Treatment Options for Post-Concussive Syndrome

Counseling Services

Brain injuries can result in altered personality and emotional functioning because of injury-induced changes in the brain structure, as well as the reactions of the injured person to problems stemming from difficulties with their thinking process.

Typical emotional difficulties include mood swings, poor tolerance of frustration, irritability, anxiety and depression. Automobile accidents are the primary cause of concussions and post-traumatic stress disorder in the Boulder Valley. Treatment can be complex because many similar symptoms result from pain, post-concussive disorder, or post-traumatic stress disorder. Proper counseling can help determine the cause of symptoms through education, stabilization, and coping methods. Available treatments at BCH include Eye Movement Desensitization and Reprocessing (EMDR) and Energy Psychology, "power therapies" which have been used for over 20 years because of their rapid and long-lasting results.

The aim of counseling throughout the adjustment process is to increase understanding about brain-related difficulties, provide emotional support and coping strategies, address issues of grief and loss, stabilize mood, problem solve interpersonal difficulties related to the injury and help the individual develop realistic goals for the future.

Cognitive Therapy

Simply stated, "cognitive" refers to "thinking." Specific skills relating to cognition include concentration, problem solving, organizational skills and memory. Language abilities such as word recall, expressing oneself, following conversation/directions and reading comprehension are specialized aspects of cognition.

Some or all of these skills may be affected by a number of variables including injury to the brain, levels of pain and/or emotional factors. Cognitive rehabilitation can address thinking problems through a number of treatment approaches.

  • Education 
    The goal of education is to improve an individual's understanding of thinking processes. It also addresses how various factors can interact to affect one's ability to think clearly. With increased awareness, most people start to feel a sense of control and support. They may begin to realize their symptoms are not uncommon.
  • Compensating 
    Therapists often provide individuals with practical ideas they can implement to compensate for cognitive difficulties. These suggestions are tailored to meet each person's specific needs for improving functioning at home, work and/or school. The use of memory aids and time managment techniques are examples of compensatory strategies which may be discussed.
  • Process-Specific Training 
    This consists of intensive exercises designed to provide repetitive practice in identified problem areas such as attention. Through this practice, individuals develop a greater understanding of where breakdowns occur and how to manage them outside of the treatment setting.

As described above, cognitive rehabilitation programs may include any or all of the components of education, compensation and process-specific training. The overal goal is to increase the individual's ability to meet the demands of daily life.

Occupational Therapy

Occupational therapy utilizes selected activities which are purposeful for each individual to facilitate learning (or re-learning) of those functions essential to daily living. These activities might include: self care (dressing, bathing, hygiene), home managment (cooking, cleaning, money management), and community-integration (shopping, transportation via driving or bus). In general, an occupational therapist's role in the treatment of brain-injured patients is to:

  • Provide structured sensory input in order to enhance awareness of the self and the environment, and to facilitate performance of basic self-care skills
  • Provide activities to increase range of motion and strength
  • Provide activities to improve both gross and fine motor coordination
  • Increase independence in homemaking, financial management and community skills, including transportation
  • Provide instruction in energy conservation and work simplification techniques
  • Conduct graded functional cognitive activities related to memory, concentration, strategizing, and problem-solving
  • Provide graded techniques for visual-perceptual and sensory improvement
  • Enhance functional social relationships
  • Teach techniques to assist with functional organization

An occupational therapist works with a patient to enable as much independence as possible in daily activities.

Neuropsychological Consultation

Neuropsychology is a subspecialty of clinical psychology. It is concerned with the study of brain-behavior relationships. Neuropsychologists may become involved in a person's treatment in the following ways:

  • Testing 
    Through the use of testing, neuropsychologist provide team members with information about the diagnosis and treatment of people with known or suspected damage to the brain. They can help differentiate between psychological/psychiatric symptoms and neurological symptoms resulting from illness or injury. They can also evaluate a patient's overall cognitive and behavioral strengths and weaknesses.
  • Consulting 
    Neuropsychologists often consult with patients, team members, attorneys or case managers to help direct patient care and ultimately help individuals to return to the best level of functioning he or she can achieve.
  • Treating 
    Because neuropsychologists are trained clinical psychologists, they often provide counseling for patients and their families. They may provide individual, couples, family, or group therapy, depending on patient need.

Physical Therapy

Physical Therapy is dedicated to optimizing one's ability to move and function successfully in the work and home environments as well as in recreational pursuits. This is achieved through comprehensive evaluation and treatment of the neuro and musculo-skeletal systems.

Treatment addresses movement difficulties manifested in decreased motor control, strength and flexibility. We also address headache, joint and dizziness dysfunctions. Treatment methods that are utilized include: soft tissue and joint mobilization, modalities to control inflammation (ice, ultrasound, and electrical stimulation), craniosacral therapy, fabricating and/or fitting orthoses and exercise. Exercise follows a functional approach and often includes stretching, strengthening, balance and coordination activities. We also provide interventions to decrease dizziness as well as Pilates-based rehabilitation.

Our physical therapists work one-on-one with patients and families to provide rehabilitation, adaptations, and education with the goal of increasing functional independence and encouraging a healthy, active lifestyle.


Pilates is a form of whole body movement conditioning which aims to produce improved fluidity and efficiency in functional movement, to enhance overall body awareness and to prevent and rehabilitate injuries. Our Pilates-based rehabilitation strives to improve functional movement patterns through gentle, non-impact, customized exercises that emphasize enhancement of:

  • Blood flow and oxygen/nutrient delivery to damaged tissues
  • Abdominal and back muscle strength to assist in spinal stabilization and prevention of low back pain
  • Balance between whole-body strength and flexibility
  • Coordination and balance
  • Posture and body alignment
  • Mental focus and body awareness
  • Breathing mechanics

 How the BCH Pilates-based Rehabilitation Services differ from others in the Boulder community:

  • Our Pilates practitioner is also a physical therapist with extensive training in functional anatomy, biomechanics, motor control and motor learning. By having a physical therapist provide this service, we can efficiently identify faulty movement patterns that exacerbate an injury, break down the faulty motor strategy and reeducate the patient in a more efficient biomechanical movement pattern.
  • Our Pilates practitioner/physical therapist has experience in treating orthopedic as well as neurological conditions, allowing our services to extend to a wide population base.
  • Our state-of-the-art equipment is highly adaptable to meet the wide range of needs of our clients with neurological and orthopedic injuries.

All of these aspects insure safe, comprehensive and effective rehabilitation for our clients.








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