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Think Therapy 1st

Working together for best client outcomes

How an OT-led approach can lead to life changing outcomes in a personal injury claim



Stephanie Fleet at Think Therapy 1st and Kirsty Mors at Bond Turner discuss joint working in personal injury claims and how a unique Occupational Therapy-led approach to rehab and commitment to joint working is delivering life-changing progress

In a personal injury claim, the overarching aim of all sides is to rebuild a person’s life so they can be in the position they would have been had they not been injured.

“It’s all about looking at what the injured person’s life was before the accident compared to now and what it would have looked like in the future vs now,” says Kirsty, serious injury lawyer at Bond Turner.

“The main thing is to understand is your client’s injury and what it is going to mean for them.

“For example, a self-employed yoga instructor with a wrist injury; to a naked eye they may look like they have fully recovered, yet when you delve in to how it has impacted them, it’s a completely different story and it has had a huge impact in their work and life in general.”

In achieving this, often the injured person will need some form of treatment or rehabilitation.

Submitting a claim can mean that your solicitor can ask the defendant’s insurers for an interim payment, or they may agree to fund rehabilitation under the Rehab Code.

They may or may not agree to this, and it usually makes a difference whether they have or haven’t admitted fault, but this will vary from case to case.

The claims process can be very stressful, intrusive and often really frustrating – but this is the advantage of having a quality legal representative and rehabilitation lead in making the process as simple and straightforward as possible.

Through establishing effective lines of communication and building a relationship that benefits all parties – the injured person, claimant and defendant solicitor and/or insurer – Kirsty and Stephanie discuss how their way of working is helping to overcome some of the traditional challenges.

Stephanie Fleet, Think Therapy 1st

An OT-led Multi-Disciplinary Team

While often the rehabilitation and multi-disciplinary team is led by a case manager, Think Therapy 1st are often able to occupy this role while involved and providing rehabilitation.

An Occupational Therapy provider, the team specifically work in specialist rehabilitation for people severely or catastrophically injured – and its ambition to restore function and autonomy aligns perfectly with the goal of the claims process as a whole.

Occupational therapy has a very important role to play here,” says Stephanie, head of service development at Think Therapy 1st, who also runs her own OT caseload.

“As a rehabilitative healthcare professional, you assess a person’s ability to do all the things they want and need to do, then figure out how to get the person back to that using fun and everyday activities as the rehabilitation intervention.

“The goal is to promote autonomy, wellbeing, and engagement in all parts of the person’s life.”

Think Therapy 1st has become well known in the sector for its Specialist Rehabilitation Occupational Therapy (SROT) approach, which sees the team engaging clients in functional rehabilitation through practical means, which is enabling them to rebuild their lives.

“We adopt what we call a functional restorative rehabilitation approach – this is where we focus on restoring the function,” says Stephanie.

“If there is permanent and long-term damage, we then look to adapt the task or use strategies to overcome the difficulties. When that avenue is exhausted, we then look at how to compensate for the long-term impact with care packages or equipment and adaptations.

“The unique thing that our OTs do is because they approach the injured person/client from the treating therapy perspective, they can provide both this element and the coordination of all other health and care needs as part of this role.

“This will either reduce the input the case manager needs to have during the rehabilitation, if there is a case manager; or if there isn’t one involved, this blended role can do both until therapy has ended.”

And the outcomes speak for themselves – at the end of therapy, less than 10 per cent of Think Therapy 1st clients need ongoing case management or care, and over 80 per cent who were in work prior to injury and are still of working age return to employment.

“Part of our approach will be to teach the person to manage their own long-term needs from the in- jury and this has a lasting impact.

“Clients can get back to living their life, their way, and know what to do,” says Stephanie.

Revised ways of working

Kirsty has found that working with Think Therapy 1st has enabled her to sometimes depart from the usual claims process, which involves obtaining medico-legal evidence from independent doctors, a process which clients can find very intrusive.

