Occupational Therapy: What it is, What it Does and NeuLife’s Use of it in Rehabilitation from Catastrophic Injuries

Contrary to what might be initially thought when hearing the term “occupational” in the phrase “occupational therapy,” it does not directly refer to the immediate return to work by a person who has sustained a catastrophic injury such as a traumatic brain injury (TBI) or a spinal cord injury SCI. Instead, occupational therapy involves the treatment of injured, ill or disabled patients through the therapeutic use of everyday activities. It helps these individuals develop, recover and improve the skills needed for daily living and working.

While returning to work may be the ideal and ultimate goal, there are many interim steps between the occurrence of the injury and the return to independence and return to work, subject to the nature and the severity of the injury. Some of the steps may include:

• Completion and medical stabilization through acute care;
• Evaluation of the individual for post-acute rehabilitation, including the development of a customized Client Goal Plan consisting of clinically relevant services for the individual. NeuLife’s customized Client Goal Plan is a prime example of this;
• Completion of initial rehabilitation;
• Completion of initial specialized rehabilitation;
• Neurorehabilitative services;
• Neurobehavioral services;
• Supported living as needed; and
• Residential services as needed.

Instead of focusing on returning to work when defining the term “occupational therapy,” it may be better thought of in terms of what an individual does on a daily basis to “occupy” time[1]. These may be mundane, but they are critical activities of daily living (ADLs). They include personal grooming, dressing, cooking and generally performing meaningful tasks. It is in this domain where the occupational therapist comes in: Training the individual who has sustained a catastrophic injury to handle his or her own care to the greatest degree possible and thereby, to engender a feeling, and the reality of independence. This can be done through the use of assistive devices, usually in conjunction with physical rehabilitation. Everything has the goal of achieving successful sustained outcomes and advancing the individual toward independence.

It is generally agreed that there is a nexus between mind and body in the recovery from and injuries, including catastrophic ones. Among the theoretical models that are used by occupational therapists, including those at NeuLife, to address the nexus between cognition on occupational performance are these:

• Toglia’s Dynamic Interactional model. This was developed for use with individuals who suffered a stroke or other kind of traumatic brain injury, but is relevant to others with cognitive dysfunction. It uses multiple activities in many contexts to help individuals understand performance problems and to develop strategies to enhance occupational performance.
• The cognitive rehabilitative approach of Katz and Averbach. This was developed mainly for persons with neurologic impairments of varying severities. It focuses on enhancing cognitive abilities and on remedial strategies to help develop the abilities needed to perform ADLs.
• Allen’s Cognitive Disabilities Model has been applied to people with traumatic brain injuries. This model provides a way to describe deficits arising from damage in the physical or chemical structures of the brain that produce observable limitations in “Routine Task Behavior.”
• The Neurofunctional Approach was developed for individuals with independent living goals after a traumatic brain injury, but has also been applied to individuals who have has strokes. In this approach, the NeuLife client and multidisciplinary specialists collaboratively develop Client Goal Plan and a task analysis that assesses the client’s strengths and limitations. With that, interventions, such as cuing, can be geared to the weaknesses[2].

The professionals at NeuLife, including its team of psychologists, psychiatrists neurologists, RNs and therapists are expert in the provision of innovative, clinically relevant services, including the development of a customized Client Goal Plan, and delivery of neurobehavioral and neurorehabilitative services. NeuLife’s goal is to provide post-acute rehabilitation to its clients to achieve the best possible outcome for those who have even the most difficult and challenging diagnoses.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve maximized, sustained outcomes that exceed the expectations of all persons served. 

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

2725 Robie Avenue

Mount Dora, Florida 32757

[1] Grand Valley State University, http://www.gvsu.edu/ot/a-definition-35.htm

[2] American Occupational Therapy Association, http://www.aota.org/