tr practice: art, science, or magic? chapter 13 hpr 453
TRANSCRIPT
TR Practice:Art, Science, or Magic?
Chapter 13
HPR 453
TR: Roots and Now
Early Civilization – Play and recreation were healing to ill and injured
Florence Nightingale – arts, music, humor, pets, writing, conversation in recovery of ill, injured, and dying soldiers
Recreation contributes to health and QoL Art, Science or Magic????
TR Practice as Art
“All Recreation is Therapeutic” CTRS seeks to supplement, alter, or
counteract effects of illness or injury Introduces media to supplement body’s
healing and health capacity Encourages individual to be autonomous and
seek meaningful experiences Results in improvement in health or condition
Based on aesthetics of environment and value of self-expression and creativity to cause one to feel good (or at least better)
Arrange interventions in a way to effect sense of quality or goodness
The participant interprets the value Art for art’s sake or as recreation as a means
unto itself
TR Practice as Science
“TR as the Means to Outcomes or Ends” More recent phenomenon due to internal and
external forces Definition of science – The observation,
identification, description, experimental investigation, and theoretical explanation of phenomena” American Heritage Dictionary (1994)
Through research phenomena and theories are tested and explained
Scientific investigation of TR Practice and formal training programs began in 1950s
Which interventions were effective? What skills do practitioners need to be
effective? Development of cause and effect and
perspective on importance of constancy of purpose and consistency of approach
Important Developments
Internally – Body of knowledge professional organizations education and training programs definition of TR observation and investigation of the practice of
TR accreditation process
Practice as a Science Milestones
Autonomous credentialing program – NCTRC Based on scientific analysis of TR job functions
and knowledge needed to perform the functions Born of efforts to provide prof self-regulation Educational prerequisites, internship under
qualified professional (CTRS), job knowledge test 1st real measure of consistency of professional
practice
1991 National Consensus Conference on Benefits of TR in Rehabilitation Temple University and National Institute of
Disability Rehabilitation Research (NIDRR) Studied efficacy in TR in rehabilitation Consistent, uniform Tx outcomes of TR with
specific populations
External Developments
Standardization and accreditation of healthcare – JC, CARF
Regulatory accountability – Healthcare Financing Administration (HCFA) now CMS
Concerns centered on quality delivered Costs skyrocketing -> Insurance industry
imposed restrictions on access to healthcare Evolution of technology/Consumers’ access
to information
People living longer, surviving catastrophic injuries and illnesses and better informed on options for healthcare
TR exists in scientific arena due to these factors
More recent developments…
Development of evidence-based protocols or practice guidelines 2003 – ATRA Dementia Practice Guidelines for
Recreational Therapy Theoretical framework and scientific evidence to
support efficacy of treatment approaches
Pending Guidelines Pain, Obesity, Stroke or other neurological events
Important to monitor trends in healthcare for direction of research and scientific inquiry
Worldwide health initiatives such as WHO ICF Move away from disease to health and health-
related domains, how the individual is impacted by internal body functions and structures, activity participation, performance, and functioning in relation to social perspective and environment’s impact on functioning = Health and Health Promotion and role of TR
TR as Magic
Holistic or Spiritual Perspective of TR Magic defined – “Possessing distinctive
qualities that produce unaccountable or baffling effects” American Heritage Dictionary (1994)
Some practitioners practice more by doing what they know works – results through power of charisma, charm, persuasiveness of personality
Mysterious qualities connected to healing
Mind-Body Connection such as acupuncture, chiropractic, naturopathic medicine, energy-based modalities such as yoga, Reiki or guided imagery, autogenics Used for centuries yet lack scientific evidence so they are
“magical” Enter “Mind and Behavior” – If you believe you can,
can you? Have we as practitioners affected the person by
design, or was it really magic that caused the change?