strengths-based therapeutic recreation...
TRANSCRIPT
Anderson & Heyne, 2013, ATRA Annual Conference
*To access powerpoint slides and handout, use the QR Code above or use this web address: http://colfax.cortland.edu/nysirrc/links-articles-interest.html
Strengths-Based Therapeutic Recreation Assessment
INTERNAL STRENGTHS
EXTERNAL STRENGTHS
Assessment Source of Assessment Assessment Source of Assessment
Domain: Leisure Discover Your Passions Interview
McGill, J. (1996). Developing leisure identities. Toronto, ON: Leisurability Publications.
Recreation Inventory for Inclusive Participation
Schleien, S., Ray, T., & Green, F. (1997). Community recreation and people with disabilities: Strategies for inclusion. Baltimore, MD: Paul Brookes Publishing.
Strengths Discovery Assessment
Clark, H. (2007). Strengths Discovery Assessment Process for working with transition aged youth and young adults at http://www.fldoe.org
Inclusivity Assessment Tool
Inclusive Recreation Resource Center at www.inclusiverec.org
Ways of Savoring Checklist
Bryant, F., & Veroff, J. (2006). Savoring: A new model of positive experience. Mahwah, New Jersey: Lawrence Erlbaum Assoc. Inc.
Leisure Resource Asset Mapping
Anderson, L. & Heyne, L. (2012). Therapeutic recreation practice: A strengths approach. Venture Publishing.
Leisure Diagnostic Battery
Venture Publishing at www.venturepublish.com
Domain: Psychological/Emotional Positivity Test
Fredrickson, B. L. (2013) at www.positivityratio.com/single.php
Supports Intensity Scale
American Association for Intellectual and Developmental Disabilities. (2005, 2009). The Supports Intensity Scale. Washington, DC: AAID.
Domain: Cognitive Mindful Attention Awareness Scale
Brown, K., & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848.
HOME Inventory Caldwell, B. M., & Bradley, R. H. (2003). Home Observation for Measurement of the Environment: Administration Manual. Tempe, AZ: Family & Human Dynamics Research Institute, Tempe, AZ: Arizona State U.
Domain: Social Home & Community Social Behavior Scale
Merrell, K., & Caldarella, P. (2008). Home and Community Social Behavior Scales (HCSBS). Baltimore, MD: Paul Brookes Publishing.
Circle of Friends
Falvey, M., Forest, M., Pearpoint, J., & Rosenberg, R. (1997). All my life’s a circle. Toronto, Ontario, Canada: Inclusion Press.
Domain: Physical Borg Rating of Perceived Exertion Scale
Borg, G. (1998). Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics.
Walk Score® Walk Score® at www.walkscore.com
Domain: Spiritual VIA Strengths Assessment
Peterson, C., & Seligman, M. (2004) at http://www.viacharacter.org/www/
The HOPE Questions
Anandarajah, G., & Hight, E. (2001). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. American Family Physician, 63(1), 81-89.
