INTREPID CENTER MISSION“To enhance life functions/ roles of individuals who experience symptoms from a mild TBI

(mTBI) event through evidence based evaluation and treatment techniques while also

contributing to the development of practice standards in the field.”

GOALS

NEEDS

HEAL: HEALTHY EXPLORATION OF ACTIVE LEISURE

SITE IMPROVEMENT PLAN

ACKNOWLEDGEMENTS

Cognitive Intro to HEALing

Leisure introduction

Card games

Creative HEAL your heARTs

Work/ life balance

Drawing, Painting, Sculpture

Physical Walk on your HEALs

Improve quality of life

Yoga, obstacle course

Cooking Mindful

Cheers to your good HEALth!

Mindfulness, habits and routines

Make energy bites

Individual Passive

See, hear, feel, HEAL

Calendar, barriers,

relaxation

Make slime, podcast

Recap Review

Now you are HEALed

Write goal and plan

Family Feud, Minute to

win it

• Research, develop and trial a six session group protocol for HEAL (Healthy Exploration of Active Leisure) OT group.

• Experience multi-discipline approach at Intrepid Spirit Center to understand service member’s experience in the program.

• Enhance clinical understanding and leadership regarding OT’s role with cognition, attention, and vision therapy.

MILITARY CLINICAL EXPERIENCE

• Army Service Members: Thank you for your openness and vulnerability. It was a privilege working with each of you - Thank you for your service!

• Expert Mentor Mark Showers: Thank you for your time, support, candor, patience and challenging conversations. I appreciate your waffles to my spaghetti!

• Faculty mentor Dr. Christine Manville: Your ideation and mental health knowledge challenged me to think differently! Your support has greatly influenced my growth as I become an OT.

• Intrepid Spirit Center of Excellence Staff and OT Department: Thank you for showing me firsthand the benefits of a holistic integrative clinic and allowing me to be part of the team!

• Belmont University OT Department and classmates: The fellowship of this group has both supported and challenged me throughout the process.

MedicalStabilizationSleep•SleepHygiene

•SleepTests

MedicationManagement

Headaches

PainManagement

EmotionalRegulationRelaxation

• Yoga• HRV

• TSR

CPT

CBT• Anger Management

Groups

•SharpeningResilience

•ChangingFocus

RehabilitationOT

•Vision•HRV

•CogGam

•Leisure

•CaMO

•Individual

SLP

•Memory

• Study

• SpeakingArts

• Individual

PT

•PTTherex

•Yoga

Groups

•TAG

•Comm Re

•BrainTrain

ReferralReceived

ProviderReviewsReferral

Part1NursingIntake

ProviderPhysicalExam

NICoE TBIClinicPatientFlowchart

*Throughouttreatment,patientwillf/uwithNCM&/orFMatleastmonthly

ArenaInterview&NCMVisit

“Leisure can provide unique meaning that a person may not be able to attain from other occupations,

including a sense of freedom, physical and mental relaxation from obligations and routines, a channel of

self-expression and exploration of one’s identity, and a platform for social engagement with family, friends,

and society.” (Leisure as an End article)

PURPOSE: The purpose of HEAL (Healthy Exploration of Active Leisure) is to increase

exposure and promote engagement in leisure activities. Through leisure exploration,

patients will gain an understanding of the importance of incorporating leisure activities into

everyday life as a part of the overall healing process for mind, body, and spirit. Participants

will have choice and ownership of activities during each session. Sessions will include active

participation in leisure activities in a variety of categories including: cognitive, creative,

and/or physical leisure. Leisure experiences will include mindfulness as a tool for stress

reduction and encourage engagement of all senses. Through a positive group experience,

participants will experience first-hand the benefits and availability of a wide variety of

leisure activities while connecting with other service members. Participants will complete

assessments and activities to help define areas of personal interest, identify time for

leisure, and discuss ways to change habits and routines to promote leisure and

ultimately improve quality of life.

• Updated curriculum, interventions and research regarding OT’s role with leisure exploration to improve quality of life for service members.

• Explore clinic improvement needs based on current design and recent DOD report: clinic objectives and design, Inspire and Multi Disciplinary Meetings, discipline flow and pain points.

