Recreational Therapy – Flashcards

improves functional outcomes for people with health conditions using active treatments such as leisure, sport, play, and community participation.

form of recreation that is provided with the sole goal of increasing recreation and leisure engagement, with the intent of a positive and/or therapeutic benefit.

Diverse range of recreational opportunities for children and adults with disabilities. Some programs include adaptive sports, Paralympic sports, special Olympics

"adaptive recreation" or "accessible recreation" where people with disabilities are given the opportunity to participate recreation open to both people with and without disabilities. Through use of adaptive equipment, appropriate choices about activities and adaptations of rule, may take place in a variety of settings. social acceptance and equal participation.

designed for individuals with disabilities. The equipment, rules, and activity choices may be made with the intent of increasing participation among individuals with disabilities. refers to recreation for people with physical disabilities, while special recreation usually refers to recreation for people with intellectual disabilities or cognitive impairment. In both, the level of skill for participants ranges from novice to elite athletes.

is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

the state of being comfortable, healthy, or happy

product of health; social, mental, and physical

putting the person before the disability; the individual is not the disability

o Can be viewed as exhibiting professional qualities in ones thoughts and behaviors. Those who exhibit professionalism openly embrace their profession. They are proud of their profession and therefore attempt to live up to the high standards important for those who claim to be professionals in their discipline. • Gaining an appropriate educational background • Having a professional organization as a major reference • Believing in autonomy and self regulation • Holding a belief in the value of therapeutic recreation to the public • Having a sense of calling • Contributing to the body of knowledge • Actively engaging in professional and community service • Taking part in continuing and advanced development • Employing theory-based practice

Freud argued that human behavior was the result of the interaction of 3 component parts of the mind: the id, ego, and superego

the addition of a reward following a desired behavior

occurs when something already present is removed as a result of a behavior and the behavior that led to this removal will increase in the future because it created favorable outcomes

empirically demonstrated behavior change techniques to increase or decrease the frequency of behaviors

the process of supplying a person with the means to develop maximum independence in activities of daily living through training or treatment

Umbrella term for disease (chronic or acute), disorder, injury or trauma; May also include other circumstances such as pregnancy, aging, congenital anomaly, or genetic predisposition.

Anatomical parts of the body such as organs, limbs and their components (systems).

Physiological functions of body systems (including psychological functions).

The execution of a task or action by an individual. o Activity Limitations are difficulties an individual may have in executing activities.

Involvement in a life situation. o Participation Restrictions are problems an individual may experience in involvement in life situations.

the way you think of and act toward someone or something; intervention designed to address a limitation

acceptance of people with disabilities, offering the same conditions as offered to other citizens

people with disabilities should be included in aspects of society without restrictions or limitation

theory of motivation; people want to be self-directed/autonomous

involves too much; too many pressures that demand too much of you physically and psychologically

working more and more overtime; vacations are delayed; lose sense of humor, self-esteem declines, anger; may be the result of unrelenting stress, but not the same

society tends to identify groups of people as different and of less value than everyone else

to give power to; stigma

stress that has positive benefits; competition

The condition of good physical health, mental and emotional health, especially when maintained by an appropriate diet, exercise, and other lifestyle modifications

the act or practice of stopping something adverse from happening

applying the best available research results (evidence) when making decisions. Health care professionals who perform this practice use research evidence along with clinical expertise and patient preferences; there is existing research that guide intervention selection

based on the idea that how we think (cognitive), how we feel (emotional), and how we act (behavioral) all interact together. Specifically, our thoughts determine our feelings and our behavior.

emotional experiences such as contentment and satisfaction encountered in the past; current feelings such as happiness, flow, and sensual pleasure; and optimistic and hopeful emotions in anticipation of the future

use more than one theory to help the client

BF Skinner; Behavior is learned o Abnormal behavior is a type of learned behavior and so it can be changed • Focus is on objective observation of behavior • Specific behavior modification procedures may prove useful in diverse therapeutic recreation settings; especially effective in serving institutionalized residents with mental disabilities or children with behavioral disorders and emotional disturbances • Depression is maladaptive behavior that can be modified through learning; use positive and negative reinforcement to change behavior and maladaptive tendencies

sees people as being self-aware, able to deal with environmental influences, and generally in control of their own decisions

personal and professional viewpoint o Know your triggers and what situations generate what reactions

expressing ones creativity, quest for spiritual enlightenment, pursuit of knowledge, and the desire to give society

independence or self-governance; Recreational Therapy personnel have a duty to preserve and protect the right of each individual to make his/her own choices. Each individual is to be given the opportunity to determine his/her own course of action in accordance with a plan freely chosen. In the case of individuals who are unable to exercise autonomy with regard to their care, recreational therapy personnel have the duty to respect the decisions of their qualified legal representative.

the capability to perform the duties of ones profession generally or to perform a particular professional task with skill of an acceptable quality

Recreational Therapy personnel shall be truthful and honest. Deception, by being dishonest or omitting what is true, should always be avoided.

