Please note: not all of the therapies listed below are available publicly and may not be covered by insurance providers. This means that there may be out of pocket costs, depending on the type of therapy.
There are several types of rehabilitation that individuals with brain injuries may find helpful in their recovery. We have included the most common and recognized rehabilitation therapies. Different rehabilitation therapies will be recommended for different people. Not every rehabilitation therapy will be available in every area. Speak with the medical team about rehabilitations available, and ways they can be accessed. In some cases, there may be online rehabilitation services that can make getting support even easier.
You can also reach out to your local brain injury association about available public groups.
- Occupational therapy
Occupational therapy (OT) assists with activities of daily living (ADLs) and creating a home environment that is designed for the person with a brain injury to be as independent as possible. This includes things like:
- Getting dressed
- Going to the bus stop
After a brain injury, these everyday activities can be more challenging. If a person is experiencing problems with their fine motor skills, having trouble with memory or processing instructions, or have issues with vision, hearing, or touch, occupational therapy will be a big help.
An occupational therapist will perform a functional assessment of the person, their family, and their environment. They identify impairments and environmental barriers and create a treatment plan designed specifically for the client. Part of the plan is developing specific goals they want to achieve, and using tools and strategies to help them do so. An occupational therapist helps them re-learn self-care, work, and leisure skills. This includes teaching them new ways to do things if capabilities have changed. Their job is to help with ADLs, and help the person reach a place where they can do them as independently as possible. They’ll do this using tools, new processes, and activities. They’ll even complete an assessment of the home environment so it can be set up in a way that works best. This includes making recommendations for furniture placement and how to remove tripping hazards and prevent further injuries.
Physiotherapy focuses on improving movement and mobility. This is done through carefully monitored stretching and exercises. This is one of the most common therapies - most people recovering from physical injuries need it. A physiotherapist is a rehabilitation professional who will perform an assessment of the person's physical capabilities and create a treatment plan to improve strength, muscle tone, or mobility. Exercises and activities can include range of motion exercises (ROM), strengthening exercises focused on building endurance and muscle, balance exercises which will target areas of deficit, and gait training to improve posture and walking.
Physiotherapy can be short or long-term. They may also be given activities or exercises that they have to do between appointments. As they meet physiotherapy goals, their abilities and needs will be reassessed, and their plan adapted to make sure they continue making positive progress.
- Psychological therapy
Psychological therapy - which can also be called counselling - is an excellent way to take care of mental health and understand more about emotions, behaviours, and thoughts. It’s also a great way to unburden oneself and receive considerate, thoughtful feedback from a professional. Counselling can be done by either a psychiatrist or a psychologist - both are licensed mental health professionals. The main difference is that a psychiatrist has a medical degree and is able to prescribe medication.
The health professional providing the treatment will first complete an assessment to help identify what they need and what goals they would like to reach.
- Speech and language therapy
Possible effects of brain injury include cognitive communication challenges. They may not be able to process their thoughts, have difficulty organizing their speech, or struggle with reading/writing. A speech language pathologist (SLP) can help with relearning communication skills and new adaptive techniques.
A person may also experience difficulty speaking or trouble swallowing. These challenges are connected to the throat and mouth muscles. Not only can it be difficult to talk, but it can be challenging to eat or drink, causing further problems with nutrition and safe eating. An SLP will perform tests in the early (acute care) stages of recovery if a person is experiencing any of these issues. It may be recommended that the person continue to work with a speech language pathologist to improve speaking and swallowing abilities. This can be a long process that requires patience, and treatment will be updated on an ongoing basis.
- Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy is rehabilitation that focuses on creating programs and activities that will help the person engage in positive and productive behaviour. Cognitive behavioural therapy covers a lot of symptoms of brain injury, including neural feedback, appropriate behaviour, memory, and information processing. Since no two brain injuries are the same, cognitive behavioural therapy doesn’t have a set program of exercises and activities. The therapist will perform an initial assessment and set goals. Once those goals are met, new goals will be set, and the treatment plan will evolve to include activities that will help them reach those goals.
Cognitive behavioural therapy is becoming more and more common, but it is still a growing part of rehabilitation for brain injury and is not as widely available as other types of rehabilitation.
- Vocational rehabilitation therapy
It can be challenging after a brain injury to go back to a job. Depending on their injury, they might not be able to return to their former workplace or may have to come up with new strategies to help them complete work-related tasks. Vocational rehabilitation therapy focuses on helping the person prepare to re-enter the workforce. They provide the tools and skills needed to find a part-time or full-time position. In partnership with the Vocational Rehabilitation Association of Canada, we have developed a guidebook to help people understand the return to work process.
- Art therapy
Art therapy is a more experimental therapy. Patients complete art projects in a personalized program. When someone is working on a creative art project, it can stimulate multiple parts of the brain at the same time and encourage neural pathways to form. Art therapy can also improve fine motor skills, help with other cognitive challenges such as memory and attention, and improve mental health and moods. Art therapy is conducted by licensed art therapists and is normally an out-of-pocket expense.
- Mindful meditation and yoga
Mindful meditation and yoga have become popular forms of therapy after brain injury. Both focus on the concept of quieting the mind, limiting outside distractions, and focusing on deep breathing and relaxing. Meditation can reduce stress and anxiety and allows for emotional self-check-ins and is a great technique for calming down.
Yoga also reduces stress and anxiety but adds an element of physical movement. Yoga moves are designed to be adapted and taken at the person’s pace. There are special classes and movements designed specifically for people who need adaptations.