“Whilst I would not advise some- one to settle a claim without medico-legal evidence, which enables legal representatives to put an accurate value on a claim, for some clients

Kirsty Mors, Bond Turner

they find the experience of going through the process too much for them,” says Kirsty.

“With Think Therapy 1st’s unique approach, their monthly reports and all parties’ meetings, I have had the information to be able to identify possible future losses at an early stage without medico-legal evidence.

“This has enabled me to conclude claims without medico-legal evidence, whilst achieving excellent results for my clients to support them in the future with their ongoing recovery.”

Furthermore, through a joint commitment by both Think Therapy 1st and Bond Turner to providing a voice for the client, effective communication and a comprehensive understanding of the process is helping all parties to work together for the best outcome for the client.

Think Therapy 1st has developed a monthly update report to serve as the client’s voice and provide a transparent and accurate account of the client’s rehabilitation journey.

The reports include goal attainment updates, progress in clinical measures and an overview of how the client is transferring all learnt strategies from all professions into their daily routine.

Through the development of Kirsty and Stephanie working together and keeping the client central to the process at all times, they found opportunities to bring all parties together in regular meetings, which is hailed as being pivotal in enabling legal teams to make decisions and provide instruction.

If the case is a joint instruction under the Rehab Code, then the insurer or their defendant solicitor will also attend meetings to agree funding and next steps.

This can expedite the rehabilitation, progress and recovery of the client and often also brings the litigation to an end much earlier.

However, a current pertinent issue in the industry is the question of cost recovery for solicitors attending multi-disciplinary meetings – an issue discussed in the recent case of Hadley v Przybylo [2023] EWHC 1392 (KB).

In this case, the claimant’s legal team argued that that the MDT attendance acted as a ‘live feed’ assisting in progressing the case. The defendant’s legal team argued the attendance at MDT meetings was non progressive.

Ultimately, the judge agreed with the defendant. Think Therapy 1st invite both the claimant and defendant legal representatives to their MDT meetings.

Attendance at these meetings provides both parties with a transparent insight into any issues as they have the opportunity to ask any specific questions to the treating team.

This maximises the benefit to the litigation and supports and open and transparent relationships between the claimant and defendant representatives whereby they can have sensible discussions, for example regarding the necessity of interim payments, which is clearly beneficial for the claimant.

It also allows for a seamless approach to the rehab as funding can be discussed during the meetings.

Kirsty is of the belief that attendance at these MDT meetings is beneficial to both parties in terms of the litigation as it enables them to value the claim earlier, and possibly settle earlier which reduces the length of time the injured client goes through the legal process.

“Essentially, if the MDT meetings are progressive i.e. the claimant’s representative is not just there to take notes, then there is a good argument that the costs are recoverable,” says Kirsty.

“With Think Therapy 1st’s approach to MDT meetings, these costs should be recoverable as the meetings are instrumental in updating and aligning all parties involved, bridging the gap between rehabilitation and the legal arena ensuring a seamless flow of information and collaboration and ultimately the best outcome for the claimant.”

Personal approach and client commitment

Underpinning everything, agree Kirsty and Stephanie, is the need for a very personal approach in supporting clients to get back to where we want to be.

In coming to understand them, who they are and their lives pre-injury, new levels of insight can be gained into where they want to be.

“One recent client had sustained a mild TBI but was immediately back at work and juggling their parental role,” says Stephanie.

“On the surface, this client had returned to all the things they wanted and needed to do and felt they had returned to all their roles.

“Yet, from the amount of effort the client was putting into these two roles, we recognised this stopped them from being able to do any of their other roles, such as social activities and hobbies.

“These roles provided the client with downtime – and despite performing well in their employed role, their rest and play time was non-existent – and therefore, the client was not doing everything they were prior to their injury.”

As a result, the rehabilitation was devised to focus on them returning to rest and play roles, without impacting on work capabilities.

For Kirsty, this kind of very person- centred approach is vital to the whole process.

“This is what I love about my job; whilst I do not like what has happened to my clients, I enjoy being able to make their life better, in the short term, and also for the long term,” she adds.

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