EDUCATION:• Learn/ discuss Army culture• Research: Military , TBI, cognition, leadership,

interdisciplinary care• MFAP: Military Functional Assessment

Program • Multimedia: Hackshaw Ridge, Homecoming,

Restrepo, Saving Private Ryan, leadership audio books

• Team meetings: Huddle, Inspire, Multi D

INTERPROFESSIONAL CLINICAL SESSIONS:• SLP: Executive function assessment, treatment• PT: Neuro com, movement and VOR exercises • PCM: Intake, acupuncture, cupping• Case Management: Inspire meeting • Sleep: Intake, sleep study results• Art therapy: Group session• Behavioral health: Alpha stim, CBT • Neuro – Optometry: Prism glasses • Neuro psychology: Alpha Stim, QEEG

“Red teaming provides units and organizations an independent

capability to fully explore alternatives in plans, operations, concepts,

structures and capabilities in the context of the operational environment

and from the perspectives of our adversaries and others… Red teaming

enhances planning, intelligence, and operations by challenging

assumptions, plans, estimates, and offers alternative perspectives to

improve decision making in today's dynamic and uncertain

environment.” (army.mil website)

TAKE – AWAYS

DELIVERABLES:

• Identified clinic concerns – convergent/ divergent thinking

• Identified patient care vulnerabilities• Mission statement survey and research • Clinic design – past, present, discussion

and research• SWOT analysis Multi D • SWOT analysis of Inspire • SWOT analysis of MFAP • Multi D form thoughts – solutions• OT improvement ideas • Plan of site improvement retreat• Power point and leadership meetings

DELIVERABLES:

• OT rationale, model, design,

leadership

• Leisure research

• Six 1 hour session protocols

• Session handouts

• SOAP note template

• Skill assessment

• Feed back from SM

• SWOT analysis, reflection,

program evaluation

• Staff presentations and training

OCCUPATIONAL THERAPY: • Assessments: NAB Attention Module, COPM• Vision: COVD, screening, treatment sessions• Explore/ research OT role in cognitive

rehabilitation • 1:1 sessions – Cognitive strategies

o Human info processingo Attention hierarchyo Focus strategieso Relaxation strategieso Memory strategieso Dynavisiono Build your own therapy houro Doll chair assembly activity

• Groups: Cognitive Gaming, TAG

PERSONAL DEVELOPMENT:• Practical application of school

objectives and model of practice through group design and facilitation

• Increase empathy, capacity, and confidence working with vulnerable service members

• Enhance OT skills: assessments, cognitive rehabilitation and education, group facilitation, vision therapy

• Collaboration with co-workers to develop patient plan of care

• Skill development: time management, written/ oral communication, leadership

“It was fun! I played the

card game with my wife last

night!”

“I want to be mindful to

take time to do activities I find

valuable.”

“I want to reduce the

amount of time I spend on my

phone and on social media and

be more active.”

“I learned that physical

activity affects brain

processing.”

Leisure Topic Name Discussion Activity

GOALS:

1. Experience joyful social active leisure during group sessions

2. Increase understanding of the importance of leisure and how it can improve cognitive performance and quality of life

3. Prove accessibility of leisure in everyday life

4. Empower change in routines and habits related to work-life balance and leisure

5. Incorporate and apply experiences from other disciplines and providers into the group

Through red teaming and

convergent/ divergent thinking

exploration we were able to study the

service members’ experiences and clinic

design at Intrepid Spirit Center. By

identifying vulnerabilities and pain

points, we can start to explore ways to

change and continue to set high

standards of excellence. Tools were

created to increase awareness of pain

points and discussed with management.

We completed a cultural study including observation of OT and other discipline sessions, research related to TBIs and military life, in-the-field experiences, and functional assessments. With this, we identified several common traits of service members: a rigid schedule and dependence on dictated directives, a lack of awareness related to the importance of leisure, and a decreased ability for work-life balance. To help solve these problems, we created the HEAL program to increase an awareness for the need to change and improve quality of life. Our hope is that OT can provide the awareness of the desire to change, as well as provide the resources for increased leisure experiences to improve all aspects of their lives.

Advancing OT within the Interdisciplinary Model through Program Development and

Integrative Client Centered Care at Ft. Campbell Intrepid Spirit CenterMARIA PAPADOPOULOS, OTD/S

CLINICAL EXPERIENCES: • Immersion and integration with the population improves the

sustainability and effectiveness of the product.• Education and change are not solely measured by tangible or visible

results. There is significant value in the process; the resiliency developed can be more valuable than the change itself.

• Red teaming and convergent/ divergent thinking processes are best completed with a team. This collaboration can help promote buy-in and positively impact success.

• Planning and managing expectations are important tools in program development. However, they should not be limiting, as you cannot know what will be the ultimate outcome. Having flexibility to adapt and overcome challenges are also vital learning experiences.

• Clinical care is different for each individual. It is most important for the client to be seen, heard and valued, and feel that they are the decision-maker in their care process.

• When developing new areas of practice and programming, it’s especially important to know the population and advocate for their needs.