|American Journal of Recreation Therapy ®|
Winter 2003; pages 7-16
Until 1990, participation in recreation activities by persons with disabilities generally was assumed to result in the formation of healthy friendships and social relationships with their nondisabled peers. Research has since proven that not all of the relationships formed through inclusion in recreation activities are true friendships in the traditional sense. In this article, varying levels of inclusion are discussed, including physical, functional, and the highest level--social inclusion. Issues of reciprocity, obligation, the inclination of nondisabled peers to take on a "supervisory" role, and other challenges to maintaining meaningful friendships are examined in detail. The importance of friendship as a key component in quality of life is emphasized, with strategies presented for promoting friendships among those with and without disabilities within inclusive community recreation programs that are welcoming, accommodating, and socially inclusive.
Key words: community recreation, disabilities, friendship, inclusive recreation, inclusion, recreation activities, social inclusion
Winter 2003; pages 17-32
This study describes a clinical trial of at-home recreational therapy for community dwelling older adults with dementia and disturbing behaviors. After two weeks of daily, individualized therapeutic recreation interventions (TRIs), results indicated a significant decrease in levels of both passivity and agitation. Biograph data collection was useful in identifying the physiological changes that occurred with each intervention technique. Specific information is included on the time of day each behavior occurred and the most effective interventions, as well as implications for service delivery.
Key words: community-based care, dementia, recreational therapy, behavioral interventions
Winter 2003; pages 33-48
Aquatics, whether offered in a community recreational program or as a form of treatment in a rehabilitation setting, are viewed primarily as physically beneficial. However, participation in aquatics in both community and clinical settings may have additional benefits. This study sample (N = 53) included participants in a Masters Swim program for adults without disabilities and a group of individuals with multiple sclerosis (MS) who participated in a segregated aquatics program. Also included were data from individuals with MS who did not participate in aquatics. T-tests were performed to examine differences between the aquatics groups and to observe whether having a disability was a significant reason for participating. Results indicate a similarity in reasons for participation between the MS and non-MS groups involved in aquatics. In addition, a life satisfaction scale was administered to the two groups of individuals with MS. Means and standard deviations were compiled, and the MS group participating in aquatics reported a higher level of life satisfaction than the individuals with MS who did not participate.
Key words: aquatics, recreation therapy, multiple sclerosis, segregated activities
Winter 2003; pages 49-55
This article presents a process for understanding the personal relevance of leisure participation through writing. Kenneth Burke (1897-1993), American philosopher, literary critic, and rhetorician, designed a flexible and adaptable method of inquiry termed the pentad. As offered here, this approach provides a framework for conceptualizing and assessing the relevance of leisure pursuits and increasing motivation. The pentad has the potential to be an exciting and innovative method of inquiry for participants and facilitators alike. It offers a useful and accessible approach for helping people learn about themselves and discover the unique meanings, goals, and purposes that leisure provides.
Key words: writing intervention, writing strategy, Kenneth Burke, pentad, dramatism, therapeutic recreation, bibliotherapy
Spring 2003; pages 17-20
Conceptual models of recreation therapy are formal presentations that provide an image of recreation therapy practice. The purpose of this article is to provide theoretical understandings of conceptual models and to discuss their evolution within recreation therapy. Only limited information on this topic has appeared previously in the recreation therapy literature. Sources from nursing and occupational therapy, as well as recreation therapy, are used. It is concluded that recreation therapy practitioners, scholars, students, and administrators should conduct systematic examinations of available conceptual models in order to determine for themselves the conceptual model that best fits their needs.
Key words: recreation therapy, conceptual models
Spring 2003; pages 21-26
This case study describes the serendipitous findings of a participant in a pilot study examining the effects of pedometers and lifestyle counseling on the physical functioning of older adults in assisted living facilities. Despite the participantís enrollment in a control group that did not receive individualized lifestyle counseling, she showed an unexpected improvement in the majority of physical functioning outcome measures. The researchers believe this case study demonstrates the potential use of the pedometer as a minimal intervention device for improving the lifestyle of older adults through adherence to exercise. As a result of the pilot study, a protocol was developed that can be used by interdisciplinary health teams in developing a secondary intervention strategy using pedometers as a motivational tool.
