HappyNeuron Pro Case Study: BIS Services


Type: Brain Injury Support and Cognitive Rehabilitation

Location: Kent, England

Size: 9+ Therapists

HappyNeuron Pro user since: 2020

Clinic's challenge:

Needed an effective solution for remote telehealth cognitive rehabilitation services for clients with brain injury.

About Natalie Mackenzie and BIS

Natalie Mackenzie

Founder and Head Cognitive Rehabilitation Therapist at BIS Services

Natalie Mackenzie provides cognitive rehabilitation services for clients. Natalie is the founder and Head Cognitive Rehabilitation Therapist at BIS Services. She holds a master’s degree in Cognitive Neuropsychology, is a certified brain injury specialist, hypnotherapist, and is the only certified brain injury specialist trainer in the UK.

BIS Services (Brain Injury Support Services) is located in Maidstone, England. BIS Services is the winner of several awards, including the Independent Business Awards Kent (2018), Kent Women in Business Awards (2018), and the Maidstone Business Awards (2019). BIS Services provides brain injury support services, cognitive rehabilitation, and specialized training to survivors of traumatic brain injury.

At BIS Services, clients receive individualized services in their homes. Natalie works with a spectrum of clients who have varying cognitive abilities. BIS Services and Natalie approach brain injury holistically, addressing the neuropsychological, physical, and emotional needs of clients. Individual and personal needs are prioritized, as Natalie understands that brain injury clients differ greatly from one another.

“There are never two days the same. Our work is very individual, very personalized. We work with a wide spectrum of cognitive deficits with clients who are more high level and still able to work, to clients who may be straight out of the rehab facility and we need to reteach functional skills right from the get-go.” – Natalie Mackenzie

Largely, Natalie provides brain injury education to her clients and the client’s family. Brain injury education helps both the client and their support system learn how to help the client and adapt to their loved one’s new life.

Like many therapists, Natalie had to adapt quickly as COVID-19 impacted her client’s method of receiving therapeutic services. Some clients were able to be seen with specialized safety protocols, whereas other clients were not comfortable to have visitors from outside their household. That is where HappyNeuron Pro came in handy for Natalie.

How HappyNeuron Helps

“I’ve been able to set up a lot of HappyNeuron Pro programs for clients who did not want to meet for therapy in person. What HappyNeuron Pro has allowed us to have is a structure so we could underpin the client’s day and start their day with HappyNeuron Pro. HappyNeuron Pro allowed us to engage with clients by allowing us to look at their scores and have a conversation around that” – Natalie Mackenzie

Therapists are able to set up home exercises for clients to complete on their own. After clients complete exercises, results are readily available in their profile. Clinicians are able to click on a client’s profile to check a client’s progress over time as well as see when clients are performing home exercises. The COVID-19 pandemic has also taught many people about how their current life situation may not be optimal for their needs. For example, clients with brain injury are particularly sensitive to stimuli, such as noise, lighting, the number of people in a space, and sometimes even smells. Because shops and public spaces have had to change their opening capacity, some clients with brain injury have learned that they enjoy a slower more calm pace of life than a busier one.

“The pandemic has had a positive impact on some of my clients. The situation has taught some of my clients that they enjoy the quieter environments and they feel less fatigued. Other clients are ready to get back, but we have to say to them that we have to do that in a graded manner or else we’ll have the same issue with fatigue”. – Natalie Mackenzie

Fatigue is a big obstacle for clients with brain injury. Clients may be eager to resume activities as normal prior to experiencing their brain injury, thus resulting in over-exertion. Ways therapists can prevent this from happening is by providing brain injury education that informs the client about when they become fatigued and what the experience of fatigue is like. With HappyNeuron Pro, Natalie can see when their client is experiencing fatigue and adjust their treatment plan to ensure that she is challenging her clients within their energy means.

“One client I work with, I can check his HappyNeuron Pro results and see that he made more errors during an exercise session. I can see that 20 minutes into his 40 minute session, he stopped.” – Natalie Mackenzie

Client engagement has also been an uphill battle for many therapists during the COVID-19 pandemic. Clinical providers all over have been searching for ways to engage their clients and help them keep up with their rehabilitation. Digital cognitive therapy tools are effective in doing this, as digital cognitive therapy tools allow clients to complete exercises and receive feedback almost immediately. Therapists often use functional activities to supplement the cognitive training component of their client’s therapy, which can help the client translate practiced cognitive skills to their daily lives and understand what areas of cognition they are struggling with.

“In terms of utilizing HappyNeuron Pro, just engagement has been the biggest thing. What HappyNeuron Pro has allowed me to do from an insight and awareness perspective is really give my client’s back evidence. Say, if you want to improve your visual memory area, then this is what you need to be doing functionally. I’ll have my clients do functional activities and I’ll review the changes I see with them in their HappyNeuron Pro activity scores.” – Natalie Mackenzie

With hidden brain injury, one cannot see exactly where the injury is impacting them on a daily basis. For many clients with brain injury, it is hard for them to realize that they need to implement strategies during the day to help them complete everyday life activities. Cognitive rehabilitation services that focus on not only rehabilitating cognitive functions but assist in the development of compensatory strategies can help clients with brain injury engage with their daily life activities that they enjoy.


HappyNeuron Pro allows clinicians to provide a range of remote options for cognitive rehabilitation sessions.


HappyNeuron Pro allowed BIS and their clients to remotely complete sessions and workouts in between sessions. Natalie has found that patient engagement has increased with HappyNeuron Pro.

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