Rehabilitation vs Habilitation: What’s the Difference?
What is the difference between rehabilitation vs habilitation? While these two words sound very similar and can seem confusing, these two words have distinct differences.
Most people know what rehabilitation means, but habilitation is its lesser known cousin. So, we’ll outline the differences, as well as the similarities, and why it’s important to be able to distinguish between the two.
Rehabilitation vs. Habilitation
Rehabilitation
Rehabilitation is the process of relearning skills that have been affected due to an injury or medical condition. These are skills and functional abilities that you once had but have subsequently lost or compromised. An example of this is learning how to move your arm again after a stroke or traumatic brain injury. It is the process of regaining strength and range of motion in the arm that you had prior to the stroke.
Habilitation
Hibilitation is the process of learning and mastering a skill for the first time. With habilitation, the person is not able to rely on any previous memory of how they used to perform that skill, as it is novel for them. An example of this is a child with cerebral palsy learning how to walk.
Habilitation and rehabilitation both focus on targeting areas of impairment to improve overall function and independence. By understanding and promoting these definitions, we are supporting the principle that therapy benefits should include services that help individuals attain and maintain skills, and not just regain skills and previous level of function. Intervention for both services can look very similar and target similar goals. The only difference is whether you are learning the skills for the first time.
So What is the Major Difference?
In rehabilitative therapy, the patient already has inherent knowledge of how the skill used to be done. The neural pathway has already formed, and the patient usually knows what is required of their body, but they are currently unable to do so due to their injury or condition. The exception may include individuals with lower levels of alertness or severe cognitive impairments impacting their memory of the task.
In contrast, in habilitative therapy, the patient is learning how to do the movements to engage in the activity for the first time. They are unable to rely on pre-existing knowledge and understanding of how to move to engage in the activity. They have not yet created the neural pathways needed to engage in the activity, so as an occupational therapist, you are helping them understand what movements are needed for the activity. Children can receive habilitation services in health care and the community, but it is more common that they are seen as part of outpatient therapy, in schools, or home settings.
Many think of habilitation services as being limited to children. Don’t forget that it can apply to adults as well, such as an adult with an intellectual disability learning a skill for the first time as an adult at an adult job training center.
It is also important to remember that someone who is currently receiving habilitation, may also require rehabilitation at some point in their medical journey.
Let’s use the example of a child with autism who burns his hand. He typically attends occupational therapy for habilitative service, but he now also requires rehabilitation for the burn on his hand.
We would love to hear another example of a patient that you had that you were offering habilitation and they then needed rehabilitation as well. Feel free to tell us your story in the comments.
Rate of Progress in Habilitation vs Rehabilitation?
As with all conditions, it is impossible to put a timeline on the recovery or rate of progress. One can argue that patients undergoing rehabilitation will progress faster as they already have the neural pathways created.
However, patients undergoing habilitation are often babies or children, and we know the beauty of the young brain and how quickly neuroplasticity happens. So, as always, it is dependent on so many factors: the severity of the condition, age, co-morbidities, support, access to therapy, and even motivation.
The goal of both rehabilitation and habilitation is to enable people with disabilities to gain maximum independence and to improve their quality of life.
Insurance Coverage Differences
The reason it is important to distinguish between the two services is for health insurance coverage. In the past, insurance plans were more prone to paying for rehabilitative services and hardly covered habilitative services.
Prior to January 2017, most insurer carriers did not require occupational therapists to stipulate whether they were providing rehabilitation or habilitation services.
Since then, however, many payers have required occupational therapists to distinguish which one they are using. This was done in an effort to provide equal coverage. Habilitative services include: occupational therapy, physical therapy, and speech language pathology.
For this purpose, it is beneficial to reflect in your therapy notes whether you are providing intervention for the patient to learn a skill for the first time or if they are relearning a skill. That way, your documentation is confirming the modifier that you have selected.
It is important to note that not all health plans require you to specify whether you are using rehabilitation vs habilitation services, so it is important to check with your individual payers.
In Summary
Rehabilitation and habilitation services may offer very similar interventions, with the key difference being whether the skill is being learned for the first time or not, depending on when the onset of the medical condition occurred.
Understanding the difference can be important for insurer carriers, but ultimately it won’t really change your therapy sessions. As always, occupational therapists assess the individual and tailor our therapy services accordingly in order to help the person gain more independence.
We hope that after reading this article, you feel more confident in understanding rehabilitation vs habilitation.
