American Journal of Recreation TherapyAbstracts
American Journal of Recreation Therapy ®

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American Journal of Recreation Therapy
Winter 2006, Volume 5
, Number 1


Article
Editorial. Mentoring our graduate students for a positive change
Linda L. Buettner, PhD, CTRS
Winter 2006; pages 5-5


Article
Be a Fit Kid: Promoting healthful lifestyles in adolescents with special needs
Jennifer Slawta, PhD
Winter 2006; pages 7-17

Abstract
The purpose of this paper is to describe a physical activity and nutrition intervention for adolescents with special needs. The initial intervention comprised sessions with 15 adolescents two to three times each week for 10 weeks. At baseline, over half the sample had high body mass index, high body fat, and high blood levels of total cholesterol. Following the intervention, significant improvements in fitness and nutrition knowledge were observed, and reductions in body fat and blood levels of total cholesterol approached significance. More than 70 percent of participants reduced their intake of refined foods and foods high in saturated fat and increased their intake of whole grains, vegetables, fruit, and unsaturated fat. These findings suggest that health promotion programs that emphasize noncompetitive and individualized fitness activities and nutrition education can positively impact adolescents with special needs and may contribute to the prevention of lifestyle-related diseases. Key words: adolescents, special needs, physical activity, nutrition intervention


Article
Facets of community-based group outings for individuals with brain injury: Perceptions of four therapists from different disciplines
Laurie Knis-Matthews, PhD; Shoshana Dahan-Barasch, OTR; Leigh M. Jablonski, OTR; Avigael Schulgasser Friedman, OTR; Kristine Whitfield, OTR
Winter 2006; pages 18-26

Abstract
The purpose of this qualitative study was to explore therapists’ perceptions of using groups as a therapeutic modality in the treatment of individuals with traumatic brain injury. Four rehabilitative therapists, working on a brain trauma unit at a rehabilitation hospital, were interviewed by using an open in-depth interview format. On the basis of thematic analysis, four main themes emerged from the data: group treatment often complements a person’s individual therapy; universality and altruism are two therapeutic factors that can be influential during group sessions; groups help to prepare individuals for the real world; and groups are helpful to a person’s recovery, but there are potential barriers to the process. Key words: group treatment modality, head injury, therapist perception


Article
Recreational therapy: Relieving pain in older adults with osteoarthritis
Karen M. Finch, MS, CTRS
Winter 2006; pages 27-39

Abstract
This paper focuses on the role a Certified Therapeutic Recreation Specialist (CTRS) has in relieving pain in older adults with osteoarthritis (OA). A description is provided of the therapeutic intervention CTRSs can implement in their pain relieving treatments for OA sufferers. Other areas addressed include defining pain, explaining the physical and social effects OA has on older adults, as well as the purpose of recreational therapy in relieving pain. The benefits of physical exercise for function, used as a recreational therapy treatment intervention, are described. In addition, evidenced-based treatments and outcomes for reducing OA pain are discussed. Key words: osteoarthritis, pain, CTRS, recreational therapy, non-pharmacological treatments


Article
Perceived biopsychosocial benefits and leisure satisfaction from participation in an Arthritis Foundation Aquatic Program
Sarah J. King, MS, TRS; Heewon Yang, PhD, CTRS; Marjorie J. Malkin, EdD, CTRS
Winter 2006; pages 40-48

Abstract
The purpose of this study was to examine perceived biopsychosocial benefits and leisure satisfaction from participation in an Arthritis Foundation Aquatic Program (AFAP) for older adults. Fourteen older adults with arthritis participated in this program. They were given a researcher-designed questionnaire and the Leisure Satisfaction Measure (LSM) at the end of the five-week program. Overall, the participants perceived that the AFAP helped them to improve their quality of life, effectively manage their daily arthritic pain, and increase their emotional satisfaction. Results also indicated that the AFAP contributed to participants’ perceived satisfaction with leisure. An increased emphasis on the physiological content of the program was suggested to help participants reduce their body weight and improve their perceived body image. Key words: Arthritis Foundation Aquatic Program (AFAP), biopsychosocial benefits, Leisure Satisfaction Measure (LSM)

American Journal of Recreation Therapy
Spring 2006, Volume 5
, Number 2


Article
Editorial. Therapeutic activities and new CMS regulations
Linda L. Buettner, PhD, CTRS, FGSA
Spring 2006; pages 5-6


Article
New CMS Regulations
Spring 2006; pages 7-14

Abstract
The revised surveyor guidance for surveying activities requirements in long-term care facilities will become effective on June 1, 2006, and will be incorporated into Appendix P of the State Operations Manual. This revision addresses the guidance’s interpretive guidelines, investigative protocol, and determination of compliance. In this article, we will provide an overview of the guidance’s key points, as well as checklists to help ensure that all nursing home surveyors are fully trained in the revised guidance by the implementation date.


