When clients come to Origami one of the goals is to transition them into the community by teaching them the skills they would need to be successful in the community. One-on-one support is given to the client once they are transitioned into their own independent living situation. The Community Integration Coordinator assists the client three times per week in the clients home, with house management, maintenance, and activities of daily living. The goal of the Community Integration team is to help the client take the structure learned in the facility into his or her own independent living situation. Support from the Community Integration team decreases as the amount of initiation and follow up from the client increases.

Occupational Therapy

Shopping:
a) Organizing/Planning: Formulating a list of items that are needed.
b) Decision Making: Deciding which stores, name brands, etc. are the most appropriate while keeping costs in mind.
c) Money Management: Ability to decide appropriate form of payment and how much money is available for the amount of items on the list.
d) Problem Solving: Determining quantities and costs of items being purchased.
e) Linguistic Short-term Memory: Remembering items needed to be purchased without having a list to refer to.
f) Endurance: Ability to maintain energy to complete the shopping trip.
g) Balance: Able to maintain balance when walking in stores that are crowded and cluttered.

ADL’s:
a) Initiation/completion: Ability to begin and complete all ADL’s that client is responsible for in his/her routine.
b) Use of Compensatory Technique: Ability to use techniques to safely and effectively performs all ADL’s. (i.e. dressing affected limb first/undressing affected limb last, electric razor if poor muscle control and coordination).
c) Use of Adaptive Equipment: Using equipment such as reachers, sock aids, button hooks, plate guards, rocker knife, and built up/extended handles to complete ADL’s.
d) Safety Awareness: Demonstrating safety when performing ADL’s (i.e. testing water temperature with unaffected hand if sensory deficits, sitting rather then standing decreased balance).
e) Fine Motor Coordination: Ability to button, tie, zip, velcro, etc all fasteners.
f) Static/Dynamic Standing and Sitting Balance: Ability to maintain balance while performing various ADL’s with or without equipment (i.e. may require tub seats for bathing if decreased dynamic standing balance).

Family Education and Support Groups:
a) Deficit awareness
b) Stress management/relaxation techniques/ coping strategies.
c) Social interaction-establishing goals and interests within the group.

Formal Education: (LCC, TBI, Computer, etc.)
TBI:
a) Self awareness-gaining insight about self.
b) Deficit awareness-gaining knowledge about individual diagnosis.
LCC/Computer:
a) Interest exploration
b) Career exploration
c) Competency/Performance-increasing one’s performance/competency within a specific area.

Neurobehavioral Counseling:
a) Coping Strategies: Assisting client in changing his/her outlook on the current situation to a more optimistic perspective to assist in coping.
b) Self-Awareness: Gaining insight about him or herself.
c) Deficit Awareness: Becoming more knowledgeable about one’s own deficit (s), risks, etc.

Communication Skills:
a) Verbal Expression: Ability to verbalize ideas, needs, thoughts, and interests.
b) Written Expression: Ability to effectively express ideas, needs, thoughts, and interests in written format.
c) Comprehension: Demonstrate ability to comprehend verbal and written information.
d) Social Interaction: Ability to effectively interact with other individuals using good verbal and nonverbal feedback.

Physical Therapy

Shopping:
Shopping for groceries and other supplies necessary at Origami will facilitate an improvement in gait training, transfer training, endurance, upper extremity range of motion and balance, and upper extremity proprioception by reaching, carrying and holding objects.

ADL’s
Typical activities of daily living occurring in and around Origami will facilitate and improvement in coordination and balance. Even simple activities such as changing sheets, or putting away laundry may provide a challenge in a persons ability to transfer while carrying a certain weight and ambulating on level surfaces with vision partially occluded (unable to see the floor directly in front of them secondary to carrying objects.) In this manner gait training will also be addressed.

Speech Language Pathology

Shopping:
a) Generate a list of items needed.
b) Read labels to ensure you are buying correct item. (i.e. flavor, low fat, regular, etc.)
c) Read signs in store to assist with finding target items.
d) Demonstrate appropriate social interaction with peers and members of the community.
e) Time management.

ADL’s:
a) Following verbal cues given by staff
b) Word retrieval-name objects being used or needed.
c) Reading ADL checklist.
d) Reading entries made in planner.

Psychology

Shopping:
a) To increase awareness of environment.
b) To develop increasing competence to meet one’s own needs.
c) To demonstrate safe/appropriate problem solving/judgement.

ADL’s:
a) To increase awareness of self and others.
b) To be oriented to person, place, and time.
c) To demonstrate an awareness of one’s deficits.