Global Outcomes of Well-Being and Quality of Life Assessment Source of Assessment
Satisfaction with Life Scale
Diener, E. (1984, 1993) at http://internal.psychology.illinois.edu/~ediener/SWLS.html
Subjective Happiness Scale Lyubomirsky, S. (2013) at http://sonjalyubomirsky.com/subjective-happiness-scale-shs/
Quality of Life Profile On-Line
University of Toronto at www.utoronto.ca/qol/profile/adultVersion.html
The Well Being Index (WBI)
Therapeutic Recreation Journal (manuscript by Dr. Jeff Witman et al. in revision)
64 • TherapeuTic recreaTion pracTice: a STrengThS approach
Figure 4.3 Flourishing through Leisure Model: A
n Ecological Extension of the Leisure and Well-B
eing Model
Facilitation of leisure skills and knowledge:
• Savoring leisure* • Interests, preferences
• Authentic leisure*
• Talents, abilities• Leisure gratifications* • Skills and com
petencies• M
indful leisure* • Leisure know
ledge• V
irtuous leisure* • A
spirations
Facilitation of leisure environments:
• Real choices for leisure• Typical lifestyle rhythm
s• Social support• Inclusive environm
ents - Physical accessibility - A
dministrative inclusivity
- Programm
ing inclusivity
PER
SON
in the ENV
IRO
NM
ENT
What the Therapeutic R
ecreation Specialist Does
Outcom
es the Participant Experiences
Enhancing the Leisure Experience
Developing Strengths and R
esources
Facilitation of psychological and emotional
strengths:• Capacity for happiness*• Em
otion regulation*• Self-aw
areness/self-acceptance/self-congruence*• A
utonomy/self-determ
ination/goal directedness*• Com
petence*• O
ptimism
*
Facilitation of psychological and em
otional resources:• Positive behavioral supports• N
atural cues• Q
uiet spaces in public areas• H
igh expectations and positive attitudes• O
ther supports and accomm
odations
Play
Recreate
PerceiveFeel
Facilitation of cognitive strengths:• A
bility to attend*• Concentration*• Follow
ing directions*• M
emory*
• Problem solving
• Goal setting*, aspiration discovery
Facilitation of cognitive resources:• Environm
ental cues• Environm
ent modifications
• Quiet spaces in public areas
• Activity adaptations
• Other supports and accom
modations
ThinkLearn
Facilitation of social strengths:• Com
munication skills*
• Interpersonal skills*• Reciprocal-relationship skills*, friendship skills• Leadership and citizenship skills• Social confidence*
Facilitation of social resources:• Inclusivity and diversity• O
pportunities to engage in meaningful
social roles• Trained staff• Peer support developm
ent• O
ther supports and accomm
odations
Relate
Belong
Facilitation of physical strengths:• Physical health*• M
obility*• Fitness—
endurance, strength, flexibility*• Energy and vitality• Physical activity skills
Facilitation of physical resources:• Safe environm
ents• U
niversal design• A
dapted equipment
• Affordability, equitable resource distribution
• Hom
e recreation resource development
• Comm
unity recreation resource developm
ent
Act
Do
Facilitation of spiritual strengths:• H
ope and inspiration• Sense of m
eaning and purpose• Peace of m
ind• Reflection and w
isdom• Self-actualization• Sense of connectedness/feeling a part of
something bigger
• Other character strengths and virtues
Facilitation of spiritual resources:• Culture of hope, support, and
encouragement
• Proximity to nature
• Quiet places in public areas
• Places of spiritual nourishment
• Beauty and aesthetics in the environment
Believe
Value
Participant’s goals, dream
s, and aspirations
Well-B
eing
Environmental resources and
personal strengths that cultivate grow
th, adaptation, and inclusion
LEISURE
WELL-BEIN
G
I find enjoyment in m
y leisure experiences and they positively
impact other aspects
of my life
COG
NITIVE
WELL-BEIN
G
I think in a focused w
ay and learn eagerly
PHYSICA
LW
ELL-BEING
I do and act in my
daily life with vitality
and no barriers
SPIRITUA
LW
ELL-BEING
I live my life hopefully,
in harmony w
ith my
values and beliefs
SOCIA
LW
ELL-BEING
I relate well to others
and belong to valued social groups
PSYCHO
LOG
ICAL &
EM
OTIO
NA
LW
ELL-BEING
I feel happy and perceive I am
in control of m
y life
I experience a state of successful,
satisfying, and productive
engagement w
ith m
y life*
A Flourishing Life
* From the Leisure and W
ell-Being M
odel (Carruthers & H
ood, 2007; Hood &
Carruthers, 2007)
from Anderson, L., & Heyne, L. (2012)
Strengths-Based Assessment in TR: Tools for Positive Change
Dr. Lynn Anderson, CTRS, SUNY Cortland Dr. Linda Heyne, CTRS, Ithaca College
2013 ATRA Annual Conference
Pittsburgh, Pennsylvania
(Dan
Wilk
ins a
nd th
e nt
h D
egre
e, 2
007)
Session Description
At the heart of therapeutic recreation practice is the art of building strengths in the individuals we serve. Therapeutic recreation is historically grounded in the medical model of practice A sea change has occurred in health and human services which focuses on orienting services toward people’s individual strengths, assets, talents, and aspirations. In order to systematically build strengths, we must systematically assess them. This session focuses on some of the assessment tools and approaches that can be used to assess the internal and external strengths of our participants. The session will help orient therapeutic recreation specialists toward strengths-based practice by giving them practical tools for positive change
Session Objectives
