- Peterson and Stumbo - independent leisure functioning is the overall purpose of tr - tr services exist along a continuum of decreasing control by the tr and increasing control by the client
treatment models: health protection/health promotion model: treatment/rehabilitation due to disabilitywellness orientedtreatment models: health protection/health promotion model: motivation to restore healthmotivation to enhance healthtreatment models: health protection/health promotion model: prescriptive activities- therapists - high level of control
- rt provides structured & direction -----> stability tendency
- interventions rt directed
- client control is small & in poor healthtreatment models: health protection/health promotion model: recreation- mutual participation of rt & client
- rt provides narrows - "stability tendency" declines
- client's "actualization tendency growing" increasing client roletreatment models: health protection/health promotion model: leisure- self-directed
- actualization tendency - client has freedom of choice
- optimal healthtreatment model: trs delivery & tr outcome- Van Andel (1998)
- two different models
- TRS delivery - outlines the types of services designed to achieve predetermined outcomes
- tr outcome - outlines various outcomes to TRS; an extension to part onetreatment models: trs delivery: diagnosis/needs assessments- formal evaluation of patient
- use of formal assessment instrument
- develop baseline
- client provides consent if able if not legal representativetreatment models: trs delivery: treatment/rehabilitation- provision of intervention by rt
- rt prescribes treatment
- client agree to actively participate or nottreatment models: trs delivery: education- teaches specific knowledge/skilltreatment models: trs delivery: prevention/promotion- promotes/reinforces healthy lifestyletreatment models: tr outcome- leisure experience - high degree of choice and freedom, and intrinsic motivation
- non-leisure experience/therapy - little choice, high constraint, and extrinsic motivation
- Van Andel's second model
- outcomes measured by a balancing of quality life, domains, domains of behaviors, and health statustreatment models: tr outcome: health statuswhere a person exists between death and optimal wellness; -10 death and +10 healthtreatment models: tr outcome: functional domains- mental
- physical
- social (leisure)
- emotional
- spiritualtreatment models: tr outcome: quality of life- satisfaction
- contentment
- joy
- self-determination
- well-beingtreatment models: self-determination and enjoyment enhancement model- Dattilo, Kleiber, William (1998)
- "based on the assumptions that if clients experience enjoyment and functional improvements, they will display self-determination in leisuretreatment models: tr outcome: optimizing lifelong health through therapeutic recreation model- Wilhite, Keller, & Cadwell (1999)treatment models: tr outcome: optimizing lifelong health through therapeutic recreation model: three key principles- health leisure lifestyle leads to reduction of further illness, disability, or secondary consequences
- individualized resources and opportunity may enhance health and well-being
- be prepared to change in respond to personal/environment changetreatment models: tr outcome: optimizing lifelong health through therapeutic recreation model: four interrelated elements1. selecting: matching interests, abilities, resources, id goals
2. optimizing: engaging in activities to optimize goals
3: compensating: for impaired abilities
4: evaluating: the effectiveness or may continue ontreatment models: tr outcome: optimizing lifelong health through therapeutic recreation model: educator/facilitator- educator - dealing w/ client's awareness, skills, and knowledge
- facilitator - provide clients w/ opportunity to use what has been learned to experience leisure
*not everyone can be completely independentbehavior health/psychiatric disorders: classification system- diagnostic & statistic manual of mental disorders
- 5th edition
- DSM-5
- widely used in US
- American Psychiatric Association
- international statistical classification of diseases & related health problems
- 11th edition
- ICD-11
- used throughout the world when DSM-5 is not usedbehavior health/psychiatric disorders: schizophrenia spectrum disorders: psychotic features- delusions
- hallucinations
- disorganized thought & speech
- disorganized or abnormal motor behavior
- know of positive characteristics (presence of characteristics)behavior health/psychiatric disorders: schizophrenia spectrum disorders: delusionsbeliefs
- even w/ factors contrary to the belief
- example: persecution, song is a secret message to the individual, belief self or others are religious characters or missing organsbehavior health/psychiatric disorders: schizophrenia spectrum disorders: hallucinationperceptual
- visual - auditory - example
- reporting hearing other plotting against self
- seeing a wolfbehavior health/psychiatric disorders: schizophrenia spectrum disorders: absent featuresinability
- experience pleasure - social withdrawal/avoidance
- motivation - known as negative
- as a feature are not present or unable to experience/avoidbehavior health/psychiatric disorders: schizophrenia spectrum disorders: cognitive symptoms- attention deficits
- working memorybehavior health/psychiatric disorders: schizophrenia spectrum disorders: executive function/higher-order cognition- episodic memory
- social cognition
- metacognitionbehavior health/psychiatric disorders: schizophrenia spectrum disorders: episodic memory- recall past experiences
- inability to project an imagined futurebehavior health/psychiatric disorders: schizophrenia spectrum disorders: executive function- purposeful - goal directed problem-solving/planning
