LEI4724

Activity Portfolio #5

Michelle Wilson

Facilitation Technique Category: Expressive Arts as Therapeutic Media

Activity Title: Bust A Move
Source: Wilson, Michelle. (2015). Specific Program Plan.
Equipment: Tables, chairs, jazz/blues music
Activity Description: Expressive arts uses art disciplines to assist individuals to
make contact with their authentic self. Therapeutic Recreation specialist can use
expressive arts as therapeutic interventions to promote self-expression as well as
improve physical, social, cognitive, and emotional functioning (Dattilo, 2016).
Dance is used as an expressive art or as therapeutic media. Dance as an
expressive art is defined as rhythmic and patterned bodily movements performed
with or without music. Typically, for dance to transpire, bodily movements occur in
a rhythmic and patterned manner conducted in specific sequences and within a
specified time frame (Dattilo, 2016). Feelings as expressed through the

client/patients movement, provide content and a framework which

influences the direction of the therapy rather than direction being taken from
the therapists agenda. The therapist supports and challenges the cline,
engaging with their expressions. Movement is creative and improvisational,
embodying the imagination whereby the body becomes the vehicle for selfexpression and a bridge between emotion and motion for integration and
healing. This form becomes the transitional space for the therapeutic
relationship. Dance movement therapy is embodiment in action (Payne,
2006). With dance and movement therapy a person can creatively engage
with others in a social setting or individually while promoting social
integration, emotional, physical, and cognitive development. The purpose is
to introduce the participants to the main topic of emotions and dance and the
objective of the activity. First, the CTRS will explain the importance of expressing
emotions through dance along with complimenting themselves throughout the
session on their performance and courage and explain how emotions affect our
daily lives. Second, provide instruction and demonstration of expressive dance.
Third, instruct participants to mirror the instructors or another participants
movements and allow time for them to follow directions. Staff members are
available to assist participants in correct form and technique. Finish the session by
processing with the participants by reviewing the steps and safety of the activity,
benefits, expectations, difficulties, how they felt before and after the activity and
how they can compare this activity to their lives and discuss their goals.
Leadership considerations: The CTRS is the instructor for this activity and is
demonstrating prior to the session. It is recommended that the CTRS have a
certification in dance and movement therapy. The CTRS should be CPR/First Aid
certified. The staff to participant ratio should be 1:1, 1:3, 1:5, 1:7. Before starting
the session the CTRS should review expectations, rules and goals with the
participants. The CTRS should demonstrate and explain the dance
therapy/expressive arts activity.

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Activity Portfolio #5

Michelle Wilson

Adaptations: Participants with Traumatic Brain Injury: A traumatic brain

injury is a form of acquired brain injury that occurs from a direct trauma to the
brain. It can be caused by a blow or jolt to the head or a penetrating injury, such as
a gunshot wound, that causes damage to the brain. Not all jolts or blows to the
head result in a TBI. TBIs are classified as mild, moderate, or severe depending on
the extent of damage to the brain. Mild TBI is also called concussion or minor brain
injury. It occurs when an impact of forceful motion of the head results in a brief
alteration of mental status, such as confusion or disorientation, loss of memory for
events immediately before or after the injury or brief loss of consciousness (shorter
than 30 minutes. Moderate TBI is when there is a loss of consciousness, along with
persistent confusion and functional impairments in one or more of the cognitive,
physical, emotional or behavioral domains. A severe TBI is when there is a
prolonged unconscious state or coma (Porter, 2015). The deficits range from
impairment of higher level cognitive functions to comatose states. Survivors may
have limited function of arms or legs, abnormal speech or language, loss of thinking
ability or emotional problems (www.traumaticbraininjury.com). Depending on the
severity of the TBI adaptations may be individualized sessions, where the session is
slow and simple eye contact, attuned breathing, verbal witness, and touch
(www.adta.org). The use of water to promote mobility and decrease fear of falling.
Other adaptions include reducing or expanding the size of the dance area,
simplifying dance steps, marking the dance floor with tape to indicate a specific
sequence, or modifying steps for a wheelchair user or participants with assistive
devices or orthotics. Simplifying directions for participants with cognitive disorders.
Assist the participant with the movements if they have limited function in their
extremities.
Adaptations: Participants with Spina Bifida: Spina bifida is a birth defect that
affects the neural tube. The neural tube is the embryonic structure that eventually
develops into the babys brain, spinal cord and the tissues that enclose them. A
portion of the neural tube fails to develop or close properly, causing defects in the
spinal cord and in the bones of the spine (Porter, 2015). Spina bifida occulta has an
opening in one or more of the vertebrae of the spinal column without apparent
damage to the spinal cord, most of the time no neurological symptoms occur and
there are no other indications of the condition. Meningocele is the meninges, or
protective covering around the spinal cord, have pushed out through the opening in
the vertebrae in a sac called a meningocele. The spinal cord remains intact. This
form can be repaired with little or no damage to the nerve pathways.
Myelomeningocele is the most severe form of spina bifida, in which a portion of the
spinal cord itself protrudes through the back. In some cases, sacs are covered with
skin; in others, tissue and nerves are exposed. The effects may include muscle
weakness, loss of sensation or paralysis below the exposed area of the spine, and
loss of bowel and bladder control (Porter, 2015). Also the individual may have
hydrocephalus. Participants may need assistance from a partner or buddy to assist
with dance movements. Other adaptions include reducing or expanding the size of
the dance area, simplifying dance steps, marking the dance floor with tape to
indicate a specific sequence, or modifying steps for a wheelchair user or

