Comprehensive Guide to Therapeutic Recreation Process

1. chapter6 The Therapeutic Recreation Process Terry Long, PhD

2. Learning Outcomes • Identify the four parts of the therapeutic recreation process • Identify basic assessment methods and potential applications of each • Identify critical considerations for planning therapeutic recreation programs • Competently conduct activity analysis, task analysis, and activity modification • Differentiate between comprehensive program planning, specific program planning, and client or session planning • Identify planning and implementation considerations related to technical skills and counseling skills • Identify and explain various aspects of briefing and debriefing therapeutic recreation-based experiences • Identify techniques for and potential applications of client and program evaluation

3. Assessment • Definition • Purpose • Methods • Standardized assessments and interest inventories • Common therapeutic recreation assessments • Common treatment team assessments • Interviewing • Observation (continued)

4. Assessment (continued) • Purpose • Gather client information • Determine overall program effectiveness • Communicate with other professionals • Meet requirements for assessment by administrators and external agencies • CMS • CARF • JCAHO

5. Assessment Methods • Review existing documents • Standardized assessments • Interviewing • Observation

6. Existing Documents • Intake assessment reports and other existing sources of information should be reviewed • Reviewing this information: • Limits unnecessary questioning • Limits repetition • Is useful in preparing other assessment procedures

7. Standardized Assessments and Interest Inventories • Examples of therapeutic recreation assessments • Leisure diagnostics battery • Leisure competence measure (LCM) • Comprehensive evaluation for therapeutic recreation (CERT) • Psych/R • Physical disabilities • General assessment systems • Resident assessment inventory–minimum data set (RAI–MDS) • Inpatient rehabilitation facility–patient assessment inventory (IRF–PAI)

8. Interviewing • Focus of the interview • Preparation • Progression of the interview • Observing behavior during the interview

9. Observation • Documents actual behavior • Useful with non-cooperative clients • Does not depend on clients communication skills • Does not measure constructs such as mood, beliefs, attitudes, or intentions, only actual behavior

10. Planning • Individualized program plan (IPP) • Strengths • Limitations • Goals and objectives • Placement of clients

11. Planning: Goal Development • Goals are general accomplishments that the client should achieve through participation in therapeutic recreation • Objectives are measurable criteria for determining when a goal has been met • Three elements of an objective • Condition • Behavior • Criteria

12. Planning: Other Considerations • Activities must have direct relationship to client goals • Activity characteristics can influence successful activity implementation • Client should be able to place the activity in the context of therapeutic recreation goals • Activities should be interesting and engaging • (Stumbo and Peterson, 2004)

13. Tools for Planning • Task analysis • Activity analysis • Activity plan • Activity modification

14. Implementation • Technical skills • Facilitation skills • Briefing • Leading • Debriefing • Specific debriefing strategies • What, so what, now what • Five stages of questioning (Jacobson and Ruddy, 2004)

15. Evaluation • Client evaluation • Program evaluation • Evaluation tools • Evaluation systems • SMART goals • Goal attainment scaling

16. Planning • Multiple levels • Assessment report • Goal development • Objectives • Goals versus objectives • Placement of clients • Other considerations • Tools for planning • Activity plan

17. Implementation • Comparison between therapeutic recreation and counseling • Technical skills • Facilitation skills • Leading • Debriefing, or processing (table 6.1)

18. Evaluation • Client evaluation • Program evaluation • Specific program (see table 6.2 for example) • Overall comprehensive program • Internal • External • Evaluation tools • Evaluation systems • Goal attainment scaling • SMART goals (figure 6.2)

19. Discussion Questions • What pros and cons do you see regarding each of the assessment methods presented in this chapter (interviewing, observation, standardized assessments)? • Discuss the relationship between assessment and planning. What does it mean to target a particular outcome, and how are these outcomes identified or established? • How can task analysis assist a therapeutic recreation specialist in determining appropriate sequencing for an activity? Perform a task analysis of a recreation-related behavior and give an example of how the activity could be sequenced for a particular client group. (continued)

20. Discussion Questions (continued) • How does sequencing relate to the two debriefing strategies presented in this chapter? What might happen if a therapeutic recreation specialist skipped stage 1 of either approach? What might happen if the specialist failed to proceed past stage 1 of either approach? • What is the difference between assessment and evaluation? What similarities do you see? How is writing goals and objectives related to these two aspects of the therapeutic recreation process?