* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download KNR 273: Session 4
Abnormal psychology wikipedia , lookup
Social work with groups wikipedia , lookup
School social worker wikipedia , lookup
Lifetrack Therapy wikipedia , lookup
Group development wikipedia , lookup
Psychiatric survivors movement wikipedia , lookup
Psychiatric rehabilitation wikipedia , lookup
Clinical mental health counseling wikipedia , lookup
KNR 273: Leisure Ability Model Stumbo & Peterson, 2009 Overview Significance of a professional philosophy Leisure Ability Model Means/end debate Framework for evaluating models Why is a professional philosophy important? It guides practice Tells you and others why you do what you do Regardless of philosophy or model, will use APIE Professional philosophies are often represented in models What is a model? Representative of something Provides an image or picture Practice models must do more Should direct practitioners in intervening with clients Should be based on theory Austin, 1999 Leisure Ability Model (Adopted by NTRS in 1982) Originally by Peterson & Gunn, 1984 Modified by Peterson & Stumbo, 2000 Services should be based on client needs or deficits Focus on needs related to leisure makes TR unique Leisure is vital to overall quality of life and life satisfaction Listen to this!!!! “This exclusive discipline focus on leisure behavior within the umbrella of health promotion makes the field of therapeutic recreation different and unique from all other health and human services. Therapeutic recreation has much to offer clients regarding their overall health and rehabilitation goals, and its specific contribution lies in the area of leisure functioning and leisure behavior.” p. 28 Rationale for TR Services Every human being needs, wants, and deserves leisure Many, if not most, individuals experience barriers to full and satisfying leisure Many PWD may experience more frequent, severe or lasting barriers than people without disabilities Rationale for TR Services (Cont.) Many individuals with disabilities will need the help of CTRS to eliminate, reduce, overcome, or compensate for their barriers The reduction of barriers allows the individuals to participate in leisure experiences of choice Ultimate Outcome of TR Services “is the improved ability of the individual to engage in a successful, appropriate, and meaningful independent leisure lifestyle that, in turn, leads to improved health, quality of life, and well-being. When the individual can independently and successfully engage in leisure of his or her own choice, the individual has the chance to receive psychological, physical, and social benefits as well as the more global benefits of improved health, wellness, and quality of life.” p. 29 Clients Any individual with a physical, mental, social, or emotional condition that limits leisure functioning Individuals with illnesses, disabilities, or conditions acknowledged by health and human services classification systems Medical & psychiatric classification schemes DSM IV WHO, ICF Healthy People 2010 Also includes legal offenders, at-risk youth Deviation from social norms & become recipients of specialized services Clients (Major groups) Psychiatric and mental health services Geriatrics 30% Physical medication services 35% 18.4% Developmental disabilities 13.6% Riley & Connolly, 2007 Settings Any agency or center that serves the clients we discussed Clinical, residential, community Page 31-32 Settings (Major settings) Hospitals 19.3% Residential & transitional settings 38.6% Skilled nursing facilities 14.4% 3.6% Schools 3.9% Day care/day treatment 15.0% Community settings Partial/outpatient facilities 1.9% Correctional centers 1.4% Riley & Connolly, 2007 Process Selection, development, implementation, and evaluation of goal oriented services Functional intervention Leisure education Recreation participation Purpose of TR Is to facilitate the development, maintenance, and expression of an appropriate leisure lifestyle p. 33 Leisure Lifestyle Is the day-to-day behavioral expression of one’s leisure-related attitudes, awareness, and activities revealed in the context and composite of the total life experience p. 14 Leisure Lifestyle (cont.) Implies that an individual has sufficient skills, knowledge, attitudes, and abilities to participate successfully in and be satisfied with leisure and recreation experiences that are incorporated into his or her individual life pattern. (Peterson & Stumbo, 2000, p. 7) Leisure Lifestyle as an Outcome Means Client … Has reduced functional limitations that prohibit leisure involvement (or has learned how to overcome these barriers) Understands and values the importance of leisure Incorporates leisure into daily life Is competent in a variety of leisure activities Has adequate social skills for involvement with others Leisure Lifestyle as an Outcome Means Client … Is able to choose between several leisure options and make decisions for leisure participation Is able to locate and use leisure resources Has increased perceptions of choice, responsibility, and independence with regard to leisure p. 70 In other words…. TR is helping individuals with disabilities and/or illnesses develop and more freely express their leisure choices AND The outcome of TR services is the improved ability of the individual to make and act on choices for leisure that are rewarding and successful Psycho-Social Theories of Leisure Behavior Perceived freedom & personal choice Intrinsic motivation Self-efficacy, locus of control, & causal attribution Optimal experiences (flow) Leisure Ability Model 3 major categories of service Functional Intervention Leisure Education Recreation Participation See p. 34 Functional Intervention Focus is on improving functional behaviors which are prerequisites to, or necessary part of, leisure involvement Baseline abilities that are prerequisite to typical leisure behavior 4 domains Physical Mental/cognitive Emotional/affective Social Sample Functional Behaviors Addressed by TR Intervention Depression: decreased energy level; inability to express emotions appropriately, decreased