Define the strengths approach Compare and contrast assessment from a strengths versus deficits approach Identify internal and external strengths that can be assessed in therapeutic recreation practice, and at least six tools that can be used to assess them using an ecological approach
Principles of a Strengths-Based Approach
Every individual, group, family, and community has strengths Difficulties are also sources of opportunity and challenge We do not know the upper limits of a participant’s capacity to
grow and change – never assume we do! Collaboration (not expert domination) with participants Every environment is full of resources Context matters Hopefulness matters Strengths can be nurtured (thus, must be
assessed, planned, focused on, and evaluated)
Strengths versus Deficits Approach Deficits Approach
Strengths Approach
Person is a “case” or a “diagnosis”
Person is unique with talents and resources
Emphasis is on what is wrong, missing, or abnormal; emphasis is on problems
Emphasis is on strengths, resources, capabilities, aspirations, and adaptive processes
Participant is viewed as a problem needing to be fixed; intervention is problem focused
Participant is viewed as potential waiting to be developed; intervention is possibility focused
Professional is the expert concerning the individual’s life
Individuals, families, and communities are viewed as the experts
Expert professional interprets the person’s story to arrive at a diagnosis
The professional knows the person through the person’s story and interpretation of events
(Anderson & Heyne, 2012; Saleeby, 2006)
Strengths versus Deficits Approach Deficits Approach Strengths Approach
The professional develops a treatment plan for the individual
Aspirations of the individual, family, and community are the focus of the work to be done—the plan is developed in collaboration
A framework and vocabulary is developed to describe problems
A framework and vocabulary is developed to describe strengths
Play, recreation, and leisure are viewed as superfluous experiences only tangentially related to improving a person’s health
Play, recreation, and leisure are viewed as integral to well-being, and are essential to recovery and rehabilitation
Absence of illness or dysfunction is the goal
Well-being, thriving, and high quality of life are the goals
Medical model is used Ecological model is used
(Anderson & Heyne, 2012; Saleeby, 2006)
Strengths – The Heart of TR Practice
A definition of strength: –The quality or state of being strong; vigor; power of resistance; vigor of action; a strong or valuable attribute; a source of power or encouragement; sustenance.
(Webster’s Dictionary)
Internal strengths External strengths and resources
Internal Strengths – Aspirations and goals – Interests and preferences – Passions – Talents – Skills and competencies – Knowledge – Character strengths and
virtues
External Strengths & Resources
– Family support – Social support, friends – Community resources – Home resources – Opportunities for
participation and contribution
(inclusive communities) – High expectations and
positive attitudes
Internal and External Strengths
Internal Strengths •Interests and preferences •Attitudes and beliefs •Talents and abilities •Skills and competencies •Knowledge •Aspirations and goals •Character strengths/virtues
THE PERSON
External Strengths and Resources
•Family support and involvement
•Friendships and social support
•Home resources
•High expectations and positive attitudes
•Community and environmental resources
•Opportunities for participation and contribution (inclusive communities)
THE ENVIRONMENT
Strengths-Based Assessment • Focus is on internal and
external strengths • Participant is potential waiting
to be developed • A framework is used to assess
and describe strengths • Understanding strengths leads
to understanding how to plan • Ecological approach
Assessment in a Deficits Approach Assessment in a Strengths Approach
Defines the diagnosis as the problem; questions are pursued related to problems, needs, deficits, and symptoms
Defines a holistic portrait: what the participant wants, desires, aspires to, dreams of; participant’s talents, skills, and knowledge
Searches for the nature of the participant’s problems from the perspective of the professional; analytical
Gathers information from the standpoint of the participant’s view of the situation; ethnographic
Is interrogative in nature
Is conversational in nature
Focus is on diagnosis to determine level of function
Focus is on the here and now, leading to a discussion about the future and how the person has managed so far
Participant is viewed as lacking insight regarding the problem, illness, or diagnosis
Participant is viewed as a unique human being who will determine his or her own wants within the environment
Assessment in a Deficits Approach Assessment in a Strengths Approach
Participant is a passive container for interventions as professionals direct decision-making
The relationship with the participant is primary to the process, where joint decision-making is key
Places the participant in diagnostic or problem categories using generic, homogenous language
Strengths assessment is specific, unique and detailed, individualized to the participant
Emphasizes compliance and management of problems and needs, with formal services seen as the solution
Explores the rejuvenation and creation of natural helping networks and social supports
Controlled by the professional Participant ownership
The professional dictates, “What I think you need to learn and work on”
The professional asks, “What can I learn from you about your life?”