- culturally appropriate responsebehavior health/psychiatric disorders: schizophrenia spectrum disorders: metacognition- social cognitive function
- thinking about thinking
- synthesis of thoughtsbehavior health/psychiatric disorders: schizophrenia spectrum disorders: mood & affective disordersrelated to individual's mood and affectbehavior health/psychiatric disorders: schizophrenia spectrum disorders: depressionmajor umbrella term including
- depression - situation disorder - atypical disorder
- persistent depressive disorder
- bipolar disorder
- seasonal affective disorder
- psychotic depression
- postpartum depression
- premenstrual dysphoric disorderbehavior health/psychiatric disorders: schizophrenia spectrum disorders: depression: effects/symptoms- depressed mood
- decreased interest in previous activities
- change in activity level
- fatigue
- decreased ability to concentrate
- suicidal thoughts
- disruption of social functioning
- impairment of other major life activities (school, work, & family)
- not associated w/ chemical dependencybehavior health/psychiatric disorders: anxiety, stress, & trauma-related disorders: anxiety & stress disorders- associated w/ previous occurrences
- no current potential for dangerbehavior health/psychiatric disorders: anxiety, stress, & trauma-related disorders: post-traumatic stress disorder (PTSD)- associated w/ traumatic eventbehavior health/psychiatric disorders: anxiety, stress, & trauma-related disorders: obsessive & compulsive disorders- thoughts &/or acts
- involves (before one can move forward)behavior health/psychiatric disorders: behavior disorders: eating disorders: bulimia nervosa- binge eating
- lack of control overeating
- behaviors (unhealthy) to control weight (exercise, vomiting, & laxatives)behavior health/psychiatric disorders: behavior disorders: eating disorders: anorexia nervosa- restriction of intake
- behaviors (unhealthy) to control weight (exercise, vomiting, & laxatives)behavior health/psychiatric disorders: personality disorders: borderline personality disorder- inability of personality functions, self-image, interpersonal relationships, affect & impulsivity beginning by early adulthood
- characteristics: risky, impulsive, self-destructive (spending, substance use, reckless driving, etc.) & hostilitybehavior health/psychiatric disorders: personality disorders: schizotypal- social & interpersonal marked by acute discomfort w/, & reduced capacity for close relationships as well as by cognitive or perceptual distortions & eccentricities of bx - beginning by early adulthoodbehavior health/psychiatric disorders: personality disorders: schizotypal: characteristics- withdrawal
- diminished capacity (social contact & interpersonal relationships)
- disruption of self-image, cognition, & emotional expressionbehavior health/psychiatric disorders: personality disorders: antisocial personality disorderdisregard for & violation of the rights of others- occurring since 15 years but 18 years old for dxbehavior health/psychiatric disorders: personality disorders: antisocial personality disorder: characteristics- failure to follow legal & ethnic standards/norms
- egocentric callous disregard to others
- deceitfulness
- not taking responsibility for own actionsbehavior health/psychiatric disorders: personality disorders: narcissistic personality disordergrandiosity (in fantasy & behavior) needs for admiration & lack of empathy - beginning by early adulthoodbehavior health/psychiatric disorders: personality disorders: narcissistic personality disorder: characteristics- grandiose attention/approval seeking
- vulnerable self-imagebehavior health/psychiatric disorders: serious mental illness- pervasive
- long duration
- large impact
- multiple areas of functioningbehavior health/psychiatric disorders: serious mental illness: characterized- disability - impairment in major life activity
- duration - present for a significant of period of time
- diagnosisbehavior health/psychiatric disorders: serious mental illness: what can it do for bx health?- interpersonal relationships (social skills)
- coping skills
- remediation of symptoms
- return to a close as possible to premorbid functioning (before symptoms occurred)
- reach highest level of functioning possiblebehavior health/psychiatric disorders: evidence-based practice - physical activity/exercise- research implies exercise & activity are very beneficial for psychiatric diagnoses
- similar effects as antidepressants
- similar to psychological therapy (aka psychotherapy, "talking" therapy
- improve cognitive functioning
- included in clinical practice guidelines for treatment of depressionbehavior health/psychiatric disorders: behavioral activation- bx activation is an intervention & coping skills primarily for depression
- purpose is to...
- increase engagement in adaptive activity
- decrease engagement in activity associated w/ depression or increased risk of depression
- solve problems which limit access to reward or maintaining aversion controlbehavior health/psychiatric disorders: social skills training (sst)- sst seeks to improve socially acceptable behaviors
- sst helps decrease psychiatric symptoms, improves functioning, improves well-being, & improves quality of lifebehavior health/psychiatric disorders: serious mental illness: sought outcome- clinical status
- functional status
- subjective well-being
- reduction in rumination, hallucination behavior, inappropriate behaviors, and controlling clinical symptoms
- self-care
- participation in community
- etc...DSM-5Diagnostic and Statistical Manual of Mental Disorders, Fifth EditionICD-11International (statistical) Classification of Diseases, Eleventh Revision
