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Traumatic Brain Injury Rehabilitation

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Table of Contents

The Human Spirit Introduction The Human Spirit Forgiveness Loss Principles That Preserve Hope Summary Appendix 1A: Kubler-Ross's Five Stages of Grief The Lefaivre Rainbow Effect Introduction How the Lefaivre Rainbow Effect Came to Be The Theory of the Rainbow Effect The Approach The Philosophy The Assumptions The Lefaivre Rainbow Effect Formula Elements of the Rainbow Effect Formula The Process of the Rainbow Effect Providers of Services Summary Appendix 2A: Definitions of Service Providers Total Sum Introduction Determining the Total Sum How This Approach Differs from Current Trends Preparing for the History Intake Advocating to the Funder The Process of Determining the Total Sum Establishing the Community Team The History-Taking Process Suggestions for Taking a Client's History Balanced Lifestyle Inventory Clinician Self-Assessment Summary Appendix 3A: History-Taking Template Appendix 3B: Balanced Lifestyle Sheet Appendix 3C: Severity of Brain Injury Stratification Appendix 3D: Post-traumatic Amnesia Appendix 3E: Glasgow Coma Scale Glasgow Coma Scale Appendix 3F: Rancho Los Amigos Scale: Levels of Cognitive Functioning Appendix 3G: Form 1: Clinician Self-Checklist for Establishing Therapeutic Rapport Appendix 3H: Form 2: Clinician Self-Checklist for Determining the Total Sum The Loss The Loss The Process of Transferring the Client from Hospital to Home and Community Case Manager Initial Clinical Reports Produced by Community Clinicians Preparing for the Team Meeting Summary of How the Case Manager will Run a Team Meeting Summary Appendix 4A: Cross-Reference of Assessment Tools and Sectors of Balanced Lifestyle Example for an Occupational Therapist Educating the Family Introduction Family Meeting Burn Blister Analogy Introducing Stress The Interplay between Stress and Organic Symptoms Summary The Loss...Stress Stress The Process for Managing Stress Summary The Traumatically-Induced Dysfunctional Family Theory Introduction Systems in General Family Systems Ideal Conditions for Best Clinical Outcomes Outcomes with Clinical Intervention Summary Intervention Introduction Setting the Stage for the Intervention Assumptions The Brain-A Brief Overview Limbic System Memory Sensory Overload: Analogy of a Breaker Box Some Causes of Sensory Overload Energy Conservation Setting Goals Observations Cognitive Retraining Strategies Useful Therapeutic Hints Summary Residual Loss Cost-of-Future-Care Analysis Introduction Helpful Hints for Preparing a Cost-of-Future- Care Analysis Summary Appendix 9A: Template for Creating a Cost-of- Future-Care Analysis Litigation Introduction The Litigation Process The Expert Witness Important Points to Remember for the Expert Witness Medical Legal Report Writing My To-Do's Preparing to Go to Court Expert Witness Testimony Summary Appendix 10A: Litigation Terms Defined Business Practices and Public Relations Introduction What Does a Good Business Profile Look Like? Establishing a Professional Profile in the Start-Up Phase Enhancing Your Image: Public Relations Summary Four-Week Time Management System Introduction The Premise Goals of the Time Management System The Process How the Time Management System Works Case Histories and To-Do's for Time Management System The 4-Week Schedule Quality Statistics How to Prepare Quality Statistics Summary Diverse Funding Introduction Funding Sources Tort Claims Partial No-Fault System No-Fault System Government Funding Medication Vocational Retraining Disability Tax Credit Workers' Compensation Veterans Affairs and Military Benefits Aboriginal Affairs Victims Assistance Blue Cross and Blue Shield Private Disability Insurance Homeowner Insurance Travel Insurance Alternate Sources of Funding for Service Provision Private Funding Fund-Raising Summary The Use of Volunteers Introduction The Use of Volunteers The Recruitment of University or College Students Orientation and Education of Volunteers Summary Ethical Considerations Introduction Prevention Identification of Risk Factors and Improvement of Public Policy International Sharing of Information and Standards Specialized Training Barriers Selection of Community Service Providers Summary Glossary of Terms References Appendix: Brain Injury Associations

About the Author

Christine Lefaivre O.T.(C) is a registered occupational therapist, President of Rainbow Rehabilitation Inc., and a clinical Assistant Professor at the University of British Columbia, Canada.


