Debbie Macomber's goal-planning worksheet is awesome

What does it take to be a successful person?

Many people would argue being a reader is one of those qualities.

My mother reads a lot of books in a year.

Debbie Macomber is one of her favorite authors.

Goal-planning and (working towards completing those goals) taking action is another trait of successful people.

My mother sent me an email today with Debbie Macomber’s 2016 goal-planning worksheet.

Debbie’s goal-planning worksheet is so awesome, I had to share it with you.

It includes “Recreation goals” too.

You can download her worksheet at her link here:

http://assets.debbiemacomber.com/wp-content/uploads/2016/01/Debbie-Macomber-New-Year-Goals-Worksheet.pdf

Be sure to follow her blog here:

http://debbiemacomber.com/updates/2016-goals-worksheet

Do You have Rec Therapy CEU goals for 2016?
Be sure to use my program for your self-study/ online continuing education.
Go here: http://www.DannyPettry.com 

Session 1: RT in Mental Health

Session 1:

Recreational Therapy in Mental Health

Presented by: Margie Fletcher, M.A., M. ED., CTRS

Friday, October 28, 2015, at 8:30 a.m.

Danny Pettry’s 
Mental Health Workshop 
for Recreational Therapists
 at River Park Hospital, in Huntington, WV

A Review by Danny Pettry

(Sorry I didn't get a better picture of her). I feel bad about the "alien shadow." 

Goals of this session included:

·         Identify three differences between “activities” and “recreation therapy”

·         Identify three ways to manage a variety of cognitive and functioning levels in group sessions

·         Identify three recreation therapy goals for people with mental health needs

Margie has graduate degrees in counseling and recreational therapy. She works full-time as a Recreational Therapist and she supervises the internship program for Recreational Therapists at River Park Hospital.

I’ll briefly share some information regarding the goals of this session (that were listed above).

·         

Activities can diversional in nature. They could have therapeutic, beneficial, or even healing outcomes. However, these outcomes are random. Activities are good. Activities are fun. They’re great! However, activities for the sake of activities are not Recreational Therapy. 

·         

Recreational Therapy differs from activities (in mental health setting) in that it is a service that is prescribed by attending physician and is part of an overall treatment plan. The focus is on the person and their treatment needs. The Recreational Therapist works on an overall treatment team with other practitioners. Recreational therapists use a systematic process to bring about outcomes. This process includes: assessment of strengths and needs in several domains, treatment planning with the patient, the RT implements the treatments (RT interventions), and evaluates the progress.

·         Reimbursement factors: Healthcare in expensive. Costs are rising. Services must be necessary. It would be nice to say, here are some wonderful, super fun, and amazing activities for people who are admitted to inpatient acute-care psychiatric settings. However, it is expensive. Recreational Therapy must be outcome based. The services must assist a patient with one of their treatment goals. The goal can’t be: have fun and enjoy some activities while you’re here.

·         What are some goals of RT in mental health? These vary depending on the person, their age, interests, their specific diagnosis and treatment needs. Some general areas of goals could focus on these areas:

o   Anger management

o   Relaxation skills

o   Physical fitness

o   Self-esteem

o   Information about illnesses or impairments

o   Goal setting

o   Healthy ways to express feelings

o   Communication skills

o   Boundaries

o   Social skills

o   Community leisure resources

o   Coping skills to decrease depression or deal with substance abuse

·        

Of course, goals must be measurable to determine an outcome. An individual with anger management needs may have goals that could include:

o   Identify at least one healthy/ safe way to express feelings of anger (without use of physical or verbal aggression) by certain date. RT could provide several interventions to help teach expressive techniques. Another goal could be to identify at least one healthy relaxation technique to help sooth self when having anger episodes. RT could provide veracious relaxation skills trainings, including: deep breathing, yoga, meditation, light fitness, etc.

·         Here are some of the RT Goals she listed in her slideshow:

A. Patient will express having fun or enjoyment during a recreational activity a minimum of 2 times a week as evidence of improved mood.

