within this group. Although some people return to productive activity and maintain a network of family and friends, others lead lives characterised by boredom and loneliness. This paper has two aims. The first is to examine TBI community integration outcome literature and selected theoretical models. The second is to describe a Community Approach to Participation (CAP), an individualised and collaborative model of community-based practice, which endeavours to address the poor outcomes identified following TBI. The CAP will be illustrated in the detailed case study of Sarah.