The more time patients with brain injury spend on meaningful treatment tasks, the better their outcomes. However, there’s often a gap between the ideal amount of time needed to improve, and the time that’s dictated by insurance coverage or busy in-clinic schedules.
Continuing specific skill practice at home, as well as generalizing those skills learned in the clinic (known as ‘carryover’), are powerful ways to improve ability and rate of mastery.
Research from Frontiers in Human Neuroscience supports a digital rehabilitation program and proves how effective home practice is in recovery from stroke or brain injury. Clinicians using the Constant Therapy app can assign their patients home practice between therapy sessions that can be done on tablet or mobile devices.
How can clinicians encourage therapy at home between visits?
Follow-through with carryover homework typically depends on the buy-in and motivation of patients and their families. Caregiver support is key.
If everyone has a clear appreciation of the importance of therapy at home, as well a positive attitude toward it, patients will complete more tasks than they could in a clinician’s office alone – leading to a quicker and more thorough recovery.
5 tips to help ensure your patients are motivated to practice therapy between sessions
- Explain the importance of home practice with an analogy.
Using an analogy to which your patients can relate can help bring the concept to life. For example, if your patients like sports, remind them that the best players practice for hours in between games in order to bring the perfect pitch or jumpshot to the big game. If they like music, remind them that it takes many hours of practice to master an instrument or a dance move. As we practice a skill, we trigger a pattern of electrical signals through the neurons in our brains. Over time with practice, the strength and speed of those signals increases, and we master the skill.
- Set treatment goals from the start.
Helping patients think through their personal dreams and aspirations can be a powerful tool to build motivation for practice. Work with your patients to set up SMART goals for their recovery (SMART goals are Specific, Measurable, Achievable, Relevant and Time-bound). A long-term goal could be something like “I will walk to Starbucks and order a cup of coffee independently.” A shorter-term goal may be: “I will say ‘Thanks’ accurately in 4 out of 5 conversations.” When patients know they are working toward achievable goals, they’re more likely to practice the skills needed to achieve those goals.
- Make a personal home practice contract with your patients.
Accountability is a great motivator of human behavior. If your patients are open to it, this can be a way to set up accountability. A personal contract can be simple, and should contain a list of patient goals, how the goals will be achieved, a timeline, and an explanation as to why it’s important to practice in between visits to achieve those goals. Contracts can then be signed by you, your patients, and possibly even a caregiver or family member. Even though it may not stand up legally, the commitment each person makes often helps contribute to delivering on their promise to help with goal achievement.
- Help patients set a regular time and place to do home practice.
Ask your patients or their caregivers if there is a stress-free and distraction-free spot they can go and practice. This might be in their home, or even a local library. If your patients are using the Constant Therapy app to practice, have them make sure their practice space always has an internet connection so their smartphone or tablet can download and keep track of their task progress. The same principle applies to time and day. Encourage your patients to find a regular time each day or week to go to their practice spot. By creating habit and making practice part of a regular and familiar routine, therapy is more likely to occur.
- Explain how to deal with therapy frustration.
It’s going to happen. Your patients will get frustrated with a task or their own abilities at some point during home practice. Since you won’t be there to encourage them to keep going, it’s important to discuss upfront what types of emotions may come up, and what some effective strategies are that they can do when those feelings take over. It may be as simple as taking a quick break, then keep going!
Published, peer-reviewed scientific research using Constant Therapy shows that the more patients practice, the more improvement they make.
Patients who practiced an average of 4 hours per week made more significant progress than those that didn’t practice as much. Encouraging home practice outside of a clinic will help them make progress toward their goals for recovery. Sending them off between visits with methods to make that practice as effective as possible is the way to ensure a faster and more complete recovery.