TR Practice Book Notes - Kathy Scholl PDF

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Kathy Scholl...

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TR Practice Book Notes Therapeutic Recreation: a broad & inclusive term from advocacy to therapy, education, and facilitation to help one “to return to wholeness”. TR embraces recreation for its inherent qualities to help people have a life of well-being Recreation Therapy: predominately used in medically oriented facilities with the goal of the TRS to “treat” a sickness, deficit, & remediation Chronic Health Conditions, Health & Well-Being Disease: illness that is prolonged (>6mo), does not resolve spontaneously and rarely have a definite cure - communicable & noncommunicable Illness: lived experience of long-term bodily or health disturbance - personal experience of intrusive bodily or mental sensations that comes with the disease Acute Conditions: health conditions which are generally associated with short episodes of illness - episodic, cure expected Health: Biomedical concept: the absence of biomedical abnormalities Positive health concept: using one’s personal and social resource to fulfill one’s dynamic life plan through, able to surmount obstacles Determinates of good health:  Lifestyle  Financial and social status  Level of education  Access to health services & facilities  Access to nutrition  Generic makeup  Community life Well-Being: Multidimensional concept: an individual’s perception of their conditions, a perceived state of harmony in all aspects of one’s life Self-Management: generic tasks that an individual must undertake to live well, especially with one or more chronic conditions

- having the confidence to deal w/medical management, role management & emotional management of conditions Toolbox for self-management  Pain management  Fatigue management  Breathing techniques  Relaxing & managing emotions  Nutrition  Exercise  Medication  Community resources  Communication w/professionals Model of Chronic Care Improving outcomes by productive interaction between patient and practice team using: - community resources & policies - health system organization of health care

Stanford Model: programs are designed to help people gain self-confidence in their ability to control their symptoms & how their health problems affect their lives - group workshops facilitated by moderators with health problems of their own with focus on building skills, sharing experiences & support TR Skills:  Integration  Encouraging independence  Accentuating the positive  Providing active listening  Exploring new lifestyle options  Setting appropriate goals

Integrative Health Coaching: a structured partnership between an individual & a health coach in which the health coach helps empower the individual to reach their health goals through various stages of learning & change - integrative: whole-person care, patient-centeredness, mindfulness & healthy lifestyle

Roots of TR: humanistic & positive psychology - applies strength-based interventions to change behaviors that promote growth & positive feelings National Philosophy: TR is directed toward functional interventions, leisure education & participation opportunities. These processes support the goal of assisting the individual to max the independence in leisure, optimal health & highest possible quality of life Therapeutic Recreation: a health profession which acknowledges the significance of leisure & recreation as integral components of optimal health & well-being of individuals with illnesses & disabling conditions

Chp. 1: Intro to TR Practice - TR helps people identify goals & aspirations and their accompanying talents, assets, interests & capacities

- TR identifies family, neighborhood & community resources to support people in achieving their goals. - Strengths based approach focuses on solutions, aspirations & dreams to improve situation Cultural competence: being able to work effectively w/cultures other than your own by using a set of behaviors, attitudes & policies that are congruent w/that culture - acceptance & respect of cultural differences - continual expansion of cultural knowledge - continual cultural self-assessment - attention to the dynamics of cultural differences - adoption of culturally relevant service-delivery models to better meet needs Critical thinking: use of previous knowledge, belief generating & processing skills to think deeply Evidence-based practice: integration of your individual practice experiences with the best available external evidence to help participants make decisions & implement plans for their leisure & well-being Chp. 2: Paradigm Shifts - Sweeping changes occurring in recreation, health, education & humanservice systems - social indicators & scientific support for the shift to a strength-based approach Chp. 3: A Sea Change in Health & Human Service - explores how the shift to a strength-based ecological approach fits into TR practice & how TR can flourish as a profession in the paradigm Paradigm: a philosophical or theoretical framework; an overall concept accepted by most people in an intellectual community Paradigm shift: a change from one way of thinking to another; a transformation driven by agents of change  Developmental Assets Approach in Youth Development: 20 internal & 20 external assets  The Recovery Model in Mental Health: using assets to recover and control mental health issues  Best Friends Approach in Alzheimer’s care: promoting life-longevity, building relationships  Circles of Support, MAPS, PATH  Community-Based Rehabilitation

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Community Coaching in Community Development: community leaders supporting community development

Sea change: fundamental and profound transformation Problem-oriented/deficits-based approach: improving problems through assessment & prescribed interventions - focus on deficits, illness, distress, disability, poor functioning & negatives states Strength/capabilities-based approach: help people reach goals and aspirations - focus on what people want from life & what resources & strengths are available or needed - empowering, individualized approach The human brain resists change. Focus is power. Expectations shape reality. Attention density shapes identity. Thriving: a positive psychological state in which individuals xp both a sense of vitality & learning Vitality: a sense of energy & aliveness Learning: a sense one is acquiring & applying new or improved skills Hedonic well-being: a subjective xp about enhancing pleasure & avoiding pain Eduaimonic well-being: emphasizes long-term well-being & focuses on meaning, self-realization & vitality, a process of living well or actualizing one’s human potential Socio-Ecological Model (Bronfenbrenner, 1979): based on the concept that humans are reliant on each other & their environment - the whole is greater than the sum of the individual elements or people, due to the interaction & energy of relationships Interdependent Systems of Support 1. Microsystem 2. Mesosystem 3. Exosystem: industry, social services, mass media, local politics, neighbors 4. Macrosystem: attitudes & ideologies of culture 5. Chronosystem: changes over time, long-term outcomes

