Everything Flashcards
Leisure Assessment Inventory (LAI)
Measures adult leisure behaviors 4 Components: 1. Leisure Activity Participation Index 2. Leisure Preference Index 3. Leisure Interest Index 4. Leisure Constraint Index
Leisure Barriers Inventory
Interview style assessment used to measure leisure barriers in 8 areas: leisure partners, activity skills, time, money, leisure resources, transportation, age, disability
State Technical Institute Assessment Process (STIAP)
Adults with physical disabilities
Measures general scope of leisure activity skills which provides the basis for program decision making
More balanced program and leisure skills
Leisure Competence Measure
Coincides with FIM and can be used with most populations
Measures OUTCOMES of recreational therapy
Leisure Diagnostic Battery (LDB)
Assesses current leisure functioning and perceived freedom in leisure Based on attribution theory 5 sections: 1. Freedom 2. Control 3. Needs 4. Involvement 5. Playfulness
Leisurescope
Measures interest in leisure, emotional motivation and risk-taking activity attraction
Uses pictures
Intake Assessment Report
Helps RT set goals consistent with a lead doctors treatment goals
Health Protection/Health Promotion Model
Emphasizes self actualization
- Help person recover from threats to health (health protection)
- Help person achieve optimal health (health promotion)
-use prescriptive activities, recreation and leisure
Clients health behavior is influenced by 8 beliefs
Therapeutic Recreation Activity Assessment (TRAA)
Adult clients with TBI, DD, psychiatric disabilities, or receiving supported care like residents of a nursing home, group home, adult daycare center, or assisted living facility. Originally piloted with clients with Alzheimer’s. burlingame noted the assessment is one of the best for use with people who have severe mental illness. Also can be used with geriatric and gero-pscyhiatric clients.
Purpose: To assess basic functional skills as demonstrated in a group setting
Measures 6 areas: Fine motor skills, gross motor skills, receptive communication, expressive communication, cognitive skills, and social behaviors
Uses interview and series of activities (game, exercises, and arts and crafts activity)Has a protocol for establishing departmental levels of interrater reliability
Sentinel Event
Unplanned incident within a healthcare facility that results in death or psychological damage to a patient
Prospective Payment System PPS
Purpose:
- Focus on client-centered provision of services
- Sets but does not limit costs
- Making sure that medicare recipients do have access to the same heath care services as others
- Assure quality of health care services provided
RT is included in #1
Problem-Oriented Medical Record (POMR)
organized around patient problems
Divided into data base, a problem list, an initial plan and progress notes
Source-Oriented Medical Record (SOMR)
Divides each section by discipline
Nurse notes, TR notes, medical notes, etc
Quality Improvement
Purpose: Implement specific changes to healthcare which have measurable improvement for a group of patients
Measured through patient satisfaction
Utilization Review
focuses on resources of department or agency that are over utilized and under utilized
Should be included in the TR written written plan of operation
3rd Party Payer
Health insurance company
Multiple Sclerosis
Affects the nervous system and can cause atrophy and restrict ROM and flexibility.
