question

book definition of therapeutic recreation

answer

the purposeful utilization or enhancement of leisure as a way to maximize a person's overall health, well-being, or quality of life.

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purposeful

answer

-should always think about the purpose of what's included in the programs -what you include and how you include it is important -described through formally written goals and targeted outcomes

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outcome-driven intervention

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intentionally designing work to a client to goals that patients expect to achieve through participation. -using this alone does not make it TR,

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utilization

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actively engaging leisure interests, choices, abilities, and behaviors to maintain or improve ability levels in both leisure and non leisure domains. (leisure used as therapy tool) ex: stroke patients works with domains to enhance grasp, number recognition, reasoning

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recreation therapy

answer

-often interchangeable with therapeutic recreation -specific form of TR that invokes the purposeful use of leisure-based interventions to improve functional abilities such as strength, attention, basic social skills, or emotional state.

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enhancement

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-rebuilding lost leisure skills, identifying new interests, learning new skills, or finding alternative ways to perform skills. ex: working with someone with substance abuse to teach them to develop a drug-free lifestyle. or teaching someone with spinal cord injury how to snow ski.

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leisure

answer

-most important word included in the definition of TR -differentiates TR from other therapies -physical, cognitive, social, or emotional activity that is freely chosen and intrinsically motivated.

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recreation

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structured leisure activities

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why is it important to develop leisure abilities

answer

- it allows us to choose and participate in activities that are enjoyable and personally rewarding.

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criteria to identify an activity to intervention as TR

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1. ensuring that outcomes are grounded in a leisure context 2. purposeful intervention-therapist must make deliberate effort to elicit specific pre-established therapy outcomes

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what makes TR different from other therapies?

answer

- includes leisure activities -provides relief from physical and psychological strains of other therapy

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reasons to know history of tr

answer

1. understanding past successes and failures helps professional avoid repeating past mistakes, learn from past successes, and predict the consequences of individual and organizational actions. 2. provides a source of professional identity (helps differentiate from other fields) 3. historical research creates perceptions of reality in the present (the present can be affected by how the past is interpreted)

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origin of TR

answer

-both clinical and community backgrounds (in medical fields and community oriented settlement house like hull house)

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Medical origins of tr

answer

-medical practices in europe influenced tr in isa -phillippe pinel and william tuke - humanitarian treatment movement, worked independently of each other, but both reformed and influenced medical experts of the time - by the close of the 1800s, humane approaches to treatment including recreation and leisure was widespread -spas and thermal baths -florence nightingale

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phillippe pinel

answer

-medical dr. of france -removed patients from dungeons and chains, allowed patients to reside in sunny rooms, and encouraged patients to exercise and move freely on hospital grounds.

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william tuke

answer

-english merchant and philanthropist founded the york retreat - a pleasant country home where people with mental illness worked in a kindly quaker environment -used medical approach to social work

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downside to moral treatment interventions

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-thought that hospitals, even if they were humane and taught leisure skills, had a purpose of removing people with mental illness from the mainstream community -humane treatment replaces chains of iron with chains of silence

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medicalization of spas and thermal baths

answer

medical spas and thermal baths led to an understanding of therapeutic consequences of leisure -used to experience leisure and freedom during a time in which leisure was no justified -its purpose was to justify leisure (but needed the medical backing) so the facility included diverse leisure programs like hotels, casinos, musical performances, tennis courts, lakes, dance halls, theaters, libraries, game rooms, and many more.

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rest cures

answer

popular psychiatric practices in middle of 1800s -created by silas weir -based on rest and recreation to restore mental health -became dominate treatment for neurasthenia

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florence nightingale

answer

-early medical expert (nurse) who highlighted effects of recreation while working in hospitals -advocated and provided recreational programs in hospital -established the inkerman cafe - small hut in center of hospital that had a large recreation room and coffee house designed for soldiers to be able to escape their problems and develop friendships -led to therapeutic program during world wars and led to red cross building recreation huts on military bases, world war II they hired females to provide hospital recreation for war -pattern of hiring recreation staff during the war and getting rid of them after

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community origin of tr

answer

-"play ladies" -hull house (jane addams) -ada sophia mickinley volunteered as head recreational host of the war camp club, which helped returning soldier and their families make a transition into american society

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"play ladies"

answer

-involved in settlement houses and community schools

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settlement house

answer

established human service agency developed purposely in city slums where human service workers provided human services (education, citizenship classes, community development, immigration protection, recreation) -their primary mission was to develop a holistic understanding of the conditions and causes of poverty by living with and learning from poor neighborhood residents

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hull house

answer

-jane addams, ellen gates starr, and Mary Keyser opened hull house, settlement house in a poor district of chicago. -jane opened many recreational facilities including coffee shops, gymnasiums, music, theatre, -providing alternative meeting places to saloons -safe way for immigrants to get away, develop friendships, and become educated citizens -used expressive arts, bibliotherapy, and leisure education

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expressive arts

answer

employment of visual arts, music, dance, or drama techniques with the intent to produce and achieve a final product -hull house provided expressive arts to people with extra needs