- Music therapy
Music therapy uses music to help people with functional goals, improve mental health and cognition, and promote self-awareness and reflection. Music can be used to help with speech problems through musical vocals, motor skills through instruments, and cognition through composing. Music therapists are licensed professionals who undergo several years of training. Music therapy is an out-of-pocket rehabilitation expense.
- Recreational therapy
Recreational therapy uses leisure activities that a person would normally do to meet rehabilitation goals. The goal of this therapy is to help the person become as independent as possible when doing those activities. This could include walking, outdoor activities, arts and crafts, dancing – anything someone would normally do in their leisure time. Certified recreational therapists will use these activities to help with cognition, mental health, and even physical health if the activities are exercise-based.
Depending on the person's rehabilitation needs, they may work with additional rehabilitation specialists who will help them with recovery. Please note: the person may not need to work with every kind of rehabilitation specialist. Doctors will make recommendations and referrals based on their needs.
An audiologist is a healthcare professional with a focus in hearing loss related to the inner ear and vestibular system. They can diagnose and recommend treatment for people with brain injury who are experiencing hearing loss.
- Behaviour therapist
A behavioural therapist is a professional that uses professional training to help people with behaviour challenges understand good vs. bad behaviour. The therapist will identify the problem behaviours, then outline a treatment plan based on what the person wants to achieve. While there are many different types of behavioural therapy, the therapist will help reinforce positive behaviours.
- Case manager
A case manager is someone who can help a person with a brain injury coordinate appointments and other daily activities, particularly if they are experiencing cognitive challenges that make planning and going to appointments difficult. They can also help by going to appointments with them and assisting with post-appointment activities.
Case managers are not available everywhere in Canada and may be an out-of-pocket expense. You should speak with the physician about available rehabilitation specialists in your area and what would be right for your friend/family member.
Chiropractors focus on treating neuromuscular (nerve and muscle) conditions by physically working on the person’s spine. Their focus is on improving muscle and skeletal structure and reducing pain in the back and related joints. Chiropractor services can be helpful for people with lingering pain from physical injuries.
A dietitian is a medical professional with a degree in nutrition science. They are able to understand how food impacts health and well-being, and work with individuals to create comprehensive diet plans that treat nutritional problems. Treating nutritional problems can aid in treating other conditions, such as brain injury.
Please note: There is a difference between a dietitian and nutritionist. Dietitian is a protected term in Canada, which means they need to have professional certification. Nutritionist is only a protected term in Alberta, Quebec and Nova Scotia. This means that someone may be a nutritionist in British Columbia but not have the same credentials as someone in Alberta. Dietitians of Canada has an explanation and a chart of protected titles by province/territory that can help identify what kind of health professional to consult for dietary needs.
- Ear, nose and throat doctor (ENT)
An ear, nose and throat doctor (ENT) - officially called an otolaryngologist - is a doctor that specializes in the connected systems in the head. An ENT can diagnose and provide treatment recommendations for conditions such as hearing loss, tinnitus, sinus issues, balance problems, and swallowing difficulties.
- Life care planner
A certified life care planner is someone who can help create a plan after a life-altering event such as a brain injury. This plan can include services, supports, and costs necessary from that point on. A life care planner will perform an in-person assessment and develop a plan that will help map out future needs. This is incredibly helpful, especially if a person’s abilities to plan are compromised, or their family is worried about care, finances, and emergency planning for the future.
- Life skills planner
A life skills planner is someone who is trained to teach other people how to develop and improve life skills. Life skills is a broad term used to describe any skills that are helpful in activities of daily living (ADLs). Examples of life skills include communication skills, interpersonal skills, decision-making, and taking care of a home.
- Personal support worker
A personal support worker is someone who helps with activities of daily living (ADLs) and self-care, and is either with the person full or part-time in their home or at a treatment centre. Their role is to help make the person's day-to-day routine more manageable.
A neurologist is a medical health professional that specializes in treating the nervous system, which includes the brain. A neurologist is one of the physicians that would be able to make a diagnosis of brain injury and address symptoms. They also help with management of brain injury and its symptoms through treatment and referrals to other treatment options.
A neuropsychologist specializes in understanding how the brain and behaviours are linked. For someone with an acquired brain injury, a neuropsychologist can help determine how the injury will affect their cognitive abilities and behaviours and make recommendations for what rehabilitations could be helpful in recovery.
A physiatrist is someone who specializes in physical medicine and rehabilitation. They can help a person with a brain injury by evaluating physical needs and making rehabilitation/treatment plans. The physiatrist can identify and make recommendations for treatment in relation to physical, cognitive or behaviours problems that can result from brain injury.
- Recreational therapist
A recreational therapist is a professional that uses leisure and recreational activities as rehabilitation to build skills. The treatments are assessment-based and can be useful for people with social, cognitive, and behavioural challenges in developing independence and improving quality of life.
- Respiratory therapist
A respiratory therapist is a professional that can assist with breathing difficulties. They work alongside doctors at hospitals to provide emergency respiratory care, or they can work in rehabilitation centres or at home to help people with ongoing breathing difficulties. Doctors will provide a recommendation if they think the person needs to see a respiratory therapist during rehabilitation.
- Social worker
A social worker is a healthcare professional that provides ongoing support to the patient and the family by serving as an advocate and assisting with accessing services. They can also provide some levels of counselling. Their primary focus is improving overall well-being. A social worker can be a huge help for someone who is not sure where to find information or resources or needs someone to help support them while they look for services.