B. Patient will focus on recreational activity a minimum of 20 minutes per session 3 times a week without responding to internal stimuli as evidence of improved reality orientation.

C. After each RT group the patient will identify 1 accomplishment to improve self-esteem/mood.

D. Prior to discharge the patient will identify 3 leisure activities that he/she can participate in to cope with depression/ or as an alternative to substance abuse.

E. Prior to discharge the pt. will identify at least one community leisure activity that he/she can participate in to develop social supports.

Margie discussed a lot more. I wish I could share it all.

Here are some of the sources she shared:

•      Burlingame, Joan, and Thomas Blaschko. Assessment Tools for Recreational Therapy and Related Fields: Fourth Edition. Ravensdale, WA: Idyll Arbor, Inc. 2010.

•      Dehn, Dave. Leisure Step Up Manual and Workbook. Ravensdale, WA: Idyll Arbor, Inc. 1994.

•      Randolph, Mary. Joggin’ Your Noggin: Fun and Challenging Word Games for Seniors, Volume One. Easton, CT: Noggin Joggin’ Books, 2012.

•      Rainwater, Agnes B. Therapeutic Recreation For Chemically Dependent Adolescents and Adults: Programming And Activities. Reston, VA:  American Alliance for Health, Physical Education, Recreation, and Dance, 1992.

Ssww.com – S and S Worldwide activity supplies: Anger Management Toss’n’Talk Ball, Positive Toss’n’Talk Ball, Brainwave Music

============================================================

Take Danny Pettry's Recreational Therapy Refresher Self-Study Course

TR Knowledge Area:Foundation Knowledge: Concepts and models of health and human services, Principles of group interaction, leadership, and safety.Practice of Therapeutic Recreation/ Recreational Therapy: Theories of human behavior and theories of behavior. changeConcepts of TR/RT

Five (5) Clock Hours or (0.5) CEUs. Notice ten (10) Clock Hours = 1.0 CEU

Course Objective: Independent learner will demonstrate an awareness of concepts, foundations, principles of group leadership, and psychology related to recreational therapy practice as evidenced by reading Dr. David Austin’s Lessons Learned: An open letter to recreational therapy students and practitioners, Watching  Models of practice [video] -- health protection/health promotion model and passing a written exam based on this book with a score of 70% or better within a one-year timeframe.recreational therapy students and practitioners, Watching  Models of practice [video] -- health protection/health promotion model and passing a written exam based on this book with a score of 70% or better within a one-year timeframe.recreational therapy students and practitioners, Watching  Models of practice [video] -- health protection/health promotion model and passing a written exam based on this book with a score of 70% or better within a one-year timeframe.

===>  <====

Making art prevents cognitive decline.

Making art has been found by a resevarch-study by the Mayo Clinic to help prevent cognitive decline.

I thought this would be beneficial knowledge to recreational therapists because RTs provide a lot of activity-based treatment interventions (like making art) and many RTs provide services for seniors.

Art could be: painting, drawing, and sculpting (to name a few).

Making art is good for building new pathways in the brain.

Read the article here:

http://www.psmag.com/health-and-behavior/making-art-tied-to-fewer-cognitive-problems-in-old-age

I recommend my own book on creativity, called, ART SOUP. Check it out on amazon here:

 

Activities for kids who have to wait.

Here is a link with 20 activities for children who have to wait:

http://www.icanteachmychild.com/activities-for-when-kids-have-to-wait/

Explore emotions with LEGO faces (activity book) .pdf file

Are you a Rec. Therapist who provides services for children in mental health setting?

If so, you might like this activity e-book:
Explore emotions with LEGO faces (activity book) .pdf file

Get it here:
http://homeschoolencouragement.com/exploring-emotions-lego-faces-free-lego-printables/

DBT workbook and RTs

Dialectical Behavior Therapy (DBT) is a form of therapy that was created by Marshal Linehan as a treatment intervention for people with Borderline Personality Disorder (BPD). It is not being used as a treatment intervention for people with various other mental health needs as well.

