question

person first terminology

answer

-addressing the person before the disability -remind people around you that they are the person and not defined by a characteristic

question

CURT

answer

-clemson university recreational therapy

question

recreational therapy

answer

-improves functional outcomes for people with health conditions using active treatments such as leisure, sports, play, and community participation -nationally certified -uses clinical process of APIE (assessment, planning, implementation and evaluation) -only performed by the Recreational therapist and using treatment to increase health

question

therapeutic reaction

answer

-a 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 -therapeutic to you, so a leisure that makes you in a benefit way

question

inclusive recreation

answer

-form of recreation open to both people with and without disabilities -use of adaptive equipment

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adapted/special recreation

answer

-recreation designed for individuals with disabilities -usually associated with with individuals with physical disabilities -skill ranges from novice to elite athletes

question

whats about the term special or special needs

answer

-highlights that they are different -the environment sometimes highlights their disability -use it for terms like "you are special to me" not "why do you get special treatment"

question

myths about people with disabilities

answer

-people with disabilities are brave and courageous or inspirational or their loved ones are -wheelchair use is confining or people use wheelchairs are "wheelchair bound" -people who are blind acquire a "6th sense" -people with disabilities are more comfortable with "their own kind" -curious children should never ask people about their disabilities

question

why do negative attitudes about people with disabilities exist

answer

-nomadic tribes-were considered useless bc they could not contribute when gathering food-often left to die -middle ages-afraid of them, ridicule turned to persecutions and impurity into an idea that a disability was a manifestation of evil -today-we pity them and see them as different

question

what can you do to dispel negative attitudes?

answer

-educate children and be advocates -positive attitudes

question

health

answer

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

question

habilitation

answer

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

question

treatment

answer

the way you think of and act toward someone or something

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wellness

answer

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

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prevention

answer

the act or prevention of stopping something bad from happening

question

evidence based practice

answer

-applying the best available research results (evidence) when making decisions about health care -health care professionals who perform evidence based practice use research evidence along with clinical expertise and patient preferences

question

normalization (definition)

answer

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

question

inclusion

answer

people with disabilities should be included in aspects of society without restrictions or limitations (without being singled out)

question

self determination (definition)

answer

theory of motivation people want to be self directed/autonomous

question

social role valorization (definition)

answer

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

question

empowerment

answer

to give power to

question

personal autonomy

answer

independence or self governance

question

sympathy

answer

feeling bad for someone

question

empathy

answer

feel what they feel

question

what are some differences between professional helping relationships and friend helping relationships

answer

give and take relationship-friend

question

effective helper

answer

-directed toward improving our clients needs as much as possible and prevention -assist client and do not do it for them

question

characteristics of an effective helper

answer

-genuineness, unconditional positive regard, empathetic understanding, active listening, ethical, creative, pushes you to be your best

question

what characteristics make an effective RT

answer

-knowledge base, strong belief in recreation and leisure experiences, flexible, genuine, patience, active listener -all the same things as an effective helper

question

self awareness

answer

-personal viewpoint vs. professional viewpoint -important to understand before engaging in a helping relationship because you want to have a whole understanding and not push your point of view on others

question

value

answer

attribute worth to it

question

what do RTs value

answer

quality of life, control and choices, client ability and strength, relationships, enjoyment, goal oriented, intrinsic worth

question

professional ethics

answer

-comprise a system of principals or standards of behavior that govern conduct in terms of right and wrong performance or professional responsibilities -whats best for the clients

question

code of ethics

answer

written document listing the values helped by a profession and expected standard of conduct for members of a profession

question

signs of manifestations of burnout

answer

working more and more overtime, vacation is delayed, people lose their sense of humor, self esteem declines, feelings of anger occur, fatigue, not yourself for long periods of time, become more impatient

question

stress vs. burnout

answer

-burnout may be the result of unrelenting stress but not the same as stress -stress involves too much too many pressures that demand too much of you physically and psychologically

question

preventing burnout

answer

do a leisure skill, socialize, outline your activities

question

why are communication techniques important?

