The Clubhouse serves as a welcome neighbor, providing a staging ground where Members attend clinical therapies and participate in work skills and recreational activities. The Clubhouse model allows for Members to be engaged in the rehabilitation process by day, while returning to their own home–not an antiquated institutional setting–in the late afternoon. All of our Members reside at home with loved ones or participate in our Home and Community Based Rehabilitation program where members are assisted with renting a house, townhome, apartment, or condominium within close proximity to the Clubhouse. Clubhouses are strategically located in downtown areas so Members can have full access to the community resources that aid in their rehabilitation.
Depending on each Member’s level of care and need for assistance, our clinicians, therapists, and life skills specialists work alongside our Members as mentors to assist in the development of generalizable skills. Skills are taught through a pro-active approach, focusing on positive praise, reinforcement of desired behaviors, preventive problem solving skills, and corrective teaching (as necessary). Through this functional approach, Members are able to practice community re-entry skills in the exact place they are expected to use those skills–in their homes, the community, and the work place.
Internal Case Management
According to the Commission for Case Management Certification (CCMC), Case Management is defined as a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client’s health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes.
At Communicare Michigan, our case managers strive to act in accordance with the philosophy that everyone benefits when our Members reach their optimum level of wellness, self-management, and functional capabilities. Case Managers help to coordinate care for Members in the following areas:
- Assist Members with medical and psychiatric treatment by scheduling and attending appointments with Pain Management Physician, Psychiatrist, Neurologist, Surgeons, Gynecologist, and Primary Care Physician
- Update physicians regarding Member progress in programming, changes in medications, and member concerns or issues
- Medication management by filling prescriptions, dispensing medications monthly, providing education, and monitoring symptoms and side effects
- Communicate with insurance companies and adjusters to ensure eligibility regarding Member’s services and medical needs as it relates to their auto accident
- Coordinate transportation for Members by working with transport companies and Site Managers
- Assist Members in obtaining State Funded Services and link them to the appropriate organizations
- Assist in legal matters by attending court dates, creating reports and generating documentation for hearings and probation department when necessary
- Refer Members or family to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, job placement or education
- Refer Members to community resources for treatment of mental health or cognitive issues
According to the American Occupational Therapy Association (AOTA), Occupational Therapy is defined as the therapeutic use of occupations, including everyday life activities with individuals, groups, populations, or organizations to support participation, performance, and function in roles and situations in home, school, workplace, community, and other settings. Occupational therapy services are provided for habilitation, rehabilitation, and the promotion of health and wellness to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perceptual, and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life.
At Communicare, occupational therapy is supported by evidenced-based practice and uses client-centered and task-oriented approaches to assist clients in compensatory and remedial strategies. Occupational therapy focuses on increasing the skills necessary for independent living, community reintegration, and vocational tasks such as participating in school courses and obtaining viable employment in the community. Our Occupational Therapists assist our Members in the following areas:
- Pre-vocational skills – resume building, interview skills, locating employment opportunities, and assessing physical and cognitive abilities related to job performance.
- Therapeutic exercises and functional movements– increasing range of motion, strengthening activities, coordination, joint protection and energy conservation techniques.
- Education – collaborate with Members to complete financial, meet with academic advisors, assist with academic planning, and setting up resources in classroom.
- Functional memory skills — compensatory strategies such as using assistive technology to increase memory during activities of daily living.
- Home management tasks – meal planning and cooking skills, budgeting and money management, creating routines for daily activities, cleaning and organizational skills, and time-management techniques.
According to the American Speech-Language-Hearing Association (ASHA), a speech-language pathologist is responsible for the diagnosis, prognosis, prescription, and remediation of speech, language, and swallowing disorders. A speech-language pathologist evaluates and treats children and adults who have difficulty speaking, listening, reading, writing, or swallowing. The overall objective of speech-language pathology services is to optimize individuals’ ability to communicate and swallow, thereby improving quality of life.
At Communicare Michigan, LLC Speech Language Pathology provides comprehensive evaluation and treatment of communication, cognitive, and swallowing disorders.
Some treatment areas include:
- Speech Disorders: Voice (vocal quality changes, vocal cord paralysis, polyps and nodules), Apraxia (difficulty imitating speech sounds, change in rate, inconsistent errors), Dysarthria (slurred speech, hoarseness, breathiness), Articulation, Accent Reduction
- Language Disorders: Aphasia (receptive and/or expressive language deficits, word retrieval errors, difficulties with written expression, reading comprehension and processing, auditory comprehension and processing deficits), Higher level language deficits (forward planning, time management) ** Results in an inability for the client to make wants and needs known effectively and efficiently
- Cognitive Disorders: Impaired memory (short or long term memory loss), disorientation, difficulty sequencing, problem solving, safety awareness, difficulty managing medication or personal finances, mathematical computation, reduced attention and concentration
- Dysphagia: Coughing, choking, wet/gurgly vocal quality, drooling, weight loss, changes in appetite, diet texture analysis; training of compensatory swallow strategies, oral motor exercises, pharyngeal strengthening.