- differences in beliefs, culture, different people, populations, just understanding what that means (diverse populations (look and think different than us)

a collection of beliefs about oneself; a cognitive or descriptive component of ones self

Recreational Therapy personnel have a duty to disclose all relevant information to persons seeking services: they also have a corresponding duty not to disclose private information to third parties. If a situation arises that requires disclosure of confidential information about an individual (ie: to protect the individual's welfare or the interest of others) the professional has the responsibility to inform the individual served of the circumstances.

Recreational Therapy personnel are responsible for ensuring that individuals are served fairly and that there is equity in the distribution of services. Individuals should receive services without regard to race, color, creed, gender, sexual orientation, age, disease/disability, social and financial status.

Recreational Therapy personnel have an obligation, first and foremost, to be loyal, faithful, and meet commitments made to persons receiving services. In addition, Recreational Therapy personnel have a secondary obligation to colleagues, agencies, and the profession.

is evaluative and opinionated

medicine doctor

Doctor of osteopathic medicine

Psychiatric disabilities

PM&R team; physical medicine and rehab

Recreational Therapy personnel shall treat persons served in an ethical manner by actively making efforts to provide for their well-being by maximizing possible benefits and relieving, lessening, or minimizing possible harm (do good for your clients)

- Recreational Therapy personnel have an obligation to use their knowledge, skills, abilities, and judgment to help persons while respecting their decisions and protecting them from harm (not bad; will not do harm)

Recreational Therapy personnel should provide services characterized by mutual respect and shared discussion making. These personnel are responsible for providing each individual receiving service with information regarding the services, benefits, outcomes, length of treatment, expected activities, risk and limitations, including the professional's training and credentials. Informed consent is obtained when information needed to make a reasoned decision is provided by the professional to competent persons seeking services who then decide whether or not to accept the treatment.

• First significant TR/RT service model • Inception in 1984 (Peterson & Gunn) • Suggests a continuum of services • Oldest, most common model/ widely used • Purpose of RT - "improved independence and satisfying leisure functioning, also referred to as a 'leisure lifestyle' " • What is leisure lifestyle? -The day-to-day behavioral expression of one's leisure related attitudes, awareness, and activities revealed within the context and composite of the total life experience • Goal is to promote and enhance an individual's quality of life, well-being, and life satisfaction • Based on the premise that the need of the client determines the nature of programs provided • Strengths • Good ideal outcomes • Generality allows application to multiple agencies & disabilities • Weaknesses • Too broad/ lacks focus • Questionable practicality

• Continuum model based on concepts of health status (from death to optimal wellness) and functional capacity (fro minimal to optimal) in the areas of mental, emotional, physical, spiritual, and social functioning. Leisure is also identified as an area of functional capacity. For the third concept of the model, quality of life, the continuum moved from low to high and is an interaction of health and functional capacities. Thus if a participant has minimal functional capacities and poor health, her or his life is low

• One of first models offered as an alternative to Leisure Ability • Purpose of RT: "enabling the client to recover following a threat to health (health protection) and to achieve optimal health (health promotion)" • Using recreation & leisure to help people deal with health problems and to grow healthier • Growth toward actualization • Strength • Good concepts that move people away from illness & into health & self-actualization • Weakness • Assumes that all participants need assistance to overcome illness

o Personality type of being very passive in the ICF (personal factors) o Arm flection (activity) o The whole purpose of the arm isn't to flex; that is the activity the arm is currently doing (difference between body function and action) o Presence of a spouse (environmental factor) o Schizophrenia (health condition)

which exemplifies strengths and virtues that enable individuals and communities to thrive. This focuses on positive emotion, experiences, individual traits, and relationships.

focus on strengths (doesn't fit in all settings) Help people reach their goals and aspirations, based on their resources and strengths

- deficits based model (focus is on what wrong with you)(problem oriented)

skills balance the challenge level of the tasks o Another one of my favorites is the Flow Theory. This explains that there is a proper balance between skill level and challenge. This balance is when you feel alert, focused, and in control. If the challenge is too hard for an individual's skill level, they become frustrated; then if the challenge is too simple, the individual can get bored. Recreational Therapy makes sure to focus on the sense of flow so our patients can remain happy, healthy, and succeed

positive enforcement is going to help the patient more than negative

beliefs you can do a certain activity

assessment, planning, implementation, evaluation o Clinical process regardless of the environment we work in (geriatric, pediatric, etc); key cornerstone as a RT • Assessment • Planning • Goal Setting • Individualized Treatment Planning • Implementation Using Diverse Modalities • Evaluation

o Where we are today • 1) We're a profession • 2) We're young and growing. • 3) We don't always get along, but we're working it out • 5) We make a difference in people's lives o We're a Profession • Things that characterize a profession • Body of knowledge • Formal Rules of Practice Established & Enforced • Codes of conduct • Standards of practice • Professional identity o We're a Profession -Professional Identity • One national organization • National Therapeutic Recreation Society (NTRS)- folded in 2010 • American Therapeutic Recreation Association (ATRA) • Independent of NRPA & ATRA is the National Council for Therapeutic Recreation Certification (NCTRC) • NCTRC administers an exam that certifies a person as qualified to practice TR/RT o We're a Profession -Professional Identity • Professional Publications • Therapeutic Recreation Journal • Annual in Therapeutic Recreation - ATRA • American Journal of Recreation Therapy • Others (e.g., Journal of Leisure Research)

