shank & coyle, chapter 11. shank & coyle (2002) activity-based interventions supportive...
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Shank & Coyle, Chapter 11
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Shank & Coyle (2002) Activity-based interventions Supportive environment Therapeutic/helping relationship
“Of these three, the relationship between a client and a recreation therapist is most essential” (p. 189)
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Austin (2002) Little has been written in TR literature about
describing or creating therapeutic relationships.
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How do they differ from social relationships or friendships? Focus solely on needs of client Assist client to achieve goals Assist client to grow toward self-sufficiency &
independence Are not reciprocal Are not automatic Need to learn & practice skills
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Identify 10-15 therapeutic/helping relationship skills needed for CTRS working with Homeless Substance abuse Spinal cord injury Mental retardation Psychiatric problems Dementia
Compare
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Sprouse, 2004 Ability to develop rapport Boundaries Empathy Hope and connectedness Ethical behavior Sense of humor Self-disclosure Compassion & empathy
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To be effective, need to understand what aspects of themselves influence client change & growth
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Altruism & compassion Desire to serve
Openness & flexibility Genuineness
Congruence between words & actions Positive regard & respect for others
Unconditional positive regard Belief in value of play, recreation, &
leisure
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Awareness of self Ability to analyze own feelings Empathy Courage
Courage to seek help & acknowledge limitations
Inventive & creative
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Stamina Job can be physically & emotionally
demanding Enthusiasm Pressure
Need reliable social support system Nurture self Sense of humor Laugh at yourself Use leisure to renew physical & mental health
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Ability to create partnerships/collaborate Clients Colleagues
Ability to empower clients Cultural competence
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Communication competence Listening & responding skills Verbal & nonverbal Interpersonal space Using touch when communicating
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Time Takes time Decreased length of stay Starts when first meet (assessment)
Emotional Closeness How close?
Self-disclosure How much?
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CPI Crisis Prevention Institute World’s leading training organization Management of disruptive & assaultive
behavior Started 1980 In the past approved for NCTRC CEUs
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CPI One-day seminar
Identify behaviors that could lead to a crisis Respond to prevent escalation Verbal and nonverbal techniques to defuse Cope with own fear & anxiety Principles of personal safety to avoid injury $699 per person
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CPI Two-day workshop
When appropriate to physically intervene Team intervention strategies & techniques Physical & psychological well-being of those involved
in the crisis Safety & how to transport individual How to maintain rapport Steps for debriefing Documentation $1,099 per person
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CPI Four-day instructor certification program Learn to conduct in-house training Learn to customize for agency Learn how to test participant’s competency in
skills $2,125
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TCI Therapeutic Crisis Intervention Training program for staff that work with
youth in residential settings 5 day curriculum Train-the-trainer course
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TCI Day 1: Crisis as Opportunity
Prevention of crisis situations Maintain self-control Awareness of person Awareness of environment Assessing the situation
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TCI Day 2: Triggering & Escalation
Verbal crisis communication Nonverbal crisis communication Behavior management Protective interventions Teach alternatives to acting out
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TCI Day 3: Escalation, Outburst & Recovery
When restraint should or should not be used Team restraint Small child restraint Breaking up fights Standing hold Recovery process
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TCI Day 4: Outburst & Recovery
3 person restraint Transferring control Responding to feelings vs. behavior Practice role plays
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TCI Day 5: Implementing the TCI System
Recovery for staff Documentation Evaluation and testing
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Termination End relationship
Ritual, parties, tokens Reunions
Client’s death Impact on you Impact on other clients
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Burnout (Austin, 1999) What is burnout?
Emotional & physical exhaustion Professional’s attitudes & behaviors change in
negative ways in response to job strain Loss of idealism, energy, and purpose as a result
of work conditions
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Who are candidates for burnout? Repetitive contact with people Intense interpersonal contacts The “giving” role Job monotony
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What are some signs of burnout? More difficult to get work done during normal
hours Lose sense of humor, effectively flat Physical fatigue Become more irritable Become more susceptible to illness,
headaches, back pain, etc. Social withdrawal Increased absenteeism
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How can we prevent burnout? Develop support system Learn how to manage time effectively Know & respect your own skills, energy, &
level of commitment Spent time out of work role Take time off (mental health days, vacations) Use relaxation techniques Cry “uncle” when you need help Learn to laugh at yourself & the situation