Article
Microswitch-based programs as therapeutic recreation interventions for students with profound multiple disabilities
Giulio E. Lancioni, PhD; Nirbhay N. Singh, PhD; Mark F. O’Reilly, PhD; Maria Luisa La Martire, MA; Fabrizio Stasolla, PhD; Angela Smaldone, MA; Doretta Oliva, MA
Spring 2006; pages 15-20

Abstract
In this study, microswitch-based programs were adopted as forms of therapeutic recreation intervention for three students with profound multiple disabilities. The effects of the programs were measured by activity engagement (i.e., object manipulation) and mood. The students were given either a wobble microswitch that was activated by manipulating a ball mounted over it or a pressure microswitch that was activated by rubbing/pushing on springy fabric embedded over it in a wooden frame. Microswitch activation produced preferred stimuli during intervention periods and no effect during baseline. Data showed that during the intervention the students displayed a significant increase in their manipulation responses and improvements in mood. The mood elevations were gauged by a significant increase in indices of happiness for two of the students and a significant decrease in indices of unhappiness for the third student. Theoretical and practical implications of the findings are discussed. Key words: multiple disabilities, therapeutic recreation, microswitch-based programs


Article
Professionalism in recreation therapy
Angela J. Wozencroft, MS; Judith E. Voelkl, PhD, CTRS; Francis A. McGuire, PhD, CTRS
Spring 2006; pages 21-26

Abstract
The field of recreation therapy has seen many changes. The emerging issues resulting from these changes lead us to question whether our current graduates understand that recreation therapy provides a professional career track and opportunities to develop a sense of professionalism. The purpose of this paper is to describe the design and evaluation of one approach used to encourage professional enculturation in 19 undergraduate students in the recreation therapy concentration at Clemson University. Evaluation of the learning tool consisted of two focus groups’ answers to open-ended questions focusing on 1) general questions surrounding the students’ understanding of issues in the field, the development of their philosophy, and professionalism in the field; and 2) questions regarding the learning tool itself. Three major themes emerged from the focus group data: 1) what was learned from the interviews, 2) what it means to be a professional in recreation therapy, and 3) the strengths and weaknesses of the learning activity. Results suggest that there is a need to systematically evaluate the impact of this learning approach on the trends affecting recreation therapy and its lasting effect on students. Key words: recreation therapy, undergraduate students, professionalism, trends


Article
Exercise: A treatment intervention for dysthymia in the geriatric population
Celeste J. Lynch, CTRS
Spring 2006; pages 27-36

Abstract
Many certified therapeutic recreational specialists (CTRSs) face the challenge of providing services to clients suffering from depression. The challenge can be twofold: recognizing depressive symptoms, and implementing effective interventions. In the elderly, depression can be associated with excessive passivity and a decline in functional mobility. Recreation therapists believe that an intervention such as a therapeutic exercise group can improve a client’s condition. When faced with a client who exhibits signs and symptoms of depression, more often than not antidepressant therapy and/or psychotherapy is prescribed. Educating physicians about the effectiveness of a recreation therapy intervention such as a therapeutic exercise group is the key to supporting advanced practice recreation therapy in geriatrics. Key words: geriatric population, dysthymia, treatment intervention, therapeutic exercise group


Article
Unique issues in pain management for older adults
Norma J. Stumbo, PhD, CTRS, FALS
Spring 2006; pages 37-47

Abstract
The intent of this paper is to examine some of the critical issues concerning the unique pain experience of older adults, highlighting the information and techniques most pertinent to the practices of therapeutic recreation specialists. First, the article provides background information concerning the high proportion of older adults who experience unabated pain. Second, the six primary reasons to concentrate on the pain experience of older adults are discussed. Third, the barriers to adequate pain management for these clients from the perspectives of healthcare professionals, patients, and the healthcare system are presented. Therapeutic recreation services for older adults will be improved by specialists’ increased awareness and use of this information in their daily practice. Key words: pain, pain management, barriers, older adults, elderly

American Journal of Recreation Therapy
Summer 2006, Volume 5
, Number 3


Article
Editorial. Scaffolding of recreation therapy programs
Linda L. Buettner, PhD, CTRS, FGSA, Managing Editor
Summer 2006; pages 4-5


Article
Children with physical disabilities. The experience of participation in Challenger Little League through the eyes of a child with a physical disability
Anna-Rochelle Barletta, MS, CTRS; David P. Loy, PhD, TRS/CTRS
Summer 2006; pages 6-12

