Conceptualization of a Comprehensive Therapeutic Recreation Program

Activity Title:  Beam with Self-Esteem!

Leisure Ability Model Focus:  Leisure Education

Activity Description:  Do you find yourself cringing at the sight of a mirror? Do you think you are ugly or worthless? Well you are not. Come to Beam with Self-Esteem to find out what makes you beautiful and worthwhile!

Client Goals: 

Participants will:

• Discuss what makes a person beautiful
• Identify someone they admire and write down why
• Learn about themselves and what is important to them
• Identify positive self-talk, activities, or steps that participants can do, say, or practice on a regular basis to help become more comfortable with their self-image or self-esteem

Facility / Space Needed:  Aclass room or quiet room that can fit a circle of chairs

Staffing needs:  One CTRS and maybe one aide

Equipment / Supplies Needed:

• Pictures of different people such as models and celebrities of different body types
• White board/chalkboard or something to write on for the class to see
• Journals for everyone in the class (unless they are told to bring their own)
• Christina Aguilera’s “Beautiful” and a music player or Ipod speakers to play it.

Is beauty in the eye of the beholder?  Is it all about physical appearance?  How much about a person’s “inner core” is what makes them beautiful?

Brainstorm and discuss answers to these questions as a group and write them on the board.

What do you do to make yourself look “beautiful”?  What makes you feel “ugly”?  Why?

Ask questions about them

During our next session we will be following up on the topic of the importance of positive self-esteem.

“You are beautiful no matter what they say
Words can’t bring you down
You are beautiful in every single way
Yes, words can’t bring you down
Don’t you bring me down today…

No matter what we do
No matter what they say
When the sun is shining through
Then the clouds won’t stay

And everywhere we go
The sun won’t always shine
But tomorrow will find a way
All the other times”

I will be here if anyone has any questions or wants to talk to me privately, otherwise have a good weekend!

Leisure Ability Model Focus:  Leisure Education

Activity Description:  Are you stressed out? Then let the Stress Out! This program consists of a facilitated small group discussion on what causes stress, and how leisure can help to alleviate stress, and how to prevent negative stress.

Client Goals:

·         Recognize physical and emotional impact of stress

• Identify the aspects of their own life that cause them stress
• Brainstorm ideas on how to alleviate the anxiety of stress with a leisure activity that they enjoy
• Learn how to prevent stress by using leisure

Facility / Space Needed:A room that can have chairs in a circle for group discussion

Staffing needs:  One CTRS and possibly one aide

Equipment / Supplies Needed:

• Music player
• Journals
• White board/chalkboard for brainstorming
• Accessible chairs

2 min

15 min

5 min

Hello, my name is Nicole Wells and I will be facilitating the activity of Stress Out! today.

I want everyone to sit in their chairs comfortably and close your eyes.  If you do not feel comfortable closing your eyes you do not have to.  Now take a deep breath in through your nose (inhale) and out through your mouth (exhale).  Now again, in through your nose and out through your mouth.  Now take all the things that are bothering you today, yesterday, this week or this year whatever is bothering you and visualize it in your mind take it and roll it up in a ball get it all tight into a ball and now I want you to take that ball in your hand and throw it as far as you can away from you right now.

Now there should be nothing in front of you and nothing on your mind just a blankness, nothing. Relax all the muscles in your body.  Relax your feet, your calves, your thighs, your butt muscles, you stomach muscles, back, arms, and lastly, lead your head sit comfortably upright or carefully let it fall in front of you.

Now, listen to the sounds around you… *the hum of air conditioner, the faint talking outside the room, the birds chirping outside… and now think of your favorite place to be.  The place you would want to run to because it always makes you feel safe. Go to that place. What does it look like? What does is smell like? What does it sound like? How do you feel when you are in this place?

Listen again to the sounds around you and come back to this room in *118 Sackett

When you are ready, slowly open your eyes.

How do you guys feel right now? Let’s go around the room and don’t be afraid to say that you didn’t feel anything from it.

Once everyone is in the room and sitting down, start the activity. Talk in a calm and soothing tone of voice.

If all goes well the participants will either clearly visualize this happening or they may even physically do the motion.

Throughout this entire monologue take pauses and speak in a fluid, soft, relaxing, voice. DO NOT RUSH through it.

*whatever the actual sounds of the room and atmosphere are

Take a few seconds before you get to the next part allowing the participants to really discover and enjoy their special spot.

Replace with whatever room/place the program is taking place.

The participants may need a few seconds to orient themselves with reality (if they have really invested themselves in it)

Go around the circle and participants will describe how they feel. This activity may not work for everyone.

Does anyone want to share where they went when I said to go to a safe place?

Someone if not more than one person should volunteer where their safe place was and discuss why they chose that place.

5  min

15 min

10 min

5 min

Did that exercise help to relax anyone?

It may not work for everyone and it may take a few times to have your brain get fully engaged. However, for those of you in which this did work, you can see how much it affects you. This affect is all about your brain which is the same thing that happens with stress. Stress acts as a mental impairment that can result in affecting you physically as well.