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bibliotherapy

answer

utilizes reading materials such as novels, plays, short stories, booklets, and pamphlets to help clients become aware that other people share similar problems, become aware of new insights, and structure their lives -hull house used reading to help people with special needs realize they aren't alone in the world

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leisure education

answer

a developmental process through which a person or group of people increase their understanding of leisure and relationships among leisure, lifestyle, and society -labor museum

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labor museum

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-exemplifies how community leisure education was a developmental process in which groups of people increased they understanding of leisure. -developed from addams concern for 1. the disdainful attitudes that immigrant children had toward their parents' old world tradition and culture and 2. the contemptuous attitudes that Americans had toward poverty-stricken immigrants who were living in chicago. -designed to bridge the gap immigrant parents and children by connecting with old world traditional leisure activities.

question

medical and community came together to document the therapeutic value of leisure services when?

answer

after the second world war

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leisure orientation to therapeutic recreation

answer

the idea that the distinctness of tr is its clear association with programming recreation and leisure services -was the underlying philosophy when hospital recreation became a special interest option or branch of the American Recreation Association (ARS) -part of philosophical battle

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NART

answer

national association of recreational therapists -founded by charles cottle (shared similar views as AAHPER) -to dissociate the therapy orientation from the recreation and physical education curriculum of AAHPER -to respond to the lack of attention by ARS to clinical outcomes and the role of recreation in brining functional improvements to clients -was a third voice in philosophical battle (not the same as AAHPER, but an additional voice along side it and ARS)

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therapy orientation of tr

answer

rival organization that stressed the curative aspects of hospital recreation -use or prescribe recreation for medical purposes -formed the recreational therapy section within the recreation division of the american association of health, physical education and recreation (AAHPER) -part of philosophical battle

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national association of recreation services for the handicapped

answer

-fourth voice in early TR (philosophical battle) -

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four voices of early tr (philoophical battle)

answer

1. ARS 2. AAHPER 3. NART 4. national association of recreation services for the handicapped

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philosophical battles of tr (years)

answer

1945-1965

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social movement of tr

answer

-began in 1960s -to unite all leisure oriented professionals together into one loosely structured organization -five organizations aligned to form National recreation and park association (NRPA) -known as utopian years of tr because the merger brought together different factions of the leisure field and developed a strong lobbying voice in washington DC.

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NRPA

answer

-National recreation and parks association -formed when these organizations aligned: national recreation association (NRA), American institute of park of park executives (AIPE), national confederation of state parks (NCSP), American Association of zoo parks and aquariums (AZA), and american recreation society (ARS)

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NTRS

answer

national therapeutic recreation society -branch of NRPA -along with nrpa brought into focus the social and moral issues of rights for people with disabilities -goals: unite therapeutic recreation personnel, encourage the professional, be an advocate for leisure rights, encourage research to improve the quality of tr practice, and promote the relationship between tr and other professions concerned with health and well being of people with disabilities. -became member of commission n accreditation of rehabilitation facilities (CARF) and joined the joint commission on accreditation of health care organizations(JCAHO) -the mission is to advance parks, recreation, and environmental conservation efforts that enhance the quality of life for all people

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normalization principles

answer

-the heightened focus on the rights of people with disabilities developed a theoretical framework for helping people with disabilities become included in mainstream society -normalization principles makes available to person with intellectual and other impairment disabilities patterns of life and conditions of everyday living which are as close as possible or indeed the same as the regular circumstances and ways of life of their communities

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inclusive recreation

answer

-created recreation opportunities so that people with disabilities could experience leisure in mainstream society -developed in 1970s along with special olympics, and SRAs

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3 ways inclusive recreation can be provided

answer

1. community reintegration programs 2. community integration programs 3. community development approach (building accessible and inclusive community recreation facilities and services

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NCTRC

answer

national council for therapeutic recreation certification -independent credentialing agency that oversees the national certification program in TR -trade marked the certified therapeutic recreation specialist (CTRS)

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unrest between ntrs and nrpa

answer

-early 80s -ntrs members had doubts about the commitment of nrpa to ntrs -after years of debate, ntrs allowed members to vote on four positions (69% for leisure ability approach 23% for therapy approach 10% for umbrella 4% for recreation service approach so ntrs adopted leisure ability approach as its model

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separatist meltality

answer

-members of ntrs who believed in therapy approach and thought ntrs was too controlling and didn't include health care ideas

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ATRA

answer

american therapeutic recreation association -members of NTRS who broke away because they believed in a more therapy approach -independent organization -inoproated in 1984 as non profit grassroots organization -formed to respond to the lack of financial support for the treatment aspect of tr

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therapeutics recreation- the benefits are endless

answer

- developed by ntrs -resource guide to enable ctrs to promote tr programs in terms of benefits and outcomes produced, develop and justify programs based on documented benefits and outcomes, manage programs in a manner that highlites efficacy.