ROM exercises are important
Exercise Therapy helps with QOL, physical and numerological function
Muscular Dystrophy
group of hereditary diseases characterized by degeneration of muscle and weakness
Activities that encourage movement are important
Spina Bifida
Activities to strengthen muscles are important
Cerebral Palsy
GMS Activities (coordination)
Left Hemisphere Brain Damage
Impaired language, memory
Use physical gestures, modeling, demonstrations, reality orientation
Right Hemisphere Brain Damage
Impair visual, spatial, dept perception
Use verbal directions, remove distractions, Leisure education
Phenylketonuria
Metabolic disorder where the body can’t process trace amounts of copper in foods
Ottis Media
Conductive hearing loss
Middle ear infection from fluid buildup, if untreated pressure build up can lead to ruptured eardrum
Conductive
Any hearing loss caused by outer or middle ear
Sensorineural
hearing loss caused in inner ear, nerves, and or brain
TBI
Acquired injury resulting from trauma to the brain
Mild: GCS 13-15 (concussion like symptoms)
Moderate: GCS 8-12 w/ loss of consciousness (persistent confusion and functional impairments)
Severe: GCS 7 or lower with prolonged unconsciousness and/or coma (severe functional impairments)
Ranchos Los Amigos Scale
TBI outlines predictable sequence of cognitive and behavioral recovery seen w/ brain injury
Level 1: no response (coma)
Level 2: Generalized response (limited & delayed)
Level 3: Localized Response (reacts to light/sound, pain)
Level 4: Confused-agitated (alert, restless)
Level 5: Confused-non agitated
Level 6: Confused-Appropriate (follows simple direction)
Level 7: Automatic-appropriate
Level 8: Purposeful-Appropriate
Glasgow Coma Scale
measures motor response, verbal response, and eye opening
levels based on points
Frontal Lobe
judgement, reasoning, motivation
Parietal lobes
sensations of touch, perception
Temporal lobes
memory function, receptive language and behavior
Occipital lobes
vision
Brain stem
controls basic functions
cerebellum
controls motor coordination, muscle tone & balance
Life Satisfaction Scale
measures perceived satisfaction with life
- Pleasure vs. Apathy
- Determination
- Desired/ Achieved goals
- Mood
- Self Concept
Gullian Barre Syndrome
autoimmune disorder that attacks the nervous system causing weakness, ataxia and progressing paralysis
Begins with lower extremities and ascends bilaterally
TR for Gullian Barre Syndrome
Relaxation Therapy, stress management, leisure education, adaptive activities, movement activities
TR for TBI
Leisure ed, endurance, safety, functional skills, compensation strategies, community re-entry
Bond-Howard Assessment on Neglect in RT (BANRT)
Measures scope and density of individuals with visual neglect
SCI
Cervical 8 C4: Diaphragm C5: Shoulder C6: Wrist T1: Hand L2: Hips L4-S1: Foot
General Recreation Screening Tool (GRST)
Developmental Disabilities
0-6 months 7-10 years
Measures general development of functioning
CERT-PB
Psychiatric setting
4 Areas of functional intervention
- Physical
- Cog/ Mental
- Affective
- Social
4 Behavioral Domains
- Psycho-motor (physical)
- Affective (psych)
- Social (interactional)
- Cognitive (intellectual)
ABC Framework of International Functioning
A: clarify relationship with activating events
B: Beliefs about them
C: Cog, emotional, or behavioral consequences of our beliefs
5 Basic Needs of Glasser’s Reality Therapy
- Power 2. Love + Belonging 3. Freedom 4. Fun 5. Survival
The Recreation Behavior Inventory
Observe the clients behavior in 20 different activities in order to evaluate skills (Sensory, Motor and Cognitive) as a pre-rec to leisure participation
Intended use for children, also used in psychiatric and long term care settings
Five stages of substance abuse
- Experimentation
- Regular Use
- Problem Use
- Dependence
- Addiction
Task/Activity Analysis Steps
- Separate the activity into component parts
- determine what the client needs to know to participate
- Assess the client for physical skills required
- Assess what modifications are required
Attribution Model
To what I attribute my success and failures
4 Factors to determine success or failure:
1. Ability
2. Effort
3. Difficulty to task
4. Luck
Type 1 Outcome Oriented Program
Designed to a large group of clients so there is little focus on individual needs and goals
All clients receive the same program, program usually intended for socialization & entertainment (movies, games like bingo)
Long-term care facilities and group homes
Flat
Blank facial expression
Blunted
Reduced or minimal emotional response
Labile Affect
Changing rapidly
Under the IDEA requirements, A functional behavioral assessment for children includes assessment of the following
