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Get Your
Leisure On!
Table of Contents
Implementation Description..4-12
Introduction...4-5
Population..5-7
Program Purpose7-8
Frequency..8
Implementation Description
Introduction
Leisure education has been one of the most used facilitation techniques used by
recreational therapists. It involves teaching and implementing recreation and leisure related
skills, attitudes and values (Dattilo & McKenney, 2011). In order for leisure education to become
a therapeutic medium it must meet clients needs and goals as well as, bring about a desired
change in the client. Not only does leisure education teach leisure skills, it also allows clients to
see personal barriers/leisure barriers and find ways to overcome those barriers. The overall goal
of leisure education is to assist individuals to gain an awareness about and learn to use leisure in
ways that improve the quality of their lives (Dattilo & Murphy, 1991).
There are four skill types that a recreational therapist should implement while facilitating
leisure education activities. These skill types include: leisure awareness, social skills, leisure
resources and leisure skills (Stumbo and Peterson, 2004). This program will focus more on
leisure awareness, social skills and leisure resources. It is important to touch base with the clients
on self-awareness, social skills, and community resources before teaching leisure related skills.
Before any kind of leisure can take place, the clients must know what leisure is. The recreational
therapists job is to bring knowledge about leisure to the client in order for the client to
successfully participate in leisure. The clients must be able to distinguish what their leisure
preferences and dislikes are in order to be more motivated in participating in leisure activities
and most importantly, be able to make their own decisions about what leisure activities they want
to participate in. Hand in hand with self-awareness, the recreational therapist must be able to
teach social and community skills to the client. Most leisure activities require social interaction
or going out into the community and finding leisure resources. The clients must have these
necessary skills before participating in activities. If these needs are not fulfilled, the clients could
most likely feel a sense of incompetency and have negative thoughts towards certain leisure
activities, leading to feeling less motivated to go out and participate in leisure activities (Dattilo
& McKenney, 2011). With the newly gained leisure awareness and social skills, the client will be
more inclined to go out into the community and participate in activities offered. Practicing
finding leisure resources would be beneficial for the client, especially by teaching the client how
to overcome certain barriers presented and how to use their own personal resources for leisure
opportunities.
Population
Shoreview VA Hospital serves the veteran community of Miami-Dade country, more
specifically the Homestead, Florida community. The recreational therapy department of
Shoreview VA Hospital is recognized for their work with veterans diagnosed with spinal cord
injuries, substance abuse, PTSD and those veterans with varying amputations.
Spinal cord injuries affect the communication between sensory and motor signals from
the spinal cord to the brain due to a lesion, most commonly caused by trauma (Jr,Frederick M
Maynard F.M., 1997). There are different classifications of spinal cord injuries depending on the
site of the injury. Tetraplegia affects the movement of arms, legs, trunk and pelvic regions.
Paraplegia does not affect the movement of the arms, but depending on the site of the injury, it
affects the movement of the legs and the trunk (Jr,Frederick M Maynard F.M., 1997). These
clients have a variety of physical limitations, as well as emotional impairments. In a study
performed by Kennedy, a population of people with spinal cord injuries were evaluated over a
longitudinal analysis and were found to have high rates of anxiety and depression due to their
accident (Kennedy, 2000). Physical impairments can include limited range of motion and
spasticity.
Amputations are classified as the surgical removal of a limb or body part due to trauma,
infectious disease, or congenital defect (Ajibade, Akinniyi & Okoye, 2013). Amputations can
also be classified due to the location of the amputation, such as under the knee, above the knee
and all other amputations. (Robertson & Long, 2008). Along with the physical impairments such
as limited range of motion, just like clients with spinal cord injuries, people with amputations
also can have depression and low self-esteem. In a study performed by Rybarczyk it was found
that the way the participants who had amputations felt about their body in a social context, were
found to have indicators of depression (Rybarczyk, 1992).
Post-Traumatic Stress Disorder, or PTSD, is a common diagnoses found in Shoreview VA
Hospital. It is defined as a person who has gone through a traumatic event causing significant
distress in a persons daily life (American Psychiatric Association, 2013). The DSM-5 has made
a clearer line as to what constitutes as a traumatic event, as well as the patient not having to show
signs of helplessness or intense fear due to the fact that it has been found that these two
stipulations have no effect on properly diagnosing PTSD (American Psychiatric Association,
2013). The DSM V has also subdivided the symptoms into the following categories: reexperiencing, avoidance, negative cognitions and mood, and arousal (American Psychiatric
Association, 2013).
Another psychological disorder commonly treated at Shoreview VA Hospital is substance
abuse disorder. Substance abuse disorder is defined as the recurrent use of alcohol and/or drugs
causing functional and clinical impairments in a persons day to day life (Substance Abuse and
Mental Health Services Administration, 2015). The DSM V recognizes 6 common substance use
disorders including alcohol use, tobacco use, cannabis use, hallucinogen use, opioid use and
stimulant use disorders. People who have PTSD and/or substance abuse disorders have been
found to have emotional and social impairments. In recent studies there has been proof that
veterans with PTSD have maladaptive patterns in social functioning including social anxiety and
violence (Frueh, B.C., 2001). People diagnosed with substance use disorders are diagnosed based
on social and emotional symptoms such impaired control, social impairment and risky use
(Substance Abuse and Mental Health Services Administration, 2015).