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fragmentation years

answer

-therapy approach members of ntrs disagreed with control on leisure ability model that was adapted so they formed ATRA

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positives of fragmented years

answer

-atra and ntrs worked in partnership on special events like the joint task force on credentialing to assist agencies in becoming recognized health care providers in their home states. -also worked together to develop a resolution and a letter of agreement acknowledging that the two organizations represent tr -created alliance for tr - an entity that bring together board members of both organizations to coomunicat and work in partnership on certain issues -worked together to develop the tr educators conference (TREC) in chicago -solid qualitative and quantitative research that showed that tr affects health and well being of people came out

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national conference on the benefits of tr

answer

sponsored by national institute on disability and rehabilitation research (NIDRR)

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benefits of tr a consensus view

answer

publication extensive and precise typology of tr benefits which highlited that tr influences health care outcomes in 1. physical health and health maintenance, 2. cognitive functioning, 3. psychosocial health, 4. growth and personal development, 5. personal and life satisfaction, and 6. societal and health care system outcomes

question

recreation service approach

answer

the primary purpose of therapeutic recreation was to provide recreation services to people with special need. thje role of a tr specialist was to help or enable people with disabilities to experience leisure and its benefits

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leisure ability approach

answer

primary purpose of tr was to integrate three phases therapy or treatment, leisure education, and recreation participation along a continuum and the ultimate goal was to help people with disabilities establish an independent leisure lifestyle

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therapy approach

answer

primar purose of tr was to treat and ameliorate the effects of illness and disability. tr was a means to a curative end

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umbrella or combined approach

answer

purpose of tr was two roles: shifted to provide rec services to people with special needs or shift to ameliorate effects of illness. may be used as both asa medium for therapeutic change and can enjoy outcome for its own sake

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bill of rights for the handicapped

answer

1932 -adopted by the white house conference on child health and protection, it provided an important endorsement of recreation for children with disabilities

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social security act

answer

1936 -a compilation of laws including numerous amendments over the last several years related specifically to older adults and people with disabilities -includes provisions for physical education on recreation though formal procedures for review of professional services, established funds in states of self support services for people, and gives grants to states to provide community based care

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vocational rehabilitation act

answer

1963 -this act provided training and research funds for recreation to those who are ill or handicapped. this act was first recognized by a specific federal agency of the importance of recreation in rehabilitation

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national outdoor recreation plan

answer

1963 -directing the formulation and maintenance of a comprehensive nationwide recreation plan, this plan was completed in 1973 and included an emphasis on compliance with architectural barriers act. -conerns for those with with handicaps were listed as a priority area

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education for handicapped children act

answer

1967 -this law established the unit of physical education dn recreation for children with handicaps within the bureau of education for the handicapped; it became the largest federal program for training, research, and special projects related to recreation for special populations

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architectural barriers act

answer

1968 -this law indicated that any building or felicity constructed in whole or part by federal funds, must be accessible to and usable by the physically handicapped

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developmental disabilities services and facilities construction act

answer

1971 -developmentally disabled persons are specifically defined, and recreation is listed as a specific service to be include as a fundable service in this federal law

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rehabilitation act of 1973

answer

-comprehensive revision of the 1963 vocational rehabilitation act that included an emphasis on the total rehabilitation of the individual

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rehabilitation act amendment

answer

-this law authorized the planning and implementation of the white house conference on handicapped individuals. the final report noted the importance of recreation for people with disabilities and called for the expansion of recreation services and an increase int he number of professionally trained people employed int eh field of recreation

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education for all handicapped children act

answer

1975 -by mandating free and appropriate education for all handicapped children, this law identified physical education as a direct service and recreation as a related service to be offered to those with disabilities. mainstreaming int he school system is usually viewed as an outgrowth of this act, which provides the legislative leverage for children with disabilities and their families to gain access to often denied educational services

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rehabilitation act of 1978

answer

the 1973 rehabilitation act and the programs it authorized expired at the end of 5 years. in 1978, legislation was introduced to extend and amend the 1973 act. this renewal called for recreation and leisure services to be part of the rehabilitation process.

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international year of disabled persons

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-designated byt eh United Nations in 1981 -its theme was the full participation of disabled persons in the life of their society

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americans with disabilities act

answer

1990 -provides comprehensive guidelines banning discriminations against people with disabilities. it is an ominous civil rights statute that prohibits discrimination against people with disabilities in sectors of private and public employment, all public sectors (including recreation), public accommodations, transportations, and telecommunications.