Abstract
Children with physical disabilities may not always progress in the same manner as their peers who do not have physical disabilities. While children with disabilities generally have the same basic needs as their peers, they often require additional support in order to meet those needs. The purpose of this study was to gather information about the experience of participating in an adapted sports program, in order to identify both positive and negative effects on the development of a child with a physical disability. This qualitative study involved interviews with one participant in Challenger Little League, conducted to obtain insight into her experience and to give reasons for additional studies to be conducted. Analysis from this study indicated three positive outcomes from participation in Challenger. The three themes were a) pride in accomplishments, b) skill development and physical health, and c) enjoyment in engagement. A discussion of practical implications for service providers is also offered. Key words: child development, physical disabilities, Challenger Little League, adapted sports, qualitative research


Article
Conceptualizing the RT role. An evidence-based approach to providing physical activity and cognitive-behavioral therapy to older adults with pain
Norma J. Stumbo, PhD, CTRS, FALS
Summer 2006; pages 13-25

Abstract
The intent of this paper is to examine some of the critical issues concerning the unique pain experience of older adults, highlighting the information and techniques most pertinent for use by therapeutic recreation specialists. General guidelines for older adults’ pain management are described, followed by a description of pharmacological and nonpharmacological approaches. The majority of the paper concentrates on therapeutic recreation specialists’ use of two specific nonpharmacological approaches to pain management: physical activity and cognitive-behavioral therapy. It is anticipated that this article will be a starting point from which therapeutic recreation specialists interested in a research-based approach to pain management can learn baseline information, allowing them to develop and research physical activity and cognitive-behavioral therapy services for older individuals living in pain. Key words: pain, pain management, older adults, elderly, physical activity, cognitive-behavioral therapy


Article
Rehabilitation RT. Recreational therapy intervention following stroke: Community reintegration
Jo A. Lewis, BA, CTRS
Summer 2006; pages 26-30

Abstract
Strokes are the third leading cause of death and the leading cause of disability in the United States. They affect not only the physical functioning but also the psychological health and leisure participation of an individual. Many individuals have reported decreases in leisure activity participation and community involvement compared to life before the stroke. This paper outlines the challenges faced by older adults who have had a stroke and discusses the benefits of their participation in recreational therapy interventions through a community reintegration program designed to improve functional status, mood, and independence in leisure pursuits. Key words: stroke, recreational therapy intervention, community reintegration program


Article
Mental health RT issues. Exercise as treatment for depression: A therapeutic recreation intervention
Tim Passmore, EdD, CTRS; Suzie Lane, EdD, CTRS
Summer 2006; pages 31-41

Abstract
An efficacy study was conducted to investigate whether there would be a difference in effectiveness between two exercise programs for individuals with depressive disorders admitted to a short-term psychiatric treatment facility. To address the long-term effects of the exercise programs, the investigators monitored adherence to exercise programs after discharge. The therapeutic recreation interventions used were aerobic exercise and a combination of aerobic exercise and resistance exercise (weight training). The study assigned 21 adults diagnosed with dysthymia to one of the two recreation therapy groups and monitored individual Beck Depression Inventory (BDI) scores and individual adherence to designated exercise routines at six-week and 12-week reporting periods. The results of this study support current literature by demonstrating that those research participants who adhered to prescribed exercise programs reported lower depression scores than those who did not. Key words: therapeutic, therapy, recreation therapy, aerobic exercise, weight training, depression, intervention, discharge recommendations


Article
Community-based RT. Peace of mind: A pilot community-based program for older adults with memory loss
Linda L. Buettner, PhD, CTRS, FGSA
Summer 2006; pages 42-48

Abstract
This pilot project was established to refine and test the Community of Care continuum for older adults with memory loss. The treatment group (n = 40) received the opportunity to select classes and was compared to the control group (n = 40), members of which simply maintained their normal lifestyles in the community after assessment. A total of 80 participants were tested at baseline, six months, and 12 months. Data were analyzed using repeated-measure analysis of variance to assess the effectiveness of the intervention over time. This allowed for analysis regarding intervention, time, and the interactive effects of time and intervention. The treatment group showed significant positive intervention effects (p < 0.05) for Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), instrumental activities of daily living (IADL), and quality of life. These preliminary findings show great promise for recreation therapists and others using community-based programs for older adults concerned about memory loss. Key words: community-based program, continuum of programs, memory, recreation therapy approaches

American Journal of Recreation Therapy
Fall 2006, Volume 5
, Number 4


Article
Editorial. Celebrating the journey
Nancy Richeson, PhD, CTRS
Fall 2006; pages 5-7


Article
Community-based recreation therapy for older adults
Nancy Richeson, PhD; Linda Buettner, PhD, CTRS; Sharon McKenzie, PhD, CTRS; Suzanne Fitzsimmons, MS, ARNP; Jean Keller, EdD
Fall 2006; pages 8-10

Abstract
The authors of this article presented this symposium at the Gerontological Society of America annual meeting in Dallas, Texas. The purpose of the symposium was to examine the influence of recreation therapy interventions on the physical, emotional, cognitive, and social well-being of community-dwelling older adults.