answer

to understand its difficult to have a conversation with someone who is awkward and unclear

question

health literacy

answer

using words that your patient can understand-not just medical terms

question

communication

answer

2 or more people exchanging ideas, concepts and meanings as they come to a shared understanding

question

populations with trouble communicating

answer

-elderly -people with learning disabilities -people with schizophrenia -people with autism

question

communications skills for health care providers

answer

-compassionate listening and speaking -teach back -low health literacy and cultural competence -verbal communication -listening is an active process

question

compassionate listening

answer

-listen to hear, really hear what is being said -listen to understand -listen to learn -listen without comment, even if you dont agree -listen completely focused on the speaker -listen with respect -listen with empathy -speak only from your experience and what you know about -use i statements rather than you they or we statements -speak without labeling or insulting -speak with consideration -speak to educate and enlighten

question

teach back

answer

-improves patient understanding of and adherence to treatment -like studying for a test with a friend

question

low health literacy and cultural competence

answer

-use simple language (avoid jargon and abbreviations) -ask patient if having a family member present is desired -ask patients to repeat information, using a teach back strategy -speak more slowly -draw a picture -follow up with a phone call -write out instructions -hand out printed material to patients

question

verbal communications

answer

-vocabulary and terms -clarity -speed, tone, volume

question

listening is an active process

answer

-attending -eye contact -posture -gestures -verbal behaviors -paraphrasing -clarifying -perception checking

question

body language

answer

-facial expressions -intimate distance-actual touching to 18 inches -personal distance-18 inches to 4 ft -social distance-4 to 12 ft -public distance-more than 12 feet -other parts of body language-smell, kinetics, voice, silence, use of time -attentive listening-SOLER S-sit squarely facing the client O-open posture L-lean forward E-eye contact R-relax -restatement-paraphrasing

question

what it means to be a CTRS

answer

-traditional/medical models/deficits based meaning that its problem oriented -strengths based meaning it helps people reach their goals and aspirations based on their resources and their strengths -RT has been recognized form of health care and human services for decades-often referred to as "quality of life profession" providing services that truly make a difference in the lives of those served -ATRA defines us as "a treatment service designed to restore, remediate, and rehabilitate a person's level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitation and restrictions to participation in life situations caused by illness or disabling conditions" -improves functional outcomes for people with health conditions using active treatments such as leisure, sport, play and community participation. nationally certified and uses clinical process of APIE

question

ATRA

answer

-american therapeutic recreation association, only program thinking of wellbeing (gives benefits) -formed in 1984-independent organization representing the needs and issues of the RT profession -2,200 members in 2014

question

recreational therapy service delivery APIE-a clinical process

answer

-assessment -planning-goal setting, individualized treatment plan -implementation using diverse modalities -evaluation

question

scope of recreational therapist services

answer

-settings-schools, rehabilitation hospitals, long term care (LTC), transitional care, psychiatric hospitals, outpatient care, community recreation facilities, residential facilities, group homes, general hospitals -populations-across the lifespan-infants, children, teens, adults and seniors; individuals with-musculoskeletal, neurological, neuromuscular impairments, sensory impairments, cognitive problems, psychological problems, social/behavioral issues, other illnesses/disabilities

question

CART

answer

committee on accreditation on recreational therapy-goal is to get each school accredited

question

NCTRC

answer

national council for therapeutic recreation certification -administers an exam that certifies a person as qualified to practice TR/RT

question

RT treatment team

answer

PTs, OTs, speech language pathologists, music or drama therapist, physicians, RNs, LPNs, CNAs

question

NART

answer

national association of recreational therapists

question

NTRS

answer

national therapeutic recreation society

question

history of recreational therapy

answer

-origins in the west-people have long thought of leisure as good for people and society -Aristotle-viewed leisure as a humans highest calling-people would be a lot happier and less stressed and today its something that we do in our free time and we feel guilty about it -plato-you can learn more about a man in an hour of play than though an hour of conversation, life must be lived as play -florence nightingale-unofficial mother of recreational therapy -late 1800s in the US-civil war+mass immigration=crowded hospitals and poor conditions, industrial revolution leads to crowded cities and conditions deteriorated in cities -Neva Boyd-recognized that Recreation had psychological and social benefits in addition to physical benefits, developed what was probably first academic training in using recreation as therapeutic intervention