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career

answer

occupation pr profession followed as a life's work

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job

answer

regular remunerative positiona person is paid for the completing of assigned tasks

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profession

answer

directs his or her efforts towards service rather than only financial renumeration -a personal choice and reflects his or her personality, creativity, interests and goals -callign that requires specialized knowledge and often long academic preparation -can also be used to ascribe collective calling body of persons engaged in calling

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body of knowledge in recreation (three sources of info)

answer

-consists of info drawn from three sources 1. scientific disciplines -provide theoretical notion of man, the environment, and how the two relate 2. values that we proves and prescribe to-belief among tr professionals that all people have the right to recreation and leisure experiences or that recreation is the medium used to bring about physical, cognitive, emotional, or social behavioral changes in the individual 3. applied and engineered skills- skills requires but eh professional to reform the job, such as leading an activity to assess client functionality or writing goals and objectives

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professional development

answer

-includes continuing education, professional and civic contributions, research, and evaluation the exchange and transmission of professional knowledge through professional associations, conferences, workshops, and publications

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involvement in professional and civic organizations as professional development

answer

provides leadership development opportunities -erving on committees or boards of professional associations and organizations

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research in TR as professional development

answer

tr usually read from Therapeutic recreation journal of NTRS, the annual in therapeutic recreation of ATRA, or other related professional journals or magazines

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career resilience

answer

an emerging aspect of professional development. -tr takes control of his or her future by seeking out appropriate training, at his or her own expense if necessary -initiate or respind to changes in the workplace -initiate new learning -reinvent ones self -take past successes and experiences and leverage them into future successes that will help the organization meet its anticipated goals -determine ones value-added ingredient -create value by doing extra work, (cut programs but donated car for adapted driving would raise it if they didn't need to provide instructor, rec therapist volunteered to do it along with his rec therapist duties)

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professional authority

answer

the ability of a profession ro hold its members accountable -how a professional responds in light of shared socialization (the norms of accepted practice) and internalized expertise ( knowledge and personal expertise - individual skills and judgement) -depends on a persons technical skills rather than their position or office

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professional credentialing

answer

-serves to document the fact that society accepts the authority of a profession -profession has sanction in community -established the minimum standards required to perform professional duties and responsibilities -purpose is to improve the level of practice and competence -provides evidence that professional has acquired a body of knowledge that includes their, philoso[phy, and practice within the field and has met specific standards and criteria in education, experience, and continuing profession -enables third partys payer, public, and government to distinguish between those who have received qualifying level of competency and those who have not -can occur at state or national level

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CPRP

answer

certified parks and recreation professional -governed by the national certification board (NCB) and affiliated with NRPA

question

three main types of professional credentialing

answer

registration, certification, and licensure -licensure is a legal requirement that must be met by anyone who wishes to practice the profession in a particular state -credentials are generally in effect 2-5 years and are maintained or renewed by completing a required number of continun=ing education units (CEUs), submitting verification of CEUs or other professional contributions(presentations or publications), and paying a fee (CTRS requires annual maintenance fee)

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two professional credentialing paths

answer

1. academic 2. equivalency (two equivalency paths)

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code of ethics

answer

represents the official moral ideology of the professional group -ethics deals with duties and obligations of professionals to their customers, to the profession, and to the wider public -considers moral conduct: who one should act -considers moral character: what sort of person one ought to be -considers moral community: how society should be constructed to enable ethical people to act ethically. -these three make ethical behavior possible -serve as a guide to decision making which may cause a person to weigh multiple principles

question

five ethical principles common to human services

answer

1. principle of beneficence - the duty to promote good to further a persons health and welfare 2. principle of non malfeasance- relates to beneficence and means that one has a duty not to injure or harm another person . one should not knowingly inflict harm and must strive to remove or reduce risk or harm in all situations 3. principle of autonomy- concerns the right of people to be respected and make their own choices. a person had the right to deterring his or her own course of action in accordance with a plan designed or designated by him or her. 4. principle of justice- requires one to teary others fairly and to be fair in distributing burdens and benefits front he point of view of the least advantaged. 5. principle of fidelity- include faithfulness as well as obligations to be truthful and to keep promises. the statement "i promise" established a moral relationship that signifies that one has accepted a self imposed obligation whereby the other party has the right to have that obligation fulfilled. note that telling and promise keeping are fundamental building blocks of trust

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professional culture

answer

is made up of customary beliefs, norms. or traits of the profession -professional association often define the professional culture -typically in consumer focused in tr

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accredidation

answer

credentialing of an academic institution and specific curriculum that meets or exceeds prescribed criteria of educational quality with regard to professional preparation -associated with organizations such as NRPA, american association for leisure and recreation (AALR), american association for physical activity and recreation(AAPAR) -voluntary process with 2 purposes: to assure program quality, and to assist in program improvement -address several points such as: focus on characteristics, philosophy, and goals of the academic unit, program content, professional competencies, and foundations of understandings

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service delivery systems

answer

-folloes different axis (clinical-community, private-public, and profit-nonprofit)

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population to serve

answer

-those with physical impairments, cognitive impairments, psychological impairments, sensory impairments, and social impairments

question

benefits of becoming a member of a professional association

answer

-sponsoring informative meetingds an dudcational development is central to fulfilling the mission of the profession organization -published literature that reflects the body of knowledge and could contribute to improving practice -providing for credentialing or maintenance of credntialing -definign professional behaviors (professionalism: perform competently and demonstrate high morale character in fulfilling obligations) -recognizing change factors that could influence the profession

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AAHPERD

answer

American alliance for health, physical education, recreation, and dance -supports efforts of tr -alliance of 5 national associations and six district associations helps practitioners improve skills and further the health and well-being of american public