Some treatment approaches include:
- Voice: The Boone Voice Program for Adults (Daniel R. Boone), The Phonetic Placement Method
- Language: Treatment of Aphasia: Special Techniques or Programs ( N. Helm- Estabrooks)
- Cognitive: Direct Attention Training (M. Sohlberg), Intervention for Memory Disorders (Avery & Kennedy)
- Dysphagia: Supraglottic Swallow Manuever, Chin Tuck, Hard Glottal Attack (Jerilyn Logemann)
Cognitive Rehabilitation Therapy
According to the Brain Injury Association of America (www.biausa.org) cognitive rehabilitation is a systematically applied set of medical and therapeutic services designed to improve cognitive functioning and participation in activities that may be affected by difficulties in one or more cognitive domains. Impairments of cognitive function are among the most common and important problems that lead to disability after acquired brain injury.
According to Sohlberg & Mateer, (2001) Individuals and families respond differently to different interventions, in different ways, at different times after injury. Premorbid functioning, personality, social support, and environmental demands are but a few of the factors that can profoundly influence outcome. In this variable response to treatment, cognitive rehabilitation is no different from treatment for cancer, diabetes, heart disease, Parkinson’s disease, spinal cord injury, psychiatric disorders, or any other injury or disease process for which variable response to different treatments is the norm.
At Communicare Michigan, we understand that treatment of cognitive impairment is central for treatment and recovery for individuals with traumatic brain injury because of the impact cognitive deficits have on safety, responsibilities of independent living, and social interaction. Some important ways that our multi-disciplinary team of clinicians and support staff work to improve cognitive functioning in our Members include:
- Social skills training in the community and work environment
- Understanding basic neuroanatomy
- Understanding own brain injury
- Understanding cognitive problems following brain injury
- Understanding emotional problems following brain injury
- Understanding how to cope with changes and challenges
- Developing a new sense of self.
- Safety awareness
- Computer aided games and other cognitive games and exercises each targeting impairment in slightly different ways
- Training in responsibilities of independent living
- Meal planning and preparation
- Shopping and budgeting
- Home repairs and maintenance
- Money management
- Time management
Mental Health Therapy
According the American Counseling Association (ACA) Mental Health Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.
At Communicare Michigan, LLC mental health counseling services are provided as a means of holistically addressing the psychological and cognitive needs of our Members. Mental health therapy is supported by evidenced based therapeutic interventions which include but are not limited to Cognitive Behavioral Therapy (CBT), Rational Emotive Behavioral Therapy (REBT), Trauma-Focused CBT, Solution Focused Therapy (SFT), Dialectical Behavioral Therapy (DBT) informed approaches, Mindfulness Based Stress Reduction (MBSR), and Motivational Interviewing (MI).
By implementing a dynamic, strengths-based, and psychoeducational approach, mental health therapies can effectively address needs commonly associated with traumatic brain injury including:
- Grief and loss issues
- Changing family roles
- Adjustment and behavioral concerns (including impulse control problems)
- Sexual issues
- Mood disturbances and disorders
- Thought disturbances and disorders
- Anxiety related disorders like Panic Disorder, Post Traumatic Stress Disorder, and Agoraphobia
- Substance misuse and abuse problems
According to the American Art Therapy Association (AATA), Art Therapy is a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem.
At Communicare Michigan, Art Therapy is provided as a means of integrating vital rehabilitative skills that aid in the generalization of problem solving from task to real life situations. Some of the focuses, advantages, and benefits of Art Therapy include:
- Using art as a means of communication and self-expression
- Images are less threatening than using only words and talking
- Using art may be an easier way to express emotions
- Re-engagement with an individual’s creative abilities – a process that encourages exploration and emotional growth
- Relaxation and stress relief
- Confidence building, self-validation, realization of one’s potential
- Freedom to make decisions and experiment/test out ideas creatively
- Insight, self-awareness, self-reflection
- Creative problem solving
- Regaining everyday living skills
A Recreational Coordinator utilizes a wide range of activity and community based interventions and techniques to improve the physical, cognitive, emotional, social, and leisure needs of their clients. Recreational Coordinators assist clients with developing skills, knowledge, and behaviors for daily living and community involvement. The coordinator works with the client and their family to incorporate specific interests and community resources in order to achieve optimal outcomes that transfer to real life situations.
At Communicare Michigan, recreational coordination is provided as a means of restoring, remediating and rehabilitating a person’s level of functioning and independence in life activities. Our recreational coordinator promotes health and wellness and works with our Members to reduce or eliminate activity limitations and restrictions as Members are adapting to a new means of living. Some of the benefits we intend for our Members when they participate in recreational services include:
- Overall improvement in physical health and a reduction in health risk factors
- Improvement in physical functioning
- Improvement in psychosocial health and well-being
- Reduction in medical complications and increase in rate of healing
- Improvement in cognitive functioning
- Improvement in psychosocial supports and psychological health
- Decrease in manifestations of stress and depression
- Improvement in social interaction and communication skills
- Increase in age-appropriate behavior in community
- Enhancement of friendship and social support networks
- Enhancement of ability to cope with hospitalization and medical procedures
- Improvement in familial coping
- Improvement in ability to manage stressors which threaten sobriety
- Enhancement of sober lifestyle and identity
- Reduction in reliance upon the health care system