Family Rehabilitation Activity Manual

Family Rehabilitation Activity Manual

Barbara Messenger, M.Ed, ABDA and Niki Ziarnek, M.S., CCC- SLP/L

Brain injury rehabilitation manual with functional activities specifically designed for families for use at home and in community.

Item: FFRM
Price: $38.00
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Full Description

With shortening stays in rehabilitation programs, individuals with brain injuries are returning home sooner after their injuries. This means that many families become responsible for caregiving, supervision and/or emotional support at home and in the community. This may be temporary or it may continue for long periods of time.

Families are often unsure how to help the person as the rehabilitation stage of care is behind them.

We have taken the four functional rehabilitation activity manuals used by clinicians in rehabilitation and residential treatment programs (see column on left) and made a special manual for families. We selected activities that families can easily use to help the individual with behavior, thinking and learning (cognition), leisure interests, and daily living (hygiene, dressing, etc). This activity manual is especially useful for families with a relative who has a moderate to severe brain injury as many of the exercises work on attention, memory, organization, behaviors, anger, emotions and concentration. There are 100 exercises designed to teach and reinforce skills for everyday activities using a step by step format that families can easily follow.

Families need no special training or equipment to use this manual. Exercises are based on activities that individuals and families do every day, such as holding conversations, watching television, playing cards, using the telephone, doing laundry, cooking, and playing games.

There are...

  • 60 activities to improve behavior after brain injury
  • 25 activities to improve cognition (thinking)
  • 10 activities for leisure
  • 5 activities on daily living skills

Recommendations for families with more information ...

  • Manual filled with practical strategies for families is the Brain Injury: It is a journey
  • Learn how to understand and respond to changes in behavior in The Helping Exchange: PEARL
ISBN# 1-931117-38-1
Pages 118 pages, 8 1/2 x 11, softcover, perfect bound, plus CD for worksheets.
Year 2006


Barbara A. Messenger, M.Ed., ABDA
Center for Comprehensive Services - Carbondale
The MENTOR Acquired Brain Injury Group

Barbara is currently working as a Behavior Rehabilitation Therapist at the Center for Comprehensive Services (CCS), MENTOR Network, with survivors of traumatic brain injury. Barb is a certified disability analyst and has a federal certification in rehabilitation counseling.

She has 5 years experience as a psychotherapist providing individual, group and marital counseling and 12 years experience as a vocational rehabilitation counselor providing vocational counseling, job seeking skills training, case management and expert testimony.

She is on the Board of Directors for Displaced Homemakers. Barb enjoys writing, playing the piano and creating programs on her computer.


Our warm thanks to all of those we are honored to work with at CCS and a special thanks to Larry and Zack who have gone without many dinners while we wrote this book.


To each of my children who are a constant source of joy and inspiration.

Niki Ziarnek, M.S., CCC, SLP/L
Center for Comprehensive Services - Carbondale
The MENTOR Acquired Brain Injury Group

Nicole is a speech-language pathologist in the Personal Intervention Program at the Center for Comprehensive Services, a residential brain injury rehabilitation facility. She has worked in the NeuroBehavioral Program for seven years, and has experience as a direct care staff, rehabilitation therapist, case manager, and for the past three years as a speech-language pathologist.


I will always be thankful for my husband Zack, my parents, Larry and Pam Fritsche, as well as rest of my family for their never-ending support, encouragement and faith in me to achieve my dreams. I also want to acknowledge my mentors and friends at CCS and elsewhere. Thank you for the support and for the opportunities you’ve given me. I have learned so much from you.

Thank you especially to Barb Messenger, the motivation and energy behind the creation of this book. It is an honor to work and create with you, and to call you a true friend


About The Authors


Impact of Deficits on Independence

Individual Strengths
Tips for Better Sleeping
Awareness of Seizures
General Information about the Brain
Medication Survey

Steps For Solving Problems
Practice Steps for Solving Problems
Attention & Memory

Watching Television Commercials 1
Watching Television Commercials 2
Watching Television Commercials 3
Card Games
Memory and Orientation

Memory Book
Recording Information
Review Daily Schedule
Social Interactions

Problem Solving: Newspaper/Magazine Article


Writing: Writing a Letter

Functional Reading

Phone Book

Money Management

Weekly Budget
Monthly Budget
Problem Solving


Making Lists
Create a Checklist


Social Skill Acquisition

Body Posture and Personal Space

Appropriate Conversation Topics

Appropriate Social Responses
Identification of Problem Communication Areas
Verbal Skills Worksheet
Social Interaction Exercise 1
Goal Planning Exercise
Appropriate Social Skills
Appropriate Social Skills Story
Identifying Body Signals and Feelings
Social Skills Worksheet 1
Social Skills Worksheet 2

Social Skills Awareness

Identifying Non-Verbal Cues Worksheet
Self-Responsibility Exercise
Time Management Strategies
Time Management Exercise 1
Time Management Exercise 2
Time Management Exercise 3
Tips for Improving Your Social Skills 1
Tips for Improving Your Social Skills 2
Tips for Improving Your Social Skills 3
Social Skills Comprehension Worksheet 1
Social Skills Comprehension Worksheet 4

Awareness of Aggressive Behaviors
Assertiveness Awareness Exercise
Assertiveness Exercise
Self-Monitoring Worksheet
Tips for Getting Organized
Goal Setting Worksheet


