What to Expect at EBFR
Patients often wonder how a functional restoration program can be effective when previous medical, surgical, or physical therapy treatments have failed to provide lasting improvement. Several factors make the difference:
- Intensity of Treatment – In the Level 2 EBFR program (the more intensive of the two programs offered), patients meet 3 days per week (M,W,F) from 8:30 AM to 3:00 PM for a 7 week intensive outpatient rehabilitation program. The intensive phase is followed by 3 months of Aftercare where patients are invited back to our clinic in Walnut Creek for weekly supervised exercise and counseling so they can learn how to sustain the gains they have made.
- Shift of Focus – Toward improved physical and emotional functioning with pain, while reducing dependence on medications and medical treatments that are no longer effective. This new focus provides a clear and achievable pathway to improved function and healthy adjustment to the injury.
- Interdisciplinary Teamwork – The patient becomes an active member of the Treatment Team that includes physicians, physical therapists, rehabilitation psychologists, and vocational counselors. A comprehensive clinic like EBFR has all specialists on site every day providing integrated care. Rehabilitation provided in a coordinated fashion by an experienced and compassionate Treatment Team is a key to success.
- Progressive Physical Reconditioning – Individually tailored and paced physical reconditioning and activity tolerance training under careful physical therapist and physician guidance. EBFR is known for its exceptional PT team under the daily guidance of Doctoral Level Physical Therapist, Iris Maoz, P.T., D.P.T.
- Coping Skills Training – For pain and stress management with our team of five rehabilitation psychologists. Patients are taught scientifically based cognitive-behavioral techniques to manage pain and stress, including biofeedback, relaxation training, mindfulness techniques, Tai Chi exercises, and art therapy. EBFR is recognized for its highly experienced psychology staff (all doctoral level) with the highest staff-to-patient ratio of any comparable program.
- Medical Management and Medication Optimization – Each patient meets with the Team Physician weekly (or more frequently as needed – a physician is on-site at all times) for comprehensive review of medical problems; management of pain medications to minimize side effects and addiction risks; intensive medically supervised taper of pain medications when appropriate. EBFR is part of IPM Medical Group with a staff of 10 physicians on-site trained in Physical Medicine & Rehabilitation and Pain Management.
- Psychological Treatment – In group and individual counseling sessions patients learn effective cognitive-behavioral strategies to manage stress, depression, anger, anxiety, sleep disturbance, and pain medication dependency problems. Expert consultation regarding psychiatric and sleep medications is available when needed.
- Activity Tolerance Training – Patients work with staff to identify goals for improving function in a range of activities: work, home, hobby, sexual, social, and leisure. Training emphasizes safety first to avoid new injury. Patients receive training in posture and body mechanics, ergonomic modifications, stretching and strengthening activities, pacing strategies, functional limits, and individualized home exercise program.
- Vocational Counseling – Patients work with staff to identify return-to-work options and are counseled regarding vocational retraining, resume and job search assistance, or coordination with current employer regarding work modifications. Some patients benefit from a transitional volunteer activity which may start during the 7 week intensive phase. Approximately three quarters of EBFR graduates are discharged ready to pursue their vocational and/or volunteer plan.
- Nutrition and Healthy lifestyle Counseling – Sustaining a healthy diet and exercise routine over the long-term is the key to successful rehabilitation. Patients receive counselling from a nutritional counselor, and counseling from PT about how to sustain an individualized home exercise program.
- Healing versus Curing – Healing means to make whole again. Healing and well-being of the whole person is the goal of EBFR, especially when a “cure” (complete elimination of injury and chronic pain) may not be possible.
- Family Participation – Spouse and family members are encouraged to participate in educational meetings to integrate healthy behavioral changes for pain, stress, and exercise.
- Group Support – The psychology staff is highly skilled at directing group interactions to insure a positive, supportive, and compassionate atmosphere in which to heal. In fact, the most frequent comment from EBFR graduates is how much their recovery was helped by the warm support and positive example of other participants. A group experience, when properly directed, is indeed a powerful tool for helping foster healthy changes and recreating a sense of self-worth.
A functional restoration program is hard work. It takes courage and perseverance to rehabilitate from a painful and disabling injury. Candidates for EBFR have to make a substantial commitment of time, energy, and spirit. They have to be willing to be physically active again even with pain; to make healthy changes in the way one copes with pain and stress; to have the courage to reclaim lost activities and be active in the world again. EBFR can’t help everybody, but for those willing to put in the effort our highly experienced treatment team has a twelve year track record of success.