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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.

Reviews

" ... 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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