The holistic neurobehavioural approach was created in the late 1980s to respond to the persisting problems that practitioners observed in their patients following head trauma and other forms of acquired brain injury.

In 1992, Professor Rodger Wood founded the Brain Injury Rehabilitation Trust (BIRT), the first network of community-based holistic neurobehavioural rehabilitation centres in the UK.

At the time, Professor Wood recognised that the existing rehabilitation and treatment of people with acquired brain injury failed to address some aspects of behavioural and social problems. He saw that there was no specific focus on helping people to overcome the barriers to living a ‘normal’ community life from the psychological and social perspectives even though the medical treatment and other therapies for people with acquired brain injury were good. There was no help for the ordinary men and women who had little memory ability after severe encephalitis, or had reduced visual ability and attention following severe strokes, or for those who were not able to plan and stop themselves from saying something impulsively, or from becoming irritable or aggressive.

Holistic neurobehavioural rehabilitation addresses these needs through the marriage of neuropsychological know-how about the specific effects of brain injury on mental functioning, and the principles of holistic rehabilitation. These principles emphasise the use of our physical and social environments to:

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  • Help people gain insight and promote their ability to self-manage.
  • Use prompts supportively, repeatedly and consistently to change a person’s life - if only we get into the habit.
  • Work with families and empower them to exchange crowded environments for supportive and enabling ones, maximising generalisation to everyday routines.

All of us at BIRT - managers, rehabilitation support workers, clinicians, cooks, maintenance staff and directors - are trained in the neurobehavioural approach, which emphasises the importance of having and implementing clear clinical plans to enable people to do what they choose.

We do this by expertly assessing their abilities, and helping them learn how and when to use strategies, technologies and social habits, which help manage the often hidden but harmful symptoms of brain injury.

Our skill is in knowing and seeing the person - not the injury or the disability - and the potential in every single individual we serve. Self-identity - who you are and what you want to be - is central. BIRT excels at providing the right support, positive feedback, specialist care, respect and encouragement all day - every day.

Behavioural change is challenging, and we recognise the bravery and commitment of our service users and their families as we gradually work through our comprehensive assessments, interventions and reviews toward discharge. There is always learning and improvements to be made in any BIRT hospital, centre or house. Scrutiny by our governance, incident management, and training systems, and constant audits and research, ensures that BIRT continually evolves. Investment in consultant neuropsychology leadership in addition to occupational therapy, speech and language therapy, physiotherapy medicine, and specialist care and, which are accessible at every BIRT service, ensures that we keep a specialist neuropsychology led, neurobehavioral focus.