Examples of how assessment shifts in the strengths approach
Assessment Focus- Deficits Approach Assessment Focus - Strengths Approach
Problems Goals, dreams, aspirations, and strengths
Functional deficits Functional abilities
Problems with leisure lifestyle
Leisure interests, preferences, talents, skills, knowledge, and goals
Leisure barriers Leisure facilitators Behavior problems Social competence Depression, anxiety, and other negative emotions
Positive emotions
Stressors Relaxers and soothers (calming inducers)
Social isolation and loneliness
Social resources, social networks, and community mapping
Family deficits and problems
Family strengths, dreams, and goals; family traditions; shared family interests and activities
Rationale for Strengths-Based Assessment
To get to know the individual – what makes this person tick? What is meaningful to this person?
To begin to develop a positive relationship with the individual and her/his support system
To establish baseline
To measure outcomes
To provide the “right” services
To focus on solutions, not on problems
How does new research on brain functioning inform TR assessment practice?
Integration of psychology and neurology (fMRI, PET, QEEG…..)
Focus is power – The act of paying attention creates chemical
and physical changes in the brain.
Expectation shapes reality – People’s preconceptions have a significant
impact on what they perceive.
Attention density shapes identity – Repeated, purposeful, and focused attention
can lead to long-lasting personal evolution.
Other theoretical underpinnings of strength-based assessment in TR Ecological approach and a social model of disability Well-being and quality of life Positive psychology: – Flourishing – Learned optimism – Broaden and build theory – Flow
Self-determination Normalization and social role valorization Social support Community building
Definition of Assessment Assessment is a treasure hunt!
Therapeutic recreation assessment is the systematic process of learning about a person, his or her strengths, and his or her aspirations for recreation and well-being.
Through assessment, collaborative planning about the person’s future goals and dreams in relation to leisure becomes possible.
Principles in Strength-Based Assessment
Assessment …… is strengths-based and person-centered is individualized, based on the participant’s world view focuses on well-being and quality of life through leisure looks at the whole person in her or his environment (authentic and ecological) is based on the aspirations and goals of the participant uses multiple methods and seeks to understand multiple variables always involves the participant and his or her circle of support
Assessment is a treasure hunt!
Components of Strengths-Based Assessment
What is the participant’s current
situation?
What are the participant’s internal
and external strengths and resources?
What will it take to reach the dream?
What are the participant’s goals,
dreams, and aspirations?
Where does the
participant want to be?
Development of a Plan
What to Assess: Use Strengths-Based Models as an Assessment Framework
Domains for Assessment Domain Outcome for Participants Leisure Domain
“I find enjoyment in my leisure experiences and they positively impact other areas of my life.”
Psychological/ Emotional Domain
“I feel happy and perceive I am in control of my life.”
Cognitive Domain
“I think in a focused way and learn eagerly.”