question

WW1

answer

-US enters WW1 in 1917 -massive #s of wounded -red cross opens 52 recreation centers at military hospitals (movies, music, drama, gardening, dance)

question

after WW1

answer

-begin to demonstrate benefits of recreation for people with illness/disability -term "recreational therapy" is used in publications -recreation used in treatment of people with physical, psychiatric and cognitive disabilities and in prisons

question

WW2

answer

-recreation was more or less an established form of treatment or wounded soldiers -formal graduate education of recreational therapist started

question

aftermath of WW2

answer

-red cross reduced budget for recreational therapist -movement underway to remove the therapy in recreational therapy -general opinion became "recreation is for diversion"

question

early beliefs

answer

-1953-hospital recreation section of american recreation society -aid in adjustment to hospital -development, restoration, maintenance or mental emotional and physical conditions

question

1950s-60s

answer

-trend toward diversional recreation continued, even among leaders of hospital recreation sections and in academia -NART formed to promote recreation as treatment -NART contributions-beginning of standards of professional education, professional qualifications for practice, helped define role of our profession -debate about the nature of recreational therapy began and continues -can there be some more serious outcome goals? -ends or means debate -recreational therapy was looked as an end -then looked as a means to an end-we wanted to have a good outcome -first RT/TR experiments were conducted-one of the first was for individual in psychiatric facility and incorporating music as an intervention -NART and hospital section of ARS come together in 1966 to form NTRS as a branch of NRPA, but the argument continued

question

1970s

answer

-NTRS members worked to form therapeutic recreation curricula in colleges, define the field, develop practice guidelines, create a certification program, conduct research

question

1970s and early 80s

answer

-leisure ability model-therapy, leisure education, recreation participation

question

1980s

answer

-NCTRC established in 1981 -NTRS primary focus was on leisure orientation (as an ends) -ATRA conceived in 1984 for those with a therapy orientation (as a means)

question

today

answer

-we're a profession, young and growing -we make a difference in peoples lives

question

we're a profession

answer

we have a: -body of knowledge -formal rules of practice established and enforced-codes of conduct, standards of practice -profession identity-one national organization (ATRA), independent of NRPS and ATRA is the national council for therapeutic recreation certification (NCTRC), professional publications

question

professional theories of RT

answer

positive psychology, flow, broaden and build theory of positive emotions, leisure coping, self determination, self efficacy, normalization, social role valorization, social support, resiliency

question

positive psychology

answer

-grew from regular psychology -idea that people live life to the fullest no matter the circumstance -building better people -4 components-positive emotions and experience (cultivating positive emotions enriches our lives from day to day and prepares us to weather the trying times), positive individual traits (help buffer against discouragement and strengthen resiliency), positive relationships (vital for individual happiness), positive and enabling institutions (understanding the strengths that improves our communities) -RT is a strength based approach so this theory really focuses on it as a whole

question

flow

answer

-reflecting on the nature and happiness of the environment around you -feeling strong and in control while doing an activity -skills based -related to RT because its goal oriented-means to an end

question

broaden and build theory of positive emotions

answer

-the importance of enjoyment and positive actions and outlooks -taking positive thoughts and turning them into positive actions -having a positive attitude with your patient is very important -have long term benefits when you have a positive emotion -linked to positive psychology -when an individual experiences something new, they broaden their experience and if they enjoy it they broaden their knowledge of it

question

leisure coping

answer

-using a strengths based approach to find what a person can do and using them to help -using leisure to help you get through whatever is going on -4 stages-appraisal (look at how the situation affects the person), assessment of leisure coping, applying coping skills, evaluation -resources-physical (positive traits such has health, fitness and energy), psychological (personality strengths such as self esteem and a positive belief system), social (companionship, friendship, intimate relationships vital for well being and coping), lifestyle (leisure, enjoyment, community involvement are all positive resources that build coping skills)

