THE ROLE OF THERAPEUTIC RECREATION IN HEALTH

PROMOTION

REFLECTIONS FROM PRACTICE

Hazel Gough (BSocSci, MASocial Work)

INTRODUCTION

Context- Barretstown (SeriousFun Camps) Types of Camps/ Programmes Research- The impact of serious childhood

illness. Health Promotion Principles Therapeutic Recreation (TR) What the research says re benefits of

camp. What the campers say. Conclusion- HP Principles and TR camps. Questions and Answers.

BARRETSTOWN & SERIOUSFUN

Founded in 1994, it is the only camp of its kind in Ireland.

Part of the global ‘SeriousFun Children's Network’, founded by Paul Newman in US, 1988

Non Profit organisation that provides Therapeutic Recreation programmes to European children experiencing/who have experienced serious illnesses such as cancer, haemophilia and renal disease.

Free of charge to all families (all incl). Therapeutic Landscapes Variety of Camps offered.

BARRETSTOWN CAMPS

Barretstown Mission: ‘to rebuild the lives of children affected by serious illness and their

families. We believe that every child with serious illness should enjoy their childhood’.

Children's Camps (Age Specific) Teen Camps Sibling Camps Family Camps Bereavement Camps (3 Camps) Hospital Outreach Programme (HOP)

IMPACT ON PARENTS AND FAMILY Research shows that parents have an

overwhelming need to ‘do’ while caring for a child with a serious illness.

Considerable demands placed on family life. Parents often feel a sense of responsibility,

anger, guilt, helplessness and powerlessness. Parents provide emotional and psychological

support to child, often neglecting their own. One or both parents remove themselves from

work/home/friends/society to care for child in hospital, hospice or at home.

IMPACT ON PARENTS AND FAMILY CONT….

As a result, parents are vulnerable to parental exhaustion as they constantly pursue some state of ‘normality’ within the family unit while tending to the competing needs of their children.

Also vulnerable to poor mental health as a result, including burn out, helplessness and/or depression.

STRESSORS RELATED TO CHILDHOOD ILLNESS

Multiple Hospitalisation and clinic visits. Severe treatment related pain. Visible side effects of illness/treatment. Repeated absences from education and

peer group. Little or no ‘normal childhood experiences’. Activity limitations. Long term implications e.g. physical

disability. Elevated risk of developing mental health

problems.

STRESSORS RELATED TO SIBLING OF CHILD WITH ILLNESS

Disruption to family life and relationships, resulting in feelings of loss.

Separation from parents (meeting needs of child with illness).

Minimal ‘normal’ childhood family experiences.

Exposure to suffering of sibling. May lack knowledge, insight and

understanding related to their sick sibling. Elevated risk of mental health problems,

particularly depression and anxiety disorders.

PRINCIPLES OF HEALTH PROMOTION

Empowerment Participative Holistic Intersectoral Equitable Sustainable Multi Strategy

THERAPEUTIC RECREATION (TR) Therapeutic Recreation is an activity based

process of challenge, reflection and personal discovery which takes a holistic person-centered approach to improve the physical, social, emotional and psychosocial wellbeing of the individual and groups participating.

Activities are specially designed to positively challenge individuals perceptions of their skills and abilities in a supportive manner and help them to recognise achievements.

THERAPEUTIC RECREATION (TR)

Targeted psychosocial intervention to address the long term psychosocial impact of childhood serious illness.

TR aims to enable individuals to achieve quality of life and optimal health through meaningful participation in, and reflection on, recreation and leisure.

Increase self esteem and self efficacy. Promotes self determination by challenging

people to move beyond their comfort zones and achieve success which is relevant to them.

THERAPEUTIC RECREATION CAMPS Camping programmes are based on an

understanding of the effects of chronic illness on children, their siblings and family units and the resultant needs.

Aim to provide a positive experience for children and families that has a healing and beneficial impact on their physical, psychological and social wellbeing.