 It has four main concepts of DBT:

·         Mindfulness skills

·         Interpersonal Effectiveness Skills

·         Emotional Regulation Skills; and

·         Distress Tolerance Skills

I really think Recreational Therapists who work in mental health settings should have some understanding of this psychotherapy technique. We, in RT, can contribute to this approach with the right training and understanding.

In example, many RTs teach stress management and relaxation skills, which would coincide with DBT: Distress Tolerance Skills. Did you know that DBT practitioners teach the use of activities as a health distraction to cope with distress?

Some RTs teach social skills, which would overlap with interpersonal effectiveness skills (which I simply call “people skills.”) It is the ability to get along well with others in the community. We, RTs provide a lot of community re-integration activities and social group sessions.

Here is a neat e-book with DBT skills activities. I would recommend that RTs have taken some type of basic training in DBT skills prior to using this e-book.

 http://www.bipolarsjuk.se/pdf/Handbook%20in%20DBT%20Group.pdf

Emotional Intelligence Activities for Teens

Daniel Goleman is the author of the famous book on Emotional Intelligence (EI).

This is a very important skill to have. Some people argue that having high EI is a better predictor of how successful a person will be in live compared to having a high IQ.

I discovered a really cool e-book online titled, "Emotional Intelligence Activities for Teens."

This e-book has some really useful activities. I have used some of them with pre-teens and teens from the first section on self-regard. Many RTs teach self-awareness/ self-concept/ values clarification to patients.

You might want to download this e-book:

http://my.extension.uiuc.edu/documents/257080502080208/Emotional_Intelligence_13-18.pdf

Programmatic Quality (before and after a CTRS)

I had the wonderful opportunity to attend the “Programmatic Quality: Before and After the Introduction of a Certified Therapeutic Recreation Specialist (CTRS).” It was presented by Carolyn McDowell, M.Ed., CTRS on Wed. Sept. 21, 2011 at the American Therapeutic Recreation Association’s 2011 annual conference in Indianapolis, Indiana.

Carolyn had presented the effects of creating a CTRS position for a day program that served adults with developmental disabilities. She covered the restructuring of the program, satisfaction surveys (prior to) and (after) a CTRS, and the justification for a CTRS position.
I’m very pleased with what Carolyn has been doing!

Penn-Mar Human Services in the Baltimore area has been providing services for consumers since 1980.

Carolyn was hired as a CTRS in 2012. The day program was previously described as, “oh, that is a place where they do arts and crafts.”

Carolyn didn’t want the day program to be described this way. She took time to survey consumers, families, and staff.

Previously consumers were passively sitting all day. Some of the consumers would participate in a preferred activity such as a book or puzzle. There weren’t any real activity programming being provided for the consumers. They were sitting around in an activity room (that looks like a warehouse).

Carolyn was specifically hired to quality assurance. She helped to assure quality programs were being provided for this program. The new programs consisted of: social skills training, expressive arts, physical fitness at the gym, and a self-selected activity time. There are also community outings too.

In one year (from 2010 to 2011) surveys showed that consumers were more actively engaged in programs. Carolyn claimed that they’re not where they want to be yet, but they have made positive changes.

I think what Carolyn is doing for this population is wonderful. She is helping assure that consumers are receiving quality programs that could help the consumer to develop skills that could help them to obtain a job.

The benefits (as evidenced by 2011) surveys show improvement in a one-year timeframe!
Here are some of the take-home lessons that I received from this session:
Develop a satisfaction survey for the patients/ customers/ clients/ students/ consumers who you’re providing services for. I think a simple rating scale would be appropriate (“0” meaning not happy at all to “5” being very happy with numbers in between.
Questions could focus on several areas of programming, including:

Social, physical, cognitive, leisure, spiritual, time of group sessions, schedule, group setting/ environment, etc. Naturally questions should reflect the population being served. These questions should also be worded so the consumers taking the survey would understand it.

I had the opportunity to do something similar to what Carolyn has done while I was working on my graduate degree in Recreational Therapy while taking a consulting course at Indiana University.

