Implementation

Question 1

Modalities/Interventions

Answer 1

dependent on client population, needs of the client, agency philosophy, and program

Question 2

Leisure skill development

Answer 2

-important component of leisure education
-leisure skills range from traditional leisure activities (sports, arts and crafts, mental games and activities) to non-traditional (shopping, spectator and audience behavior, pets)

Question 3

Leisure education

Answer 3

-assists people in regaining a fulfilling leisure lifestyle and to understand the importance of leisure in their life or gain a new leisure skill
-often forgotten when clients in hospitals or health care agencies and is needed when patient returns home
-can help clients understand importance of using leisure wisely, developing a healthy leisure lifestyle, expanding their knowledge of leisure activities, and developing new skills
-can help them learn how to adapt activities or determine any specialized equipment needed to participate
-can help with learning about and utilizing leisure resources to community resources or even activity opportunities

Question 4

Relaxation techniques

Answer 4

-can help clients understand and manage stress
-deep breathing, progressive relaxation, creative visualization, autogenic training, tai chi, yoga, meditation, and stretching

Question 5

Coping

Answer 5

-deliberate process and not an automatic adaptive behavior
-diversional activities can help people learn to cope with stressors
-exercise can help reduce tension and cope with stress
-reliance on social support systems can help cope

Question 6

Social Skills

Answer 6

-used frequently with ASD, psychiatric impairments, ID, TBI, and many more
-difficulty understanding importance of friendship and how to make friends, use of manners, etc.
-important for CTRS to teach clients social skills since many rec activities are in social environments
-techniques include modeling, role playing, social reinforcement, homework to practice in real-life situations

Question 7

Reality orientation

Answer 7

-older adults who are confused, disoriented, and have memory loss
-can occur all day through use of a reality orientation board with time, place, day of the week, date, next meal, next holiday, etc.
-can also be run as group with CTRS where they review facts on the board using activities to diminish confusion with various aspects of daily living

Question 8

Cognitive (retraining) rehab

Answer 8

-TBI or CVA
-helps person work on regaining some of the cognitive processes such as memory or sequencing that were injured or impaired
-games and crafts that rely on planning skills and decision making are used in cognitive retraining groups
-teaches people variety of compensatory strategies such as memory techniques or assistive devices to keep track of information

Question 9

Sensory training/stimulation

Answer 9

-bombard senses with variety of stimulants
-dementia or children with DD or neurological deficits
-use sensory cues to relate to familiar life activities
-any of the senses is selected, and the individual is expected to relate that experience to environment or a memory

Question 10

Validation intervention

Answer 10

-dementia
-does not try to orient them to reality but to accept feelings and assist older adult in resolving unfinished business/conflicts experienced earlier in life
-simple techniques for adult to accept people who are confused or disoriented for where they are right now and to use good listening and communication skills
-allows older adult to express their feelings, acknowledge their life through reminiscence, and come to terms with their losses

Question 11

Community reintegration

Answer 11

-used in almost every setting by CTRS
-resuming roles and activities, including independent or interdependent decision-making and productive behaviors with family and social supporters in natural community settings
-many clients have issues returning to the community, either social or cognitive, and issues may be dealing with architectural issues that are new to client
-often reimbursable program for TR

Question 12

Facilitation

Answer 12

-method or procedure used to intervene with client problems or needs
-combination of activity and CTRS interaction skills to facilitate change

Question 13

Interpersonal skills

Answer 13

-in a helping relationship is most important to facilitate interventions
-require practice and include things such as inviting requests and responding with information, being able to listen and actually hear a client, and providing active listening
-CTRS must communicate sense of caring or warmth to the client

Question 14

Strengths-based approach

Answer 14

-being aware of client’s strengths along with their weaknesses allows CTRS to utilize those strengths and build upon weaknesses

Question 15

Palliative care

Answer 15

-focuses on providing relief from the symptoms and stress of a serious illness
-goal is to improve quality of life

Question 16

Modality vs intervention vs facilitation technique

Answer 16

Modality=activity (horticulture, crafts, games)
Intervention=broad category of type of intervention (behavior modification, social story, peer engagement)
Facilitation technique=specific things you do to facilitate change (positive verbal reinforcement, visual cuing)

Question 17

Behavior management techniques

Answer 17

-behavior modification and coping skills
-positive reinforcement=provision of reinforcer that causes behavior to be repeated (attention, food)
-Punishment=decreases repeat behavior
-modeling =demonstrating desired behavior combined with reinforcement causes the client to want to repeat the behavior
-time outs, token economies