For all the treated disabilities, it has been found that there are physical, social and
emotional impairments that prevent veterans from fully being re-integrated into the community
as well as living a healthy leisure lifestyle. This program is dedicated to those veterans that are
diagnosed with psychiatric disorders such as PTSD and substance abuse disorder in order to
reintegrate the returning veterans into their community.
Program Purpose
The purpose of this program is to use leisure education on clients in order for them to
gain an appreciation for leisure in their life. This program will allow clients to see that by using
leisure, many aspects of their lives will be improved especially reintegration into society and
regaining emotional control. Clients will be taught how to find and use leisure resources that are
available to them, as well as, identify and overcome barriers that are presented. Clients will also
be taught how to express their feelings and thoughts in an appropriate manner, in addition to
appropriate social skills, in order to initiate and maintain social networks. The recreational
therapist will identify and target these social and emotional deficits through proper evaluation.
It has been found that people diagnosed with PTSD or Substance Abuse Disorder have
varying levels of social and emotional problems that lead to flashbacks or usage of substances. In
veterans diagnosed with PTSD it can be found they have a hard time feeling emotions and may
feel detached from others, causing problems with personal relationships. Those with PTSD also
tend to avoid situations that may remind them of their traumas leading to avoiding social
activities. Veterans with PTSD often struggle with intense anger and impulses and in order to
avoid such feelings, they avoid closeness or suppress those feelings (PTSD: National Center for
PTSD). PTSD is usually comorbid with substance abuse disorder or a way for veterans to cope
after coming back from war. Substance abuse has been linked to failing to maintain relationships,
initiating relationships that encourage use of substances, becoming violent, depression, etc.
(Social Effects of an Addiction - Drug Addiction).
Using leisure education on veterans with PTSD or Substance Abuse Disorder will allow
the client to focus on finding their preferred leisure lifestyle, changing the habits that they once
had into better and more productive habits. Leisure education will allow the veterans to gain
those social skills that they lost and use them to reintegrate into society in a much healthier way.
Frequency
Veterans in the Shoreview VA Hospital will participate in this leisure education program
for a total of 9 sessions. The sessions will be performed twice a week for 4 weeks, and the final
week will contain 3 sessions. Studies have shown that prolonged exposure to therapy has a
substantial effect on the person undergoing therapy, therefore, the sessions will occur for 60
minutes. The sessions will be determined to be one on one sessions or group sessions by the
recreational therapist, as well as what the activity designates.
Facilities and Equipment
Shoreview VA Hospital has two rooms dedicated to recreational use. The facilities are
equipped with the most up-to-date equipment available and are open enough to accommodate a
group of 15 people comfortably. If the activity requires a more open space, the facility has large,
grassy areas that the therapist can use if needed. The following items are provided and required
for the activities implemented in this program (any additional items will be mentioned in the
specific activity):
Paper
Pens/pencils
Desks/tables (enough to seat at least 10 people)
Chairs (enough for each table or desk)
Markers
Crayons
Colored Pencils
Velcro
Tape
Scissors
Glue
Erasers
Name tags
Staff
Shoreview VA Hospital has 2 CTRS certified Recreational Therapists employed, as well
as 2 recreational therapist assistants. The program will be implemented by the two therapists who
hold a CTRS certification, as well as a 4 year Bachelors degree. The therapists will have leisure
education experience and training. The recreational therapist assistants will also have to have a 4
year Bachelors degree, as well as some experience in leisure education programs. The RT
assistants will provide assistance to the CTRS when needed, or will be guiding the activities
under the supervision of the CTRS.
The recreational therapists will also have volunteers assisting with gathering materials
and setting up/taking down activities. Every 4 months there will be a new intern that will be
10
under the supervision of the CTRS. The intern will be required to observe and take action during
the program.
Evaluation
Program Evaluation
Evaluations are important to conduct in order to make sure that programs are constantly
being modified and improved, as well as for our clients to get the best service possible in order
for them to reach and improve their needs. Evaluations are also conducted to evaluate
accountability, what goals have been met, and the cost effectiveness of the program. Shoreview
VA Hospital goes under a numerous amount of evaluations, especially the recreational therapy
department.
The Shoreview VA Hospital Recreational Therapy Department will be undergoing
formative and summative evaluations. Formative evaluations are performed while the activity or
program are in progress. This allows the therapist to make improvements during the duration of
the program for the client to meet specific needs. This also allows the therapist to add or remove
certain aspects of the activity that will make the program more effective. Furthermore, the
formative evaluation allows the therapists to address any problems that may have gone unnoticed
while planning the program. The therapist performing the formative evaluation will be using the
Post Session Report form (Appendix A) after each activity session. Summative evaluations, as
the term coins, is performed at the end of each program. In the case for this program, it will be
conducted after every 9-session cycle. Summative evaluations are used to compare other
programs against one another as well as to provide information for the next cycle of the program.