stamina Dementia: minimal orientation; limited attention span Intellectual disability: delayed motor and social development; limited attention span Spinal Cord Injury: minimal strength; endurance; depression Functional Intervention Role of CTRS Degree of Control Therapist Intervention mostly controlled by therapist Degree of Freedom in Participation Obligatory behavior, constrained, prescribed, dependent, extrinsically rewarded Leisure Education Focus on the development and acquisition of various leisure-related skills, attitudes, and knowledge 4 components Leisure Awareness Social Interaction Skills Leisure Activity Skills Leisure Resources See p. 43 Leisure Awareness Cognitive appreciation of leisure Content includes, but not limited to: Knowledge of leisure Self-awareness in relation to leisure Leisure and play attitudes Related leisure participatory and decision-making skills Can be separate or combined programs See page 45-48 Social Interaction Skills Communication skills Relationship-building skills Friendship development, cooperation, competition Self-presentation skills Assertiveness, active listening, empathy Manners, hygiene, grooming, appropriate attire See page 49-52 Leisure Activity Skills Develop a repertoire of diverse leisure skills Two categories Traditional Nontraditional See page 52-56 Leisure Resources Activity opportunities Personal resources Family and home resources Community resources State and national resources Knowledge Utilization See pages 57-60 Leisure Education Role of CTRS Instructor, advisor, counselor BUT cautions about use of term counselor Degree of Control Responsibility shared between CTRS & client Recreation Participation Focus on providing an opportunities for fun, enjoyment, and self-expression within organized delivery systems Leagues, tournaments Special Events Activities requiring specialized equipment Opportunities for self-initiated activity Recreation Participation Goals Increase ability to assume responsibility for personal leisure participation Increase ability to make and follow through on decisions, regarding leisure involvement Increase competence in leisure skills through practice and involvement Increase sense of mastery through attainment and performance of skills Recreation Participation Roles Practice and application of skills Inclusionary program Normalization of institutional routine Focus on “well” aspects of client Expression of leisure lifestyle Diversion or palliative purposes Fun & belonging Recreation Participation Role of CTRS Degree of Control Leader, facilitator, supervisor Opportunity for participation provided for client Degree of Freedom Independent, self-regulated, intrinsically rewarding Leisure Ability Model Programs/interventions based on individual client need that is related to leisure All populations All settings May need services in 1, 2, or all 3 areas Leisure Ability Summary Assumptions (Rationale): Leisure is a need & right of all individuals Many individuals experience constraints & barriers to leisure TR services are designed to facilitate individuals’ independence in leisure functioning Mission: Leisure Leisure is end product or outcome Summary (Cont.) Definition of TR (Purpose) To facilitate the development, maintenance, and expression of an appropriate leisure lifestyle for individuals with physical, mental, emotional or social limitations Service Areas Functional Intervention Leisure Education Recreation Participation Leisure Ability Strengths Extensive use in field (most widely used) Acceptability & utilization in field Flexibility (settings & population) Services based on client needs Stood test of time Oldest Fostered consistency in practice Brought profession together Most recognized Recognizes importance of recreation participation Strengths (Cont.) Referenced in NCTRC & accreditation Common sense approach to TR High degree of merit Tied to leisure theory Graphics clear, concise & comprehensive Good clarity of terms Good for program design (1-1 or group) Leisure Ability Concerns Based on nondisabled adult leisure behavior Some terms ill defined (leisure lifestyle) Focuses on leisure instead of therapy Too broad More empirical research is needed Widely debated Problems with conceptual/theory Recreation participation is not reimbursable service Concerns (Cont.) Recreation participation as role of CTRS Lack of attention to health & independent functioning outside of leisure Programs designed for 1 outcome Linear conceptualization Not in concert with current health cares’ focus on functional outcomes Is Therapeutic Recreation a means to an end or an end in itself? Means means… Instrumental Tool to produce some other outcome (eg. Improve health, decrease depression) Recreation as an agent (means) of change Means is anything that contributes to the attainment of an end. It receives it value in proportions to its utility for yielding an end. A means, therefore, is subordinate to an end and has no value unless directed toward one. Means (Cont.) Means orientation indicates change or improvement of functional behaviors as the desired end. Draws from a medical, psychiatric, psychological and human development body of knowledge End means… Intrinsic Leisure or recreation is the outcome that TR services aim to produce End is anything that is valuable in its own right and is done for its own sake. An end is good for its own sake Ends (Cont.) Implies that the ultimate outcome is related to leisure behavior Draws on the body of knowledge related to leisure Some models regard leisure as both a means & an end Both a tool and a product of TR services Can TR be both at the same time? Does the Leisure Ability Model emphasize one over the other? Which? How? Criteria to Evaluate TR Practice Models Easy to follow (graphic depiction, clarity of terms & concepts) Accommodates a variety of clients & settings Flexibility in types of services What is the end goal? Purposes Underlying assumptions Theoretical bases Direction for research & practice Could you explain TR with this model? Could you design programs? One Minute Paper Clear Muddy General Comments