Key words: Pedometer, intervention, physical performance, interdisciplinary care
Spring 2003; pages 27-34
Concern exists nationally about the excessive mortality rates of persons with psychiatric disabilities. Comorbidity of disabilities and disabling conditions has been shown to place a disproportionately large burden on the healthcare system. An investigation was undertaken that examined the impact of a structured recreation fitness program on selected psychological parameters in a population of persons with psychiatric disabilities. Further, the research sought to investigate specific factors influencing fitness within a psychiatric population. Thirty individuals with psychiatric disabilities were randomly selected from an available population of 177 such persons and were further randomly ordered into experimental and control groups of 15 persons each in a pretest/post-test design. The experimental group received a seven-month recreation fitness program but the control group did not. The two groups, which were determined to have been equivalent in levels of activity and depression at the onset of the study, differed significantly in a therapeutically positive direction in favor of the experimental group. The effects were more pronounced in reducing levels of depression over time as assessed by the Beck Depression Inventory (BDI). Results of the study suggest there are potential benefits from integrating recreational and fitness programs into a regimen of psychiatric rehabilitation of persons with psychiatric disabilities.
Key words: recreation fitness program, psychiatric disabilities, depression
Spring 2003; pages 35-45
The main purpose of the study was to explore the relationship between leisure participation and the health and well-being of a sample of 62 community-based consumers of a mental health service in a regional city in Australia. The author undertook a quasi-experimental design using a leisure intervention and a pretest, post-test, and six-month follow-up procedure to examine the variable of perceived control. The therapeutic recreation intervention was undertaken for a three-hour duration, once a week, for a period of 24 weeks. Participants were assigned to one of three groups: autocratic, interactive, or comparison. The results of this study support the interactive style of instruction as a more effective method than relying on a traditional autocratic and directive style, as it provides greater choices and opportunities for consumers. Furthermore, the research findings provide additional support to validate the importance of leisure programs in community-based psychiatric facilities for people with a range of mental illnesses.
Key words: Mental health, perceived control, leisure, deinstitutionalization
Summer 2003; pages 9-22
This paper reports on a two-part study of nursing home recreation. In part one, a retrospec-tive activity calendar and chart review was used in this comparative study of 107 long-term care residents with dementia. Data were collected and documented regarding demograph-ics, cognitive and physical functioning, medications, activities listed on facility activity calen-dars, leisure preferences, and actual involvement in recreation over a two-week consecutive period during baseline. In part two, this information was compared to opportunities offered during a two-week clinical trial of recreational therapy. The results showed that, during baseline, almost 45 percent of the subjects in the sample received little or no facility activi-ties, 20 percent received occasional activities, and 12 percent received daily activities but they were deemed inappropriate based on the functioning levels or interests of the residents. The clinical trial period demonstrated that small group recreational therapy was successful in engaging residents 84 percent of the time.
Key words: activity calendars, dementia, leisure preferences, recreation therapy, func-tioning
Summer 2003; pages 23-32
Internet access is becoming more and more commonplace for persons with and without disabilities. Computers and Internet access were given to persons with disabilities who live in rural, isolated areas of North Carolina through the Virtual Buddies program. Participants completed a pretest and post-test after six months regarding social support, loneliness, spare time activities, and friendships. Results of the study are presented, along with sug-gestions for future research and programming for recreation therapists in the area of computer-mediated communication.
Key words: disability, Internet, computer-mediated communication, social support,
loneliness, friendships, rural
Summer 2003; pages 33-39
The current healthcare environment focuses on high quality care, and professionals are expected to deliver services based on standardized interventions that have been tested and proven to ensure that clients attain valued and expected outcomes. This requires many actions on the part of the profession as a whole and the professional as an individu-al. At a minimum, it demands that professionals understand the language and premises of quality care. The purpose of this article is to make explicit the language currently used in quality healthcare literature and practice, specifically terms related to client outcomes, evidence-based practice, and standardization.