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networking

answer

-tool for advcancement, leadership, power, influence, and related organizational variables such as socialization, motivation, commitment, and innovation. -ability to create and maintain a diverse system of resources -develop skills and accomplish activities, bridge gaps between or within functions of a job or organization, to foster communication both formal and informal, to gather and manage information, and to facilitate change or interchange of resources. -can be intraorganizational or interorganizatinal

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intraorganizational networking

answer

-operating within an organization to reach a shared goal and ultimately to advance the organization

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interorganizational networking

answer

-operating among organizations that share similar characteristics such as populations served, service delivery systems, goals, or issues

question

what are the valuable purposes of labels

answer

-facilitate communications of the nature of a particular condition to others -allows for appropriate care -allows access to resources or accommodations -program enrollment

question

problems with labels?

answer

-misused and misunderstanding of them -tendency to generalize impairment in one particular area of functioning to overall ability of a person

question

according to ADA, a personw ith a disability is someone who...

answer

-has a physical, mental, or cognitive impairment that substantially limits one or more major life functions or activities -has a record of such an impairment, or -is regarded as having such an impairment

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handicap

answer

a situation in which person can be disadvantaged not by the disability but by other factors

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person first philosophy

answer

-considering humanity first, we treat each other as unique human beings with the potential to grow and develop (regardless of one's limitations) -respond to human needs first and then on individual needs -each persons uniqueness is positive not negative -serve as empowerment instead of demeaning people with disabilities

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person first terminology

answer

-requires the use of respectful language when referring to those with disabilities -terminology should focus not eh person first not the disability -refer to the disability only when necessary -doesnt refer to adult with disabilities as kids or in a childlike manner -refrain from words such as imbecile, psycho, lunatic, moron, and spaz

question

social inclusion

answer

-sharing common experiences, valuing the participation of all people, and providing support for participation -focused on creating a sense of belonging within a group (skills would not be ridiculed when performed by those with disabilities) - a way to break down barriers so that people can feel comfortable and welcome in a recreation environment

question

least0restrictive environments

answer

-provide maxim support for person with disability for engagement in recreation without over reliance on adaptations if they are not necessary -situations in which adaptation would be made only when evidence indicates that a person with a disability needs changes to function -the goal is to make changes based on the persons individual strengths and limitations (or needs) - making changes that are beyond the persons needs may actually make the environment more restrictive

question

interdependence

answer

-relationships of cooperation and reciprocity among participants with and without disabilities as well as the staff to accomplish and achieve common goals ex: wall mural: those using wheelchairs paint the bottom dn those who don't paint the top

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attitudes towards peoples with disabilities

answer

-can create positive force of change or barriers -historically people attitudes towards people with disabilities has been negative resulting in segregation and discrimination as well as thinking that those with disabilities something have superhuman abilities (treated as heroes simply because they have a disability) -taught that those without disabilities are lucky which leads to belief that those with disabilities are less of a person

question

influencing language and attitudes

answer

-we objectify and victimize people with disabilities (that poor woman is a victim of polio or the blind, the deaf) -using them vs us

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IDEA

answer

individuals with disabilities education act -mandates that all children with disabilities have access to free and appropriate public education

question

medical model of disability service delivery

answer

-views disability as a variation from the physical norm that can disadvantage the person physically and in quality of life -based on assumptions- disability is a physical condition in that something is physically different about a person compared to the norm (can be treated through medical or therapeutic intervention), responsibility of society to provide therapies to cure disabilities -barriers arise from individual functional limitations resulting from disability instead of social factors that limit individuals -recreation is used as a prescriptive way to correct or improve negative effects of disability

question

social model of disability service delivery

answer

-views disability as a result of social discrimination toward people who are different from the norm -rather than a problem with the individual, disability occurs when society does not accommodate physical, cognitive, social, emotional, differences. -when people don't function at set standards, they are assumed inferior

question

ecological model of disability service delivery

answer

based not eh idea that people and their environments are interconnected. -if a change occurs within the community, the change will affect not only that system but also individual directly or indirectly -ex: when tr consults with person's family, school, etc.

question

most CTRS work where?

answer

hospitals and nursing homes

question

acute care hospital

answer

-most familiar t many people -treats acute conditions that require immediate medical attention -because of the short length of stay, CTRS will only see patients long enough to conduct assessment and recommend outpatient follow up services -offers many different healthcare services typically focusing on short term care for serious health concerns -remain here until medically stable

question

outpatient services

answer

-where people receive treatment after they become medically stable -acute care hospitals usually have both inpatient and outpatient facilities. -CTRS has longer term access to clients which leads to greater client progress

question

rehabilitation hospital

answer

-specialize in logn term rehabilitation of peplr with acquired disabilities that often result from trauma such as stroke or accident -usually receive treatment at acute care hospital before coming here -CTRS provide cotreatment