question

self determination

answer

-having control of your own life and making you own decisions -3 dimensions-autonomy (an individual acting on his or her behalf in accordance with his or her priorities and values), self actualization (an individual builds upon his or her unique capabilities and talents to the extent that they are fully developed and used), self regulation (an individuals ability to control his or her behavior) -RT provides a choice to patients -3 assumptions-self awareness (knows who he or she is and understand his or her capabilities and limitations), self confident (he or she is able to make decisions and follow through with them), self advocate (requires sufficient communication and assertiveness skills)

question

self efficacy

answer

-having confidence and self determination to complete a task -4 parts-mastering experiences, social modeling, social persuasion (others convincing people that they possess the qualities and characteristics to master an activity), physical and emotional states -if someone lost a limb self efficacy helps

question

normalization

answer

-giving everyone the same opportunities and making everything as normal as possible -RTs implements everything for things like this -giving everyone the possibility to live a normal life

question

social role valorization

answer

-inclusion of people with disabilities by giving them a role in society -improve the role in individual society -participate in activities that are culturally normal -empowerment -important to use person first language -important for RT because by getting people to engage in activities it'll help them feel valued -comes from normalization

question

social support

answer

group of people who cares for others to improve the quality of life

question

resiliency

answer

-ability to bounce back from things -4 patterns- dispositional (a persons self perception and physical psychosocial attributes that serve as protective factors against life's stressors), relational (intimate relationships and social relationships), situational (individuals ability to interact constructively with stressful situations), philosophical (individuals worldview-will prove hardier if she or he believes life has a purpose)

question

ICF

answer

-improvements on understanding disabilities and health impairments -allows for interventions by just about everyone to impact overall wellbeing -health condition, body structure/function, activity, participation, environmental factors, personal factors

question

health conditions

answer

-whatever health event that is the case for the individual -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

question

body structure/function

answer

-structure-part of the body that is affected such as organs and limbs -function-physiological functions of the body symptoms (including psychological functions) -impairments-problems in body functions or structure such as a significant deviation or loss

question

activity

answer

-the execution of a task or action by an individual -activity limitation-difficulties an individual may experience in involvement in life situations throwing the baseball

question

participation

answer

-involvement in life situation -broader picture -participation restrictions are problems an individual may experience in involvement in life situations playing the game of baseball

question

environmental factors

answer

-products/technology -natural/human made changes -services, systems and policies -support and relationships -attitudes

question

personal factors

answer

-internal influences on functioning and disability -the particular background of an individuals life and living -not classified as the other factors because of the large social and cultural variations associated with them

question

psychoanalytic theory

answer

-authored by Sigmund Freud -basic assumptions-biological instincts, unmet biological needs-unmet needs=deprivation, subconscious -Id, ego, superego -defenses -long term therapy -examines actions and interprets in light of developmental stage

question

behaviorism

answer

-basic assumptions-response to external demands, behaviors are tried out in response to situations-behavioral repertoire, behaviors are learned and maintained-maladaptive behaviors -focus is-objective observation of behaviors, learning of new behaviors, develop behavior modification plans in a variety of settings

question

cognitive behavioral approaches

answer

-basic assumptions-world is complex, choices before actions, cognitive models simplify complexities, changes in belief, helper must hear messages accurately -identify confusing or problematic logic -examine cognitions-events and stimuli, beliefs or interpretations, action taken

question

growth psychology (humanistic)

answer

-basic assumptions-searching for meaningful and rewarding experience, enduring relationship, self determining, highest level of functioning -belief in human potential -improving self concept/awareness -focuses on how client constructs the world -providing a stabilizing presence -experience emotionally consistent responses -aiding client in examining his/her experience

question

positive psychology (counseling theory)

answer

-basic assumptions-focuses on positive and the individuals strengths and their potential, positive emotions have the effect of broadening the range of thoughts and actions, undoing hypothesis -focus-enjoyable activities, strengths-building not deficits

question

PM&R

answer

physical medicine and rehabilitation

question

typical teams in PM&R

answer

-PT, OT, RT, SLP, SW, physiatrist (MD or DO), RN, LPN, CNA, wound management, prosthetics/orthotics

question

typical teams in psychiatry

answer

-RT, RN, LPN, CNA, SW, LPC (licensed professional counselor), other counselor psychiatrist, MD, PA, drug/addictions specialist, OT-but not there all the time

question

why do RT interventions work?