I surveyed patients and staff about programs at a residential treatment facility for teens with offending issues in 2004. I regret to say I don’t have these survey results here right now. Several of the teens wanted more activities during group times opposed to watching t.v. and movies. They wanted more physical fitness activities too. Here was one of my surprise findings. Several of the direct care staff who oversees patients didn’t feel comfortable with providing group activities due to lack of experience, training, and other reasons.

I developed an Activity Training Program that taught the direct care staff how to lead group activities. I enjoyed providing the training session the most! And I felt the staff at this program got a lot of benefits from the training too. I should have done a follow-up on the training.

You may want to develop a satisfaction survey for your setting to assess your own setting. Develop improvement plans, Implement them and evaluate the outcomes. It sounds like the Rec. Therapy APIE process to me.

Teambuilding Interventions (Teaching boundaries)

I had the opportunity to attend the “Teambuilding with Offenders/ Boundaries Session by M. Gail Cecil, CTRS. This was presented at the 2011 Annual American Therapeutic Recreation Association’s conference in Indianapolis, Indiana.

The focus of this session was on implementation of teambuilding activities for people who need to develop healthy and appropriate boundaries. Persons with this need could be offenders who lack empathy for others.

She defined teambuilding as activities that are designed d to encourage people to work cooperatively. She defined cooperation as working together: the act of working or acting together to achieve common goals.

Gail Cecil provides services for about 460 male sex offenders who are 19 years or older at a detention and treatment facility.

Gail points out that a Rec. Therapist can’t run something she (or he) has not done before. Basically, the Rec. Therapist needs to have competencies in the interventions she (or he) is providing.

Gail also points out the importance of debriefing at the end of a session. She says that if you don’t debrief then it is just an activity. The debriefing is the part that makes it therapeutic. Here are some general guidelines for debriefing: equal circle so eye contact can be made with everyone. Start questions with things the Rec. Therapist observed in the group session. What were the group’s difficulties? How did they overcome these challenges? Or how could they have done better? Gail likes to get the “Bad: out of the way first and then move towards the positives. I like this idea. End the session on a positive note. What were their strong points and strengths? What did the group participants do well?

The purpose of the debriefing is basically: how are these skills going to help you (the participant) in the future?

I’ve heard these “debriefings” called different things in different settings. I often use the word, “wrap-up” when working with children in adolescents. Some therapists who I work with call it “processing” the group session.

Here are some of the general expectations that Gail Cecil pointed out for teambuilding:
Diversity, respect, acceptance, goal-oriented, using resources, collaboration, communication, etc.
An Ice-Breaker Activity

Gail uses ice-breakers to assess a group and to determine the people who she is providing services for. It is a good way to observe the group dynamics. Look for people who are leaders, followers, and for people who lack boundaries.

She provided an ice-breaker activity to help the participants who attended this group session to get to know each other. She made the comment that we Recreational Therapists sit around the big tables at the general sessions and lunches and have the basic conversations: Where are you from? What population do you serve? What setting do you work in? I’m sure I laughed aloud because that seems to be so true based on my expectations from attending conferences. Here is a picture of the dining hall at the 2011 ATRA conf. in Indy (to the right).



During this ice-breaker activity that Gail facilitated, “each participant shared their name and a favorite place. I regret to say that I can’t remember all of the participants in my little circle. However, I did have the opportunity to meet Anel Van Rooy, CTRS who was sitting right beside me. She said her favorite place was her parent’s farm. I noticed that her accent was different from ones that I know, but I couldn’t place where she was from. Naturally, Gail’s ice-breaker headed into more conversations. I asked Anel where her parent’s farm is at. Anel told our small group circle that she is from South Africa, which, I think is really awesome.

Anel earned her B.A. in Recreation from North Western University and her graduate degree at Eastern Washington University. She is going to take a lot of neat things back to South Africa with her! I was glad I had the opportunity to meet her and so many other Recreational Therapists who are doing wonderful things.

Gail introduced a second question once all of the group participants had answered the first one. She had us state when was the last time we had visited our favorite place.
Other ice-breaker questions that Gail pointed out where to have group members
to:

• a.) Answer: Who am I?