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Michelle Wilson

participants with assistive devices or orthotics. Participants may need skin checks
post dance therapy to ensure no development of blisters or sores.

Adaptations References
Butcher, J., Hooley, J., Mineka, S. (2014) Abnormal Psychology. Sixteenth edition.
Upper Saddle River,
New Jersey: Pearson Education, Inc.
Dance. Retrieved October 6, 2016. From http://www.spinalcord.org/resourcecenter/askus/index.php?pg=kb.printer.friendly&id=1#p2695.
Dance/Movement Therapy and Brain Injury. Retrieved October 6, 2016. From
http://blog.adta.org/2015/03/18/brain-injury-awareness-month/.
Dattilo, J., & McKenney, A. (2016) Facilitation Techniques in Therapeutic Recreation.
Third edition. State
College, PA: Venture Publishing, Inc.
Living with Spina Bifida: School-Aged Children. Retrieved October 6, 2016. From
http://www.cdc.gov/ncbddd/spinabifida/school-age.html.
Payne, H. (2006). Dance Movement Therapy: Theory, Research and Practice (2nd
ed.). New York,
New York: Routledge.
Porter, Heather. (2015). Recreational Therapy for Specific Diagnoses and Conditions.
Enumclaw, WA:
Idyll Arbor, Inc.
Traumatic Brain Injury. Retrieved October 6, 2016. From
http://www.traumaticbraininjury.com/understanding-tbi/what-is-traumaticbrain-injury/ .

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Activity Portfolio #5

Michelle Wilson

Facilitation Technique Category: Mindfulness

Activity Title: Breathing Buddies
Source: 7 Ways to Teach your Kids Mindfulness. Mind Body Green,
www.mindbodygreen.com
Equipment: Small object or stuffed animal
Activity Description: Mindfulness is that state of open awareness that comes from
the acceptance of intentional and nonjudgmental attention to the unfolding of
present moment to moment external and intern experiences such as sensations,
emotion, thoughts, and perceptions. Mindfulness practices reduce negative affect
such as anxiety, dysthymia, depression, as well as habitual, reactive and coping
(Dattilo, 2016). The purpose of this activity is to bring awareness to breath control,
inner and outer experiences, stress reduction and provide tools for impulse control.
The presence of a breathing buddy makes the activity of meditation a little
friendlier and allows the participants to see how a playful activity does not need to
fast paced or energetic. First, hand out a stuffed animal or small object to each
participant of their choosing. Second, if there is ample room, have the participants
lie down on the floor and place the stuffed animal or object on their stomach. Third,
instruct them to silently breath for one minute and notice how their breathing
buddy moves up and down, and any other sensations that they notice. Fourth,
instruct them to imagine that the thoughts that come into their minds turn into
bubbles or smoke and float away.
Leadership considerations: The CTRS is the instructor for this activity and is
demonstrating prior to the session. It is recommended that the CTRS have a