Article
Trends and issues in therapeutic recreation programs in Wisconsin’s correctional and forensic institutions
Patricia S. Ardovino, PhD, CTRS, CPRF
Fall 2006; pages 11-18

Abstract
The intention of this study was to gather information on the trends and issues in therapeutic recreation programs in Wisconsin’s correctional and forensic facilities using reports from the therapeutic recreation specialists (TRSs) employed in those facilities. A survey using the Delphi technique was administered to an expert panel of jurors to determine the trends and issues facing these TRSs. Seven trends and 10 issues were identified after five rounds of communication. Key words: corrections, forensics, criminal offenders with disabilities, therapeutic recreation


Article
Positive behavioral support for clients with challenging behavior: An adapted multicomponent approach for recreation therapists
Heewon Yang, PhD, CTRS; Marjorie J. Malkin, EdD, CTRS; Tae Joon Chun, PhD
Fall 2006; pages 19-28

Abstract
Although still emerging, positive behavioral support (PBS) approaches appear to offer a comprehensive and proactive alternative to traditional behavior management plans in both school settings and other community settings, including residential psychiatric centers and clinical settings. PBS is a comprehensive approach to behavioral support aimed at facilitating behavioral changes for clients with challenging behavior. The principles of PBS can easily be utilized by recreation therapists who work in treatment, community, and educational settings. The purpose of this paper is to introduce the principles of PBS to recreation therapists. In particular, an emerging conceptual framework for developing PBS plans for clients or students with behavior problems is introduced, and concerns and specific strategies for these individuals are discussed. Key words: Multicomponent Intervention Model, positive behavioral support, clients with behavior problems, recreation therapy


Article
An exploratory study of the use of recreation as a means of support for caregivers of older adults with dementia
Suzanne Fitzsimmons, ARNP
Fall 2006; pages 29-32

Abstract
This exploratory research study examined gender differences in the following areas: • the needs of caregivers pertaining to social, emotional, and leisure issues; • satisfaction with and level of leisure participation, social engagement, and support- seeking behavior; and • response to participation in formal support groups versus in informal social leisure groups. The ultimate goal was to determine whether providing support through a leisure activity helps preserve elements of caregivers’ lives despite the burden of care. Key words: caregiver, caregiver burden, support, recreation, leisure, satisfaction


Article
How family physicians perceive therapeutic recreation: A study from a Midwest community
Rodney B. Dieser, PhD; Jamie Bachman, BA; Allison Ball, BA; Mackenzy Herrick, BA; Abbie Lincoln, BA; Trent Thenhaus, BA
Fall 2006; pages 33-39

Abstract
The purpose of this study was to determine how family physicians perceive the profession of therapeutic recreation. Out of the sample frame of 39 family physicians working in a specific healthcare system located in a Midwest community, 23 physicians responded to a mixed-methods mail survey regarding their perceptions of the profession of therapeutic recreation. Overall, this study underscores the presence of conflicting ideas. On the one hand, family physicians agreed that therapeutic recreation is an important profession, and the family physicians who had interacted with therapeutic recreation specialists reported that those specialists were competent and well trained. On the other hand, most family physicians did not have a solid knowledge base or an accurate definition of the therapeutic recreation profession. Professional and research recommendations are suggested. Key words: family physician perceptions of therapeutic recreation, interprofessional perceptions of therapeutic recreation, mixed-method surveys, therapeutic recreation


Article
A choice, not an instruction
Richard Taylor, PhD
Fall 2006; pages 40-41


Article
I’m normal, you’re NOT! Essay and discussion questions
Richard Taylor, PhD; Suzanne Fitzsimmons, ARNP
Fall 2006; pages 42-44

Abstract
The first part of this article is an essay, a frank look at what is “normal” from the point of view of a person with cognitive impairments. The second section is a guide for a discussion group on the essay. This discussion can be used with family and professional caregivers as well as with adults with cognitive impairments. In the discussion group, read the essay and then provide each participant with a copy of the second section.


Article
Movie review. Selective optimization with compensation: Aging theory as it relates to the movie Strangers in Good Company
Phyllis Cummins
Fall 2006; pages 45-47