Encourage a self sufficient attitude, enhanced self esteem, sense of mastery and efficacy in peer relationships.

Also promotes collectivism and interdependency.

WHAT THE RESEARCH SAYS Research has indicated that campers

experience positive results from RT camps in the following areas:Experience of physical symptoms related to

their illness (particularly through peer interaction).

Self esteem, particularly pertaining to self worth and physical appearance.

Confidence, affect and self efficacy.Quality of life.Adapting to illness and it’s impact shared exp).Social functioning.Enjoyment of camp.

WHAT THE CAMPERS SAY

‘Barretstown is an amazing, fun-filled, emotional place that needs to be experienced to be fully understood. It is a

healing, magical place, with wonderful people and beautiful surroundings’.

‘Thank you for making our lives a little bit happier. Camp made us realise that it’s ok to have fun as a family, and even

smile without feeling guilty’.

‘We found new peace as a ‘new’ family. Even though she was not physically here, thank you for making Chloe part of

the memories from camp’

(Families who attended Bereavement Camps)

WHAT THE CAMPERS SAY CONT..

‘Barretstown is my favourite place in the world. There is no other way to describe it. It has changed my life. I was

diagnosed with acute lymphoblastic leukemia in 2005 when I was 12 years old and it changed everything about me; I became shy, quiet, lost confidence and felt alone. Then I

went to Barretstown……. When I came home I felt so different. Everything was so much more optimistic and I

decided to live life to the full. I gained more confidence and I started to really enjoy life again’.

(Twice a camper of Teen Camp aged 14 and 15)

‘Every one of my family got so much out of our time there. Most importantly it helped my little girl to find herself again’

(Parent camper of Family Camp)

CONCLUSIONHP PRINCIPLES & TR CAMPS

Sustainability

Holistic

Empowerment

Intersectoral

Equitable

Participative

Multi strategy

Short term intervention with long term benefits.

Physical, social, emotional and psychological wellbeing.

Promotes self esteem, self efficacy, independence and interdependence and social skills.

SeriousFun and Hospital links.

Activities adapted to ensure inclusivity.

Participation and self determination is paramount.

Variety of different methods used to ensure outcomes.

QUESTIONS?

BIBLIOGRAPHY Barretstown SeriousFun Camp (2014) Blog Archives- It helped my little girl find

herself again. Retrieved from http://www.barretstown.org/2012/07/it-helped-my-little-girl-to-find-herself-again/ .

Health Service Executive (2011) The Health Promotion Strategic Framework. HSE National Health Promotion Office. Retrieved from http://www.healthpromotion.ie/hp-files/docs/HPSF_HSE.pdf .

Kiernan, G.& MacLachlan, M. (2002) Children’s Perspectives of Therapeutic Recreation:Data from the ‘Barretstown Studies’. Journal of Health Psychology, 7, 599-612.

Kiernan, G., Gormley, M., & MacLachlan, M. (2004) Outcomes associated with participation in a therapeutic recreation camping programme for children from 15 European countries: Data from the ‘Barretstown Studies’. Social Science and Medicine, 59, 903-913.

Kiernan, G., Gormley, M., & MacLachlan, M. (2005) Children’s voices: qualitative data from the ‘Barretstown studies’. International Journal of Nursing Studies, 42, 733-841.

McKenna, V.,& Connolly,C. (2013) Health and Health Promotion in the Social Care Context. NUIG:HPRC.

Seriousfun Children’s Network (2013) Fact Sheet. Retrieved from http://www.seriousfunnetwork.org/document.doc?id=520 .

Sloper. P. (2000) Experiences and support needs of siblings of children with cancer. Health & Social Care in the Community, 8(5), 298-306.

Walker, D. A.,& Pearman, D. (2009) Therapeutic recreation camps: an effective intervention for children and young people with chronic illness? Arch of Disease in Childhood , 94(5), 401-406.

Therapeutic Recreation Ontario (2014) About therapeutic Recreation. Retrieved from https://www.trontario.org/about-therapeutic-recreation .