question

psychiatric care

answer

-ctrs members of treatment teams to achieve therapeutic goals -expressive arts, stress and coping, fitness, behavior management -two most common: mood disorders like depression and anxiety disorders -most patients are voluntary but can be involuntary

question

nursing homes

answer

-lifespan increasing, demand for cars in this area is likely to increase - type of care varied by needs: 1. long term care 2. nursing home 3. skilled-nursing facility 4. custodial care facility

question

long term care

answer

variety of services that help people with health or personal needs and activities of daily living over a period of time (can be provided at home, in community, or at facilities including nursing homes and assisted living) -most ling term care is custodial

question

nursing home

answer

-a residence that provides a room, meals, and help with activities of daily living in and recreation -generally have physical or mental problems that prevent them from living on their own -usually require daily assistance

question

skilled-nursing facility

answer

-meets specific regulatory certification requirement s provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitation services, but does not provide the level of care or treatment available in a hospital

question

custodial care facility

answer

-provides room, board, and other personal assistance services generally on a long term basis -does no include medical component

question

municipal therapeutic recreational settings

answer

-hired by municipal parks and recreation agencies to work with adapted recreation programs -some have reintegration support programs

question

other settings for TR

answer

correctional facilities, camp settings, wilderness therapy, schools

question

leisure ability model

answer

-oldest most widely used -goal is improved independence and and satisfied leisure functioning (leisure lifestyle) -organizes tr by 3 components 1. functional intervention 2. leisure education 3. recreation participation

question

functional intervention of leisure ability model

answer

-correcting functional defects related to leisure related activities in the physical, mental, social, or emotional domains -eliminate, improve, or adapt functional defects that limit leisure -ctrs has high control while client is constrained and motivated by extrinsic reward

question

leisure education of leisure ability model

answer

focus on helping cients acquire leisure related attitudes, knowledge, and skills -four subcomponents: leisure awareness, social skills, leisure activity skills, and leisure resources - the goal is to help clients understand the importance of leisure and learns ways to participate successfully in leisure -ctrs maintain some control, clients have opportunity for choice and experience more freedom than during treatment services

question

recreation participation of leisure ability model

answer

- structured activities that allow the client to practice newly acquired skills and or experience enjoyment and self expression -client behavior is intrinsically motivated and cars hav relatively little control besides being a facilitator of activities

question

health protection-health promotion model

answer

-related to humanism, wellness, and self-actualization -goal is to assist clients to recover following threats to health (protection) and to achieve a high level of health as possible (promotion) --more in time with modern health care -three components: 1. prescriptive activities 2. recreation 3. leisure

question

prescriptive activities of HP-HP model

answer

-CTRS may have to prescribe activities, in order to prevent withdraw and self-absorption, to help clients regain control of their lives and begin progressing toward health and actualization -main goal is to make clients stabilize

question

recreation of HP-HP model

answer

-as clients assume some control, and move toward actualization, they move to recreation -rely on naturally healing powers of recreation -ctrs offer opportunities to gain valuable skills, knowledge, and values

question

leisure of HP-HP model

answer

-teh first two focus on health prevention, the third on health promotion. -engagement in leisure, clients have opportunity to become self-determined, actualized -threats to health have been largely eliminated, the third component provides the opportunity to become healthier an begin reaching their potential

question

Recreation service model

answer

-world health organization (WHO) -represents an attemot to integrate tr services into the wider system of health care delivery -mirrors WHO's model described in levels -WHO's model levels:disease, impairment, disability, and handicap -recreation service model described these levels in terms of TR and adds three additional levels: education, organized recreation services, and independent activities -organizes practice into scientific model

question

treatment modalities

answer

-describes recreation or other activities used to help clients meet therapeutic goals -most common treatment modalities: games, exercise, parties, arts and crafts, community reintegration programs, music, problem solving activities, sports, elf esteem, activities of daily living

question

the purpose of community reintegration programs

answer

-reduce the stigma associated with an acquired disability, practicing in a real world setting the skills that have been learned in treatment, gain gin familiarity with community resources

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therapeutic recreation process

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APIE -assessment -planning -implementation -evaluation

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assessment

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-indentification of a clients current level of functioning as it relates to tr services -information gathering process when clients the tr program -used to identify needs or issues to be addressed as well as any information that is relevant to the process of addressing those needs

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purposes of TR assessment

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-to gather client information to establish baseline for client functioning and to monitor client progress -to determine overall program effectiveness -to communicate with other professionals inside and outside tr -meet the requirements for assessment by administrators and external agencies such as medicaid

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assessment methods

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-review of existing documents : -observation: -interviewing: -use of standardized assessments and interest inventories:

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reviewing existing existing documents as assessment method

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-intake assessment report which come from psychiatrist, psychologist, social worker, doctor, or other approved professional responsible for identifying and developing a plan to address clients needs -presenting problem, history, precautions, results from other assessments, and summary that includes overall goals and objectives for the client -other documents include medical chart or medical history -common information to know: name, age, family members, presenting problem, results from previous assessments, any leisure related interests, physical limitations, medication precautions, dietary needs, doctors orders, facility restrictions, client goals -registration forms take the place of general intake assessment in community setting