The agency will be able to look upon client satisfaction and client behavior and be able to see
11
what activities worked and what did not work. Even though those clients will not be in the
program anymore, the information is valuable for the next round of clients. This also allows the
agency to perform cost-benefit analyses, to see which programs are most effective and should be
offered again. The therapist performing the summative evaluation will be using the Post Session
Analysis Form (Appendix B).
Client Evaluation
Client evaluations are an integral part of patient care monitoring (Stumbo & Peterson,
2004). Client evaluations are conducted for the therapist and the client to see if the client
outcomes formed during the initial treatment plan were accomplished. They allow the therapist
to see what behavioral changes were made due to the program. Client evaluations are performed
on an individual basis, due to the varying client outcomes in each treatment plan. The agency
later has the ability to synthesize individual evaluations to test the efficacy of the program as
well as note any major problems with the program. The recreational therapy department will
perform client evaluation through pre and post assessments, as well as through journals that the
clients will be documenting their progress in. Before the participants are accepted into the
program, the therapist will sit down with the client and discover what goals the client wishes to
achieve, what needs have to be addressed and improved, and what will be the best way to
achieve those goals/needs safely and successfully. The therapist will also review other reports
from prior treatment team members in order to see if the client can work in small groups and
shows social/emotional deficits.
Once the therapist deems that this program will be beneficial to the client, the therapist
will have the client undergo a pre-assessment to determine benchmarks. The therapist will use
two assessment tools: the Leisure Boredom Scale (Appendix D) which allows the therapist to see
12
the clients current leisure lifestyle and satisfaction and another tool that measures the clients
knowledge of leisure, their leisure needs/preferences and dislikes, known barriers/resources
available and what they plan to do with leisure once they are discharged (Appendix E). The same
tools will be used as a post-assessment tool to evaluate the changes made in the clients leisure
knowledge and behavior. During the sessions, the therapist will take note if the client has
achieved the performance measures for each activity and any behavioral changes made within
the client. The information will later be used to fill out a Performance Sheet (Appendix C) after
the program has ended.
Program Plan
Program Title: Get Your Leisure On!
Statement of Purpose:
To provide leisure education to reintegrate the client into society and gain control of emotional
states by improving leisure awareness and social skills.
Program Objectives
TPO 1: To demonstrate an improved knowledge of leisure awareness.
Enabling Objective (EO)
13
decisions.
2.1- To demonstrate the ability to identify what 2.1.1- By the end of the third week, the client
is personally needed in order to participate in a
leisure activity.
14
therapist.
manner.
15
16
PROCESS
1. Orientation Activity:
The purpose of this activity is to serve as an
a. introduce the participants to one another
icebreaker. This is the first session of the
b. practice social skills and teamwork
program and many of the participants do not
c. See Appendix F
know each other. The participants will be
seeing each other frequently, so it is
important for them to be introduced to each
other. Learning each others name will serve
to help the participants familiarize
themselves with one another and begin to
become comfortable with other people. The
RT should remain close to the group, but let
the participants develop in the game
independently. The RT should take note of
any behaviors such as frustration, anger,
anxiety, etc.
2. Introduction:
2. Introduction:
a. RT should introduce the concept of
The purpose of this program is for the
leisure.
participant to use leisure as an appropriate
b. Provide definitions of play, recreation
way to reintegrate back into society after
and leisure
serving in the military. Veterans with PTSD
-Play: Behavior that is engaging,
and Substance Abuse Disorder usually do
intrinsically motivated and chosen that not practice appropriate leisure activities or
results in a transformation of reality.
avoid them.
-Recreation: Leisure activity that is
Have the participants sit at the tables and
17
18
leisure activity can be repeated.
5. Debriefing/Conclusion
1. Why did you pick the leisure activity
you stated?
2. What did you learn about leisure?
3. Where do you see leisure taking a part
in your life right now?
4. Can you give me your own definition of
leisure?
a. Leisure is a subjective state of mind
b. Start thinking of what leisure activities
you prefer
5. Debriefing/Conclusion
The RT should use the questions in the
content section to debrief the group.
The RT should conclude the session by
going over the concept of leisure and how it
can be found all around. The RT should ask
the participants to start thinking about their
leisure preferences for the next session.
19
PROCESS
2. Introduction:
a. Talk about leisure preferences and
self-awareness
b. Discuss what the participants will be
doing for this session and the intended
goals
2. Introduction:
In order to live a healthy leisure lifestyle, a person
needs to know what they enjoy doing in their free
time. Everyone has different leisure preferences
and should be made aware of these preferences.
The RT should be able to make the participants
wonder what kind of leisure activities they would
20
like to participate in and describe how beneficial
the activities they participate in now are to their
life.
5. Debriefing/Conclusion:
1. Why did you choose your response?
2. What does the entire coat of arms say
about you personally? (Mostly positive
or negative attributes, etc.?)
3. What values were revealed to you?
4. Now that you can see what preferences
you usually lean towards, what can
you say about your leisure
preferences?
21
participants to see what leisure activities can help
them overcome feelings of anxiety, depression or
anger.
Introduce clients
Familiarize each other
Find common interests
See Appendix J
PROCESS
1. Orientation Activity:
The purpose of this activity is to have the
participants go around the room and introduce
themselves to people they have yet to meet and
to incorporate aspects of the previous session.