Social Domain
“I relate well to others and belong to valued social groups.”
Domains for Assessment Domain Outcome for Participants Physical Domain
“I do and act in my daily life with vitality and no barriers.”
Spiritual Domain
“I live my life hopefully, in harmony with my values and beliefs.”
Overall Outcome: Well-Being
“I experience a state of successful, satisfying, and productive engagement with my life” (Hood & Carruthers, 2007).
Overall Outcome: A Flourishing Life
Enhanced environmental resources and personal strengths that cultivate growth, adaptation, and inclusion
Domains for Assessment:
Leisure
Outcome for Participants
“I find enjoyment in my leisure
experiences and they positively impact other areas of my life.”
Discover Your Passions Interview
Interview questions designed to ascertain what most interests and excites a participant in leisure For example:
• What lights you up? • When do you seem and feel most alive? • What helps you feel a sense of purpose? • When do you seem most focused and
unaware of distractions? • What inspires you to talk or get excited? • When was a time you felt at peace with
yourself?
Strength Discovery Assessment
Process for uncovering and identifying young people’s strengths and resources Informal semi-structured interviews with participant, family member, and key support personnel – “strengths chats”
Strength Discovery Assessment Interests and preferences Values and traditions in one’s life Skills, abilities, and competencies Personal attributes (e.g., sense of humor, resilient) Dreams/aspirations Strategies in the past that have worked best at home, school, or in the community Settings that are most comfortable Family members, relatives, friends, and other informal key players valued by and/or in this young person’s life Formal key players involved in his/her life Priority needs and goals across transition domains
Ways of Savoring Checklist
Ways of Savoring Provides quantitative
information about ten different dimensions of savoring
Sharing With Others Memory Building Self-Congratulation Comparing Sensory-Perceptual Sharpening Absorption Behavioral Expression Temporal Awareness Counting Blessings Kill-Joy Thinking
Leisure Diagnostic Battery
Leisure Diagnostic Battery
– Assesses an individual's "leisure functioning”
Perceived Leisure Competence Perceived Leisure Control Leisure Needs Depth of Involvement in Leisure Playfulness Scale Barriers to Leisure Involvement Knowledge of Leisure Opportunities Test Leisure Preference Inventory
Recreation Inventory for Inclusive Participation
Part I: Appropriateness of recreation activity/setting
Part II: Activity/discrepancy analysis
PART III: Specific activity requirements (adaptations and teaching procedures)
Recreation Inventory for Inclusive Participation
Leisure Skill Inventory +/- Inventory for Participant with Disability
STEPS (Activity Analysis) Teaching Procedure and Adaptations/Modifications
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
etc. etc.
Inclusivity Assessment Tool
Measures the physical and social aspects of inclusion at a recreation agency
Inclusion U Online training qualifies you as a “CIA” (Certified Inclusivity Assessor) to use the IAT
IAT Checklists, User Manual, and Tool Kit
60” circle
Leisure Resource Asset Mapping
Creates a visual map of the recreation resources available to a participant
Domains for Assessment:
Psychological/Emotional
Outcome for Participants
“I feel happy and perceive I am in control of my life.”
Positivity Test
10-item scale to help people measure the level of positive to negative emotion they experience, called their “positivity ratio”
Supports Intensity Scale
Home Living Community Living Lifelong Learning Employment Health and Safety Social Activities
www.aaidd.org
Domains for Assessment: Cognitive
Outcome for Participants
“I think in a focused way
and learn eagerly.”
Mindful Attention Awareness Scale
MAAS Provides quantitative
information about one’s level of mindfulness in day to day experiences
The HOME Inventory
Home Observation for Measurement of the Environment Measures the quality and quantity of stimulation and support available to a child in the home environment. Several versions available (toddler to teen)
Domains for Assessment:
Social
Outcome for Participants
“I relate well to others
and belong to valued social groups.”
Home & Community Social Behavior Scales
Designed to be completed by home- and community-based raters. Social Competence scale includes 32 items that measure adaptive, prosocial skills on two subscales: Peer Relations, and Self-Management/Compliance.
