assessing strengths in tr/rt: tools for positive change part i

Assessing Strengths in TR/RT: Tools for Positive Change Part I

Dr. Lynn Anderson, CTRS, SUNY CortlandDr. Linda Heyne, CTRS, Ithaca College

2014 ATRA Webinar L1October 1, 2014

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. These webinars (Part I and II) focus 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 TR/RT toward strengths-based practice by giving them practical tools for positive change.

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Webinar Outlines

Webinar L1: Part I (today)

Webinar L2: Part II (October 8)

• Introduction and brief overview of the strengths approach• A model and framework for assessment in strengths-based TR/RT practice• The ecological approach to strengths-based assessment• Tools for assessment of internal and external strengths: Leisure Domain• Tools for assessment of global outcomes of TR/RT services: Well-Being• Questions, discussion

• Brief overview of the strengths approach and a framework for assessment from Part I• Tools for assessment of internal and external strengths: Psychological/Emotional Domain• Tools for assessment of internal and external strengths: Cognitive Domain• Tools for assessment of internal and external strengths: Social Domain• Tools for assessment of internal and external strengths: Physical Domain• Tools for assessment of internal and external strengths: Spiritual Domain• Questions, discussion

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Session Objectives

Define the strengths approach in health, recreation, and human services and its impact on practice

Compare and contrast TR/RT assessment from a strengths versus a deficits approach and identify important differences

Identify internal and external strengths and at least six assessment tools to measure and describe them, using an ecological approach

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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)

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Deficits versus Strengths ApproachDeficits 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) 6

Deficits versus Strengths ApproachDeficits 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) 7

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 strengthsExternal strengths and resources

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Internal Strengths

– Aspirations and goals – Interests and preferences– Passions– Talents– Skills and competencies– Knowledge– Character strengths and

virtues

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External Strengths & Resources

– Family support – Social support, friends– Community resources– Home resources– Opportunities for

participation and contribution

(inclusive communities)– High expectations and

positive attitudes

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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

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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

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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

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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?”

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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 facilitatorsBehavior problems Social competenceDepression, 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

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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

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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.

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Definition of AssessmentAssessment 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.

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Principles in Strength-Based Assessment

Assessment ……is strengths-based and person-centeredis individualized, based on the participant’s world viewfocuses on well-being and quality of life through leisureis based on the aspirations and goals of the participantuses multiple methods and seeks to understand multiple variablesalways involves the participant and his or her circle of supportlooks at the whole person in her or his environment (authentic and ecological)

Assessment is a treasure hunt!19

Ecological Approach to Assessment

Participants viewed as part of their larger environmentsSearch 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 lifeUnderstand 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

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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

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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

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What to Assess:Use Strengths-Based Models as an Assessment Framework

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Other Models to Frame Assessment

Leisure & Well-Being Model

ICF

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Domains for AssessmentDomain Outcome for ParticipantsLeisure 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.”

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Domains for AssessmentDomain Outcome for ParticipantsPhysical 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

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Domains for Assessment:

LeisureOutcome for Participants

“I find enjoyment in my leisure experiences and they positively impact

other areas of my life.”

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Leisure Diagnostic Battery

Leisure Diagnostic Battery

– Assesses an individual's "leisure functioning”

– Perceived freedom in leisure

Perceived Leisure CompetencePerceived Leisure ControlLeisure NeedsDepth of Involvement in Leisure Playfulness ScaleBarriers to Leisure Involvement Knowledge of Leisure Opportunities TestLeisure Preference Inventory

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Discover Your Passions Interview

Interview questions designed to ascertain what most interests and excites a participant in leisureFor 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?

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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”

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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 comfortableFamily 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

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PEAT

Pittsburgh Enjoyable Activities Test– A brief index that assesses

the frequency of engagement in a spectrum of enjoyable activities that could be done alone or with others, in an array of locations, and are both active and inactive

– Breathers and restorers

We are interested in how often in the last month you were able to spend time in activities that you enjoyed. Over the past month, how often have you been able to spend time doing the following?

Never ……. to ……………Every day

Pressman, S., et al. (2009). Association of enjoyable leisure activities with psychological and physical well-being. Psychosom Med., 71(7): 725–732

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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)

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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.

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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

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IAT Checklists, User Manual, and Tool Kit

60” circle

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Leisure Resource Asset Mapping

Creates a visual map of the recreation resources available to a participant

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Domains for Assessment:

Overall Well-BeingOutcome 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

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Satisfaction with Life Scale

Measure of general life satisfaction

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Subjective Happiness Scale

A single composite score for global subjective happiness

Available online and in pdf on Positive Psychology Lab website

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WHO Quality of Life Scale

This questionnaire asks how you feel about your quality of life, health, or other areas of your life. Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your life in the last two weeks.

Physical health Psychological Social relationships Environment

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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

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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

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NEXT WEEK!Assessing Strengths in TR/RT:

Tools for Positive Change Part II

2014 ATRA Webinar Session L2October 8, 2014

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Questions?

lynn.anderson@cortland.edulheyne@ithaca.edu

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