Key words: recreation therapy, terminology, client outcomes, standardized care, evi-dence-
Summer 2003; pages 41-44
Clients at an adolescent eating disorders day hospital were offered a three-day adventure therapy program as a unique addition to their treatment plans. Objectives of the program were to build self-esteem, enhance trust in others, try new foods outside of the hospital setting, meet weight gain parameters required by the day hospital, gain backcountry camping skills, and incorporate skills learned into their daily lives. Modifications to tradi-tional adventure therapy included using meals and snacks as the basis for scheduling and providing light to moderate rather than rigorous activities. Activities included paddling, fishing, team building, trust and problem-solving initiatives, therapeutic journaling, cookouts, backpacking, and camping. After participating in the program, clients complet-ed self-evaluations. Their responses, along with their ability to meet the weight gain parameters required by the day hospital, indicated that all the objectives of the program were met. This result reinforced that adolescents with eating disorders can successfully participate in and benefit from adventure therapy programs.
Key words: eating disorders, anorexia nervosa, recreation, adventure therapy, adolescents
Summer 2003; pages 45-48
This paper describes a unique project designed to support families who adopt children with special needs. The Respite & Recreation (R & R) Project provides respite services within the context of therapeutic recreation. It is a collaborative effort between the School of Exercise, Leisure, and Sport at Kent State University and Northeast Ohio Adoption Services (NOAS). The project focuses on four objectives: developing respite models to support adoptive families whose children have special needs; providing spe-cialized training to respite providers that combines knowledge of special needs adop-tion with training in therapeutic recreation; providing respite care to meet the special needs of each child and increase the stability of adoptive families through therapeutic recreation programming; and developing educational programs for families who have adopted children with special needs to increase their repertoire of leisure skills, increase family functioning, and reduce stress.
Key words: recreation therapy, respite, adoption, special needs
Fall 2003; pages 9-16
The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the agitated behaviors and social interactions of older adults with dementia were examined using the Cohen-Mansfield Agitation Inventory and the Animal-Assisted Therapy Flow Sheet. In a nine-week pilot study using a quasiexperimental time-series design, 15 nursing home residents with dementia (Mini-Mental State Examination mean score 3.9; mean age 88.8) participated in a daily AAT intervention for three weeks. Results showed statistically significan decreases in agitated behaviors and a statistically significant increase in social interaction pretest to post-test. Results provide new experimental evidence for using AAT in geriatric therapeutic recreation programs to decrease agitated behaviors and increase social interaction.
Key words: animal-assisted therapy, therapeutic recreation, agitated behaviors, agitation, evidence-based practice, social interaction
Fall 2003; pages 17-22
This paper focuses on the expectations and challenges that Certified Therapeutic Recreation Specialists (CTRSs) face on a daily basis while trying to implement recreation therapy services for clients within a skilled nursing facility. Areas that are addressed include the definition and purpose of recreation therapy, space and time constraints, federal regulations, third-party reimbursement, clientele served, expectations of recreation therapy, and motivation of residents. It also discusses the concept of group cotreatments as a possible solution for clients reluctant to particpate in recreation therapy programs.
Key words: recreation therapy programming, nursing homes, RT programming constraints, group cotreatments.
Fall 2003; pages 23-33
This study describes a clinical trial of a recreational therapy cooking program for older adults with dementia and disturbing behaviors living in an assisted living center. After two weeks of daily participation, results indicated a significant improvement in levels of both passivity and agitation. Biographical data collection was useful in identifying the physiological changes that occurred during each session. Implications for service delivery are included.
Key words: therapeutic cooking program, agitation, apathy, dementia, Alzheimer's disease.
Fall 2003; pages 35-42
The effects of an outpatient pulmonary rehabilitation program on the subjective well-being of older adults participating in the program were evaluated.
Key words: therapeutic recreation, subjective well-being, pulmonary rehabilitation, interdisciplinary treatment team, chronic obstructive pulmonary disease (COPD)
Fall 2003; pages 43-47
Social cognitive theory may serve as a guiding framework for therapeutic recreation (TR) practice. Although the applicability of the theory to TR has been the focus of previous articles, one feature of the theory -- the use of multivariable models to explain human action -- has not been explored in detail.
Keywords: behavior, self-efficacy, self-regulation, theoretical framework, therapeutic recration.