Family Education Support Groups:
a) to increase awareness of self and others
b) To develop increasing competence to meet one’s own needs.
c) To interact as a member of a group.
d) To initiate spontaneous interaction to increase knowledge about patient needs and concerns.
e) To be involved in patients plan of care and goal setting as an integral member of the treatment team.
f) To foster and preserve family cohesion.
g) To gain a realistic appraisal of patients functioning, and both short and long term needs for care and supervision.
h) To correct knowledge deficits
i) To develop realistic goals and objectives
j) To correct knowledge deficits.
k) To use strategies for alleviating stress.
l) To enlist support from family/significant others.
m) To plan for discharge care and service.
n) Respect sexual identity and needs of others.
o) Recognize and understand sexual dysfunction.
p) To increase understanding about the risks associated with head injury and drug/alcohol use.

Formal Education: ( LCC, TBI, Computer, Etc.)
a) To develop increasing competence to meet one’s needs.
b) To demonstrate the ability to monitor one’s behavior.
c) To demonstrate an awareness of one’s deficits.
d) To incorporate treatment goals into action.
e) To set realistic goals.
f) To demonstrate safe/appropriate problem solving/judgement.

Neurobehavioral Counseling: (Emotional management, Social skill training, etc.)
a) To increase awareness of self and others.
b) To establish an appropriate means of communication with team members.
c) To interact with individuals.
d) To interact as a member of a group.
e) To initiate spontaneous interaction.
f) To exercise self-control.
g) To demonstrate an awareness of one’s deficits.
h) To set realistic goals.
i) To demonstrate safe/appropriate problem solving/judgement.
j) To increase attention span or attention to a task.
k) To increase awareness of relationship between action-behavior-consequence.
l) To decrease inappropriate behavior.
m) To increase or decrease sleep/rest appropriate to functional activity.
n) To decrease (or prevent) inappropriate sexual behavior (touching, words, actions).
o) To increase self-control based on awareness of appropriate social interaction.
p) To increase interpersonal competency regarding the needs of others.
q) To increase internal motivation and decease external prompts or cues.
r) To increase personal insight.
s) To correct knowledge of deficits.
t) To develop realistic goals.
u) To use emotional outlet for frustration, anger, and discouragement related to functional changes in status.
v) To benefit from treatment related to changes and fluctuations in mood and effect.
w) To use strategies for alleviating stress.
x) To alleviate or decrease pain.
y) To reestablish sexual identity.
z) Respect sexual identity and needs of other people.
aa) To recognize and understand sexual dysfunction.
bb) To comply with a therapeutic drug regimen.
cc) To abstain from drugs or alcohol during recovery from head injury.
dd) To increase understanding about the risks associated with head injury and drug/alcohol use.
ee) To increase awareness and knowledge regarding the consequences of drug/alcohol abuse.

Communication Skills:
a) To increase awareness of self and others.
b) To respond with purposeful gestures or words.
c) To ask for assistance to meet one’s needs.
d) To establish an appropriate means of communication with team members.
e) To interact with individuals.
f) To interact as a member of a group.
g) To initiate spontaneous interaction.
h) To demonstrate the ability to monitor one’s behavior.
i) To decrease or prevent inappropriate sexual behavior (touching, words, actions)
j) To increase self-control based on awareness of appropriate social interactions.
k) To increase interpersonal competency regarding the needs of others.

Vocational Therapy

Shopping:
a) Decision Making: To demonstrate cost effective decisions of deciding on which stores, brand name etc.
b) Problem Solving: To demonstrate the ability to determine quantities and cost of items being purchased.
c) Social Interactions: To demonstrate the ability to communicate appropriately with peers and members of the community.

ADL’s:
a) Hygiene: To demonstrate the ability to be dressed appropriately, clean/kept appearances to be socially accepted in the work place.

Formal Education: (LCC, TBI, Computer etc.)
a) Interests: To have an opportunity to explore interest areas in particular areas of study.
b) Skill Development: To demonstrate the ability to participate in an identified area of formal study/classes.

Neurobehavioral Counseling:
a) Coping Strategies: To learn ways to change outlook on current situation to a more optimistic perspective.
b) Self Awareness: To gain personal insight.
c) Deficit Awareness: To have an opportunity to become more knowledgeable about one’s own deficits, risks, etc.
d) Goal Setting: To have an opportunity to discuss, explore realistic vocational goals.

Communication Skills:
a) Verbal Expression: o demonstrate the ability to verbalize ideas, needs, thoughts, and interests.
b) Written Communication: To demonstrate the ability to effectively express ideas, needs thoughts and interests in written format.
c) Comprehension: To demonstrate the ability to comprehend verbal and written information.
d) Social Interaction: To demonstrate the ability to effectively interact with other individuals using good verbal and non verbal feedback.