" ... the vital piece that has been missing in the treatment of traumatic brain injury. ... brilliantly uncovers and develops strategies to manage the unique stress experience for each patient and makes insightful use of the brain's enhanced capacity to grow while pursuing pre-injury interests and motivations." -David I. Levy, MD, Neurosurgeon, University of California, San Diego "This is a valuable resource for healthcare practitioners working with TBI clients because it provides a unique approach to community integration. It also offers many practical suggestions on how to work with brain injury clients and their families." -Cristy Daniel, EdD, OT, College of St. Mary for Doody's Review Service "From a litigation point of view, there is no better way to prepare your evidence for trial than to follow the Rainbow Effect rehabilitation approach. Whether you are a survivor, a family member, a medical /rehabilitation expert, or a lawyer, read this book-it was a game changer for me and it will be for you as well." -David Marr, Personal Injury Lawyer, Kamloops, British Columbia, Canada "Chris Lefaivre puts forth a framework that truly reflects the best elements of person-centered care." -Tina M. Trudel, PhD, President, Lakeview NeuroRehabilitation Centers and Specialty Hospitals, USA "Through her longstanding extraordinary experience in the therapy of (TBI) survivors, Christine Lefaivre succeeds in transcending primary organic damage with a multi-modal therapeutic approach." -Dr. Michael Starke, Radiologist, Federal Armed Forces Hospital Berlin, Germany "Chris Lefaivre's portrayal of working with her clients, their families, and the treatment team is inspirational. ... This well written and accessible book is truly a must-read for all health and social workers, legal professionals, family members, employers and indeed anyone involved in the support of traumatically brain injured individuals." -Deborah Buszard, PhD, Deputy Vice Chancellor, University of British Columbia " ... [it] provides a multi-modal, multi-disciplinary model that stages interventions for the survivor, the family, and the community (e.g. school, workplace), so that recovery is maximized." -Bill de Bosch Kemper, PhD, Neuropsychologist, Kelowna, British Columbia, Canada "As I read Lefaivre's work, I was astounded by her complete understanding that the best chance for functional recovery and optimal psychological benefit is when the TBI client is in their pre-injury environment, versus an institutional setting ... What a gift this text is to the world of traumatic brain injury treatment and patient care in general." -Gaye Gould, MSW, RSW, Mississauga, Ontario, Canada "I strongly recommend this book. It's not just an important teaching tool for professionals but a guide for families as well. Christine has provided an excellent framework for TBI management-with tools, templates, diagrams, case studies, and practical resource material for managing individualized treatment. It offers an insightful and common-sense approach you will refer to often." -Diane M. Wilson, mother of TBI daughter "What makes this book unique and a must-read for any clinician working in community brain injury rehabilitation is the attention to topics that are not traditionally addressed in similar texts: business practices, litigation, future care cost analyses, case management, quality statistics, and complex family dynamics." -Canadian Journal of Occupational Therapy "In this 15-chapter book on Traumatic Brain Injury Rehabilitation author Ms. Christine Lefaivre (Clinical Assistant Professor, University of British Columbia) has methodically elucidated a new model: The Lefaivre Rainbow Effect, exclusively for the rehabilitation of TBI. Based on her vast clinical experience of 26 years with TBI patients, she has developed this model which appears to be simple and can be implemented conveniently ... The core of this model is based on the principles of human spirit, forgiveness, acceptance, and hope. The model comprises medical as well as occupational assumptions such as brain plasticity, client centered ness, environment, adaptation, and therapeutic devices. In most of the chapters, numerous case studies are highlighted that make this book effortless to appreciate and apply clinically. ... In conclusion, the book may be clinically helpful for the rehabilitation of TBI clients. The concepts will enhance the understanding of TBI and related issues. The principles of the novel model may also be utilized for other neurological disabilities. The occupational therapists, co-professionals, students, family members, employer, and insurance executives may benefit a lot from this book." -Dr. Kamal Narayan Arya, MOT, PhD, in The Indian Journal of Occupational Therapy, Vol. 47, Issue 2, May - August 2015 The Lefaivre Rainbow Effect is a clearly written and logically sequenced book, one that is worth reading. It offers healthcare providers involved in the rehabilitation of TBI patients a basic strategy to optimize functional restoration across the spectrum from mild to severe injury. - Bruce A. Barron, Springer Science, 2018

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