chapter 3 facilitation techniques hpr 450. facilitation techniques (interventions) from austin text...

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Chapter 3 Facilitation Techniques HPR 450

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Chapter 3Facilitation Techniques

HPR 450

Facilitation Techniques (Interventions)• From Austin text chapter 3• We will not cover all in depth• Presentation later this month allows

opportunity to research in greater detail• I will try to focus on those you are most

likely to encounter and/or those you may be most likely to introduce/use in settings

• For CTRS exam, a general familiarity/ability to define and to differentiate is probably sufficient – For practice more knowledge and ability is needed

• Review and begin to consider what you would prefer to use for presentation

• Note that there are broad categories but some techniques belong in multiple categories

Leisure EducationTo be covered more in-depth later in semester

Learning about leisure-related information, values, attitudes, skills

Used to be called “Leisure Education” or ‘Leisure Counseling” – now just Leisure Education

IncludesLeisure appreciation Leisure Activity SkillsSelf-Awareness Community SkillsDecision Making Social SkillsSelf Determination Leisure

Resources(Dattilo and Williams, 2000)

Values ClarificationTechnique used to help clients make

decisions consistent with their valuesValues – Deeply held beliefs about truth,

beauty or worth of a person, object, idea or action

V C activities could include Pie of Life20 Things You Love to doSpending an Unexpected Free Day

Media or Culture Therapies• Cinematherapy – movies (easier to watch

than read book)• Bibliotherapy – novels, plays, short stories,

pamphlets to show clients others have similar problems– Choose works that are appropriate for client– Discussions following movie or reading can

reveal unexpected interpretations by clients– Goals: develop self-concept, foster self-appraisal,

relieve emotional or mental pressure, provide a means to find interests outside ones self, more on pg 71 (Jake, 2001)

Media or Culture Therapies cont’dComputer/internet/technology therapy

Wii or other gamesHow can you use computers or the internet for

TR/RT?Would social networking be good for your

clients? Why or why not?Music therapy – (listening, not performing)Theater therapy – dittoMuseumotherapyAny other ‘experiences’ (passive) of art and

culture

Horticulture TherapyPlants – small/indoor under lights, window

sill, outdoor gardens, greenhouseRaised and rolling gardens, rooting house

plants, using flowers, plants, etc with craftsGoals: Instill a sense of purpose, life

satisfaction, mild to moderate exercise, interaction with environment, enjoy beauty, develop leisure activity, etc (see pg 74)

Relaxation Techniques/Stress Management• 67% of adults report experiencing

“great stress” weekly• Is relaxation a skill? Can it be acquired,

learned or mastered?• Do RT/TR practitioners need to be able

to help clients relax?– Relaxation as an activity in itself– Relaxation to help clients with other activities• Social stress• Performance nerves• Stressful (unfamiliar, new) situations

Relaxation Techniques/Stress Management

• Massage– Should obtain training; many TR/RTs are certified

massage therapists• Self-massage– May be more appropriate with some clients

• Deep Breathing– As an activity or with activities (Yoga)– Belly breathing (Yoga or singing)

• Alexander Technique (not from text)– Focus on improper posture and positioning as root

of many physiological disorders. Working on proper alignment

• Progressive relaxation– Progressive muscle relaxation. Also used in Yoga

Relaxation Techniques/Stress Management

Transcendental Meditation® (maybe)TR/RT should have training or become familiar

with techniques before teachingCannot teach TM® without specific trainingOther methods covered in books

Qigong (chee goong)Instructor guided relaxation combining postures

and visualizationVisualization/Creative Visualization

Also a means of assertiveness training

Physical/Activity TherapiesMental and physical benefitsVigorous or moderate?

Current thinking is moderate better than nothingHow long, how often

Current thinking is some is better than noneFear that asking people to do too much will

result in people not doing anything

Physical/Activity Therapies Recommendations for 30 mins moderate,

non consecutive, per day“Paradigm shift” in book may or may not be a

good or appropriate thingThink about what bodies are ‘engineered’ to doModern society demands less and less

movement or activity – is it a good idea to recommend less and less physical activity?

