Treatment and Phases
Clients with more severe deficits will begin therapy in the Day Treatment Program if they meet criteria for admission. These include potential for improvement with participation, stable medical status, no serious behavior problems, and no evidence of ongoing substance abuse. They must be functioning at a minimum of Level V on the Rancho Los Amigos Cognitive Scale. They must be able to communicate functionally and have adequate receptive skills. They must have supervision and support in the home environment, and a family member or significant other must be willing to participate actively with the rehabilitation program.
In the Day Treatment Program, therapies are integrated across programs. Cognitive rehabilitation and compensatory strategies, including behavior management and modification, are included in all phases of therapy. Family members observe some of the sessions, and they learn techniques to transfer therapy activities to the home environment so that therapy continues during the client’s entire waking day. Home visits are made by the team, as needed, but most therapy sessions occur in the clinic. Psychological services staff members meet regularly with family members to provide education about neurological dysfunction and techniques that will help family members deal with the client’s emotional/behavior needs and issues.
The continuum of care continues as the focus of the Day Treatment Program changes to the Community Reintegration phase of the program. Community Reintegration involves the direct application of skills acquired in the clinic to the community—that is, into the real world environment. Family members will take a more direct role in therapy as they help the client, with staff guidance, to deal with real-world challenges. Communication between the family and the staff is facilitated by use of a family journal in which family members keep a record of the client’s progress in his or her daily activities. The family journal also provides a mechanism for communication between the staff and family members.
The majority of clients with mild-moderate impairments will enter the program at the Outpatient Rehabilitation Phase. Day Treatment “graduates” will also progress to the limited treatment status when appropriate. Purposeful rehabilitation extends beyond the clinic into community settings (e.g., gyms, pools, health clubs, restaurants, grocery stores, work, home). As in rehabilitation for the severely impaired client, working with the client who has mild-moderate impairments requires a generalization of treatment and transfer of learning that is addressed within the process of a multi-contextual treatment approach. In the Outpatient Phase, schedules for individual therapies can range from one to three sessions per week per modality to less contact, as appropriate, as the person nears completion of the program or she or he transitions back to work or school and only requires follow-along services.
Some individuals who are able to function fairly well independently, after completing their program, still need minimal follow-along support to live independently in their own home or apartment in the community. A follow-along specialist can work with such clients, under supervision of an occupational therapist or a speech-language therapist. The goal of this process is to help the client meet challenges of daily living, facilitate peer contacts and relationships, become involved in community activities, exercise choices in his or her life, and gain greater status and respect in the community. In such cases, contact with the client could vary from two to three visits each week, to a visit every several months, or only as needed.
Center For Neurorehabilitation Services
The Center for Neurorehabilitation Services, P.C. (CNS) is an independent clinic located in Fort Collins,Colorado. The mission of CNS is to provide outpatient, community based, comprehensive neurorehabilitation and neurodevelopmental therapy through a transdisciplinary approach to care. We provide innovative, collaborative, supportive treatment that is focused on the needs of the individual client resulting in increased independence and quality of life.