All the participants should take off one of their
shoes and throw them into a big pile in the
front of the room. Once all the shoes are in a
pile, have everyone grab a random shoe that
isnt their own and go around the room
introducing themselves and their preferred
leisure activity; all while trying to find the
person holding their shoe.
2. Introduction:
a. Talk about the importance of making
your own decisions
b. Talk about the influences behind
decisions that are made
2. Introduction:
One of the most important aspects of leisure
education is to have the clients make their own
decisions. Many people going through these
programs do not make decisions for
themselves, depending on others to make the
decisions for them. Others might make
22
decisions that negatively impact their life.
The RT should make it clear that the decisions
you make in your life impact you greatly. The
participant should realize how big of a
responsibility it is to make a decision. The RT
should also go over different influences that
drive participants to make certain decisions
such as family, friends, peer pressure, etc.
5. Debriefing/Conclusion:
1. How much do outside influences affect
your decision making?
2. What are the differences between the
decisions made by others for you and
the decisions made by you?
3. What does society expect you to do?
4. Do you depend on anything/anyone to
make your decisions?
5. What are some barriers to your decision
making.
5. Debriefing/Conclusion:
The RT should lead a debriefing with the
questions found in the Content section.
The debriefing questions are to allow the
participant to take a deeper look at the
decisions that have been made in their lives.
For clients with PTSD and Substance Abuse
Disorder, many of the decisions made are from
family or from peers. Some of those decisions
are either for the own good of the participant
23
and others cause the participant to act out.
The RT should drive home the importance of
making decisions. Make a point of how
decisions, either big or small, can influence the
goals the participant has set out to reach. Also,
make sure to discuss how decision making
affects the leisure lifestyle they lead.
PROCESS
1. Orientation Activity:
The participants have attended three sessions of
this program and should be familiar with the
other participants. There should be no need for a
formal icebreaker. Allow this time for the
participants to interact with each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
24
2. Introduction:
Before the participants can be sent out into the
community to find leisure activities, they must be
able to identify the personal resources they
already have or might need to gain. Since leisure
was something that was not well understood in
the beginning of this program, many individuals
had a limited awareness of possible leisure
opportunities already at their reach. Some
resources that the individual may already have
are functional abilities such as running or
walking. Other resources that they may have are
creativity, finances, or even educational level.
3. Presentation and Discussion:
While the intern or the RTAs pass out the
worksheet and the pens, the RT should go into a
brief discussion with the participants about some
examples of personal resources. Ask the
participants what functional abilities they have,
what educational level are they at, do they
possess any special skills, etc.
It is important for the participants to understand
the purpose of this activity and the goals they are
trying to meet. Answer any questions posed with
as much clarity as possible.
4. Learning Activity:
The participants should all be seated at a table
with the Get Ready worksheet in front of them.
The participants should list activities they would
like to participate in. Once they list those
activities they must list all the personal resources
they have to perform that activity, as well as all
the resources that they do not have. Give the
participants 10-15 minutes to fill out the
worksheet. Go over their responses
25
5. Debriefing/Conclusion:
The RT should lead a debriefing with the
questions in the Content section
The RT should conclude the session by going
over the different ways of getting those personal
resources that the participants were lacking.
Recommendations to other programs can be
helpful for the participant. The RT should also
go over how those skills that were not developed
could become a barrier to participating in the
activity. Discuss with the group how they would
overcome those personal barriers.
Remind participants to bring family members or
friends to the next session.
PROCESS
1. Orientation Activity:
The participants have attended four sessions of
this program and should be familiar with the
other participants. There should be no need for a
formal icebreaker. Allow this time for the
participants to interact with each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
26
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
2. Introduction:
a. Talk about the importance of
community resources
b. Talk about different activities offered
around the area
c. Involvement of family/friends
2. Introduction:
The RT should stress the importance of finding
community resources. Shoreview VA Hospital
offers a variety of leisure programs, programs
that are available for all veterans. The veterans
who are going through treatment take advantage
of these programs, but once they are released,
those programs are not visited. The veterans
being treated should be made aware of the
programs and activities that are offered in the
community.
The RT should also mention activities and
programs that are offered outside of the facility.
The activities/programs do not need to be in the
same area, but closer to the area that the
participants lives in.
Mention how involving family/friends can be
motivation to go out and participate in programs
and activities offered in the community because
many of them are family oriented.
27
4. Learning Activity:
There should be different displays on each table.
One table should be brochures about programs in
the facility. Another table should have business
cards, phone numbers, maps and flyers from
other facilities that offer a variety of leisure
programs and activities for families with a
veteran who has PTSD/Substance Abuse
Disorder. One table should have sign-up sheets
for programs offered at the facility.
Have the families go to each station. The RT
should answer any questions that may arise.
The RT should also take note of any behaviors
shown by the participants around family
members/friends.
5. Debriefing/Conclusion:
1. What places stood out the most to
you? Were most interested in? Least
interested in?
2. Are your family members/friends
interested in partaking in programs?
3. What other places do you know that
offer leisure activities/programs?
5. Debriefing/Conclusion:
The RT should lead a debriefing with the
participants with the question found in the
Content section. The RT should gather the
participants in another room for the debriefing.