Chp. 11: Implementation in Strength-Based TR Practice

Implementation: to put something into effect or action using carefully selected strategies, interventions & approaches Deliver: to do what has been promised, provide or produce something Spiral effect: the participant takes a step in the right direction making them feel empowered & encourages them to progress further Interventions: a combo of activity & education-based strategies, a supportive & accommodating environment & a therapeutic relationship. To effectively implement plans, a specialist must understand:  The nature & diversity of rec & leisure activities  How to select activities to help participants reach goals  How to analyze & modify activities  How to select & effectively use facilitation techniques, approaches, modalities & interventions Groups facilitated by TR specialists examples:  Recreational (shared leisure interests, clubs, hobby groups)  Educational (leisure education, relaxation training)  Functional Skills (daily living skills, transportation skills, self-advocacy skills)  Psycho-educational (pet therapy, remotivation, therapeutic adventure, medical play)  Support (social clubhouse, autism support) Implementation Principles 1. Recreation is at the core of TR services. 2. The helping relationship is more important than technique. - helping: means by which you assist a participant in mobilizing resources to reach a goal or satisfy a need 3. Contextualized & authentic learning is rich & effective. 4. Wraparound services are desirable as they are person-centered & sustainable. - wraparound services: surround participant with services that are holistic, strengths-based & individualized (support the lives of participants & tap into their personal & environmental strengths assuring sustainability) 5. Activity analysis & adaptation are effective tools to support other techniques & to enhance leisure.

- activity analysis: process of breaking down & identifying the capabilities, skills & knowledge inherent in an activity & necessary for successful participation - task analysis: description of the sequence in which skills & responses must occur during an activity for a participant to experience success - activity adaptation: altering some aspect of activity or environment to allow for more successful participation & inclusion 6. Advocacy & self-advocacy are important to initiate & sustain change. 7. All interventions require thoughtful planning & delivery to increase effectiveness. Chp. 5: Strengths at the Heart of TR Practice Strength: desirable qualities & characteristic, talent, skill, environment, interest, aspiration - ability to consistently produce a positive outcome - composed of skill, knowledge & talent - resources, assets, protective factors, capabilities Resources: source of supply or support, natural feature or phenomenon that enhances that quality of human life Assets: advantages or resources Protective factors: qualities of a person or context or their interaction that predicts positive outcomes, particularly in situations of risk or adversity Capabilities: possession of attributes required for performance or accomplishment Internal Strengths: recreation as strength  Interests & preferences - passion: what compels us to pursue & devote ourselves to certain goals & activities  Talents & abilities  Skills & competencies  Knowledge  Aspirations & goals  Character strengths & virtues External Strengths: recreation as a context to build strengths  Home resources  Community & environmental resources  Opportunities for participation and contribution (inclusive communities)

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High expectations and positive attitudes Friendships and social support Family support & involvement

Theory of Multiple Intelligences (Gardner)  Linguistic  Logical mathematical  Visual spatial  Musical  Bodily kinesthetics *  Inter personal *  Intra personal *  Naturalistic  Existential 6 Core Virtues & 24 Character Strengths (Peterson & Seligman) - Positive traits that define us as human beings. - Recreation & leisure are ideal arenas for people to employ their strengths, due to the level of choice people have to express themselves.      

Wisdom: creativity, curiosity, judgement, love of learning, perspective Courage: bravery, persistence, honesty, zest Humanity: love, kindness, social intelligence Transcendence: appreciation of beauty, gratitude, hope, humor, spirituality Justice: teamwork, fairness, leadership Moderation: forgiveness, modesty, prudence, self-control

World Health Organization (WHO) 1. Promote socioeconomic dev & reduce poverty 2. Promote health security in the face of epidemic diseases 3. Strengthen health resources & systems 4. Harness research, evidence & info 5. Enhance partnerships 6. Improve performance of health organization through result-oriented management

US National Health Agenda: Healthy People 2020 1. Access to health services 2. Clinical preventive services 3. Environmental quality 4. Injury & violence 5. Maternal, infant & child health

6. Mental health 7. Nutrition, physical activity & obesity 8. Oral health 9. Reproductive & sexual health 10. Social determinants 11. Substance abuse 12. Tobacco Person-centered movement: participants dreams & goals are the engine that drives the helping process, empowering participants & their circle of support to specific plans Team Approaches to Health Care & Human Services Models Multidisciplinary: disciplines work separately Inter-disciplinary: communication, works together, collaborative Trans-disciplinary: everyone is involved & works as a team, integrative (family & client centered)...