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Friday, September 4, 2015

Stress is bad as (maybe worse than) second-hand smoke.

CNN health often has interesting articles.

They had an interesting article that argues stress can be as bad as second-hand smoke.

Recreational therapists (in mental/ behavioral health) settings as well as physical rehab settings (based on my personal experiences) provide stress management interventions.

I provide a mix of interventions for children and adolescents at a residential treatment program for three different needs. My primary triaging and experience is providing services for children with abuse-reactive needs. These children have all had suffered some type of abuse or traumatic life experience. Some of the kids have Post-traumatic stress disorder.

I provide several types of interventions under the recommendation and supervision of physician to help these children (patients). Some of these include: psych-education about stress and trauma, relaxation skills training, emotional regulation skills (to cope with various emotions), and components of Trauma-Focused Cognitive Behavior Therapy (TF-CBT), which I’ve had additional training.

Of course, many types of relaxation skills for children are play-based. It includes outdoor activities, sports, games, fitness, and activities as a healthy distraction.

In my opinion, Recreation Therapists provide interventions that are best suited for helping people learn ways to cope with stress. I do think we, as RTs, need to find more ways to make outcomes measurable.

There are several ways. In examples, the Heart-Rate Variability measurement is one tool to determine if a person is in Heart-Rate Coherence. I’ve had training on using HeartMath tooks at several of the American Therapeutic Recreation Association (ATRA) conferences.

There are other ways to measure too, in example: measuring cortisol levels, which are associated with stress.

I’d like to argue that the education component of RT is very important. Patients/ clients/ (kids in my case who I provide services for) need to having an understanding of the benefits (what is in it for them), the outcomes: like less feelings of stress, less stress-related health problems,  improved health, less likely to have physical illness as a result of stress. That sentence felt redundant. The client also needs to have an awareness of the skills that they can take-home with them and use in daily living. This could be a mix of relaxation skills: taking walks, physical exercises, taking a mini-vacation/ relaxation break, self-care, basic renewal. In other words, work ourselves out of a job.

I’d like to point out that RTs should be using the American Therapeutic Recreation Association’s standards of practice. Services (in clinical settings) need to have physician order for assessment and treatment. A comprehensive assessment should be used to evaluate client’s strengths and areas of needed improvement in the functional domains. Treatment plan goals need to be written (with client) to be part of the overall treatment team plan. RTs will provide interventions they are competent to provide (in example: relaxation skills training, psycho-education or leisure-education that teaches healthy life skills, and of course, activity-based interventions to allow the client to practice the skill. The RT will be providing these interventions along with other members of the treatment team. In a psychiatric setting, this will probably include: professional counselors, social workers, psychologists, nurses, mental health technicians or direct care providers, dieticians, and other allied professionals.

Documentation along the process is important as well. Individual and group RT-based interventions are to be documented by the RT as part of the medical record to evaluate the client’s outcomes and progress (or lack of progress).

Well, I could go on for hours about this.

I will leave you with the CNN link about the harm of stress here:

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