The guests can stay in the other room and keep
browsing. Leave an RTA supervising that room.
Conclude this session by discussing with the
participants what they learned during this
session.
PROCESS
28
1. Orientation Activity:
The participants have attended five sessions of
this program and should be familiar with the
other participants. There should be no need for a
formal icebreaker. Allow this time for the
participants to interact with each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
2. Introduction:
a. Discuss what leisure barriers are
b. Give examples of leisure barriers
c. Give possible solutions the leisure
barriers
2. Introduction:
The RT should discuss the topics that will be
covered in this session. Many returning veterans
have returned home and have yet to readjust to
non-war environments. Participants with PTSD
and Substance Abuse Disorder have an even
more difficult time readjusting to their
environment. Leisure barriers are found
everywhere and can make participating in leisure
activities complicated. The RT should make sure
to discuss personal barriers as well as other
common leisure barriers that can arise. Go over
stigmas that are made towards people diagnosed
with PTSD or Substance Abuse Disorder. Make
sure to also go over possible solutions for the
barriers if encountered.
3. Presentation and Discussion:
While the intern or the RTAs pass out the
worksheet and the pens, the RT should go into a
brief discussion with the participants about
leisure barriers. Ask the participants if they have
experienced any leisure barriers and how they
responded to the barrier.
It is important to clarify any questions that the
participants have about leisure barriers. Leisure
barriers are a common occurrence when
participants have a disability, whether it be
physical or psychological.
29
4. Learning Activity:
Have the participants sit at the tables. Make sure
that each participant has the according worksheet
and pen to write responses. Give a description of
what the worksheet is and give the participants
10-15 minutes to complete the worksheet as the
questions apply to him/her.
This worksheet allows the participant to see the
leisure activities they participant already is
involved in and those activities they would like
to participate in. It forces the participants to
come up with good reasons as to why they are
not participating in the activity and to come up
with ways that would enable them to participate.
The RT should go around the room and make
sure that the participants are writing honest
responses to why they are not participating in
ideal activities.
5. Debriefing/Conclusion:
1. What common barrier did you find
while completing the worksheet?
2. Are the possible solutions achievable?
3. How many of the barriers listed, were
personal barriers?
4. What can you do to improve those
personal barriers?
5. Debriefing/Conclusion:
The RT should lead a debriefing using the
questions that are found in the Content section.
The RT should conclude the session by
discussing with the participants that many of the
leisure barriers can be overcome with the help of
other people or by gaining the skills needed to
complete the activity. Many veterans diagnosed
with PTSD or Substance Abuse Disorder believe
that seeking treatment for personal barriers is not
for them or that it may hurt their career. There
are many stigmas that surround the person with
the diagnoses. The RT should make sure that the
participants understand that these stigmas can be
overcome.
30
PROCESS
31
1. Orientation Activity:
The participants have attended five sessions of
this program and should be familiar with the
other participants. There should be no need for a
formal icebreaker. Allow this time for the
participants to interact with each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
2. Introduction:
a. Talk about the importance of
expressing emotions/feelings
b. Discuss how repressing
feelings/emotions can be detrimental
c. Talk about how participating in leisure
activities can help participant express
emotions.
2. Introduction:
The RT should present to the veterans the
importance of expressing emotions/feelings.
PTSD and Substance Abuse Disorders are
psychological disorders that affect the way the
veterans control their emotions. One of the ways
that patients with PTSD cope with emotions is
by repressing them or withdrawing from social
situations. Not being to express or control
agitation, anxiety or stress can lead to rash
behaviors or to the use of substances. The RT
should stress the importance of being able to talk
about feelings or expressing emotions in order
for others to be able to help during a situation as
well as for the individual to reach their goals.
The RT should also discuss how participating in
leisure programs can help the participant get a
better grip on their emotions all while finding a
way to cope with their symptoms in a healthy
manner.
3. Presentation and Discussion:
While the intern or the RTAs pass out the
worksheet and the pens, the RT should go into a
brief discussion with the participants about
different kinds of emotions and how they affect
everyones life. Explain that this session should
allow the participant to not be afraid of
expressing themselves.
32
Clarify any questions that the participant has
about the goals and purpose of the following
activity.
4. Learning Activity:
Have the participants sit at the tables with the
already set up materials. Explain to the
participants that they must fill out their bingo
card with the emotions that are found at the
bottom of the page. The emotions that they are
using must be emotions that they are currently
feeling or are feeling when they are experiencing
symptoms of their disability. None of the
emotions can be used more than once. If a
particular emotion is not found on the list, the
participant can write it down on their card and let
the RT know so that he/she can add it to the bag
and let the other participants know that another
emotion has been added that they can use.
Once everyone has filled out their bingo card, the
RT should pick emotions, one by one, out of a
bag and read it out loud. Require the participants
to mark their bingo chip if they have written that
emotion on their card. The first person to have
five emotions in a row wins the round. The
person who has won should be given the
opportunity to pick out one of those emotions
and retell a story of when they felt that way.
5. Debriefing/Conclusion:
1.
2.
3.
4.
