Katherine Koplow Therapeutic Recreation Process Compare/Contrast Review

Katherine Koplow U0700381 PRT-3330-Foundation in Therapeutic Recreation Therapeutic Recreation Process Compare/Contrast Review Devries, D. & Lake J. (2005). Recreational Therapy: maximizing a residents level of functioning. 1) Definition of Recreational Therapy (RT) RT provides active treatment that is designed to help a patient improve their skills and abilities for daily living. TR is the provision of treatment services and provision of recreational services to persons with disabilities or illness. The purpose is to restore, remediate, and rehabilitate in order to increase functioning and independence as well as cut or eliminate the effects of illness and disabilities. Recreation therapy is provided by TR professionals, who are trained, certified, registered, and/or licensed. 2) Purpose of RT in long term care The purpose of RT in long-term care is to provide special interventions, which include: special dementia care units, restorative programs, and subacute programs for patients suffering from psychiatric disorders. RTs in these units help maintain cognitive abilities, reduce challenging behaviors or reduce risk of falls, use of restrains and unnecessary medications. RTs help address psychosocial issues and communication/ social skills. They try to improve physical functioning and activities of daily living and provide community re-entry and leisure education to help promote independence. RTs are responsible for providing purposeful and meaningful activities, helping establish routine and structure and teaching new appropriate leisure and social skills. 3) Difference between Activity Services and Recreational Therapy RTs provide a holistic approach to patient treatment and dont focus on physical, cognitive or social functioning; they view the entire person and all aspects of their life. RTs have a variety of treatment interventions, which allow them to have a variety of modalities to address patients functional abilities and skills. It is therapy focused and emphasizes restoration, remediation and rehabilitation. RT is also a cost-effective means of treatment and are physician-ordered services that a medically needed and are intended to provide expectations for improvement. Treatment is provided 1-on-1 or at maximum 1 to 4 by a qualified CTRS Activity services are designed to meet the physical, cognitive, emotional and psychosocial needs of each resident. The minimal requirements for activity service director is a high school degree and approved training course, 2 years of experience in social or recreation programing and occupational therapist or occupational therapist assistant qualifications. They provide service on maintenance of skills to promote quality of life and the actives are tailored to meet the individual needs of residents. Activity 1

Katherine Koplow Therapeutic Recreation Process Compare/Contrast Review

services provide recreation for large groups and are lead by activity staff, nursing staff or community members and volunteers. LeConey, S., Devine, M., Bunker, & H., Montgomerg, S. (2000). The case of sue. Parks & Recreation Magazine. Vol. 35, Issue 5. 1) Definition of Therapeutic Recreation (TR) process According to Peterson and Stumbo, Therapeutic Recreation is a systematic method of planning and providing services for individuals with disabilities. The process is based on a systems theory approach meaning parts of components are interrelated. The systems design is a guide for a well defined, goal oriented purpose to the activity or program being provided. It involves following APIE and isnt dependent on location, but on systematic and consistent use of APIE for people with disabilities. This process is done in hospitals and long-term facilities and applied when helping provide leisure education and recreation services.

Reading these two articles was very helpful in analyzing the way a Recreational Therapist goes about the TR process depending on the environment and client population. During my critical review, I was able to analyze the difference between community based practice and health care based practice. There was a difference in the RTs goals, purpose and the direction of implementing the TR process. The community based implementation that is described in the Case of SueLeConey, et. al, is a practice that focuses on helping a larger group of people. The services are provided by RTs but due to the number of clients, a general recreation staff might implement the program plan that the RT creates. The implementation phase during community based is the action phase and pays attention to the social (attitudes), programmatic (adaptions) and environmental (accessibility) issue that might be faced. Because this is a community-based implementation, there is an inconsistent attendance and often a lack of support, which makes the wanted results difficult to achieve.

Katherine Koplow Therapeutic Recreation Process Compare/Contrast Review

The health care base service from the Devrise & Lake article is implemented very differently. Service is only provided by RTs and is 1-on-1 and at most a 1:4 ratio of therapist to client. This treatment is prescribed and is more consistent. Both forms of implementation desire to improve the quality of health in the client while facilitating treatment. While the community based is more goal oriented and focuses on an activity or program based on the clients needs, the health care based, especially in the case of long-term care, focuses on helping patients keep functioning until their death and tries to improve their skills and abilities so they can maintain their ADL. The purpose of community-based treatment is to maximize inclusion into community recreation at the end of the therapy, and increase their community recreation options allowing them to have more independence after therapy. The health care treatment purpose is to restore, remediate and rehabilitate their patients. Critically reviewing each of these practices helped me to realize that the purpose of a TR is dependent on the goals and desires of their patient and the importance of recognizing that when creating a treatment plan. Each form of implementation has its unique strengths in providing TR/RT services. The Case of Sue has the TR utilize the environment in helping act out the plan of treatment. RTs are to positively influence the quality of life for people with disabilities. The long-term treatment RTs, provide services in a different way. They provide education and treat the patient in a holistic approach. They try not to focus on one aspect of the person but view the entire person. The strength of both approaches is that it is an affective means of treatment. 3

Katherine Koplow Therapeutic Recreation Process Compare/Contrast Review

I was able to understand each approach of treatment much better after realizing how they were being used in recreation, leisure and activity. The community base is the means and the end. At the end of the intended program and after meeting the expected goals, RTs hope that patients will be able to go out into the community, find a program of interest, maybe similar to the one they have been working with a RT on, and individual participate in the activity without the aide of an RT. The long-term health care approach views TR as a means to an end. The RT is focusing on maintain the quality of life while the patient is living. The end, death, is in sight and the focus of this approach is to make measures so that the patients life is as enjoyable as possible while they are still functioning. It was easier to understand the differences of service delivery models when having cases to compare them to, and having to assess which model would work better for the different situations. As an RT, I would use the Leisure Ability Model to help in the Case of Sue and would use the Health Protection and Health Promotion Model at a long-term health care facility. The Leisure Ability Models primary outcome is to improve independent and leisure function that affect a persons quality of life. This applies to the Case of Sue because the RT was using dancing to help improve her social skills. Sue, like all humans, has needs, wants, and deserves leisure. The base of this model is to have a therapist improve functional ability, which will help with leisure education and allow the participant to engage in recreation. This model helps with leisure awareness, social interaction skills, leisure resources and leisure activity skills, all of which Sue and her RT are working on trying to improve in her treatment plan. 4

Katherine Koplow Therapeutic Recreation Process Compare/Contrast Review

The Health Protection and Health Promotion Model is used to assist a person to recover following threats to health and to achieve as high a level of health as possible. This correlates directly with the goals of the long-term treatment RT. Because this approach uses recreation as a means, the goal is to overcome barriers to health and have the highest level of satisfaction while able. There are three components of this model: prescriptive activity, recreation and leisure. These means go from little client control to client directed. The goal of an RT while in a long-term care facility should be able to help the patient have the highest level of independence and be self-directed. Taking the time to really understand how RTs implement the TR process depending on their patients, the environment and their clients desired outcome really helped me to better understand the TR process. There are many different elements that are taken into account when a RT creates an implementation plan and this assignment gave me a better idea of how the different elements are used and how to apply APIE to best benefit your clients.

References: Devries, D. & Lake J. (2005). Recreational Therapy: maximizing a residents level of functioning.

LeConey, S., Devine, M., Bunker, & H., Montgomerg, S. (2000). The case of sue. Parks & Recreation Magazine. Vol. 35, Issue 5.