1st Edition

Traumatic Brain Injury Rehabilitation The Lefaivre Rainbow Effect

By Christine Lefaivre Copyright 2014
    368 Pages 196 B/W Illustrations
    by Routledge

    368 Pages 196 B/W Illustrations
    by Routledge

    The Lefaivre Rainbow Effect is a groundbreaking treatment for those suffering from a traumatic brain injury (TBI). This strategy is different from most others because it is individually designed for each client and focuses on the cognitive retraining of the brain based on pre-injury lifestyle as well as the organic damage to the brain, rather than the disability alone.

    Starting in the community, after the acute and in-patient rehabilitation phases of recovery have been completed, the Lefaivre Rainbow Effect maximizes the recovery process by positioning the TBI survivor to be a motivated participant in the arduous journey of recovery.

    Key features:

    • Provides tools and templates for managing the individualized treatment and integration process, including additional material available for download
    • Addresses physical, emotional, and cognitive deficits with a strong influence on participation in life activities
    • Includes the unique theory of the traumatically induced dysfunctional family, with the aim to preserve the family unit and reduce the overall loss for the survivor of brain injury
    • Features a practical approach, including chapter summaries, case studies, diagrams, and templates
    • Offers guidance on producing an Independent Medical Evaluation and preparing effectively for cross examination in recognition of the adversarial aspect of many TBI cases

    This essential text demonstrates how rehabilitation professionals, including occupational therapists, doctors, nurses, social workers, speech pathologists, and neuropsychologists, can use the Lefaivre Rainbow Effect in their practices to improve therapeutic outcomes for their clients.

    The Human Spirit
    The Human Spirit
    Principles That Preserve Hope
    Appendix 1A: Kubler-Ross’s Five Stages of Grief
    The Lefaivre Rainbow Effect
    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
    Appendix 2A: Definitions of Service Providers
    Total Sum
    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
    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
    Preparing for the Team Meeting
    Summary of How the Case Manager will Run a
    Team Meeting
    Appendix 4A: Cross-Reference of Assessment Tools and Sectors of Balanced Lifestyle Example for an Occupational Therapist
    Educating the Family
    Family Meeting
    Burn Blister Analogy
    Introducing Stress
    The Interplay between Stress and Organic Symptoms
    The Loss…Stress
    The Process for Managing Stress
    The Traumatically-Induced Dysfunctional Family Theory
    Systems in General
    Family Systems
    Ideal Conditions for Best Clinical Outcomes
    Outcomes with Clinical Intervention
    Setting the Stage for the Intervention
    The Brain—A Brief Overview
    Limbic System
    Sensory Overload: Analogy of a Breaker Box
    Some Causes of Sensory Overload
    Energy Conservation
    Setting Goals
    Cognitive Retraining Strategies
    Useful Therapeutic Hints
    Residual Loss Cost-of-Future-Care Analysis
    Helpful Hints for Preparing a Cost-of-Future-
    Care Analysis
    Appendix 9A: Template for Creating a Cost-of-
    Future-Care Analysis
    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
    Appendix 10A: Litigation Terms Defined
    Business Practices and Public Relations
    What Does a Good Business Profile Look Like?
    Establishing a Professional Profile in the Start-Up Phase
    Enhancing Your Image: Public Relations
    Four-Week Time Management System
    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
    Diverse Funding
    Funding Sources
    Tort Claims
    Partial No-Fault System
    No-Fault System
    Government Funding
    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
    The Use of Volunteers
    The Use of Volunteers
    The Recruitment of University or College Students
    Orientation and Education of Volunteers
    Ethical Considerations
    Prevention Identification of Risk Factors and
    Improvement of Public Policy
    International Sharing of Information and Standards
    Specialized Training
    Selection of Community Service Providers
    Glossary of Terms
    Appendix: Brain Injury Associations


    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