Traumatic Brain Injury Rehabilitation: The Lefaivre Rainbow Effect, 1st Edition (Hardback) book cover

Traumatic Brain Injury Rehabilitation

The Lefaivre Rainbow Effect, 1st Edition

By Christine Lefaivre


368 pages | 196 B/W Illus.

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pub: 2014-08-07
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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 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

Table of Contents

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

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.

Subject Categories

BISAC Subject Codes/Headings:
MEDICAL / Health Care Delivery
MEDICAL / Neurology
MEDICAL / Nursing / General
MEDICAL / Physical Medicine & Rehabilitation