5. Debriefing/Conclusion:
The RT should lead a debriefing with the
questions found in the Content section. The RT
should also go around the room and have
participants share stories of times they felt a
strong emotion and how they reacted.
The RT should conclude the session by again
stressing the importance of expressing how one
feels. Explain how learning how one reacts when
feeling a certain way is one of the first steps in
learning how to control emotions or cope with
that emotion.
33
PROCESS
34
1. Orientation Activity:
The participants have been attending this
program for several sessions, there is no need for
the use of a formal icebreaker. Allow this time
for the participants to talk amongst each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
2. Introduction:
a. Talk to the participants about the
importance of appropriate initiation
and maintaining of a conversation
b. Explain the goals for this session
2. Introduction:
Veterans who has PTSD or Substance Abuse
Disorder lack the appropriate social skills to
initiate or maintain a conversation. Although
they can communicate, most tend to avoid social
situations on order to avoid triggering flashbacks
or cannot maintain a conversation resulting in
bursts of anger or violence. There is also the lack
of opening oneself up to another person. The RT
should explain to the participants the goal for this
session.
3. Presentation and Discussion:
The intern or the RTAs should move the tables
and clear an open space in the room to allow the
participants to move around freely.
The RT should clarify any questions the
participants may have.
4. Learning Activity:
The RT should start off the activity by opening a
discussion about appropriate communication and
social skills such as building trust and selfdisclosure. The RT may ask the participants to
share appropriate skills needed in order to initiate
and maintain a conversation.
Have the participants pair up with someone
he/she does not know very well and hand them a
topics for them to discuss for five minutes.
35
After the five minutes are up, each participant
should find another person they do not know
very well and should be given another topic to
discuss for five minutes.
After the two five minute conversations are over,
have the participants come together and hold a
group discussion.
5. Debriefing/Conclusion:
1. Were you really listened to? Did your
partner show interest in what you said?
2. Did you listen to what your partner
was saying?
3. Did you really share your feelings or
did you screen what you said?
4. Would you have continued the
conversation if you had more time?
5. Did you find it difficult to maintain a
conversation?
6. What did you feel while talking to
your partner?
5. Debriefing/Conclusion:
The RT should follow up the activity with a
debriefing, using the question found in the
Content section.
It is important for the RT to conclude this session
by going over appropriate social and
communication skills and how to react in
situations where emotions tend to run high. The
RT should give coping mechanisms for
participants who are feeling highly anxious or
experiencing stress such as excusing yourself
from the conversation or expressing yourself to
the person so that they understand. This
participants should be able to use skills learned
from the previous session.
PROCESS
36
1. Orientation Activity:
The participants have been attending this
program for several sessions, there is no need for
the use of a formal icebreaker. Allow this time
for the participants to talk amongst each other.
The RT should take note of any behaviors that
can be observed during this time. Take note of
any symptoms of PTSD or Substance Abuse
Disorder. It is common for people with PTSD to
withdraw from social interactions, act on impulse
or have bursts of anger. People with Substance
Abuse Disorder often are depressed or show
signs of anxiety/high stress.
2. Introduction:
a. Talk about leisure partners and the
importance of maintaining appropriate
partners.
2. Introduction:
Veterans with a Substance Abuse Disorder
usually partake in illegal leisure activities due to
the people they consider their leisure partners.
Veterans with PTSD often do not have leisure
partners due to withdrawing from social
situations. The RT should stress the importance
of developing and maintaining appropriate social
networks in order to improve their life.
3. Presentation and Discussion:
The intern or the RTAs should move the tables
and clear an open space in the room to allow the
participants to sit in a semicircle. Hand out
worksheets and pens. The RT should explain the
purpose of this activity and start introducing the
importance of appropriate leisure partners.
The RT should clarify any questions the
participants may have.
4. Learning Activity:
Have the participants form a semicircle with
worksheet in hand. The RT should introduce the
activity by explaining that many leisure activities
take place in social situations with other people.
Have the participants complete the worksheet for
10-15 minutes.
Once the participants have finished the
worksheet, start a group discussion about the
37
activities.
worksheet.
Have the participants gather with each other and
plan to participate in a leisure activity with one
another. The participants should be able to use all
the skills they have learned throughout the
program and put them in practice.
5. Debriefing/Conclusion:
5. Debriefing/Conclusion:
Sequence Sheet
A sequence sheet is provided as part of a specific program plan to delineate how the total
program is to be implemented (Stumbo & Peterson, 2004). The sequence sheet shows what
enabling object will be addressed, what contents and processes are going to be performed, and a
time estimation of each activity. Recreational therapists can use the recommended sequence sheet
but can make quick alterations depending on the participants (Stumbo & Peterson, 2004).
TP
O
EO
DESCRIPTION
SESSION
NUMBER
TIME (min.)
TP
O
1.1
1.2
1.3
EO
38
DESCRIPTION
10
5
5
5
5
20
5
5
10
5
5
5
5
20
5
5
10
5
5
5
5
20
5
5
SESSION
NUMBE
R
TIME (min.)
