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Monday, November 9, 2015

Session 6: Using Counseling Skills in Rec. Therapy

Session 6:
Using Basic Counseling Skills in Rec. Therapy
Presented by: Danny Pettry, M.Ed., LPC,NCC, CTRS
Friday, October 28, 2015, at 2:30 p.m.
Danny Pettry’s
Mental Health Workshop for Recreational Therapists
at River Park Hospital, in Huntington, WV

I could talk about this subject for a long time. I have graduate degrees in Recreational Therapy and Counseling, from Indiana University and Lindsey Wilson College, respectively. I have the Certified Therapeutic Recreation Specialist (CTRS) credential for Recreational Therapists as well as (National Certified Counselor (NCC) credential. I work as a therapist/ practitioner for three residential treatment programs designed for children and adolescents. I’m currently working to complete training and certification in providing trauma-focused CBT.

Goals of this session included:
·         Identify at least three concepts for building a therapeutic relationship with patient/client
·         Identify at least three counseling skills that Recreation Therapists can use in different phases of the Rec. Therapy process including assessments, treatment planning, implementing the intervention and for evaluations.
·         Identify at least three counseling skills a Recreation Therapist can use in group settings.

Compassion fatigue/ burnout can  happen to RTs
RTs need to do some self-care in order to be the best RT they can be.
The Counseling for Dummies book suggested many self-care activities that are “recreational” in nature.
Some of the tips included:
         Social support/ positive contact with families
         Activities: walking, swimming sports, gym, dancing, gardening
         Sedentary activities: reading, watching a movie, journaling, drawing, painting.
         Spiritual activities
OF course, a healthy functioning individual can do those activities.

A person in treatment (example in acute-care psychiatric setting) is not at a point where they can independently choose those activities. They need assistance from professionals.
Let’s get started:
What is Rec. Therapy? ATRA definition:
        Recreational Therapy, also known as Therapeutic Recreation, is a systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illness and/ or disabling conditions, as a means to psychological and physical health, recovery, and well-being (2015).
Basic counseling skills can be used in all four parts of the TR/RT process: assessment, planning, implementation of the intervention, and evaluation.

What is counseling? ACA definition:
         ACA Definition:
        Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals (2010).
Note: both Rec Therapy and Counseling are strength-based and wellness based human service professions. Skills in this session will focus on that “professional relationship”

         This session won’t train an individual to become a counselor. That requires additional education, training, clinical supervision, and a license.
         This session will take some of the counseling skills that can be used by other professionals, like Rec. Therapy or direct care, or teaching.

Listening is an important skill. I suggested Dr. David Austin’s video: Effective listening video:

Some character traits for listening:
         Empathy: be in their shoes/ feel their pain
         Respect: value that individual
         Integrity: honest/ doing right thing
         Resilience: bounce back ability
         Humility: we all have problems
         Courage: break confidentiality for child safety.
         Assertiveness: speak plain and direct 

Factors Why Therapy Works:
         Michael Lambert’s research:
        40%: factors outside of therapy: family, life situations, circumstances, biology,
        30%: the helping relationship: caring, warmth, empathy, acceptance, mutual affirmation and encouragement
        15%: the actual technique we use in therapy.
        15%: placebo – just works.

How to build a helping therapeutic relationship? Carl Rogers:
Carl Rogers was a required reading for the Rec. Therapy graduate degree program.
His theory was also studied in graduate school for counselors.
Rogers discusses that concepts for building that helping/ healing/ professional relationship in his humanistic/ person-centered therapy approach.
Three concepts:
         Realness: congruent and not hiding behind a professional mask.
         Unconditional positive regard: accepting, prizing, unbiased, listening. Even when they mess up.
         Empathetic: appreciates their perspective.
A side note on: empathy. Yawn effect. Sorry about your yawn, but congratulations too! 

Skills Needed for Groups
        Active Listening
        Lecture/ Info. Giving (keep that brief)
        Tone setting
        Use of eyes
        Use of voice
        Use of leader’s energy
        Self-disclosure (use this one rarely and when it can benefit client)

Skills for Assessment:
         Attending to the patient/ client
         Listening: active/ fully/ non-distracted
         Focusing: on the patient/ client
         Observing: what do you see? Does what they share match/ is congruent with body language?

Skills for Planning:
         Goal-setting is a skill to have.
         Work with the patient/ client so they can be self-directed in their treatment goals.

Skills for Implementing the Intervention:
This is the “activities” part.
RTs can use several skills here:
Information giving: in example: the benefits
Modeling skills: showing/ demonstrating
Confronting behaviors: hitting
Decision-making skills: what is the best choice? Maturity of judgment
Challenging skills

Skills for Evaluation:
         Questioning: what did you gain from Rec. Therapy sessions/ treatments?
        Did you meet your goals?
         Summarizing: the goals, the treatment, the outcomes

         SuppoRTing: providing emotional support 

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