Recreational therapy operating within a transdisciplinary team. (National Therapeutic Recreation Society).

The Maine Center for Integrated Rehabilitation (MCIR) is Maine's leading day treatment rehabilitation program for individuals with acquired brain injury. Its name exemplifies its integrated approach to rehabilitation of individuals with acquired brain injury. Acquired brain injuries can include traumatic brain injuries from motor vehicle accidents or assaults, strokes, aneurysms, brain infections, brain tumors, toxic exposure from substance abuse, and anoxia/hypoxia from respiratory or cardiac arrest, near drownings or aspiration. MCIR recently expanded its operation to Rockport, joining its facilities in Bangor, Winslow and South Portland.

The Maine Center for Integrated Rehabilitation provides clients with the highest quality of cost-effective care while continually recognizing the human dignity and rehabilitation needs of individuals with acquired brain injuries in our community, and the personal investment of our staff. The program at MCIR provides outpatient day rehabilitation services focused on achieving the highest possible level of independence through functionally-based treatment in a variety of settings including the center, the community and whenever possible, the individual's home.

MCIR offers therapeutic groups to complement and enhance the individualized treatment delivered by speech and language therapists, occupational therapists, physical therapists, recreation therapists, social workers, neuropsychologists, physiatrists, case managers, rehabilitation nurses as well as rehabilitation technicians. The transdisciplinary model is now the industry standard for brain injury rehabilitation, as it has proven to be highly effective and efficient. The team approach addresses the varied and complex issues that can result from an acquired brain injury. Goals are established by the individual and the treatment team, based on the client's physical health, self-care, environment, and leisure and emotional needs that holistically encompass an individual's life. This transdisciplinary model represents a paradigm shift from services based healthcare delivery to outcome-oriented health care.

Recreation therapists at the Maine Center for Integrated Rehabilitation play an integral part in each individual's rehabilitation. As equal members of the transdisciplinary team, recreation therapists work collaboratively with other disciplines to help their clients meet both short-term and long-term goals involving all facets of the rehabilitation process.

Recreation therapists deliver individual treatment at the Maine Center for Integrated Rehabilitation that is focused on the development of leisure awareness, interests and pursuits as methods to address physical impairments, as well as cognitive issues of decreased planning and organization, decreased safety awareness, decreased follow through, etc., which typically impact the daily lives of individuals with acquired brain injury. Recreation therapists also develop and implement a wide variety of groups that address many of these same issues and also focus on social pragmatics and group dynamics. Because many individuals with acquired brain injury are experiencing social isolation, anxiety and depression, group therapy is an effective and valuable treatment modality. Some of the specialized group programs include therapeutic horseback riding, aquatics, life skills, computer skills/internet communications, horticulture therapy, music therapy, art therapy, adaptive sports, pet therapy, as well as several community based groups.

Recreation therapists also provide outreach education about acquired brain injury to various community groups, including high school students. While providing education about brain injury, therapists also inform students about professional opportunities in field of rehabilitation. This educational outreach by recreation therapists increases community and professional awareness about the importance of recreation therapy in the rehabilitation process.

For more information about the Maine Center for Integrated Rehabilitation and its programs go to www.braininjuryrehab.net or contact Sharon Trull, CTRS; Renee Guerette, CTRS; or Tobie Bouchard, CTRS, at 207-253-5440. The Regional NTRS Institute at the NRPA Southeast Regional Conference & Trade Show, March 28 to April 2 in Birmingham, Ala will also provide compelling instruction on Recreation After Traumatic Brain Injury. There you can obtain approximately 10 CEU credits. For more information go to www.nrpa. org or contact 423-424-3880 or email [e-mail].--David Jones, Ed.D., CTRS, University of Southern Maine, Mary Lombardo, BSN, CRRN, MCIR Program Manager, Adrian Putnam Boyle, Community Relations Coordinator, South Portland, Maine