TP
O
2.1
2.2
2.3
EO
39
Orientation
Introduction
What are personal resources
Effect of personal resources on leisure activities
Presentation/Discussion
Hand out materials
Brief discussion
Learning Activity: Get Ready
Perform activity
Debriefing/Conclusion
Questions
Discussion/end session
Orientation
Introduction
Community Resources and examples
Involvement of family/friends
Presentation/Discussion
Set up room
Greet guests
Learning Activity: Leisure Coat of Arms
Perform activity
Debriefing/Conclusion
Questions
End session
Orientation
Introduction
What are leisure barriers
Possible solutions
Presentation/Discussion
Handing out materials
Brief discussion
Learning Activity: Leisure Barriers
Perform activity
Debriefing/Conclusion
Questions
Discussion/end session
DESCRIPTION
5
5
5
5
5
20
10
5
5
5
5
5
5
30
2.5
2.5
5
5
5
5
5
20
10
5
SESSION
NUMBE
R
TIME (min.)
3.1
3.2
3.3
40
Orientation
Introduction
Importance of emotions/feelings
Repression of emotions
Presentation/Discussion
Hand out materials
Brief discussion
Learning Activity: Emotions Bingo
Perform activity
Debriefing/Conclusion
Questions
Discussion/end session
Orientation
Introduction
Importance of initiating and maintaining conversation
Presentation/Discussion
Handing out materials
Brief discussion
Learning Activity: Are You Listening
Perform activity
Debriefing/Conclusion
Questions
Discussion/end session
Orientation
Introduction
Leisure partners
Appropriate social networks
Presentation/Discussion
Handing out materials
Brief discussion
Learning Activity: Discovering your Leisure Partners
Perform activity
Debriefing/Conclusion
Questions
Feedback
End session
5
5
5
5
5
20
10
5
10
10
5
5
20
5
5
5
5
2.5
5
5
20
2.5
2.5
2.5
41
References
AshscadaAjibade, A., Akinniyi, O. T., & Okoye, C. S. (2013). Indications and complications of
major limb amputations in kano, nigeria. Ghana Medical Journal, 47(4), 185.
American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders,
(5th ed.). Washington, DC: Author.
Blanket Name Game. (2014, June 28). Retrieved November 20, 2015, from
http://www.icebreakers.ws/medium-group/blanket-game.html
Connecting Stories Icebreaker. (2014, June 28). Retrieved November 21, 2015, from
http://www.icebreakers.ws/small-group/connecting-stories.html
Dattilo, J., & McKenney, A. (2011). Facilitation techniques in therapeutic recreation (2nd ed.).
State College, PA: Venture Pub.
Dattilo, J., & Murphy, W. (1991). Leisure education program planning: A systematic approach.
State College, PA: Venture.
Frueh, B. C. B. C. (2001). Assessment of social functioning in combat veterans with ptsd.
Aggression and Violent Behavior, 6(1), 79; 79-90; 90.
Jr, F. M. M. F. M. (1997). International standards for neurological and functional classification of
spinal cord injury. Spinal Cord, 35(5), 266; 266-274; 274.
Kennedy, P. P. (2000). Anxiety and depression after spinal cord injury: A longitudinal analysis.
Archives of Physical Medicine and Rehabilitation, 81(7), 932; 932-937; 937.
42
Pettry, D. (2006). Exploring Emotions through Activities. Retrieved November 21, 2015, from
http://www.dannypettry.com/ebook_emotions.pdf
PTSD: National Center for PTSD. (n.d.). Retrieved November 16, 2015, from
http://www.ptsd.va.gov/public/family/ptsd-and-relationships.asp
PTSD: National Center for PTSD. (n.d.). Retrieved November 16, 2015, from
http://www.ptsd.va.gov/public/family/effects-ptsd-family.asp
Robertson, T., & Long, T. (2008). Foundations of therapeutic recreation. United States: Human
Kinetics.
Rybarczyk, B. D. (1992). Social discomfort and depression in a sample of adults with leg
amputations. Archives of Physical Medicine and Rehabilitation, 73(12), 1169.
Sharpless, B. A., & Barber, J. P. (2011). A Clinicians Guide to PTSD Treatments for Returning
Veterans. Professional Psychology, Research and Practice, 42(1), 815.
http://doi.org/10.1037/a0022351
Shoe Pile Mingle - Icebreakers, Ice Breakers, Ice Breaker Games. (2014, August 8). Retrieved
November 21, 2015, from http://www.icebreakers.ws/medium-group/shoe-pile-mingle.html
Social Effects of an Addiction - Drug Addiction. (n.d.). Retrieved November 16, 2015, from
http://www.medic8.com/drug-addiction/social-effects.html
Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual of
Activities and Resources (pp. 256-258). Venture Publishing.
43
Stumbo, N., & Peterson, C. (2004). Therapeutic recreation program design: Principles and
procedures (4th ed.). San Francisco, CA: Benjamin/Cummings.
Substance Abuse and Mental Health Services Administration. (2015). Substance use disorders.
Retrieved from http://www.samhsa.gov/disorders/substance-use
44
Appendix A
Post Session Report Form
45
46
Source: Stumbo, N., & Peterson, C. (2004). Therapeutic recreation program design: Principles
and procedures (4th ed.). San Francisco, CA: Benjamin/Cummings.