- Precipitating Conditions (Setting, Situation prior to onset of behavior)
- Specific Behavior Observed
- Consequences
- Function of Behavior (assumed reason for behavior)
CAGE Tool
C: Cutting down
A: Annoyed at criticism
G: Guilty feeling
E: Eye opener
2 out 4 indicates drinking problem
4 Criteria for Active Treatment
- Prescribed and supervised by physician
- Based on assessment & individualized treatment plan
- Specified duration. intensity, & frequency of interventions
- Positive outcomes expected
Therapeutic Recreation Outcome Model
- extension of Service Delivery Model
- looks at products / outcomes of the delivery of TR services
- takes into account changes in functional capacities and health status that will impact quality of life
Steps to Ethical Decision Making
- Gather facts and info
- Assess if ethical problem is present
- Identify alternative actions
- Identify consequences
- Choose action
- Evaluate
4 Core Values of Recreational Therapy
- Right to leisure
- Autonomy
- Optimal Health
- Quality of life
Digital Repetition Test
Used to assess attention
Scores less then 5 indicate impaired attention
Leisure Activity Blank (LAB)
Focuses on past and future
Assesses types and degrees of activity client participated in prior to disability and can serve as a guide for selecting activities clients may enjoy
Proprioceptive
position and movement impairment
Clinical Problem Solving
- Define the issue
- Collect data
- Identify important concepts
- Consider reasons
- Decision
Negligent conduct
Failure to provide reasonable care to another, based on standards and expertise
Gross Negligence
Willful provision of inadequate care
Therapeutic Recreation Accountability Model
- Assessment
- Treatment plan
- Progress Notes
- Discharge/referral summaries
Focuses on accountability and documentation
4 Steps of Risk Management
- Identify
- Analysis
- Prevention
- Assessment
Therapeutic Service Delivery Model
- Diagnosis/needs assessment
- Treatment/ rehabilitation
- Leisure Education
- Health Prevention/ Health Promotion
Motivational Interviewing
Role motivation has to bring about change
Elements:
Collaboration
Evocation (Draw ideas out of clients)
Autonomy (clients responsible to make change)
Activity Therapy Model
Similar to the medical model but is a blurring of different departments
Experimental Learning Model
The process of making meaning from direct experience.
Experiential Learning is learning from experience.
The experience can be staged or left open.
Staged experiential learning is often called a Dynamic Learning Experience (DLE)
Kolb’s Model of Experiential Learning
Theory if Reasoned Action (TRA)
Derived from the attitude model
Can predict actions based on personal attitude and perception of how others will view them
Used as a basis for the practices of health education
Developed in the 1960’s
Tool for observing behaviour and developing interventions based on those observations
Person intention is the main factor
Intention is a function of attitude and subjective norm:
Attitude: concerns a person’s belief that their behaviour will produce a beneficial outcome
Subjective norm: whether key people in the person’s life support the behaviour, and whether the subject Is inclined to agree with them
Theory of Planned Behavior (TPB)
A persons intention of doing something is the main factor in determining whether he will actually do it
Behavior attention does not necessarily result in action
Builds on TRA by adding a their indicator of a person’s intent:
Perceived behavioral control: whether the person believes he can control the conditions necessary for change to occur
Transtheoretical Model
Six stages of behaviour change and advocated various interventions to keep clients motivated:
- Pre-contemplation - client does not feel they have a problem. (Interventions would involve making him/her aware of the problems)
- Contemplation - client admits a problem, but is still not sure if he/she wants to change. (Interventions would include encouraging the subject to make specific plans to change.)
- Preparation/commitment - client realizes a need to change and gathers information. (Interventions would include setting goals; awareness of the positives vs. the negatives of change)
- Action - client follow a plan for change behaviors.
(Interventions involve providing feedback and support.) - Maintenance - client sees the benefits of the new behaviors. (Interventions including helping in case of relapse; continues feedback and support)
- Termination - client can’t imagine ever doing the old behavior. (Interventions include proving help when needed and continuing to offer support.)
Therapeutic Milieu Model
Where every person & interaction can be therapeutic.
Everyone has equal impact.
