Implementation Flashcards
Modalities/Interventions
dependent on client population, needs of the client, agency philosophy, and program
Leisure skill development
-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)
Leisure education
-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
Relaxation techniques
-can help clients understand and manage stress
-deep breathing, progressive relaxation, creative visualization, autogenic training, tai chi, yoga, meditation, and stretching
Coping
-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
Social Skills
-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
Reality orientation
-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
Cognitive (retraining) rehab
-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
Sensory training/stimulation
-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
Validation intervention
-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
Community reintegration
-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
Facilitation
-method or procedure used to intervene with client problems or needs
-combination of activity and CTRS interaction skills to facilitate change
Interpersonal skills
-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
Strengths-based approach
-being aware of client’s strengths along with their weaknesses allows CTRS to utilize those strengths and build upon weaknesses
Palliative care
-focuses on providing relief from the symptoms and stress of a serious illness
-goal is to improve quality of life
Modality vs intervention vs facilitation technique
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)
Behavior management techniques
-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
Counseling skills/communication skills
-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;
risk management
-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
Risk Management steps
- risk identification=identify all potential risks that could occur in the facility with equipment or during program to employee, patient, or family member
- risk evaluation=reviewing and evaluating errors and threats and analyzing them as low, medium, or high risks
- risk management strategies=ways to control consequences of risks
- risk management implementation and reporting=written up in policies and procedures manual, implemented, and effectiveness evaluated
Quality improvement
- seeking out problematic areas that lower quality
- correcting those problems
- evaluating how well those corrections are solving the program
Effective evaluation plan
-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
Performance improvement
-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
Utilization review
looking at how effectively a department uses its resources (over utilization, underutilization, and inefficiency)
Outcome monitoring
-outcomes=differences that occur in a person from when they begin treatment or enter facility to when they leave
-hoped changes will be positive
Outcome measurement
-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
Efficacy
-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
Active listening techniques
- paraphrasing: when a person reads or actively listens to a message and is able to clearly express it back in their own words
- 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…”
- perception checking: state what you perceive the other to be experiencing “I want to understand your feelings…is this how you feel about it?”
- 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
- 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
- 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
- confronting:
- informing:
- self-disclosing: sharing personal information
- summarizing:
Motivational Interviewing
3 elements:
1. Collaborative
2. Evocative
3. honoring client’s autonomy
Tuckman stages of group development
- 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)
- Storming: resistance, lack of participation, conflict, competition, high emotions, starting to towards group norms (leader can normalize matters and encourage leadership)
- 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)
- 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)
- 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)
STAR safety measures
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
Remotivation
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)
