Session 2: Dialectical Behavioral Therapy for Recreational Therapists

Session 2:

Dialectical Behavioral Therapy for Recreational Therapists

Presented by: Jennifer Kangas, M.A. , LPC

Friday, October 28, 2015, at 9:30 a.m.

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

A Review by Danny Pettry

Goals of this session included:

·         Identify at least three symptoms associated with a diagnosis of BPD according to the DSM-5

·         Identify the four skill sets that taught in DBT and the evidenced based outcomes for these skill sets

·         Identify one way a Recreation Therapist can be involved in a treatment team that uses a DBT approach.

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

Jennifer works full-time as a therapist for children and teens in an acute-care psychiatric setting. She has advanced training in DBT.

Here are some brief points that I recall from this session:

• Dialectical Behavior Therapy (DBT) was created by Marsha Linehan, specifically for the treatment for people who have Borderline Personality Disorder (BPD).
• DBT is now used to treat various mental health needs (eating disorders, mood disorders) and for people with traumatic brain injury.
• DBT is heavily based on validation of a person with unconditional positive regard.
• In DBT, four main skills are taught. These include: distress tolerance skills, interpersonal effectiveness skills, mindfulness meditation skills, and emotional regulation skills.
• DBT is a very good model for RTs. Those trained in DBT can provide manyeducation about how to use the skills, why to use the skills, and implement activity-based interventions to allow individuals to gain awareness and practice using these skills. 

Here are some resources she shared:

• What is DBT? http://behavioraltech.org/resources/whatisdbt.cfm
• BPD fact sheet: http://www2.nami.org/factsheets/bpd_factsheet.pdf
• Marsha Linehan biography: http://blogs.uw.edu/linehan/
• No Longer Wanting to Die: http://opinionator.blogs.nytimes.com/2015/05/16/no-longer-wanting-to-die/?_r=0

Understanding Borderline Personality Disorder

· TR Knowledge Areas:

Foundation Knowledge: Psychiatric disorders and related impairments (with an emphasis on Borderline Personality Disorder)

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

· Independent self-study learner will demonstrate a basic awareness of Borderline Personality Disorder as evidenced by reading I Hate You, Don't Leave Me: Understanding the Borderline Personalty by Jerold Kreisman and Hal Straus (2010) and passing an online written exam based on the book with a score of at least 70% or better within a one-year timeframe.

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Dialectical Behavior Therapy and Recreational Therapy

· TR Knowledge Areas:

Foundation Knowledge: Theories of human behavior and theories of behavior change, Principles of behavior change (CBT Model is covered)

Practice of TR/RT: Concepts of TR/RT: DBT Interventions

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

· Course Objective: Independent self-study learner will demonstrate a basic awareness of the theories and basic concepts of dialectical behavior therapy as evidenced by reading Sheri Van Dijk’s (2012) DBT make simple and passing an online written exam with a score of at least 70% or better within a one-year timeframe.

This course is currently as a discounted price! Regular price is $80.

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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

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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.

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Lower risk of alzheimer's disease

Rec. therapists who work with the elderly may be interested in this article I found on foxnews.

It suggests 7 ways to decrease risk of alzheimer's disease.

In a nutshell, here are the tips:

1. increase cinnamon in diet.
2. drink apple juice
3. drink coffee (my personal favorite tip)
4. socialize more.
5. meditate
6. Mediterranean diet helps.
7. Protect your vison.

Rec. therapist could develop social activities, meditation, coffee and conversation, offer apple jucie during sessions, and include cognitive activities. It was said that the social activities increase cognitive functioning.

Read the full article here:

http://www.foxnews.com/health/2011/12/09/7-ways-to-lower-your-risk-alzheimers/?test=faces

Read more here:
http://www.foxnews.com/health/2011/12/09/7-ways-to-lower-your-risk-alzheimers/?test=faces#ixzz1gH5OG9nf