Why do an MNRI® Intensive?
In recent years, many therapy providers have started offering, in addition to their weekly, 30-60 minute therapy sessions, longer sessions carried out over the course of a few days all the way up to multiple weeks. This more concentrated form of therapy is referred to as an “intensive” since it allows for more of a thorough period of therapy. We see this at larger therapy clinics that employ qualified personnel who can work with individuals for longer durations because the research has shown that this supports therapeutic growth in all areas of development and rehabilitation. Traditionally, insurance companies have determined that physical, occupational, and speech goals needed to be addressed and met in weekly appointments, mostly occurring once a week. New skill acquisition in these short, infrequent sessions is not impossible, but many therapists and families can verify that it takes months for the behaviors to become a new habit or pattern. Additionally, many times families report that children may lose the skill after the child becomes sick or when they are going through a growth spurt in another area of development. With MNRI®, when the intensive therapy model is well utilized, I see that developmental growth happens across multiple domains and keeps being built on as newer skills appear. Over the years, as my experience, appreciation, and depth of understanding MNRI® has increased over multiple years, I have transitioned my preference in favor of these intensives because I have seen and heard of the huge amount of growth that can and does occur when MNRI® is provided this way. Below you’ll find answers to frequently asked questions regarding the structure, cost, and details of an intensive. Feel free to reach out to me via email if you have any more questions that I can answer.
Q: What are the benefits of doing an intensive vs. weekly, shorter appointments?
A: When working on a reflex, MNRI® has so many different techniques and ways to address the components to establish or correct the pattern. To do this, experienced MNRI® practitioners pull techniques from different programs (see list of programs later in the document). During a shorter, weekly session I may only be able to work from a single program to address only one reflex. When more time is available through the intensive model, I can implement many more techniques and work on many reflexes to ensure that your loved one is on the right path to a happy sensory system. The MNRI® Family Conferences, from which the rich research data has been collected, is structured in 5-8 day for this reason. It may seem that if I am focusing on one area of development (e.g., speech production), I would only implement one specific program, but because the reflexes are so interconnected, I need to establish a strong foundation of multiple reflexes before we can anticipate a noticeable change in that one area. It’s worth noting though, that I don’t usually see improvement in just one area of development but in multiple areas simultaneously.
Q: What is the timeline for each day?
A: The start time for each day of the intensive is usually dependent on the length of the sessions each day, but is somewhat flexible to accommodate each family’s needs. I generally like to start around 9am and do three, 50-55 minute sessions in the morning then take an hour lunch around noon to resume at 1pm and finish up the sessions after lunch. Some families may prefer to start earlier if they want to get all their sessions in before lunch or opt to start later in the day.
Q: What does each day of an intensive look like?
A: The first session of the first day will consist of an initial evaluation of reflexes to determine benchmarks of most reflexes as a starting point to work from. Each session after that will be direct intervention with parent training and handouts on techniques you can start doing after the intensive as part of the Home Exercise Plan (HEP).
Q: What if my child or teen will not stay on the massage table?
A: Initially, many children and adolescents have difficulty with laying still on the massage table. This is because their body craves constant movement and stimulation so that it can keep sending information to their vestibular and proprioceptive receptors within the body. This is a way that they step into “negative protection” to cope with stressors that they encounter every day in all environments. Using MNRI®, we are inviting their sensory systems to shift into “positive protection” so that they can regulate their systems and feel safe. All that to say, I work systematically using specific techniques and targeting specific reflexes to help them feel more regulated in their body translating to more relaxation on the table. I also support the individual by creating a routine in which we encourage time on the table and work in short breaks for active reflex repatterning.
Q: How can I support you during the sessions when you’re working with my child or partner?
A: I would say the best way to provide support during the session is to be present and engaged. There may be times with younger children when you’ll need to engage with them or provide snacks for your child to help them feel comfortable while on the table. For older children, your role will be to have discussions with them outside of the sessions to help them understand why we do the exercises and what expectations you have of them when in the session. Also, when I’m showing exercises for homework, you will want to have paper and pencil ready to jot down notes for yourself. Asking questions and participating in the session to help you understand is encouraged!
Q: What is the difference between an in office intensive and a traveling intensive?
A: An intensive would be a series of visits in a week that occur in my office in Spring, Texas. A traveling intensive consists of me traveling out of town or state to do a series of visits in a week in the recipient's home.
Q: Will Travel Intensives have extra fees to cover gas, food stipend, Airbnb?
A: Yes, additional expenses related to my traveling for intensives may be added to the total charge for services. In some instances, it could be financially helpful to coordinate with another local family who is interested in participating in an intensive to split these extra expenses.
Q: Is there a minimum of hours per day and days per week?
A: Yes, for the intensive model to be effective, I suggest that for local intensives we do at least 4 hrs a day, 3 days a week. For traveling intensives to be beneficial for the participant and financially feasible for me, I recommend at least 5 hrs a day, 4 days per week.
Q: Is a deposit required for the intensives?
A: Yes, a 10% deposit for cost of services will be collected for travel intensives. Deposits are non-refundable but can be applied to future intensives or a future regular session. After two cancellations, deposits will no longer apply to a future intensive or regular session and will not be refunded.
Q: What is the deadline for the deposit?
A: 2 weeks prior to the first day of the intensive.
Q: Can I bill my insurance for the intensive?