• NTRS members worked to: • Form therapeutic recreation curricula in colleges • Define the field • Develop practice guidelines • Create a certification program • Conduct research

- goal directed; focus on the means (functional outcomes) o Novelty o Disguised intentions o Promote physical activity o Allow choice & control o Integrate multi-disciplinary treatment skills o Fun & enjoyable o Effective Interventions • Interventions should relate to functional outcomes • Intervention is facilitated to address client goals and not for the sake of activity • Useful & applicable context • Carry-over value • Enjoyable o Factors in Selecting Interventions • Characteristics of clients • Characteristics of activities • Characteristics of resources o Factors in Selecting Interventions • Characteristics of client • Preferences • Age • Socio-economic status • Education level • Social support network • Functional abilities • Personality • Cultural & religious influences o Factors in Selecting Interventions • Characteristic of Interventions • Physical requirements • Interaction & social requirements • Cognitive requirements • Emotional factors o Summary • Interventions are client & problem specific • Interventions must be practical and applied to client goals and abilities • Recreational therapists require diverse skills • Fun can and should be therapeutic

o Teach back - improves patients understanding of and adherence to treatment • Asking the patient to explain or teach back the action items from intervention o Dealing with low health literacy • Clinical skills • Be specific • Use multiple forms of communication • Help patients ask questions • Confirm comprehension o Active listening • Attending • Eye contact • Posture • Gestures • Verbal behavior • Paraphrasing • Clarifying • Perception checking • Attentive listening • S: sit squarely facing the client • O: open posture • L: lean forward • E: eye contact • R: relax

o RT is an important part of the treatment team o Physical therapists (PT), PTA o Occupational therapists (OT), OTA o Speech language pathologists (SLP) o Music or Drama therapists o Physicians (MD, DO) o RNs, LPNs, CNAs o What does the RT do?

o Directed toward improving our clients needs as much as possible o We assist not do it for them o Characteristics • Genuine • Empathetic • Unconditional positive regard • Personable, compassionate, goal-oriented o Characteristics: effective RT • Knowledge based • Strong belief in recreation and leisure experiences o Self-awareness • Personal viewpoint • Professional viewpoint

o Minimum of Bachelor's degree o To become certified as a recreational therapist, the individual must meet requirements of the National Council for Therapeutic Recreation Certification (NCTRC) • At least 5 courses in RT/TR • Coursework in supportive courses • Must include: o Abnormal Psychology o Human Growth and Development o Anatomy and Physiology • 560 hour internship demonstrating knowledge and competency of the therapeutic recreation process

o To be used as a guide for promoting & maintaining the highest standards of ethical behavior • The code applies to all recreational therapy personnel • CTRS, recreational therapy assistants, and recreational therapy students o Acceptance of membership in the American Therapeutic Recreation Association commits a member to adherence to these principles

o Standard 1. Assessment • The RT receives and responds, consistent with standards, regulatory requirements and policies for the setting, to requests, including referrals and physician order, for assessment and treatment; and conducts an individualized assessment to collect systematic, comprehensive and accurate data necessary to determine a course of action and subsequent individualized treatment plan. o 2. Tx Planning • The RT plans and develops an individualized tx plan that identifies goals and evidence-based treatment intervention strategies. o 3. Plan Implementation • Implements and individualized plan, using evidence based practice, to restore, remediate, or rehabilitate functional abilities in order to improve and maintain independence and QoL o 4. Re-Assessment & Evaluation • Systematically re-assesses, evaluates and compares the pt's progress relative to the individualized tx plan o 5. Discharge/Transition Plan • Develops discharge plan in collaboration with the pt, family, significant others and tx team members in order to discharge the pt or to continue treatment and aftercare, as needed. o 6. Prevention, Safety Planning and Risk Management • Systematically plan to improve pt and staff safety by planning for prevention and reduction of risks in order to prevent injury and reduce potential or actual harm. o 7. Ethical Conduct • Adhere to the ATRA code of ethics in providing pt tx and care that are humane and professional o 8.Written Plan of Operation • Recreation therapy tx and care is governed by a written plan of operation that is based upon the ATRA standards for the practice of recreational therapy, state and federal laws and regulations, requirements of regulatory and accrediting agencies, payers and employer's policies and procedures as appropriate. o 9. Staff Qualification and Competency Assessment • Recreational therapy staff meet the defined qualification, demonstrate competency, maintain appropriate credentials and have opportunities for competency development o 10. Quality Improvement • There exist objective and systematic processes for continuously improving pt safety and for identifying opportunities to improve recreational therapy tx and care and pt outcomes o 11. Resource Management • Recreational therapy tx and care are provided in an efficient manner that reflects the reasonable and appropriate use of resources o 12. Program Evaluation and Research • Recreational therapy staff engages in routine, systematic program evaluation and research for the purpose of determining the appropriateness and effectiveness of recreational therapy tx and care provided