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standardize assessments and interest inventories as assessment method

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-leisure diagnostic battery: indicator of perceived freedom in leisure (sub scales for perceived freedom: perceived competence, perceived control, needs, depth pf involvement, playfulness) three sub scales for ;leisure functioning: barriers, leisure preferences, knowledge of leisure opportunities -leisure competence measure (LCM): measure current level of functioning in 8 domains including leisure awareness, leisure attitudes, leisure skills, community integration skills, community participation, cultural and social behaviors, interpersonal skills, and social contact rated using FIM functional independence measure 1-7 -comprehensive evaluation for tr (CERT) : determine ones ability to integrate successfully into society through social interactions related to following domains: gross muscular function, fine movement, motor skills, sensory, cognition, communication, behavior

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general assessments used for health care systems

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-inpatient rehabilitation facility-patient assessment inventory (IRF-PAI): assess client functions in domains of self care, locomotion, communication, and social cognition, rates on FIM system (same as LCM) -resident assessment inventory-minimum data set (RAI-MDS) used in log care facilities. observations of clients functional level

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interviewing as assessment method

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-question should focus on leisure functioning (interests, behaviors, desires, barriers, resources) as well as physical, social, emotional, cognitive, and spiritual considerations -professional must be good at finding common ground between the purpose and of the tr programs offered and the clients presenting problem. -prepare by looking at existing documents -should address following questions before conducting interview: what documents should i review before the interview, have i made arrangements for needed space and time, how should i start the interview, what behaviors should i be watching for during the interview, what questions do i want to ask related to the presenting problem, what questions o i want to ask related to re and leisure, when do i want to ask these questions( beginning, middle, or end of interview), when I'm finished questioning hw will i close interview -use orientation with clients who have dementia, brain injury, stroke (time: ask what day month and year it is, place: ask where are they, person: ask who they are

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observation as an assessment method

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- benefit in that it documents actual behavior -does not depend on clients communication skills -observation cannot measure constructs or internal states such as motivation, depression, or intelligence) -rather, observation focuses on documenting behavior patterns -valid, reliable, and useful assessment results are the foundation ffor developing goals and objective

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comprehensive program planning

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-the broadest form of planning that refers to the development of the overall tr program -form mission statement, develop goals, and identify specific programs to be implemented

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specific program planning

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-involves the detailed planning of the chosen specific programs to be implemented

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tiers of planning

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-first tier: comprehensive program planning -second tier: specific program planning -third tier: planning for the individual client

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IPP

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individualized program plan - results from assessment out into tr specific assessment report and IPP that complement the general assessment report -a statement of the clients strengths, limitations, goals, and objectives - thought the two are different often integrated into one report

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goal development of planning

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- goal are general accomplishments that the client should achieve through participation in the TR process. -goals should be directed tied to assessment results

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objectives of planning

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- measurable criteria for deterring when a goal has been met. -consists of three parts: condition, behavior, criteria ex: when given the cue "throw ball into bucket (condition) the client will throw a tennis ball into a 24 inch bucket(behavior) within 30 seconds and at a distance of 3 feet at least once a day during 4 out of 5 days of camp (criteria) -condition: circumstance under which an objective is to be achieved -behavior: measurable behavior to be performed represented by action verb -criterion: measurable indicator of goal achievement -since goals are broad, typically 3-5 objectives will be formed under each goal

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placement of clients (planning)

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-after establishing goals and objectives, cars must determine the best way to help client achieve these goals while worrying about program goals as well -teh cars job is t match clients with specific programs that address their personal goals which means that: not every client needs to participate in every program, the groups that a client participates in should provide outcomes consistent with his or her goals, and cars is likely to be planning several specific programs at the same time.

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other considerations for planning

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-multiple ongoing programs designed to address needs presents challenging work environment -ctrs try to plan programs for long term but daily planning for each session of program is based on various client factors and environmental factors -these challenges make it east to lose sight of tr process and importance of developing programs that consistently address clients goals -reccomendation: produce prediuctable programs

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outcomes

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observed changes in a clients status as a result of our interventions and interactions -outcome-driven planning

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activities

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the methods by which cars helps clients change their abilities, knowledge, and attitudes

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specific considerations ofr identifying appropriate activities

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-actvities must have a direct relationship to client goals -activity characteristics can influence successful activity implementation -client should be able to place the activity in the context of overall tr goals (outcomes) -activities should be interesting and engaging for the client, as well as enjoyable

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tools for planning

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-activity analysis -task analysis

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task analysis

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-breaking down specific skill into its component parts ex: bending down to pick a pencil off the floor (1. flex neck into downward position, 2. visually locate pencil, 3. position body so that pencil is next to foot directly below hand, 4. bbd at knees until hand touches floor, 5. grasp object, 6. rise to standing position -this can be used as an assessment tool to identify aspects of the skill that the client is able or unable to perform -can also be used to identify appropriate increments of skill or information when teaching complex behaviors in incremental steps