answer

-novelty, disguised intentions, promote physical activity, allow choice and control, integrate multidisciplinary treatment skills, fun and enjoyable

question

effective interventions

answer

-interventions should relate to functional outcomes -interventions is facilitated to address client goals and not for the sake of activity -useful and applicable context -carry over value -enjoyable

question

factors in selecting interventions

answer

-characteristics of the client-what are their preferences, age, socio-economic status, education level, social support network, functional abilities, personality, cultural and religious influences -characteristics of activities/interventions-physical requirements, interaction and social requirements, cognitive requirements, emotional factors -characteristics of resources

question

how to increase your repertoire

answer

-specific classes-yoga, art, dance, exercise -seminars and workshops -volunteering -mentoring -seeking outside reading -graduate school -professional conferences

question

ATRAs code of ethics

answer

-used as a guide for promoting and maintaining the higher standards of practice -applies to all RT personnel -beneficence -non-maleficence -autonomy -justice -fidelity -veracity -informed consent -confidentiality and privacy -competence -compliance with laws and regulations

question

beneficence

answer

RT personnel shall treat persons served in an ethical manner by actively making efforts to provide for their wellbeing by maximizing possible benefits and relieving, lessening or minimizing possible harm

question

non-maleficence

answer

RT personnel have an obligation to use their knowledge, skills, abilities, and judgements to help persons while respecting their decisions and protecting them from harm

question

autonomy

answer

RT personnel have a duty to preserve and protect the right of each individual to make his/her own choices

question

justice

answer

RT personnel are responsible for ensuring that individuals are served fairly and that there is equity in distribution of service

question

fidelity

answer

RT personnel have an obligation, first and foremost to be loyal, faithful, and meet commitments made to persons receiving services

question

veracity

answer

RT personnel shall be truthful and honest

question

informed consent

answer

RT personnel should provide services characterized by mutual respect and shared decision making

question

confidentiality and privacy

answer

RT 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

question

competence

answer

RT personnel have the responsibility to maintain and improve their knowledge related to the profession and demonstrate current, competent practice to persons served. in addition, personnel have an obligation to maintain their credential

question

compliance with laws and regulations

answer

RT personnel are responsible for complying with local, state, and federal laws, regulations and ATRA policies governing the profession of RT

question

qualities of a professional

answer

-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 and continuing in advance development -employing theory based practice

question

two types of models continuum and integrate

answer

continuum-share the characteristics that participants must work through a continuum from less functional and unhealthy to more functional and healthy integrated-share a cycle and not a continuum approach to RT service

question

lesiure ability model

answer

-oldest and most widely used in RT -self determination -goals of LAM- ----independent and satisfying leisure functioning ----theoretical foundations rooted in the ideas of self determination, control and choice ----3 main areas of service in LAM-functional intervention-assess the individual, mostly controlled by the RT using APIE; leisure education-help our clients develop knowledge skills and attitudes necessary for successful leisure involvement, model assumes client has certain competencies for leisure, 4 areas under this-leisure awareness, social interaction skills, leisure resources, leisure activity. control in this area is evenly shared between the client (make sure they know things and applying it) and the RT (teaching); recreation participation-RT facilitates fun, enjoyable freely chosen activities, RT role-make activities accessible, guiding and facilitating, client role-has most control

question

health protection/health promotion

answer

-conceptual basis is health-looking to improve health/not focus on deficit -theoretical foundations rooted in ideas of -wellness, stabilization/actualization and humanistic perspective -as the client becomes healthier, she/he gains more control over his/her life and more likelihood of experiencing leisure -3 main areas- --prescriptive activities-focus on restoring or regaining stability of their health and using activity as a tool for that, APIE-develops activity, once the client is stabilized, ready for the next step --recreation component-clients participation in activities that are intrinsically motivating, freely chosen activities with a focus on health stabilization and restoration, client/RT roles are 50/50 --leisure component-focus less on restorations and more on growth/self-actualization, client has freedom of choice of his/her leisure and how she/he will experience it, minimal role of RT, continuum approach, client must protect their health before experiencing leisure, client must change in order to reach leisure component (with RT assistance)