Appendix B
47
Post Session Analysis
Source: Stumbo, N., & Peterson, C. (2004). Therapeutic recreation program design: Principles
and procedures (4th ed.). San Francisco, CA: Benjamin/Cummings.
Appendix C
48
Performance Sheet
Source: Stumbo, N., & Peterson, C. (2004). Therapeutic recreation program design: Principles
and procedures (4th ed.). San Francisco, CA: Benjamin/Cummings.
49
Appendix D
Leisure Boredom Scale
Rate the following items from 1 to 5 according to the extent to which you agree. A rating of "1"
indicates that you strongly disagree and a rating of "5" indicates that you strongly agree.
1 = STRONGLY DISAGREE
2 = DISAGREE
3 = NEUTRAL
4 = AGREE
5 = STRONGLY AGREE
4. _____ If I could retire now with a comfortable income, I would have plenty of
exciting things to do for the rest of my life.
10. _____ In my leisure time, I want to do something, but I dont know what I want to do.
12. _____ I like to try new leisure activities that I have never tried before.
16. _____ During my leisure time, I almost always have something to do.
Source: http://uwf.edu/svodanov/boredom/lbs.htm
50
51
Appendix E
1. What is leisure?
______________________________________________________________________________
2. What does leisure mean to you?
______________________________________________________________________________
3. What leisure activities do you participate in?
______________________________________________________________________________
4. What leisure activities would you like to participate in?
______________________________________________________________________________
5. What are you leisure needs?
______________________________________________________________________________
6. What are some leisure barriers?
______________________________________________________________________________
7. Provide possible solutions to leisure barriers?
______________________________________________________________________________
8. What are your plans after the program is over?
______________________________________________________________________________
Adapted from: Stumbo, N., & Peterson, C. (2004). Therapeutic recreation program design:
Principles and procedures (4th ed.). San Francisco, CA: Benjamin/Cummings.
52
Appendix F
Blanket Names
Activity Description:
Have the participants introduce each other by stating their name. After the group has introduced
themselves, have the group form 2 teams with the same amount of participants. Have each team
go to the front of the room. If the leader has assistants, have the assistants hold the blanket up
between the two teams so that the two teams cannot see each other (if no assistants, have two
volunteers hold up the blanket). For each turn, each team chooses a volunteer to stand or sit
behind the blanket. The facilitator will count to three and then have the assistants drop the
blanket. The first player to identify the name of the other player, wins the round. Keep repeating
the rounds until one team reaches the desired number of points.
53
Appendix G
Leisure Name Games
Source: Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual
of Activities and Resources (pp. 256-258). Venture Publishing.
54
Appendix H
Connecting Stories
Activity Description:
Have the participants split up into groups of 4-5 and sit at a table. Make sure that each table has
enough pens and post it notes. The goal of the activity is to connect mini stories in an interesting
way. Each person must share at least one item that connects to the other mini stories. The longer
the chain of items that can be created, the better.
The first person begins by sharing an interesting memory or experience that they have. For
example, one time I locked myself out of my apartment, so then I spent the entire day in a
coffee shop. The next person can tell a related story that has any similar themes or elements the
previous story such as, I am a total coffee addict, I drink at least 3 cups and sometimes it
prevents me from going to sleep. The story continues the same way with the other participants.
Any person can add something to the story to keep it going. To remember the chains of the story,
have the participants write down notes on the post its.
At the end of the activity, whichever group has the longest chain of stories is the winner. The
facilitator can ask the group to share the long story with the whole group. The point of this
activity is to have a fun way of getting people to share stories with each other while finding
common interests.
55
Appendix I
Leisure Coat of Arms
56
57
Appendix J
Shoe Pile Mingle
Activity Description:
Ask everyone to take off one of their shoes and throw them into a big pile in the front of the
room. Once everyone has taken off one shoe and placed it into the pile, the facilitator should
have everybody grab a random shoe that is not their own. The goal is to go around the room and
introduce yourself to as many people, state your favorite leisure activity, all while trying to find
your shoe.
58
Appendix K
For My Leisure
59
60
Get Ready. In LEISURE EDUCATION: A Manual of Activities and Resources (pp. 256258). Venture Publishing.
Appendix L
Get Ready
61
62
Source: Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual
of Activities and Resources (pp. 256-258). Venture Publishing.
Appendix M
Community Resources Awareness Night
63
Source: Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual
of Activities and Resources (pp. 256-258). Venture Publishing.
Appendix N
Leisure Barriers
64
65
Source: Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual
of Activities and Resources (pp. 256-258). Venture Publishing.
Appendix O
Emotions Bingo
66
Source: Pettry, D. (2006). Exploring Emotions through Activities. Retrieved November 21, 2015,
from http://www.dannypettry.com/ebook_emotions.pdf
67
Appendix P
Are You Listening
68
(1986). Get Ready. In LEISURE EDUCATION: A Manual of Activities and Resources (pp.
256-258). Venture Publishing.
Appendix Q
Discovering Your Leisure Partner
69
Source: Stumbo, N., & Thompson, S. (1986). Get Ready. In LEISURE EDUCATION: A Manual
of Activities
and
Resources
(pp. 256258).
Venture
Publishing.