That said, moderate to vigorous activity can be achieved through many means – yard work, housework, gardening, other hobbies

Adventure TherapyElements

Active engagement in risk or adventure activityIndividuals may be seeking changeNovel nature of activity creates “disequilibrium”Environment emphasizes community and

cooperationDemand of problem solvingPerception that activity is challengingFeelings of accomplishmentChanges occur based on processing

(generalization of these experiences to other things in their lives)

“Adventure” Therapy cont’d Ropes courses

Non competitive, teamwork, etcHow often can you do this and have it be

fresh/effective?Critical to have trained leader and appropriate

‘processing;’ otherwise the experience loses much impact

Outdoor adventure interventionsCamping, hiking, etc.May make great progress during event but when

real life is very different, ultimate success of intervention may be questionable

Sensory TherapiesAromatherapy

Using scent to promote relaxationMassage or bathsTraining, familiarity with essential oils – can be

caustic/dangerous in pure formsSensory training

For children with perceptual-motor problems, older adults who are disoriented

Stimulus bombardment directed at all 5 senses; interactive with discussions

Hope is to improve individual’s perception and alertness in responding to environment

Sensory Therapies cont’dSensory Stimulation

Treatment for TBI patients in comaMultimodal (all senses at once) unimodal (only

one sense per session); very high degree of stimulation

Looking for any patient reactionMay reduce depth and duration of coma

Creative Arts (doing, not passive)Painting, drawing, sculpture, photography,

music (drum circles!), theater, creative writing (poetry, journaling, fiction), jewelry making, etc.Provides means of self-expressionMay be easier, ‘safer’ way to communicateMental health and physical health (gross, fine

motor skills)VSA – here and elsewhere

Social Skills TrainingActivities that help people develop or

improve their skills for dealing with social situations

Uses classroom instruction, modeling, demonstrations, and role play with social reinforcement as a reward

Helps develop skills that help individuals with other aspects of life, including leisure/recreation participation

May benefit chemically dependent, developmental disabilities, residents in long-term care, some mental health (depression, children with learning disabilities

Assertiveness TrainingTherapy that helps people become more

assertive (not aggressive) in social situations

Role playing, modeling, reinforcement, practice in ‘safe’ and controlled settings

Helps people change habits and behaviors and learn to stand up for their legitimate rights, leads to improvements in self-esteem

Can benefit anyone with a deficit in this area

Cognitive Rehabilitation• Multi-disciplinary interventions using varied

activities that use client’s cognitive and/or motor functions

• Uses games, activities, outings, anything that appropriately combines cognitive and motor activities

• Ideally will improve cognitive functioning and lead to neuropsychological recovery

• For individuals with ABI including TBI

RemotivationTechnique used with small groups to inspire

interests of participantsUses weekly group meetings to promote

discussions of topics that may bring participants in closer touch with the world beyond the institution

Goal is to reawaken interests in facility residents for things that brought gratification in the past and may lead to sense of control over leisure activitiesSelf-selection of activities found to help replace

feelings of helplessness with feelings of mastery or control

Used with moderately confused elderly in facilities

Resocialization Small group format to combat isolationism and

to improve satisfaction Groups meet 3 times weekly with staff

member/leader who tries to maintain a free and accepting atmosphere

Goal is to increase social functioning of residents in geriatric settings by increasing awareness of self and others by helping clients to form relationships and friendships and to discover new interests

Used in geriatric facilities

Validation Therapy Developed by Naomi Feil in response to

RO to meet the social and psychological needs of primarily disoriented individuals

Therapists use empathy and acceptance in dealing with clients – maintain eye contact, rephrase while responding, speaking in a caring tone of voice

Help clients regain dignity, reduce anxiety, accept their own ‘reality’ without trying to correct them (as RO does)

Persons with Alzheimer’s type dementia