question

therapeutic recreation service delivery and outcomes model

answer

-the TR service delivery and TR outcomes models portray outcomes from RT services and service component of practice -2 models work in harmony-ultimate goal -outcome model-model based on concepts of health status and functional capacity in areas of mental, emotional, physical, spiritual and social functioning; leisure ID as functional capacity; moves from low to high and in an interaction of health and health capacities-so if the client has minimal functional capacities and poor health=his/her quality of life is low -service delivery model-works with outcome model; 4 service areas-diagnosis/needs assessment (APIE)-determine the strengths, limitations and abilities of clients in achieving goals, treatment/rehabilitation component-focuses on remediation of deficits in health or functional limitations of client, education-RT focuses on assisting client development skill, attitudes and values to help them function in society, improve health, and achieve higher QofL, prevention/health promotion-focuses on attitude and behaviors that protect or promote a healthy lifestyle; throughout the service components the RT facilitates leisure experiences and enables change through specific interventions

question

aristotelian good life model

answer

-goal of services-attainment of happiness and the good life, rooted in theories of human happiness, client gains freedom and responsibility as she/he is able to attain the elements necessary for the good life -hierarchy elements-primary goods (biological needs and functional abilities), secondary goods (learning, creativity, and development of relationships), summum bonum (leisure and intellectual virtues) -as client overcomes deficits freedom increases and they move toward happiness -RT role determined by the clients levels of functioning

question

some pitfalls to continuum models

answer

-"readiness" assumption-clients get caught in continuum because they cant earn their readiness to move to the next level, clients dont graduate to next level of control until they reach certain levels of functioning, vicious cycle-feels like youre stuck -assumes more intensive and skilled services need to be provided by RT -professional has control of control -assumes changes must happen in the client in order to move up continuum toward more freedom-saying you have to change, not the environment -important to think of continuum model in the context of time and evolution of our field

question

integrated models of RT

answer

share a cyclical rather than a continuum approach to RT service

question

self determination and enjoyment enhancement model

answer

-goal for this is the cultivation of enjoyment and functional improvements-strongly related-if you can do something you'll have more fun -foundations-self determination, role of enjoyment in well being and personal growth, flow and intrinsic motivation-get into the flow of things that matches your ability levels, choose it for yourself rather than someone else -model makes assumptions that enjoyment and functional improvement lead to greater self determination-which leads to greater challenges and in turn to greater self determination and so on -self reinforcing-dont need outside forces attributing to it, able to do something and think that they can do something else -6 components to this model-self determination, intrinsic motivation, perception of manageable challenges (flow, participants feel that their skills and abilities match the challenges of activity), investment of attention (too easy or too hard), enjoyment, functional improvement (both outcomes-enjoyment and functional improvement or RT)

question

optimizing lifelong health through TR model

answer

-ultimate outcomes-health enhancements and healthy leisure lifestyle -grounded in developmental theory and successful aging through selective optimization-looking at what i can do now, different stages of improvements in activities, put weight on participant, participant makes informed decisions to accommodate changes to remain involved in values leisure activities -elements include- selection (activities and goals), optimization (personal and environmental resources), compensation (for impairment), evaluation (effective in promoting a valued leisure lifestyle) -focuses on abilities of clients in their environment

question

ecological model

answer

-based on theory of human ecology and social systems with varying levels, inputs, interactions, energy and outcomes -concept based on capabilities, growth and the creative adaptations through the leisure experience

question

leisure and well being model

answer

-developed to capture leisure and well being from the strengths approach and use it as a guiding framework for RT practice -ultimate outcomes-wellness -goals-enhanced leisure experiences and strengthened resources (support group)-contribute to increased well being -conceptual basis-leisure-leisure is central role in well being that provokes positive emotion and provides opportunities for self determination and ones strengths, strengths based focus on resources development, well being -two main areas of service for RT-enhancing leisure experience, developing resources -both are cyclical and reinforcing each other-doing things you like, the RT works to enhance leisure experience of clients, their resources strengthened-making leisure enhanced

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