The goal of outpatient treatment is to ensure the highest quality of living for all individuals. The flexibility of the program ensures the highest level of success for each person based on their needs: independence in the home and in the community, success on the job, and return to a productive lifestyle. The brain injury rehabilitation programs are designed for adults with acquired neurological disorders, including, but not limited to, brain injury, stroke, multiple sclerosis, Parkinson’s disease, and balance disorders.
The Brain Injury Day Treatment program is one of the first holistic brain injury programs in the country and still enjoys a national reputation in the field. A major reason for this reputation is due to the evidence-based rehabilitation manual that was developed at our outpatient clinic. This has become the core of the manual that is being sponsored nationally by the American Congress of Rehabilitation Medicine (Haskins, et al., 2012).
The program is divided into two tracks: Community Re-Entry 1 and Community Re-Entry 2. Each track is staffed with a team of specialists including a full-time clinical neuropsychologist, speech pathologist, physical therapist, occupational therapist, and recreational therapist. A physiatrist, a physician who specializes in rehabilitation, has an office on site and is available for appointments on a weekly basis.
Each client is placed in the appropriate track based on the results of the team evaluation while taking into consideration severity of impairment, goals, and other factors. The daily schedule includes individual occupational, physical, and speech therapies, as well as psychotherapy with a neuropsychologist. It also includes various group therapies designed to address specific areas of impairment (see group descriptions below). Groups add value by helping clients to increase awareness of physical and cognitive deficits while providing a support system to handle their emotional responses to neurological injury. In addition, clients are provided with independent work time for homework, computer work, and projects assigned by the therapy team.
Unique to these programs is the role of the primary therapist, who is the key individual in the client’s rehabilitation. This person may be a physical therapist, occupational therapist or speech pathologist. The primary therapist works with fellow team members by gathering information about the client’s progress, eliciting support and suggestions from the team, and discussing strategies to carry over skills learned in therapy.
Throughout the course of a client’s stay in the Day Treatment Program, family involvement is encouraged and necessary. Family members are urged to observe individual therapy sessions and attend monthly conferences, at which time the client’s progress is reviewed and discussed. In addition, a monthly family education day is offered, consisting of a lecture on some aspect of brain injury, a family support group to discuss problems the families are encountering, and a client-panel discussion in which former clients return to discuss their personal experiences with rehabilitation and adjustment.
Community Re-Entry Track 1
Community Re-Entry Track 1 is scheduled Tuesday through Friday from 8:15 a.m. to 5 p.m. This track is for individuals with brain injury whose goal is to regain independence in the home and in the community. The four-day schedule allows the client to build cognitive and physical endurance.
Community Re-Entry Track 2
Community Re-Entry Track 2 is scheduled Monday through Friday from 8:15 a.m. to 5 p.m. This track is for individuals with brain injury whose goal is to regain independence in the home, in the community, and in a work setting. Because many individuals have return to work as their primary goal, collaboration with vocational rehabilitation and/or individuals at the client’s worksite can occur as needed.
For some individuals participating in this program there may be the possibility of residing in the semi-independent living home (see below). The home, supervised 24 hours a day by trained staff, is located near the outpatient clinic. All clients residing there must be participating in the Community Re-Entry Track 2. Daily transportation is provided to and from therapies at the outpatient clinic.
Semi-independent living home for Hook Rehabilitation
Click here for more pictures of the home.
Group therapy descriptions
- Awareness group - Education about brain injury and each client’s individual deficits and how these deficits impact relationships with others and daily life.
- Life skills group - Focus is on rebuilding daily living skills such as money, time, and medication management as well meal planning and preparation.
- Physical skills group - Focus is on balance and posture, architectural barriers, and home exercise.
- Memory group - Focus is on use of strategies to facilitate recall.
- Language group - Focus is on understanding what is heard, read, and expressing ideas in a group setting.
- Psychotherapy group - Led by a neuropsychologist with focus on the emotional and adjustment issues surrounding a brain injury, as well as coping strategies.
- Milieu group - Focus is on building relationships and trust amongst clients in order to gain awareness and provide constructive feedback to one another.
- Cognitive group - Focus is on strengthening and building cognitive skills (i.e., attention, divided attention, organization, problem solving).
- Community outing - Client-planned group activity to address carry-over of goals learned in the clinic to the outside community (i.e., stores, museums).
- Leisure education - Led by a recreational therapist with focus on adapting pre-injury activities and encouraging interests and skills in new leisure activities.
- Wellness group - Focus is on holistic health and well-being (i.e., diet, nutrition, exercise).
Additional information for outpatient programs
- Each client is responsible for transportation to and from the clinic.
- Clients bring a lunch each day; a microwave is available for use.
- There are snacks and drinks available for purchase.
Hook Rehab offers driving evaluation services, which consist of an in-clinic evaluation screening and a behind-the-wheel evaluation with a certified driving instructor and an occupational therapist. After successful completion of the outpatient clinic evaluation, the client should visit the Indiana BMV to retake a vision and driving test. Learn more about driving evaluations >>
Neuropsychological diagnostic services
Neuropsychological services are designed to help you and your physician better understand your cognitive functioning, make diagnoses, guide treatment and more. A neuropsychological evaluation involves standardized testing that is sensitive to problems in brain functioning. While CT or MRI scans may show structural abnormalities in your brain, neuropsychological testing shows how well your brain is actually working (for example, remembering and learning). Learn more about neuropsychological services >>
Traditional therapies offered include physical therapy, occupational therapy and speech therapy. A thorough assessment will be completed and therapy recommendations will be discussed with client and family.
For more information, please call Hook Rehabilitation Outpatient Services at 317-621-3000 or toll-free at 800-551-4665 (HOOK).
Haskins, E., Cicerone, K., Dams-O’Connor, K., Eberle, R., Langenbahn, D., Shapiro-Rosenbaum, A. and Trexler, L. Cognitive Rehabilitation Manual: Translating Evidence-Based Recommendations Into Practice. Reston,Virginia, American Congress of Rehabilitation Medicine, 2012