Circle of Friends
PURPOSES:
To identify who’s in the participant’s life – friends, acquaintances, and professionals
To assess participant’s satisfaction with social circle
To plan intentionally to build and sustain a circle of support
Domains for Assessment:
Physical
Outcome for Participants
“I do and act in my daily life with
vitality and no barriers.”
Borg Rating of Perceived Exertion Scale
Measures self-assessed perception of physical exertion based on sensations of… – Increased heart rate – Increased breathing – Increased perspiration – Muscle fatigue
No exertion Moderate Maximum
Walk Score
Walk Score measures the walkability of any address. Walk Score analyzes hundreds of walking routes to nearby amenities. Points are awarded based on the distance to the amenities in each category.
Domains for Assessment:
Spiritual
Outcome for Participants
“I live my life hopefully, in harmony
with my values and beliefs.”
Values in Action Signature Strengths Questionnaire
Measures character strengths and virtues 48-item short form Long form online
Six Core Virtues and 24 Character Strengths Wisdom
Curiosity Love of learning Judgment Ingenuity Perspective
Courage •Valor •Perseverance •Integrity •Zest and vitality
Humanity Kindness Loving Social intelligence
Justice •Citizenship •Fairness •Leadership
Temperance Self-control Prudence Humility Forgiveness
Transcendence Appreciation of beauty Gratitude Hope Spirituality Humor
(Peterson & Seligman, 2004)
The HOPE Questions
Assesses spiritual aspects of care:
H = Sources of hope, strengths, comfort, meaning, love, peace and connection
O = Role of organized religion in participant’s life
P = Personal spirituality and practices
E = Effects of participant’s spirituality on medical care and end-of-life decisions
Domains for Assessment:
Overall Well-Being Outcome for Participants
Well-Being
“I experience a state of successful, satisfying, and productive engagement with my life” (Hood & Carruthers, 2007).
A Flourishing Life
Enhanced environmental resources and personal strengths that cultivate growth, adaptation, and inclusion
Life Satisfaction Scale
Measure of general life satisfaction
Subjective Happiness Scale
A single composite score for global subjective happiness Available online and in pdf on Positive Psychology Lab website
Quality of Life Profile ON-LINE (University of Toronto)
Assesses the degree to which a person enjoys the important possibilities of his or her life
BEING – who one is
– Physical Being – Psychological Being – Spiritual Being
BELONGING – connections with one’s environment
– Physical Belonging – Social Belonging – Community Belonging
• recreational programs • community events and
activities BECOMING -- achieving personal goals, hopes, and aspirations
– Practical Becoming – Leisure Becoming – Growth Becoming
The Well-Being Index (WBI)
18 statements based on the Flourishing through Leisure model
I relate well to others
I live my life hopefully
I have a sense of meaning and purpose
I find enjoyment in my leisure experiences
Ecological Approach to Assessment
Participants viewed as part of their larger environments Search for internal strengths and external strengths and resources in social and physical environments Spend time getting to know not only the participant, but the participant’s home, school, work, community, and other contexts of his or her life Understand how participants interact with the context of their lives Learn what changes need to be made on the part of the participant or the environment to help him or
her reach goals and achieve well-being
Ecological Assessment
This is what we know about the
person
This is what we know about the
environment
Spiritual
Psychological and emotional
Leisure
Cognitive
Social
Physical
Goals and
dreams Friends
Expectations
Home
Community resources
Family
Opportunities for inclusion
Work/ School
Resources
Anderson, L., & Heyne, L. (2012). Therapeutic recreation practice: A strengths approach. State College, PA: Venture Publishing, Inc. Anderson, L., & Heyne, L. (2013). A strengths approach to assessment in therapeutic recreation: Tools for positive change. Therapeutic Recreation Journal, 46(2), 89-108. University of Pennsylvania Authentic Happiness website: – www.authentichappiness.sas.upenn.edu
Handout online