Emotional problems are often the product of unhealthy interactions with one’s environment
Staff are organized as a caring community
Primary therapist = most effective relationship
Rehabilitative Model
Activities of Daily Living: Activities related to personal care
These Include: bathing, showering, dressing, getting in and out of bed or a chair, using the toilet, and eating
A plan of care must be developed that allows for meeting both the physical and psychosocial needs of the client/patient
Two types of goals:
- Rehabilitative - the goal of restoring independence
- Habilitative - helping the person function at their highest level
Optimizing Lifelong Health Model
Therapeutic recreation specialists work with individuals who have illness, disease, and/or lifelong disability to achieve and maintain leisure lifestyles that will enhance their health and well-being across the life course.
Through the elements of o selecting o optimizing o compensating o evaluating
Havighurst developmental tasks
Early childhood: learn walking, toilet, talk
Middle childhood: school related skills, conscious + values, independence
Adolescence: skills for occupation, emotional independence, social role
Early Adulthood: life partner, establish family, +career, take care of a home
Middle Adulthood: civic + social responsibility, maintain standard of living, caring for teens, adjust to physiological change
Late Maturity: Deteriorating health, retirement, loss of spouse
Health Belief Model
Predicts health behavior w/ understanding that people take health action to avoid negative outcome.
CTRS credential
Rectified every 5 years
Recertification requires 50 hours of continuing ed and 480 total hours of work
Diverging
Concrete experience and reflective observation
Assimilating
Abstract conceptualization and reflective observation
Converging
Abstract conceptualization and active experimentation
Accommodating: concrete experience and active experimentation
Accommodating
Concrete experience and active experimentation
Kolb Model
Acquiring knowledge through grasping experiences and transforming that experience into knowledge through cognitive process and perception
Pseudohypertrophic (Duchenne) muscular dystrophy
Enlargement of muscles by fatty infiltration, which causes contractors and deformities of joints
Progresses rapdily
Facioscapulohumeral (MD)
weakness in upper arms, shoulders angled forward, and lack of facial mobility
Limb Girdle MD
weakness of proximal musical of the pelvic and shoulder girdles
Oculopharyngeal MD
weakness of eyelid muscles and throat muscles
FIM
Purpose: make measurements and data on disability and rehabilitation
Level 7 = complete independence;
Level 6=modified independence;
Level 5= client requires supervision or set up;
Level 4= minimal contact assistance, client performs 75% or more of the task;
Level 3= moderate assistance, client performs 50-74% of task;
Level 2=maximum assistance, client performs 25-49% of task;
Level 1= dependent/total assistance, client performs less than 25% of task;
Pre transfer assessment should include
Physical, cognitive and emotional status
Screening child for hearing loss
0-6 months: Otoacoustic emissions or auditory brain stem response
6-24 months: visual reinforcement audiometry
2-5: conditioned play audiometry
5+: standard audiometry
PPO
Provides discounted rates for those on medicare who have agreed to accept medicare assignment
COPD
Progressive airflow limitation.
Inflammatory response that causes a narrowing of the peripheral airways and a thickening of the vessel walls of the pulmonary vasculature.
Exertional dyspnea and chronic cough.
Mini-Cog Test
Assesses dementia
Remember and repeat common objects and draw a clock face with a time
MMSE
Assesses dementia w/ a series of tests (remembering names, counting backwards, providing location, copying shapes and following directions
Digit Repition test
Assesses attention
ASIA (American Spinal Injury Association) Impairment Scale
Used to classify the degree of Spinal Cord Injury and degree of strength of 10 key muscles
WHODAS
Psychiatric assessment
Global Assessment of Functioning GAF
This is considered one of the most often used scales for assessing impairment in clients with psychiatric disorders. Mental health and social work practitioners use it during patient or caregiver interviews. It is a helpful tool for tracking individual patient’s clinical progress.
Global Deterioration Scale
also called the Reisberg Scale, to measure the progression of Alzheimer’s disease. This scale divides Alzheimer’s disease into seven stages of ability.
Ohio Scale of Leisure Functioning
Evaluation for recreational therapy
Individuals with MR/DD
Purpose: To obtain functioning levels
Measures 3 areas: functional skills, behavioral skills, and social/communication skillsd.Used specific activities to assess area
