420 Exam 3

Social Interactions

sense of well being

foster social support networks

improve life satisfaction

decrease stress

creates happiness

Social Skills

communication skills

dealing with stress, anger, anxiety

relationship building

decision making and planning

expression of feelings

follow rules and laws

self-presentation

Social Skill Association

one of the main influences on quality of life and leisure

effective communication skills → other’s association with us → more social interaction & opportunities → enhanced quality of life and leisure

Leisure Ability Model - Social Skills as Leisure Education

Leisure Awareness, Leisure Resources, Social Interaction Skills, Leisure Activity Skills

Leisure Ability Model as Functional Intervention Communication Skills

appropriate conversation & active listening

negotiate conflict, disagreement, compromise

read body language

appropriate expression thoughts and feelings

Relationship-Building Skills

develop and maintain friendships

greet and initiate a conversation

appropriate self-disclosure and privacy issues

Self-presentation skills

hygiene and grooming

appropriate dress

etiquette, politeness, manners

Social Skills Diagnostic Groups

developmental disabilities - intellectual disability

autism spectrum

mental illness

physical disabilities

early-stage dementia

anyone who has a social deficit

Contraindicated Criteria of Social Skills

actively psychotic

severe depression

high levels of social anxiety

RT must determine if client is appropriate and ready for group social skills training program

RT Modalities for Social Skills

RT models appropriate behavior

role-playing activities

social stories - teaching someone how to “read” a social situations

group recreational activities

cooperative games

community outings

Summary of Social Skills

teaching appropriate social skills is usually the primary responsibility of the recreational therapist

inappropriate social skills prevents successful integration into society

social skills groups are run in almost every setting a RT works

include personal support network when possible

Program Evaluation

systematic process vs. just asking “did you have fun”

assess the effectiveness of an RT program

assess the efficiency of an RT program

Why do a program evaluation?

determines if an RT program is achieving its intended purpose

determine how it impact clients

suspect a problem with the program

working professionals and admin need to know information

Components to RT Program Evaluation

1. program goals

2. client’s measurable outcome

3. data collection

4. analysis of the data

5. attendance and participation rates

6. cost effectiveness

7. feedback and improvement

8. stakeholder involvement

9. ethical consideration

10. documentation and reporting

1. Program Goals (Program Evaluation)

clearly defined intended outcomes of the RT program

identified and written when developing the intervention protocol

what are the general goals

are the goals appropriate, being addressed, and achieved?

2. Client’s Measurable Outcomes (Program Evaluation)

comparing client’s individualized goals and objectives to the program

does the client’s individualized treatment plan match the goals of the program?

can functional need be addressed through participation in the program?

is the RT program helping clients to achieve their goals and objectives

3. Data Collection (Program Evaluation)

How?

• qualitative vs. quantitive

• feedback from participants, family, staff

• standardized instruments (rating scales)

When?

• summative data - at the end

• formative data - during the program

4. Analysis of Data (Program Evaluation)

analyze data collected to determine program’s impact

compare pre/post program results

look for trends/patterns in client response to participation

determine if the program is meeting its stated goals

is participation assisting clients with meeting individual goals/objectives

5. Attendance and Participation Rates (Program Evaluation)

can be tracked in a variety of settings

tracking attendance/participation can indicate engagement levels

if clients not signing up or will but is not attending, why?

6. Cost Effectiveness (Program Evaluation)

evaluate whether the program is cost-effective in achieving its intended goals

compare costs to benefits

money, time, staffing, equipment

sometimes programs are beneficial to clients but cost too much to run

7. Feedback & Improvement (Program Evaluation)

use evaluation findings to provide feedback to program staff and administrators

identify program strengths and areas for improvement

identify adjustments needed to enhance the program’s effectiveness

• staffing, time, equipment, money

8. Stakeholder Involvement (Program Evaluation)

involve stakeholders in the evaluation process

stakeholders: participants, family, staff, administrators, community partners

insight is valuable

9. Ethical Considerations (Program Evaluation)

evaluation methods protect participants confidentiality and privacy

obtain consent forms if necessary

always follow agency’s guidelines for research involving “human subjects”

10. Documentation and Reporting (Program Evaluation)

document evaluation findings thoroughly

prepare clear and concise reports

communicate findings with all stakeholders, that support decision making regarding the program’s future

Assertiveness

expressing your thoughts, feelings, needs, and rights in a clear, direct, and honest way while showing respect for the rights and boundaries of others