• b.) Line up and get in alphabetical order by first name. Gail had us to practice this one too, however, we had to be silent and we couldn’t use sign-language. We could use body language and non-verbal communication.





• c.) Make a shape. This is where the group members hold a rope or string. They must form shapes with the string. Gail suggested state borders. In example: Colorado would be easy to create because it is more of a square shape. West Virginia would be a little difficult however, but I’d like to see a group try to do it. I provide services for children and I have a deck of cards that show the state borders and it has facts on the back. I plan to use this deck of cards! I’m having a Halloween carnival at our residential facility in October. This is for diversion and beyond their typical day of therapy activities. I plan to have several small groups of children participating in teams to create Halloween shapes: pumpkin, ghost, haunted house, etc. We’ll compare each of the three to four team’s shapes. Gail suggested using toilet tissue if the placement does not allow ropes or strings due to precautions.
  

More Interventions

Cecil had the participants in this training to participate in several other activities that we could take back to our own facilities and use as interventions.
Gail had hand-outs for activities titled: traffic jam, I am the egg man, Ultimate, What are your values?, and read my emotions. I’m going to email Gail to see if she’ll email me these documents so I can post them at this blog.

Here are some of the resources she suggested:

Rec. Therapy in Pediatric Pain Rehab.

I had the great privilege to attend and participate in the training session on “The Role of Recreational Therapy (RT) in Pediatric Pain Rehabilitation Program” by Gayle Kanary, CTRS. This was the first session she has presented and I'm glad she did because I admire her a lot. She is providing many neat RT interventions for Peds. in pain.

Gayle is a Recreational Therapist at the Children’s Hospital, Cleveland Clinic, Shaker Campus.

This is a three-week Pediatric Pain Program Rehabilitation and it is CARF accredited.

She played a quick video at the start of this session about their program. I felt very impressed at their overall program and what they’re doing to help children who are in pain. The video showed Occupational Therapists, Physical Therapists, and of course, Recreational Therapists!

You can watch that video at this link. It is a smaller video on the right side of the screen: http://my.clevelandclinic.org/childrens-hospital/specialties-services/therapy-rehab/pain-rehab.aspx

The children who are admitted into this program are diagnosed with some type of pain. It could be Headaches (chronic daily or migraines), abdominal pain, Chronic Regional Pain Syndrome (CRPS), Fibromyalgia, or pain associated disability syndrome.

I felt that I [Danny Pettry] had empathy for this population. I know what it is like to experience pain. I had dislocated my left shoulder from a skateboarding accident in 1996 (when I was 16-years-old). It was quite painful. This accident was during the summer so I didn’t miss any school. I had outpatient Physical Therapy (PT) and I thought PT meant Painful Things. It hurts, but it does get movement back.

Back to the training session:

The Pediatric Pain Rehab Program is designed to help get the child back to a full day of school, return to leisure and sports, recognize stressors in her (or his) daily life, use new tools to cope with stress and to help the individual switch from being in a “sick” role to more of a healthy/ well, role.

Their program is chockfull of individual and group sessions. The child isn’t allowed to stay-in-bed at this facility. Their day is full of sessions including: Aquatics, Occupational Therapy, Physical Therapy, Psychology, Recreational Therapy, School, Nutrition, and Music Therapy.

Their treatment staff acknowledges the child’s pain and express belief in it from day to day. They do not promise to eliminate the pain. They do help the child to change her (or his) mindset so that pain is no longer the focus.

Their program takes a holistic approach.

Although my [Danny Pettry] personal background has been in Behavioral Health with pediatrics, I think I would enjoy working in a rehabilitation setting like this one.

It appears to be rewarding work based on my observations from this training session.

Gayle uses two assessments. The CAPE/PAC is a standardized assessment designed by Occupational Therapist. This tool works for her population and she selected it with the help/ assistance of the OTs who work at her facility. She also uses the “Pie of Life” assessment. This is a circle with all the hours of the day from midnight until midnight. The child colors each part of the pie a different color for activities, including: sleep, school, homework, passive leisure activities, active/ physical leisure activities, etc. She said that many of the children have a lot of time napping, sleeping, and being passive during the day.

