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!
http://my.clevelandclinic.org/childrens-hospital/specialties-services/therapy-rehab/pain-rehab.aspx
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