1. Disability As Transformation Saybrook Graduation School June 2006

2. The Whole is Greater Than the Sum of the Parts

3. THE BISCAYNE HEALTHCARE COMMUNITY  MODEL Structure

4. I HOSPITALS & MEDICAL SPECIALISTS T HE H EALTH C ARE C OMMUNITY  PROVIDES A BRIDGE TO THE MEDICAL SYSTEM

5. T HE B ISCAYNE H EALTH C ARE C OMMUNITY  EMPHASIZES HEALTH ADDRESSES PHYSICAL/BEHAVIORAL/COMPLEMENTARY APPROACHES TREATS CHILDREN & ADULTS PROVIDES SEAMLESS DELIVERY TO/FROM SPECIALTY CARE IS COST EFFECTIVE ADVANCES THE HEALTHY PEOPLE 2010 OBJECTIVES

7. Appendix: Short Titles for Healthy People 2010 Objectives 6. Disability and Secondary Conditions Goal:Promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population. Objective Number and Short Title 6-1 Standard definition of people with disabilities in data sets 6-2 Feelings and depression among children with disabilities 6-3 Feelings and depression interfering with activities among adults with disabilities 6-4 Social Participation among adults with disabilities 6-5 Sufficient emotional support among adults with disabilities U.S. Department of Health and Human Services November 2000 6. Disability and Secondary Conditions Goal:Promote the health of people with disabilities, prevent secondary conditions, and eliminate disparities between people with and without disabilities in the U.S. population.

8. Team Approach: Patient & Patient Groups Physicians and Psychologists Physical, Occupational & Speech Therapists Social Workers, Teachers, Art Therapists Traditional Chinese Medicine Practitioners

9. Function: Transdisciplinary Protocols Examples  Physical Therapy & Biofeedback  Relaxation Therapy & Acupuncture  Combined Medical & Psychological Evaluations

10. Activities & Participation: Community Events Examples  Gold Coast Theatre  Miami Opera  Florida Council on Spirituality, Medicine & Healing

12. J “PEOPLE WHO FEEL LONELY AND ISOLATED HAVE THREE TO FIVE TIMES THE RATE OF PREMATURE DEATH AND DISEASE COMPARED TO THOSE WHO HAVE A SENSE OF COMMUNITY.” - Dean Ornish, M.D.

13. Creativity and the Journey Back to Self Marie A. DiCowden, Ph.D. Executive Director The Biscayne Institutes of Health & Living, Inc. Miami, Florida

14. Traumatic Brain Injury:  1.4 Million each year in United States  230,000 people are hospitalized and survive

15. Currently, 5.3 million Americans (2% of the U.S. population) live with disabilities resulting from TBI. The average age is 38.3 years.

16. NIH Consensus Report on Rehabilitation of Persons with Traumatic Brain Injury

17. Neuroplasticity

18. Left Hemisphere Memory Word FindingReasoningJudgment

19. Right Hemisphere Visual Discrimination Visual Spatial MemoryVisual OrganizationVisual SequencingImagery

20. Personality Changes

21. Traumatic Brain Injury Program Cognitive Retraining I (Left hemisphere) Cognitive Retraining I (Left hemisphere) Cognitive Retraining II (Right hemisphere) Cognitive Retraining II (Right hemisphere) Group Therapy Group Therapy Individual Therapy Individual Therapy Biofeedback Biofeedback Meditation Meditation Physical, Occupational, Speech Therapies Physical, Occupational, Speech Therapies as needed and prescribed as needed and prescribed

22. Cognitive Retraining Program:  Modules for Left Hemisphere Retraining  Modules for Right Hemisphere Retraining

23. OBJECTIVESMETHODSMEASUREMENTS (FIM Scales)

24. Cognitive Retraining I EXAMPLES: Memory Notebook Memory Notebook Orientation Orientation Medication Charts Medication Charts Safety Safety Attention Attention Procedures Procedures

25. OBJECTIVES Develop compensatory memory strategies Develop compensatory memory strategies Develop skills to begin and proceed through treatment independently Develop skills to begin and proceed through treatment independently Increase attention and concentration Increase attention and concentration Develop methods to track medication Develop methods to track medication Develop safety check strategies Develop safety check strategies

26. Cognitive Retraining II EXAMPLES: Collage Collage Self Portrait Self Portrait Mask Mask Clay Hand Building Clay Hand Building Bridge Bridge Free Drawings Free Drawings

27. OBJECTIVES Concept of self before and after trauma Concept of self before and after trauma Eye-hand coordination skills Eye-hand coordination skills Visual discrimination Visual discrimination Visual organization Visual organization Visual memory Visual memory Visual planning Visual planning Self awareness and expression Self awareness and expression

28. Collage

29. “The healing journey is so to speak the title of this collage because mine is a healing journey. Are there angels among us? I picked this because of the great many people that had helped me in this journey. They’ve been like angels. Butterflies are picked for their fragility— our own fragility...and last but not least the ‘pain’ word as connected with my car accident but not almost relegated to the background.” Collage description TBI survivor

31. Free Drawings

32. Masks

33. SELF PORTRAITS

35. 3-D CONSTRUCTION

43. CLAY HAND BUILDING

44. CLAY HAND BUILDING

46. Clay Hand Building

47. Brain Injury Figure Project

48. GROUP PROJECTS

50. HEALING BEHIND THE MASK

52. TRANSFORMATIONFROMWITHIN

56. “Ultimately, human intentionality is the most powerful evolutionary force on this planet.” Leonard & Murphy, 1995

57. The Biscayne Institutes of Health & Living, Inc. “A HEALTHCARE COMMUNITY  ”