A: Unity Therapy Solutions is a fee-for-service, out-of-network provider and does not bill insurance directly. If you’d like to file a claim with your insurance provider to seek reimbursement for services, upon receiving payment in full, I can provide you with the superbill with all the information you will need to submit to your insurance. I recommend that you refer to your out-of-network benefits for information regarding potential reimbursement. If you are requesting a superbill, a physician's order, with appropriate diagnosis code(s), is required in order to submit towards your out-of-network benefits. If your child is already receiving speech therapy, the physician’s order is probably on file at the therapy institution they attend. All therapy documentation will reflect services provided but are not guaranteed reimbursable through third payer sources. Additional traveling expenses that I incur cannot be covered by insurance and will need to be paid out of pocket.
Q: What payment methods do you accept?
A: I accept debit or credit card, FSA/HSA funds, cash, and check. Payment can be completed at the end of the intensive or invoiced at the beginning of the following month through the Simple Practice EMR system that I use. A three month payment installment option is available if needed. I ask that intensives be paid in full before subsequent ones be scheduled.
Q: What are some of the MNRI® programs that you implement in the sessions?
A: There are five main programs that are considered to be the basis of the work we do with MNRI®. These are the programs that are implemented at Family Conferences to facilitate the most positive change.
Reflex Repatterning - Reflex repatterning is simply working with your primary reflex patterns. These patterns have been coded into our neurological system since being in utero. They integrate as we grow and develop, which helps us with motor development, cognition, focus, speech. When our reflexes are unintegrated our system no longer functions efficiently and our body is left with compensations, which is not the most efficient path for our growth and development. This program works with these primary reflexes and helps to integrate them to fulfill their original design and function.
Neuro Tactile - This program works with skin receptors that give the body information through touch. This information is about safety and protection and eventually about comparison and contrasts like hot vs cold, rough vs soft, etc. It also helps our body to be able to understand where it is in space. This program helps to integrate this tactile system so that our brain can properly filter and appropriately respond to any tactile-sensory input.
Neuro-Structural - Neurostructural works with your Core Tendon Guard Reflex. This reflex has a primary function that is vital for protection and survival. We hold onto stress throughout our body through connections to our Core Tendon Guard and the larger muscle groups. This program helps release the stress that causes our systems to become either hyper-responsive or hyporesponsive. It also balances out old patterns of trying too hard or feeling overwhelmed, leaving instead the feeling of inner balance and clarity.
Archetype - Archetype movement is the blueprint of all movements. This varies from the primary movement of flexion and extension to advanced movements that cross the midline of the body. These movements lay the groundwork for our primary reflexes and all movement patterns we will use throughout our lives.
Oral Facial/Visual-Auditory - This program works with your facial motor reflexes and visual reflexes. These reflexes not only affect the facial-visual-auditory system but the whole brain-body system. These reflexes play a foundational role that can impact coordination (example: hand-eye coordination, etc.), communication, and cognitive development. It also helps with physical symmetry, speech development as well as processing of vision and hearing.
* Definitions of programs came from MNRI® website.
Q: What supplemental MNRI® programs do you include?
A: In addition to the programs listed above, there are ancillary programs that may be used in place of one of the main programs if it is more applicable for specific needs and circumstances.
Breathing - Breathing is an essential part of living. It helps give our body the oxygen that it needs to survive, as well get rid of waste through our exhalation. This program helps to improve your overall breathing system which optimizes your health and cognitive resources.
PTSD/Trauma Recovery- This technique is geared toward people who have experienced both acute or chronic stress/trauma. Our approach is unique because we work through the body’s neurological system instead of the cognitive system. This is a bottom-up approach, which is working first with the primary brain pathway. We work through specific natural reflexes to create a sense of safety within the body's system which allows for the stress/trauma to release in a non-cognitive way.
Stress Hormones - Stress hormones are hormones that get circulated in our system when our sympathetic system gets activated. These stress hormones help give us the extra energy we need to have the fight or flight response. This is a survival instinct. The problem is our bodies can hold onto these particular stress hormones throughout the body. Storing these stress hormones can have a negative impact on your overall health. This program helps release those stress hormones from your body.
Proprioception Cognition - Proprioception is the unconscious movement of perception and spatial orientation from stimuli within the body itself.
* Definitions of programs came from MNRI® website.
Q: What is the plan for after an intensive?
A: I almost always recommend that the family take a week (7 days) off from doing any MNRI® to help the body rest and adjust to the changes that were made during the intensive. Once that rest week is over, it is beneficial to get started with the HEP that will be introduced to you during the intensive. If you have any questions or need a refresher on specific techniques, we can schedule a virtual chat to review.
Q: How much time each week should I set aside for the Home Exercise Plan (HEP)?
A: The answer to this question has a lot of variables that factor in, so it won’t be the same for each family or individual. Some children and adults may have more exercises and techniques included in their plan to support the developmental or rehabilitative function of the specific reflexes that need to be addressed and therefore would be looking at needing work every day 1-2 hours. Other plans may address fewer reflexes but require slower and more frequent repetitions of the exercises. Family schedules can also impact the amount of time that can be devoted to completing the Home Exercise Plans each week and is always considered when the plan is created. I generally share with families that even if you are only able to do 30-40 minutes of the plan on assigned days, if you are connected and intentional with the work that you’re doing, you will still be making an impact.