Gayle does so many wonderful Recreational Therapy Interventions to help each child to get back to life.

Here is a brief summary of the RT Interventions she facilitates:

• Aerobics: dance, Zumba, pool.
  
  


• Use of the swimming pool: swimming laps, treading in water, running, jumping, steps, noodle work, weight balls, and teambuilding.
  She went into detail about the expressive arts projects that she provides. I plan to implement some of these interventions to assist the patients who I provide services for in learning how to express themselves.
  


• Journaling: each child receives a prompt for the day. The child can choose to share aloud or not. It is their choice.
  


• Body Drawing: The child’s body outline is traced on a giant sheet of paper. Each child has to write something about each of these parts: eyes, heart, ears, mouth, hands, and feet. It can’t be generic like my eyes are blue. It must be in more detail.
  


• Masks: They can decorate a mask. They can choose to draw what they’re feeling for the day, a feeling they frequently have, a feeling they try to display to others, a feeling they’d prefer to have. They write words and phrases on the inside of the mask about what they have learned about themselves.
  


• Inside-Outside Box consists of a heart-shaped box. The child decorates the oustisde of the box with words that describe what others know about them. They put words on the inside of the box that are hidden from other people. They can also put their hopes and dreams on the inside of the box.
  


• Qualit making: the child receives a quilt square. I [Danny Pettry] don’t sew. I’d have my children draw the picture on a sheet of paper and compile them as a quilt. Gayle will hang the small qulity sheets from the ceiling.
  


• Time Capsule: This is a good family intervention. At the start of the program she has the child to write letter to future self. A parent writes a letter to a future self. The child can open it when she (or he) is discharged.
  


• Community Re-integration: The patient sets a goal to practice new skills in the community. They can go to a zoo, hiking, museum, or beach.
  Their program also offers evening activities that could consist of: games, crafts, movies, outside activities.
  


• Reiki: This is a Japanese technique of stress reduction that Gayle knows how to use.
  It promotes healing. ATRA is providing training on this topic at the ATRA conference. I regret to say that I’m not attending this training. This is based on an unseen life force energy that flows through us. It sounds interesting to me.

Gayle pointed out a few important reminders:
Regular exercise decreases stress, anxiety and depression.

Remember to help the person to return to fun and functioning!

Gayle said that they help the patient to control her (or his) response to the pain. The therapists help to motivate, encourage, and support the patient!

Overall, I give this session an: “A +”

I think it was awesome!

Here is a link for their program:
http://my.clevelandclinic.org/childrens-hospital/specialties-services/therapy-rehab/pain-rehab.aspx

National Letter Writing Week

National Letter Writing Week begins on Jan. 9, 2011.

So, send some hand-written letters to your family, friends, and people you know.

Here are some stationary kits. Get some of these (not only for yourself) but for the kids, too. Let them discover the joy in writing letters.

30 Day Drawing Challenge

My friend Bryony posted this at her blog. I'm not sure which month it was for. I thought Recreational Therapists may like to know this list. They may want to adapt the 30 drawing challenge for their patients. It could be good expressive arts, self-concept... therapeutic journaling


30 Day Drawing Challenge



1. Self Portrait
2. Imaginary Friend
3. Most Recent Dream
4. Re-Design Book Cover
5. Childhood Memory
6. What’s in Your Bag?
7. Hybrid Animal
8. Scene From a Movie
9. Siamese Twins
10. Super Hero
11. Super Villain
12. An Elderly Person
13. A Freakin’ Baby
14. Portrait of a Pet
15. A Dinosaur
16. Draw Something with Your Eyes Closed
17. A Delicious Food
18. ZOMBIES!!
19. Sea Creature
20. Your Dream Job
21. A Guilty Pleasure
22. Favourite Cartoon Character
23. Actor/Actress
24. A Collage
25. Best Friend
26. Instrument
27. Something with Sentimental Value
28. Your Zodiac Sign
29. The Meaning of Your Name
30. Favourite Outfit