Question 18

Counseling skills/communication skills

Answer 18

-effective communication is important with clients
-active listening=lets them know you heard what was said; both verbal and nonverbal
-nonverbal=eye contact, posture, gestures
-verbal=”uh-huh”, I see;

Question 19

risk management

Answer 19

-every department needs plan for each service area and program
-involves loss prevention and control, handling all incidents, claims, and other insurance or litigation-related tasks

Question 20

Risk Management steps

Answer 20

1. risk identification=identify all potential risks that could occur in the facility with equipment or during program to employee, patient, or family member
2. risk evaluation=reviewing and evaluating errors and threats and analyzing them as low, medium, or high risks
3. risk management strategies=ways to control consequences of risks
4. risk management implementation and reporting=written up in policies and procedures manual, implemented, and effectiveness evaluated

Question 21

Quality improvement

Answer 21

1. seeking out problematic areas that lower quality
2. correcting those problems
3. evaluating how well those corrections are solving the program

Question 22

Effective evaluation plan

Answer 22

-created by CTRS
-focus on client assessment, treatment plans, specific intervention techniques used, patient safety or risk management, staff training and continuing education
-identify how to collect data
-collects data
-analyzes data
-makes identified changes in patient care

Question 23

Performance improvement

Answer 23

-focuses on quality of the process used in delivering services to the quality of the outcomes produced
-seen as a total management process that should be integrated into the overall operations of the agency on a daily basis

Question 24

Utilization review

Answer 24

looking at how effectively a department uses its resources (over utilization, underutilization, and inefficiency)

Question 25

Outcome monitoring

Answer 25

-outcomes=differences that occur in a person from when they begin treatment or enter facility to when they leave
-hoped changes will be positive

Question 26

Outcome measurement

Answer 26

-being more discussed than monitoring
-Joint commission has 3 outcome measure categories:
1. Health status (functional well-being of an individual
2. patient perceptions of care (satisfaction measures of care from patient or family perspective
3. Clinical performance outcomes (outcomes of processes of care)
-CTRS need to understand outcomes and be able to support positive outcomes as a result of their treatment

Question 27

Efficacy

Answer 27

-improvement in health outcome achieved in a research setting, in expert hands, under ideal circumstances
-this research usually done to determine effectiveness of an intervention with a particular diagnosis

Question 28

Active listening techniques

Answer 28

1. paraphrasing: when a person reads or actively listens to a message and is able to clearly express it back in their own words
2. clarifying: reflecting on the broader context of what you understand the speaker to be saying and often comes in the form of a question “what do you mean by…”
3. perception checking: state what you perceive the other to be experiencing “I want to understand your feelings…is this how you feel about it?”
4. probing: subset of clarifying; used to prompt a speaker to give more information or to explore a situation that is not clear to you as the listener
5. reflecting: reflecting or expressing to the other the essence of the content and feelings you hear as well as summarizing larger segments of what is said
6. interpreting: combine the visual and auditory information we receive and try to make meaning out of that information; we may begin to understand the stimuli we have received
7. confronting:
8. informing:
9. self-disclosing: sharing personal information
10. summarizing:

Question 29

Motivational Interviewing

Answer 29

3 elements:
1. Collaborative
2. Evocative
3. honoring client’s autonomy

Question 30

Tuckman stages of group development

Answer 30

1. Forming: questioning, socializing, displaying eagerness, focusing on group identity and purpose, sticking to safe topics (leader will take “lead”, provide clear expectations and instructions, quick response times)
2. Storming: resistance, lack of participation, conflict, competition, high emotions, starting to towards group norms (leader can normalize matters and encourage leadership)
3. Norming: reconciliation, relief/lowered anxiety, members are engaged and supportive, developing cohesion (leader can recognize individual and group efforts, provide learning opportunities and feedback, monitor the ‘energy’ of the group)
4. Performing: demonstration of interdependence, healthy system, ability to effectively produce as a team, balance of task and process orientation (leader can celebrate, ‘guide from the side’, encourage group decision-making and problem-solving, provide opportunities to share learning across teams)
5. Adjourning: shift to process orientation, sadness, recognition of team and individual efforts (leader can recognize change, provide an opportunity for summative team evaluations, provide an opportunity for acknowledgements)

Question 31

STAR safety measures

Answer 31

S=stop to concentrate on task at hand
T=think about best way to complete task
A=act to accomplish task
R=review success of or problems

Question 32

Remotivation

Answer 32

5 steps:
1. creating climate of acceptance (greetings)
2. bridge to reality (poetry reading)
3. sharing the world we live in (open-ended questions)
4. appreciation of the work of the world (sharing opinions and values)
5. climate of acceptance (summary and closure)