Complex Concussion Clinic Care Team

Improving activity

Athletic trainers (AT’s/ATC’s) are licensed health care professionals who specialize in the management, prevention, and recovery of injured patients. Athletic trainers collaborate with the treatment team and provide guidance and communication between the injured athlete, physician, coach, athletic trainer, and family to determine when patient is ready to return to activity and play.

At CCC, the athletic trainer provides concussion injury prevention and outreach education, discuss treatment options, complete concussion testing, and educate and discuss return-to-play guidelines. They communicate with external athletic trainers, coaches, and school personnel; serve as point of contact with providers; and coordinate with the therapists and physicians to provide the best goal-centered care. They also assist with exercise/wellness plan and education.

During an appointment, the athletic trainer will assess the patient’s current symptoms, medication side effects, and physical activity level. They will conduct concussion testing, educate and progress return to play, coordinate care with providers, and answer and address questions.

Improving wellbeing

Behavioral health providers include licensed clinical psychologists and/or licensed clinical social workers. These providers assess, diagnose, and treat patients experiencing psychological distress, which is commonly experienced after an injury.

Our behavioral health providers at the CCC specialize in sport and rehabilitation psychology and neuropsychology.

• A sport and rehabilitation psychologist specializes in working with both athletes and non-athletes as they recover from a significant physical or neurological injury, and/or chronic medical difficulties.
• A neuropsychologist specializes in evaluating and treating individuals with several types of neurological conditions. In addition to providing individual counseling, a neuropsychologist can perform a comprehensive cognitive evaluation to assess a patient’s current functioning.

A behavioral health provider provides individual counseling, conducts neuropsychological assessment, and collaborate with the therapy team on a patient’s treatment needs. They help patients with education, healthy coping strategies, sleep hygiene, emotion regulation, stress and anxiety management, complementary and alternative medicine strategies, posttraumatic growth, and exploration of identity, purpose, and values. They can provide comprehensive cognitive assessments and recommendations.

When referred by a physician, a patient meets individually with a behavioral health provider to complete a clinical interview and determine treatment needs and plan of care. A counseling session includes activities based on each patient’s needs and goals, such as supportive listening about current life stressors, education, cognitive behavioral therapy (CBT), structured exercises and worksheets, and relaxation and imagery strategies.

A neuropsychological assessment involves a clinical interview with the neuropsychologist, neuropsychological testing with a psychometrist, who is trained to administer and score neuropsychological tests, and a feedback session with the neuropsychologist to review the test results and receive treatment recommendations.

Collaborative care

Case management is the collaborative process that manages patient wellness and promotes independence through advocacy, communication, education, and the identification and facilitation of needed services.

At CCC, case managers serve as patient advocates. They serve as liaisons between the patient and family, the interdisciplinary treatment team, physician, and the external treatment team to ensure quality care and optimal treatment outcomes. They connect patient with community and clinical resources to foster access to needed health care services. They can assist patients in the management of insurance requirements.

For worker’s compensation patients, case managers advocate for approval of prescribed treatment and services. They act as a liaison between the patient, the treatment team, and worker’s compensation parties. They also provide work status updates to worker’s compensation case manager and adjuster and keep the worker’s compensation case manager and adjuster updated on any changes in the treatment plan.

Patients meet with their case manager when they’re admitted to therapy to review CCC scheduling and attendance policies along with an explanation of benefits. During treatment, meetings may include weekly check-ins and as needed at the request of the patient and/or case manager.

Improving abilities

Occupational therapy (OT) helps you get back to doing the things you need, want, or are expected to do in your day-to-day life.

At CCC, occupational therapy works with patients to improve participation in instrumental activities that may be impacted following a mild traumatic brain injury (mTBI) or concussion. Session activities vary based on each patient’s needs and goals. Treatment may include a range of tactics.

• Daily living: Strategies to improve function with activities such as grocery shopping, finances, driving, education, work tasks, and daily routines
• Visual symptoms and sensitivities: Exercises to improve eye muscle strength and coordination, visual perceptual skills, and the ability of both eyes to work together
• Upper extremity: Exercises to improve strength, endurance, sensation, coordination, range of motion, and pain management
• Sensory processing and integration: Techniques to retrain the body understand and respond to sensory information more appropriately
• Fatigue management: Strategies to manage energy levels when participating in activities
• Driving: Activities and simulations to improve reaction time, visual scanning, attention, and range of motion, as well as adaptive strategies such as vehicle modifications, driving only during the day, driving with another person in the car, limiting highway driving, and using transportation alternatives

Improving symptoms

Physical therapists (PT) are movement experts who improve quality of life in children and adults through prescribed exercise, hands-on care, and patient education. PTs examine each person and develop a treatment plan to improve their ability to move, reduce or manage pain, restore function, and prevent disability.

At CCC, the PT works with patients to improve neurological, orthopedic, and/or cardiovascular problems that result from a mild traumatic brain injury (mTBI) or concussion. Symptoms can include dizziness, headache, fatigue, light and noise sensitivity, nausea, balance issues, and pain.

Session activities vary based on each patient’s needs and goals. Treatment may include a range of tactics and activities.

• Rest and recovery: Education on when and why activity should be limited and when it is safe to return to those activities
• Restoring strength and endurance: An individualized exercise program and close symptom monitoring throughout the program
• Reducing dizziness and improving balance: Helping to reduce or stop dizziness or balance problems through specific exercises, some of which will need to be performed at home in addition to during PT sessions
• Improving headaches: Assessments of the cause of headaches and treatment through exercise, manual interventions, and specific modalities
• Returning to play: Assessment of patient’s readiness to return to the pre-injury activities in collaboration with the athletic trainer and physician

Improving communication

Speech-language pathologists (SLP) work to evaluate and treat speech, language, social communication, cognitive communication, and swallowing disorders in children and adults.

At CCC, the SLP works with patients on improving thinking and communication skills, such as memory, attention, and executive function, that may be impaired following a mild traumatic brain injury (mTBI) or concussion.

Session activities vary based on each patient’s needs and goals. Treatment may include a range of tactics and activities to manage common challenges or symptoms of mTBI or concussion.

• Learning to use a planner or build a daily routine to help remember
  appointments or things you need to do
• Pacing yourself while studying or throughout your day to reduce symptoms
• Exercises to improve your ability to focus on a task with noise in the
  background so that you can learn to tune out the distracting noise
• Keeping a log of communication difficulties you are having and looking for patterns to help identify what strategies could be helpful

Session activities vary based on each client’s needs and goals and may include:

• Researching a calendar app to use as a memory tool and coming up with a system for using it consistently
• Creating a daily routine or schedule
• Establishing weekly goals then checking in on progress and obstacles related to those goals
• Learning strategies for improving attention or focus

Improving employment

Vocational specialists help patients with injuries, disabilities, or impairments find employment, request reasonable accommodations for existing job functions, and access meaningful community engagement through exploration of volunteer opportunities.

At CCC, the vocational specialist helps patients connect to resources and other agencies and supports clinical team in relating therapies to work goals. Session activities vary based on each patient’s needs and goals.

• For patients looking for work, vocational specialists can help identify patient job goals, assist with resumes and job searches, and work on interview skills.
• For patients with a job, vocational specialists can coordinate plans for returning to work, help patients understand clinical work recommendations, secures a physician’s release for return to work, negotiate job accommodations with employers, and interact with parties involved in a worker’s compensation case.