hpr 450 chapter 3 by VI802W


									   HPR 450

       Chapter 3
Facilitation Techniques
Facilitation Techniques (Interventions)
• From Austin text chapter 3
• We will not cover all in depth
• Presentation later this month allows opportunity to research
    in greater detail
•   I will try to focus on those you are most likely to encounter
    and/or those you may be most likely to introduce/use in
•   For CTRS exam, a general familiarity/ability to define and to
    differentiate is probably sufficient – For practice more
    knowledge and ability is needed
•   Review and begin to consider what you would prefer to use
    for presentation
•   Note that there are broad categories but some techniques
    belong in multiple categories
Leisure Education
To be covered more in-depth later in semester
 Learning about leisure-related information, values,
  attitudes, skills
 Used to be called “Leisure Education” or ‘Leisure
  Counseling” – now just Leisure Education
 Includes
   Leisure appreciation                Leisure Activity Skills
   Self-Awareness                      Community Skills
   Decision Making                     Social Skills
   Self Determination                  Leisure Resources
                            (Dattilo and Williams, 2000)
Values Clarification
 Technique used to help clients make decisions consistent with
  their values
 Values – Deeply held beliefs about truth, beauty or worth of
  a person, object, idea or action
 V C activities could include
   Pie of Life
   20 Things You Love to do
   Spending an Unexpected Free Day
Media or Culture Therapies
• Cinematherapy – movies (easier to watch than read
• Bibliotherapy – novels, plays, short stories, pamphlets to
  show clients others have similar problems
  – Choose works that are appropriate for client
  – Discussions following movie or reading can reveal unexpected
    interpretations by clients
  – Goals: develop self-concept, foster self-appraisal, relieve
    emotional or mental pressure, provide a means to find interests
    outside ones self, more on pg 71 (Jake, 2001)
Media or Culture Therapies cont’d
 Computer/internet/technology therapy
   Wii or other games
   How can you use computers or the internet for TR/RT?
   Would social networking be good for your clients? Why or why
 Music therapy – (listening, not performing)
 Theater therapy – ditto
 Museumotherapy
 Any other ‘experiences’ (passive) of art and culture
Horticulture Therapy
 Plants – small/indoor under lights, window sill, outdoor
  gardens, greenhouse
 Raised and rolling gardens, rooting house plants, using
  flowers, plants, etc with crafts
 Goals: Instill a sense of purpose, life satisfaction, mild to
  moderate exercise, interaction with environment, enjoy
  beauty, develop leisure activity, etc (see pg 74)
Relaxation Techniques/Stress Management
• 67% of adults report experiencing “great stress” weekly
• Is relaxation a skill? Can it be acquired, learned or
• Do RT/TR practitioners need to be able to help clients
  – Relaxation as an activity in itself
  – Relaxation to help clients with other activities
    • Social stress
    • Performance nerves
    • Stressful (unfamiliar, new) situations
     Relaxation Techniques/Stress Management
• Massage
  – Should obtain training; many TR/RTs are certified massage therapists
• Self-massage
  – May be more appropriate with some clients
• Deep Breathing
  – As an activity or with activities (Yoga)
  – Belly breathing (Yoga or singing)
• Alexander Technique (not from text)
  – Focus on improper posture and positioning as root of many
    physiological disorders. Working on proper alignment
• Progressive relaxation
  – Progressive muscle relaxation. Also used in Yoga
    Relaxation Techniques/Stress Management
 Transcendental Meditation® (maybe)
   TR/RT should have training or become familiar with techniques
    before teaching
   Cannot teach TM® without specific training
   Other methods covered in books
 Qigong (chee goong)
   Instructor guided relaxation combining postures and visualization
 Visualization/Creative Visualization
   Also a means of assertiveness training
Physical/Activity Therapies
 Mental and physical benefits
 Vigorous or moderate?
   Current thinking is moderate better than nothing
 How long, how often
   Current thinking is some is better than none
 Fear that asking people to do too much will result in people not
  doing anything
Physical/Activity Therapies
 Recommendations for 30 mins moderate, non consecutive,
 per day
   “Paradigm shift” in book may or may not be a good or appropriate
   Think about what bodies are ‘engineered’ to do
   Modern society demands less and less movement or activity – is it a
    good idea to recommend less and less physical activity?
