Foreword

Associate Professor, Associate Department Head, & Graduate Advisor | Department of Occupational Science and Occupational Therapy
Research Associate, MS Clinic | Division of Neurology, Department of Medicine
Affiliate Investigator | Vancouver Coastal Hospital Research Institute
Principle Investigator | International Collaboration of Repair Discoveries
University of British Columbia

Amartya Sen, the 1998 Nobel Prize Laureate for economics, has an unyielding commitment to the fundamental tenets of social justice, social choice theory, and welfare economics that lead to the development of a theory and measures addressing the well-being of citizens of developing countries. His convictions were informed by experiences from his early years when he witnessed groups living in poverty. In his landmark theory the capabilities approach developed in the early 1980’s he focuses on positive human development and freedoms arguing that these must be afforded to all citizens. At the heart of this work is the concept of capability that is a person’s ability to participate freely in valued activities while recognizing the diverse nature of activity and the need for such opportunities to be accessible throughout society.

As with Sen, the like-minded occupational therapist Christine Lefaivre was influenced by her early experiences that lead to the birth of the Lefaivre Rainbow Effect. Knitting together concepts to support her conviction that persons with brain injury could relearn and participate in valued activities is something that Sen would argue should be afforded to all human beings. Both authors are passionate about their work and focus on positive human development, for Sen it was mitigating poverty and for Lefaivre maximizing the potential of persons with traumatic brain injury.

The Lefaivre Rainbow Effect provides an empowering, real-world, tangible and systematic approach for specialized community-based traumatic brain injury rehabilitation that builds on the individual capabilities and social situation to extend their potential to re-engage in life and visualize future possibilities. This powerful approach embraces the essence of the issues, without skirting the tough problems faced in the presence of brain injury. Deeply embedded in the Lefaivre Rainbow Effect is the philosophy of respecting the complexity of the human spirit and as such, this approach does not heal but facilitates the healing process through collaboration and an implicit understanding of each person’s unique circumstance. It was developed based on years of clinical practice and fluency with academic developments and has the potential for far-reaching application across borders, classes, and religions.

The nugget of the Lefaivre Rainbow Effect is conceptualized in a formula that is grounded, realistic, proactive and honest.  It is grounded as the formula fully appreciates and accounts for life pre-injury and is realistic by factoring in the diverse array of primary and secondary losses.  The proactive aspect of the formula is realized in the nimble intervention that is tailored and responsive to the distinct client and family needs.  It is through the expertise of the team that the full situation is collectively understood and translated into the functional everyday life of the client. Finally, the formula is honest because it acknowledges that all will not return to the way things were prior to the injury by accounting for the residual loss or the permanent deficits. Unique to this approach is that the formula includes both the client and the family unit in order to identify issues, educate all parties and to minimize the phenomena of the traumatically induced dysfunctional family described by Lefaivre.

Discretely nested throughout the book are numerous clinical secrets and sage clinical experiences that Lefaivre shares to provide the reader with practical tips and numerous forms and templates on illusive subjects. There are guidelines on practical issues of how services are provided including medical legal work and establishing a professional practice as well as pragmatic, thoughtful lessons for using volunteers, accessing funding sources, and being alert to ethical issues.

There is a superb use of broad base cases to illustrate principles both of the Lefaivre Rainbow Effect and in the chapters that address medical legal and business practices. These case examples provide a rich tapestry of realistic scenarios that are useful to the practitioner and address the many difficult functional, medical, social and legal issues confronted.

Through these pages, it is clear that the Lefaivre Rainbow Effect was developed from the heart with a true sense of urgency and immediacy to make a difference in the lives of persons living with brain injury. From the beginning to the end of this book it is understood that the revolutionary development of the Lefaivre Rainbow Effect and the 25 years of implementation is just the beginning.  It is for this reason that the Lefaivre Rainbow Effect is like a nova – we must explode its potential for the benefit of persons living with brain injury.