Individual Direct Time Process for Transfer of Function to Therapy Support Worker OT/PT Department

1. Page 1 Aug 2009 Individual Direct Time Process for Transfer of Function to Therapy Support Worker OT/PT Department August 2009 Therapist identifies a client who would benefit from services from the Therapy Support Worker (TSW). • Points to emphasize with family/guardian: • TSW is not a therapist • TSW works with the child under the supervision • of the therapist • TSW is not responsible for setting goals or developing • activities – these are done with the guidance • of the supervising therapist • TSW is not qualified to assess skills or provide • information about a child’s diagnosis, progress • or prognosis Therapist discusses the role of the TSW with the family/guardian, and assesses their interest in having TSW work with their child. If the family/guardian is interested in having TSW services, the child Is put on the TSW program waitlist, using the Internal Referral form Receptionist adds client name to TSW program waitlist on HOMES TSW waitlist is discussed at monthly department meetings, and priority/urgency is set with input from all therapists. TSW schedule is developed through conversation with all therapists in the department.

2. Individual Direct Time Process for Transfer of Function to Therapy Support Worker Page 2 Aug 2009 Moving from TSW Waitlist to Active Therapist establishes goals with the family/ guardian to be targeted during TSW service delivery time. Activities are developed with family/guardian, therapist and TSW input. Clear timelines are decided upon (how many weeks, how often per week, start date and end date.) Therapist joins the TSW at least twice more during visits, once in the middle of the arranged sessions, and at the final one to assess progress.. Some families may benefit from a printed schedule to outline visit dates, identify who will be attending, and provide a contact phone no. in case of cancellations (see Sample attached) Therapist attends first visit with TSW to introduce the child and family, to observe TSW working with the child, and to ensure competency. Ongoing communication between TSW and therapist is important to ensure that activities progress as appropriate, that therapist is aware of what activities work and do not work, and that modifications can be made as necessary Therapist completes and signs Review of Competency Form and files this in client’s file

3. Page 3 Aug 2009 Individual Direct Time Process for Transfer of Function to Therapy Support Worker Documentation and HOMES Therapist Therapy Support Worker (TSW) Therapist moves client from Monitoring to Active, if not already in the Active program TSW moves client from Therapy Support Waitlist to Therapy Support OT/PT program. Therapist revises Needs Assessment on HOMES to reflect the goals being targeted by TSW. TSW documents activities and observations on HOMES, under Therapy Support OT/PT Program. Therapist documents in HOMES 1) clients will be seen by TSW 2) transfer of function is complete. Therapist writes out goals and activities for TSW to follow (see Sample attached). Upon Completion of TSW Service Delivery Therapist conducts re-assessment at end of sessions, and documents progress on revised goal form. TSW discharges client from Therapy Support OT/PT program, and files her casenotes in client’s working file Therapist discusses with family future Intervention and documents this in HOMES casenotes Therapist completes Needs Assessment to reflect change/ progress, and the future focus of intervention Therapist moves client to Monitoring if that is appropriate