Low Self-Esteem Worksheet
Strategies for Building Self-Esteem
Self-Esteem Uniqueness Worksheet
Self-Esteem and Support System Worksheet
Self-Esteem Awareness Worksheet 1
Asking For Help

Anger Management

Identifying Signs of Anger
Identifying Signs of Anger Exercise
Relaxation to Manage Anger
Positive Self-Management Strategies
Self-Monitoring Anger
Strategies for Developing Self Control
Anger Control/Replacement Behaviors
Changing Behavior

Daily Behavioral Journal
Identifying Appropriate Behavior
Appropriate Behavior Worksheet 1
Setting Behavioral Goals
Coping Skills Worksheet
Attitude Awareness Worksheet
Replacement Behavior Worksheet 1
Replacement Behavior Worksheet 2

Stress Management

Stress Management Skills
Stress Reduction Strategies
Stress Awareness Exercise 2
Living with Brain Injury

Tips for Living Life after Brain Injury
Understanding Brain Injury Worksheet
Rehabilitation Goals Worksheet

Special Topics

Medication Survey
Depression Survey
Alcohol Abuse Survey
Alcohol and Drug Addiction Survey



Interest Inventory Worksheet 1
Interest Inventory Worksheet 2
Reading Interest Inventory Worksheet


Fun with Mazes 1
Fun with Words
Identifying Differences
Watching Television

Television Critic

Reading and Writing

Learning About Me Book or Pamphlet
Write an Autobiography

Personal Hygiene

Medication Checklist

Household Activities

Tips for Home Safety
Cleaning my Room
Cleaning the House

Meal Planning and Shopping

Planning Grocery Shopping Checklist

6 Extra Functional Rehabilitation Activity Documentation Forms



Importance of Functional Rehabilitation

During seven years of providing brain injury rehabilitation in a residential facility in numerous capacities including direct care staff, rehabilitation therapist, case manager and speech pathologist, I learned the importance of functional rehabilitation. Functional rehabilitation involves teaching basic skills that are related to the everyday activities which are needed for individuals to become more independent with a variety of tasks. It has been my experience that direct care staff tend to view their role as one of making sure basic needs are met regardless of an individual’s participation in meeting these needs, as opposed to teachers who facilitate learning new skills. When staff or family members interact in a way that only ensures basic needs are met, without a focus on increasing independence, the opportunity for providing functional rehabilitation is lost. The individual with a disability does not learn the necessary skills to become independent because these tasks are done for the individual.

A tremendous need was realized- how do we as clinicians teach direct care staff how to provide functional therapy? The skill of knowing how to teach basic everyday activities, ones that are taken for granted by a person without a disability, in a positive therapeutic manner, is very much a learned skill. However, learning how to interact in a way that teaches others how to perform activities more independently takes experience, time, appropriate models, and a willingness to learn how to interact differently.

Step-by-Step Approach to Therapeutic Tasks

The purpose of this manual is to teach this therapeutic way of interacting through the step-by-step format. This gives a caregiver, even one without models of how to interact in this teaching manner, all the tools needed to help individuals become more independent. Someone with little or no experience working with persons with disabilities can pick up this manual and immediately be able to interact in a therapeutic manner, while instantly facilitating independence. The goal is to generalize this interaction style to other areas and activities. By using this approach, direct care staff will develop an array of tools and methods for effective rehabilitation.

Functional Rehabilitation Activities are therapeutic tasks designed to facilitate an individual’s independence with activities of daily living. The activities are implemented by caregivers and consist of step-by-step instructions for teaching specific tasks. Caregiver refers to direct care staff, family, teachers, etc., who work with individuals with special needs. Throughout the manual, caregivers are referred to as “staff”. The activities are divided into four areas: cognition, behavior, activities of daily living, and leisure. Each activity targets a specific skill area and describes the task. The procedure takes the caregiver step-by-step through completion of the activity, beginning with simply asking the individual to participate in the task. Next, tasks are broken down into simple steps. One of the most important features of each activity is to provide verbal praise and positive reinforcement for the individual’s efforts regardless of accuracy or successful completion. Any form of participation should be reinforced.

Activities for all Disabilities and Settings

These activities are useful for children or adults who have experienced any type of disability. The majority of these activities provide basic everyday fundamental skills that are appropriate for habilitation or rehabilitation. This manual was initially written for use with persons with acquired brain injury. By the time it was finished, we realized that the skills taught are appropriate for adults or children with many other types of disabilities or those who simply lack skills in particular areas. Throughout this manual, the individual completing the activity is referred to as “participant”.

Many people with disabilities may not receive formal rehabilitation to the extent needed to become independent with these skills. Families are often unsure how to help their loved one become more independent. The activities included in this manual are appropriate for use in the home setting, as well as rehabilitation programs, residential programs, outpatient facilities, schools, etc.

The activities in this manual were created by conceptualizing how, as clinicians, we teach these skills. The activities are designed to be an extension of clinical therapy goals, while promoting positive quality therapeutic interactions between caregiver and the individual. The manual may be used in a variety of ways. Individuals may choose which activities to complete in a specific area or the caregiver may suggest activities that are daily activities.

I hope you find these activities useful and that through their use you are able to facilitate independence by providing functional rehabilitation through positive interactions.

Niki Ziarnek

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