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activity analysis

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-systematically identifies the skills necessary to participate in an activity through the comprehensive analysis of various areas of functioning -typically areas correspond with functional domains categorized as physical, social, cognitive, and emotional -further exploring the skills necessary for each sequestrial step -typicall considers various aspects of physical ability the reason that step 4. bending down of the task analysis was so difficult

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activity modification when planning

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-task and activity analysis allow for modifications involving adjusting the activity or activity environment to meet the ability of the client -used to circumvent impairments that are barriers to participation -may adjust equipment, adjust how an activity is performed, adjust rules and procedures of activity -shoudl allow participation while minimizing the effect on the inherent nature of the activity (modification should not occur unless it is necessary) -removing modifications when they are no longer needed is also important, some modifications will be permanent

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activity plan

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-outlines exactly what will occur during a particular therapeutic recreation program -addreses many logistical concerns that should be considered during planning -addresing these issues before implementation is critical to success -issues to be addressed include: equipment needed, safety precautions, targeted program and client goals, rules and procedures, potential modifications, and activity time line -often kept on record for future sessions

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implementation

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-technical skills -facilotation skills (briefing, leading, de-briefing)

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technical skills for implementation

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-sometimes referred to as hard skills are physical taks associated with job responsibilities -when mastered, it maximized facilitation skills sequencing is a technical skill that can greatly increase success (arrangement of elements of a session or series of sessions in an order that facilitates successful performance) -another skill is ability to monitor all clients at one time (what they are doing and how they are doing) -active involvement -being prepared for the program you are about to lead (can't successfully lead it if you don't know know the activity ex: can't lead magic show if you don't know anything about magic)

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facilitation skills of implementation

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-sometimes referred to as soft skills -what create and maximize a tr relationship or experience -humanistic side of tr -observation skills, active listening, and counseling skills act together to enable personal growth -three stages of implementation: briefing, leading, debriefing

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briefing

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-informing clients of what is about to happen, describing associated behavioral expectations, and establishing goals related to the session -spiral goals: generally tie the immediate activity to the overall tr and general treatment goals of the client -activity goals shared by group whereas spiral goal are individual specific -also a time to maximize interest in activity -focuses on goals and creates motivation

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leading

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-ctrs works consistently to ensure that the events that take place relate to the targeted goals -provide solutions that clients should be allowed to discover independently -dont provide hints or other forms of assistance that make the activity too easy (maintain balance between too little and too much) -consider the following questions: what role was i playing during the session, how did my location and movement affect the group (physical), was i nervous frustrated impatient (emotional), was i listening directing facilitation using verbal non verbal communication, was i anticipating problems such as victimization or isolation, what were my successes and mishaps, was i monitoring goal achievement and making adjustments, did i take notes mentally or written

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de-briefing

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-aka processing includes reviewing events that occurred during the session , the experience the emotions of clients, the progress made toward goals -what, so what, now what (outward bound approach) -what involves reviewing concrete events during session -so what involves reviewing activity goals that were established for the session as well as emotional reactions to events that occurred -now what involves relating the content of the session to issues outside of therapy -also can use the 5 stages of questioning: did you notice? why did this happen? does that happen in life? why does that happen? how can you use that? -ctrs should be facilitating discussion and not lecturing, clients should do most of the talking -role of facilitator is to make sure discussion stays focused

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evaluation

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-systematic and logical process of gathering and analyzing selected information in order to make decisions about the quality, effectiveness, and or outcomes of a program, function, or service -insurance companies, gov funding programs, accreditation agencies want to see quality documented (justifies cost of service which in turn justifies our existence) -client evaluation -program evaluation -individual client eval and specific program eval usually conducted internally, but internal or external parties can mandate comprehensive program evals

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client evaluation

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-evaluating an individual's progression or regression should be built around his or her goals and objectives -summative evaluation: data collected at end of program -formative evaluation: data collected in ongoing manner -clients with similar needs placed in similar programs which allows evaluation of program as a whole

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program evaluation

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-evaluation of a specific program -financial reports can be combined with outcome data to analyze the cost to benefit ratio - should review overall comprehensive tr program

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evaluation tools

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-review what areas need to be evaluated -attendance and participation are easiest areas to evaluate but least informative (simple check lists) -participation satisfaction (gathered from participants, spouses, parents) -client goals (targeted utcomes): methods for measuring these will vary nut procedures are analogous to assessing: interviews, observation, standardized assessments and interest inventories, and existing documents

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evaluation systems

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-goal attainments scaling -SMART

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goal attainment scaling (GAS)

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-general method to evaluate the outcome of mental health treatment -takes measurable objective and established various levels of achievement -consistent method of evaluation agency effectiveness -clients can be compared to each other -evaluation of overall program can be based on unique goals of individual clients

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SMART

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-goals that are specific and strategic, measurable, attainable, results oriented, and time bound. -tree diagram used as tool for operationalizing SMART -less complex than GAS but can be equally as useful in ensuring that the individual and departmental goals and objectives are being developed and evaluated.

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