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Michelle Wilson

certification in meditation or stress management. The CTRS should be CPR/First Aid

certified. The staff to participant ratio should be 1:1, 1:3, 1:5. Before starting the
session the CTRS should review expectations, rules and goals with the participants.
The CTRS should demonstrate and explain mindfulness or meditation arts activity.
Adaptations: Participants with Post Traumatic Stress Disorder: Post
traumatic stress disorder is the development of characteristic symptoms following
exposure to one or more traumatic events (Porter, 2015). It is now grouped with
trauma and stressor related disorder adjustment disorder (Butcher, 2014). In PTSD
a traumatic event is thought to cause a pathological memory that is at the center of
the characteristic clinical symptoms associated with the disorder. These memories
are often brief fragments of the experience and often concern events that happened
just before the moment with the largest emotional impact (Butcher, 2014). Those
events may include rape, abuse, natural disaster, being in a war zone, or exposure
to a terrorist attack. Characteristic symptoms develop following the exposure to an
extreme traumatic stressor. After the traumatic event, if PTSD develops, the person
may avoid anything associated with trauma. A person who has developed PTSD
may feel emotionally numb or may easily become hyper-aroused. An individual with
PTSD symptoms may re-experience the traumatic events through flashbacks,
nightmares, and frightening thoughts. Other symptoms may be anhedonia,
dissociation, or a combination of various symptoms (Porter, 2015). Sound clinical
judgment is crucial when introducing mindfulness practices, safety and effective
timing are essential. Mindfulness techniques that promote the open awareness of
internal experiences, such as emotions or physical sensations, can bring
participants into closer contact with existing trauma, leading to destabilization.
Triggering of past emotions and experiences can occur when individuals are
instructed to place themselves in a vulnerable position, such as on their backs with
their eyes closed, direct their attention to a part of their body, or listen to certain
sounds or words (Dattilo, 2016). Participants may need to be closely monitored,
assist the participants as needed, be knowledgeable of their triggers. Make sure the
room is calm with no bright colors. Group size needs to be taken into consideration,
some participants may need individualized session to decrease interference with
other participants or to anticipate triggers to manifest. Allow them to acknowledge
the distraction but redirect back to the task of breathing and focusing on that to
reduce the impulsivity. Participants may need a buddy to assist with coaching and
to teach proper behavior.
Adaptations: Participants with Attention-Deficit/Hyperactivity Disorder:
Attentions -deficit/hyperactivity disorder, often referred to as hyperactivity, is
characterized by difficulties that interfere with effective task-oriented behavior in
children- particularly impulsivity, excessive or exaggerated motor activity, such as
aimless or haphazard running or fidgeting, and difficulties in sustaining attention
(Butcher, 2014). ADHD is a neurodevelopmental disorder that interferes with social
and academic/occupational functioning or development. Individuals with ADHD
have markedly decreased inattention (not due to defiance or comprehension
deficits) such as difficulty staying on task and lack of perseverance, organization,
and focus, and/or an age-inappropriate level of hyperactivity/impulsivity (Porter,

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Michelle Wilson

2015). Adaptations that may need to be considered when working with participants
with ADHD; do not force the activity on the participant, it should not be a
punishment. If the participant is not interested at the moment try again later. The
length of the mediation/mindfulness activity may need to be flexible according the
participants. Group size needs to be taken into consideration, some participants
may need individualized session to decrease interference with other participants.
Be consistent with the activity with scheduled time each day to develop a routine.
Participants may need a buddy to assist with coaching and to teach proper behavior.
Participants my need special non-verbal communication cues to reinforce their
behavior.
Adaptations References
Butcher, J., Hooley, J., Mineka, S. (2014) Abnormal Psychology. Sixteenth edition.
Upper Saddle River,
New Jersey: Pearson Education, Inc.
Dattilo, J., & McKenney, A. (2016) Facilitation Techniques in Therapeutic Recreation.
Third edition. State
College, PA: Venture Publishing, Inc.
Payne, H. (2006). Dance Movement Therapy: Theory, Research and Practice (2nd
ed.). New York,
New York: Routledge.
Porter, Heather. (2015). Recreational Therapy for Specific Diagnoses and Conditions.
Enumclaw, WA:
Idyll Arbor, Inc.
Schonert-Reichl, K., Roeser, Robert. (2016). Handbook of Mindfulness in Education:
Integrating Theory and Research into Practice. Verlag, New York. Springer.
7 Ways to Teach Your Kids Mindfulness. Retrieved October 6, 2016. From
http://www.mindbodygreen.com/0-18136/7-fun-ways-to-teach-your-kidsmindfulness.html