Obviously you all are here because you know that you suffer from stress and you want to get better. The fact that you have come to accept this issue is the first step in solving the problem. As I said, stress all starts in the brain and how you handle stress can greatly affect you mentally and physically.

So now I want you to write down in your journal the biggest aspects of your life that cause YOU to stress. Branching out from the stressors write down what you do to help alleviate the stress or how you deal with it.

Now let us brainstorm together some ideas on how we handle stress. What are ways that you deal with stress? Good or bad?

Now let’s look at this list and talk about which of these are positive ways to handle stress and which ones are not beneficial ways to handle stress.

As you can see from our brainstormed ideas on the board, leisure activities are a great way to alleviate stress. So right now in your journal write down at least 2 leisure activities you do or used to do that you really enjoyed.

What are some people’s leisure activities? How often or when was the last time you were able to do this activity?

You may think you don’t have time for leisure activities; however, leisure time is very imperative to your life because it can actually alleviate and prevent stress.

Therefore, from now until the next time we meet I want you to make time to practice at least one of these leisure activities and either take note of how it makes you feel in your journal or make a mental note of it so that we can discuss it next time.

Thank you for coming to our session of Stress Out today! I look forward to seeing you at our next group session on (date) at (time) at (location).

During our next session we will be following up on the topic of the importance of positive leisure to reduce and prevent stress. We will also focus on tactics on how to relax and calm yourself down when you are stressed.

I will be here if anyone has any questions or wants to talk to me privately, otherwise have a good afternoon!

Hopefully some people say yes

Let the participants be creative in how they write down their stressors in their journal.

Write down on the board all the things that the participants throw out there such as smoking, running, crying, etc.

By throwing out ideas onto the board, people forget who put up which idea and it is generalized for everyone the do’s and don’ts of handling stress. Put a + sign next to the positive ways to handle stress and a – sign next to the bad ways

Make sure the participants bring home their journals.

Background / Demographic Information:  Caroline is a well educated trial lawyer and senior partner. She is married and lives with her husband and most recently her two teenaged step-children.

Current Diagnosis:  Major depressive disorder with associated anxiety

Referral to Therapeutic Recreation Services:  Received referral for therapeutic recreation services from her psychologist, Dr. Kincaid.

Identified Strengths / Assets: 

·         Though patient has had suicidal thoughts, she has never attempted suicide.

·         Patient has a strong positive relationship with her husband

·         Patient has accepted the fact that she is in need of help

·         Patient continues to jog, but less frequently than she used to

·         Patient continues to work and support the family income

Identified Limitations / Problems / Assessment Results:

·         Patient shows low self-confidence, has suicidal thoughts, and feelings of failure and inadequacy.

·         Patient shows continual weight loss, electrical charges in her upper body, fatigue, insomnia, and gastrointestinal problems.

·         Patient feels out of control, overwhelmed, stressed, and depressed

·         Patient is experiencing social withdrawal and is hiding her problems from her co-workers

·         Patient is having difficulty sustaining concentration

·         Patient abandoned her main recreational activities of collecting music and reading mysteries. She needs help to find happiness in pursuing them again.

·         Patient does not have the option to leave work because her husband and herself both share substantial weight in their income.

Client Goals & Objectives:

1.      General goal:  Functional Intervention (FI)

To provide services that will improve clients’ physical fitness, emotional control, social skills, and mental stability.

Measurable objective:  After two weeks of active participation, the client will show signs of relaxation and calmness as observed by the CTRS.

2.      General goal: Leisure awareness (LE)

To provide services to help clients understand the relationships between leisure, health, and quality of life.

Measurable objective: After completion of the program, the client will plan out a weekly schedule time for work, household maintenance, and personal leisure as judged by the CTRS.

3.      General goal:Leisure activity skills (RP)

To provide opportunities for clients to freely engage in healthy leisure activities.

Measurable objective: When given an opportunity, the client will choose to engage in a recreational activity of their liking, as judged by the CTRS.

Action Plan for Client Involvement:

1.      Enroll patient in “Stress Out!” (learning and realization focus) Mondays from 3-4pm from 4/12 to 5/3. Focus on:

a.       Recognizing the physical and emotional impact of stress

b.      Identifying the aspects of their own life that cause them to stress

c.       Brainstorm ideas on how to alleviate the anxiety that stress brings on with a leisure activity that they enjoy

d.      Learn how to prevent stress by using leisure

2.      Enroll patient in “Guided Imagery” (treatment and leisure education focus) Wednesdays 4:00 to 5:00PM from 4/14 to 5/6. Focus on:

a.       Learning what imagery is how the process of guided imagery works

b.      Being able to relax and alleviate pain through imagery

c.       Being able to see if guided imagery does in fact work for them as a pain/stress reliever/relaxer

d.      Seeing images and find things in their mind that may help them in the healing process

3.      Enroll patient in “Yoga” (physical health focus) Tuesdays and Thursdays 8:00 to 9:00 PM from 4/13 to 5/7. Focus on:

a.       Learning the basic positions

b.      Demonstrating breathing techniques

c.       Becoming mentally relaxed

d.      Learning the benefits of yoga