Passive

allows others to take advantage, does not express own needs/wants

Aggressive

loud, interrupts, disrespectful, overbearing, unwilling to compromise

Passive-Aggressive

complains, silent treatment, express negativity indirectly

Assertive

listens, clearly states wants/needs, stands up for self, willing to compromise

Assertiveness Training

form of behavior therapy designed to help people stand up for themselves (empower themselves).

based on the idea that assertiveness is not inborn, but a learned behavior

Purpose of Assertiveness Training

teach appropriate strategies to express desires, needs, opinions in a respectful way

help decrease passivity or decrease aggression

helps with stress management, conflict resolution, and setting realistic goals

Assertiveness Training Modalities

community outings

table games

sports

outdoor rope course

initiative games

communication games

Step 1 of Assertiveness Training

Information-gathering exercise

areas in life where you have a hard time asserting yourself (where are the patterns)

Step 2 of Assertiveness Training

Learning to use “I” statements

help express feelings & reactions to others

when you are late, I feel anxious and angry

when you do not listen to me, I feel irrelevant

Step 3 of Assertiveness Training

Role-Playing

practice clear and direct communication, assertiveness techniques

immediate feedback is given

Step 4 of Assertiveness Training

Practice

outside the structured training session

helps with self-observation

can be done while participating in a voluntary recreational activity

Assertiveness Training Diagnostic Groups

depression, TBI, PTSD, anxiety, intellectual, DID, addiction, sexual trauma

Assertiveness Training Expected Outcomes

increased self-esteem

decreased passivity, increased assertiveness, social anxiety

improved communication skills, self-efficacy, interpersonal skills

Assertiveness Training Contraindications

RT must consider “readiness” and interest

not effective with someone experiencing delusions and/or paranoia

reinforcement of delusions, misinterpretation of social realities

Assertiveness Training Risk Management

increased anxiety during initial stages of training

leaving comfort zone and being forced to be assertive, “speak up”

overcompensation for passivity and become too aggressive

personal relationships may change (for the good and bad) as the individual becomes more assertive

Anger

normal healthy emotion

natural response to being treated unfairly

problematic when expressed inappropriately, happens over extended period of time, and results in aggression or violence

Negative Impacts of Anger

anger driven aggression & violence is one of the most common reasons for referral of children and teens to clinical behavioral health services

RT assessment of anger

identify cause of anger

client may/not be fully aware of the cause

anger decreases ability to concentrate, problem solve, make decisions

negatively affects social relationships

extended anger can lead to anxiety and depression

Potential Causes of Anger

TBI, stroke

aggression can be a side-effect

aphasia, linguistics

intellectual disability, autism

emotional instability/trauma

Diagnostics of emotions and anger

Traumatic Brain Injury

Stroke

Developmental Disabilities

Behavior disorders

Mood disorders

Addiction

ADHD

Anger Management

is a psycho-therapeutic program and skill-building process designed to help individuals recognize, control, and appropriately express anger

Anger Modalities

8-step Anger Coping Program (ACP)

ZIPPER strategy

In Control Program

Individualized Plans

Anger Management Step 1 Identifying Anger

daily stressors, levels of anger

identify situations that cause anger; 1 irritating 2 cause anger 3 cause an aggressive response

Anger Management Step 2 Reacting to Anger

identify bodily reactions to anger

understanding the fight or flight reaction (nervous system and muscles prepare to attack)

verbal reactions to anger

Anger Management Step 3 The Boiling Point

provide a visual of anger levels using a thermometer or volcano

Anger Management Step 4 Coping with stress/anger

teaching coping techniques

Anger Management Step 5 Discussing Assertiveness

teaching assertiveness and assertive behaviors

Anger Management Step 6

Model Assertive Behavior

Anger Management Step 7

Role-Playing scenarios

Anger Management Step 8 Process Feelings

talking and journaling

Anger Management Zipper Method

1. Zip your mouth

2. Identify the problem

3. Pause

4. Put yourself in charge

5. Explore choices

6. Reset

getting started, introduce ZIPPER, promote cognitive modeling, practicing with help, practicing self-instruction, committing to using the strategy

Anger Management In Control Program

10 weekly, 30 minute sessions

uses cognitive-behavioral intervention to teach skills for reducing aggressive behaviors while developing prosocial behavior skills

Participants learn how to identify: triggers, degree of anger arousal, using anger log, use de-escalation techniques

participants then engage in: discussion, role-playing, and modeling

Anger Management Individualized Plan

recreation therapist will…

help participant identify triggers

assist participants in evaluating triggers, distorted thinking, and warning signs

help participants understand that anger is normal but that it is important to learn how to cope with and effectively express it

Other Anger Management Modalities

activity books, anger charades, deep breathing, guided imagery, anger journal, stress fidgets, behavior volcano, anger masks