   That said, moderate to vigorous activity can be achieved through
    many means – yard work, housework, gardening, other hobbies
    Adventure Therapy
 Elements
   Active engagement in risk or adventure activity
   Individuals may be seeking change
   Novel nature of activity creates “disequilibrium”
   Environment emphasizes community and cooperation
   Demand of problem solving
   Perception that activity is challenging
   Feelings of accomplishment
   Changes occur based on processing (generalization of these
    experiences to other things in their lives)
    “Adventure” Therapy cont’d
 Ropes courses
      Non competitive, teamwork, etc
   How often can you do this and have it be fresh/effective?
   Critical to have trained leader and appropriate ‘processing;’
    otherwise the experience loses much impact
 Outdoor adventure interventions
   Camping, hiking, etc.
   May make great progress during event but when real life is very
    different, ultimate success of intervention may be questionable
    Sensory Therapies
 Aromatherapy
   Using scent to promote relaxation
   Massage or baths
   Training, familiarity with essential oils – can be caustic/dangerous in
    pure forms
 Sensory training
   For children with perceptual-motor problems, older adults who are
   Stimulus bombardment directed at all 5 senses; interactive with
   Hope is to improve individual’s perception and alertness in
    responding to environment
    Sensory Therapies cont’d
 Sensory Stimulation
   Treatment for TBI patients in coma
   Multimodal (all senses at once) unimodal (only one sense per
    session); very high degree of stimulation
   Looking for any patient reaction
   May reduce depth and duration of coma
Creative Arts (doing, not passive)
 Painting, drawing, sculpture, photography, music (drum
  circles!), theater, creative writing (poetry, journaling,
  fiction), jewelry making, etc.
   Provides means of self-expression
   May be easier, ‘safer’ way to communicate
   Mental health and physical health (gross, fine motor skills)
   VSA – here and elsewhere
Social Skills Training
 Activities that help people develop or improve their
  skills for dealing with social situations
 Uses classroom instruction, modeling, demonstrations,
  and role play with social reinforcement as a reward
 Helps develop skills that help individuals with other
  aspects of life, including leisure/recreation participation
 May benefit chemically dependent, developmental
  disabilities, residents in long-term care, some mental
  health (depression, children with learning disabilities
Assertiveness Training
 Therapy that helps people become more assertive (not
  aggressive) in social situations
 Role playing, modeling, reinforcement, practice in ‘safe’
  and controlled settings
 Helps people change habits and behaviors and learn to
  stand up for their legitimate rights, leads to
  improvements in self-esteem
 Can benefit anyone with a deficit in this area
Cognitive Rehabilitation
• Multi-disciplinary interventions using varied activities that
  use client’s cognitive and/or motor functions
• Uses games, activities, outings, anything that appropriately
  combines cognitive and motor activities
• Ideally will improve cognitive functioning and lead to
  neuropsychological recovery
• For individuals with ABI including TBI
 Technique used with small groups to inspire interests of
 Uses weekly group meetings to promote discussions of topics
  that may bring participants in closer touch with the world
  beyond the institution
 Goal is to reawaken interests in facility residents for things
  that brought gratification in the past and may lead to sense of
  control over leisure activities
   Self-selection of activities found to help replace feelings of
    helplessness with feelings of mastery or control
 Used with moderately confused elderly in facilities
 Small group format to combat isolationism and to improve
 Groups meet 3 times weekly with staff member/leader who tries
  to maintain a free and accepting atmosphere
 Goal is to increase social functioning of residents in geriatric
  settings by increasing awareness of self and others by helping
  clients to form relationships and friendships and to discover new
 Used in geriatric facilities
Validation Therapy
 Developed by Naomi Feil in response to RO to meet the
  social and psychological needs of primarily disoriented
 Therapists use empathy and acceptance in dealing with
  clients – maintain eye contact, rephrase while
  responding, speaking in a caring tone of voice
 Help clients regain dignity, reduce anxiety, accept their
  own ‘reality’ without trying to correct them (as RO
 Persons with Alzheimer’s type dementia

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