knr 273 : tr models continued health protection/health promotion self-determination and enjoyment...
TRANSCRIPT
KNR 273 : TR Models Continued
Health Protection/Health Promotion
Self-Determination and Enjoyment Enhancement
TR Models Leisure Ability Model (Peterson &
Stumbo) Health Protection/Health Promotion
Model (Austin) Self-Determination and Enjoyment
Enhancement: A Psychologically-Based Service Model for Therapeutic Recreation (Dattilo, Kleiber, & Williams)
TR Models (Cont.) TR Service Delivery and TR Outcome
Models (Van Andel) Aristotelian Good Life Model: Integration
of Values into Therapeutic Recreation Service Delivery (Widmer & Ellis)
Optimizing Lifelong Health and Well-Being: A Health Enhancing Model of Therapeutic Recreation (Whilhite, Keller, & Caldwell)
Health Protection/Health Promotion Model Easy to follow (graphic depiction, clarity of
terms & concepts) Accommodates a variety of clients & settings Flexibility in types of services What is the end goal? Purposes Underlying assumptions Theoretical bases Direction for research & practice
Could you explain TR with this model? Could you design programs?
Health Protection/Health Promotion Model Purpose of TR
To assist persons to recover following threats to health (health protection) and to achieve as high a level of health as possible (health promotion)
Mission of TR To use activity, recreation, and leisure to help
people to deal with problems that serve as barriers to health and to assist them to grow toward their highest levels of health and wellness
Health Protection/Health Promotion Model Underlying Concepts
Humanistic Perspective Each of us has responsibility for own health Have capacity for making self-directed & wise choices
regarding our health Critical to empower people to become involved in
decisions regarding health to the fullest extent possible
People are active participants in the world Human beings are holistic Each is unique and should be treated accordingly All humans have an inherent drive for health &
wellness that can be nurtured by nonjudgmental & caring profs.
Underlying Concepts (Cont.) High-level wellness
Goes beyond absence of physical illness
Deals with health enhancement vs. treating disease
Should strive to not only alleviate illness but to enhance health
Underlying Concepts (Cont.) Stabilization & actualization
tendencies 2 motivational forces
Stabilizing tendency Maintain steady state of individual Keep stress in manageable range Protects from bio-physical & psychosocial harm (Health Protection) focuses on efforts to move
away or avoid negative states of illness and injury Actualizing tendency
Directs toward health promotions Movement toward high-level well-being
Underlying Concepts (Cont.) Health
Encompasses both coping adaptively and growing and becoming
Healthy people can cope with life stressors Ultimate goal is to help clients strive
toward health promotion. Based on philosophy that encourages
clients to attempt to achieve maximum health, rather than just recover from illness
Components
1. TR is a modality to help people to, first, restore themselves or regain stability following a threat to health (health protection), and second, optimize their potentials in order that they may enjoy as high a quality of health as possible (health promotion)
Components Prescriptive activities, recreation, & leisure
Components (Cont.) Prescriptive activities
Clients at first withdraw, loss of control, helplessness
Activity is necessary prerequisite to health restoration
Activity is means to gain control over situation and overcome helplessness & depression
TRS provides direction & structure for prescribed activities
Components (Cont.) Recreation
Restorative properties which offer opportunity for participant to re-create himself
Regain equilibrium disrupted by stressors so they can resume quest for actualization
Take part in intrinsically motivated recreation that produces mastery and accomplishment in a supportive environ.
Learn they can be successful in the world
Components (Cont.) Leisure
Means to self-actualization
Health Protection/Health Promotion Model Any setting in which the goal of TR
is holistic health and well-being TR client could be anyone who
wishes to improve level of health Typical outcomes
Improved physical functioning, improved perceived control, decreased stress, etc.
Health Protection/Health Promotion Summary Assumptions
Activity, recreation, and leisure interventions facilitate individuals’ movement towards high levels of health and wellness
People are motivated by stabilizing tendencies for managing stress, and actualizing tendencies for seeking growth and health
Health is the focus because most professionals work in healthcare settings
Summary (Cont.) Mission: Health
Therapy-oriented Outcome is optimal health Leisure & recreation are means only
Definition of TR A means, first, to restore oneself or regain
stability or equilibrium following a threat to health (health protection), and second, to develop oneself through leisure as a means to self actualization (health promotion)
Summary (Cont.) Service Areas
Prescriptive activities Recreation Leisure
Health Protection/Health Promotion Strengths Health is focal point Reality based
paradigm that goes well with competitive health care market
Opens door for reimbursement
Focus on whole person
Theoretical foundation
Health Protection/Health Promotion Concerns Doesn’t apply to
agencies that do not have health as a major goal
Narrow scope of practice
Leisure can do more than protect & promote health
Health doesn’t address disabling conditions
Victim blaming – responsibility for problems & recovery
Components are unclear
Serves general population
Unclear how to facilitate client’s movement in programs or how design programs
Concerns (Cont.) Limited direction
for practice Not specify content Leisure theory not
included Doesn’t include
functional outcomes
Not all have drive for health
Ross & Ashton-Shaeffer 2001) note more weaknesses than strengths
Self-Determination and Enjoyment Enhancement Easy to follow (graphic depiction, clarity of
terms & concepts) Accommodates a variety of clients & settings Flexibility in types of services What is the end goal? Purposes Underlying assumptions Theoretical bases Direction for research & practice
Could you explain TR with this model? Could you design programs?
Self-Determination & Enjoyment Enhancement Purpose
Enjoyment and the creation of environments conducive to enjoyment ultimately contribute to well being and to personal growth
Creating conditions that help concentration, effort, and a sense of control and competence while promoting freedom of choice and expression of preference is the “engineering of enjoyment.”
Purpose (Cont.) To support participants in
achieving goals of self-determination and enjoyment, and ultimately functional improvement
Model Components Self-Determination
Acting as primary causal agent in one’s life and making choices and decisions free from external influence or interference
Ability to choose from options Ability to adjust when more than one
option is present Self-determination occurs when people
take control of their freedom
Components (Cont.) Intrinsic motivation
People will seek challenges which are commensurate with their competencies
Avoid situations that are too easy or hard Interest, excitement, and relaxation
provide reinforcement for activities Intrinsic motivation doesn’t depend on
ability level
Components (Cont.) Perception of manageable challenge
Flow Merging of action and awareness
Investment of attention Goals are clear, challenges and skills
are in balance Involves concentration, effort, sense of
control
Components (Cont.) Enjoyment
Experience derived from investing one’s attention in activities that are intrinsically motivating
Functional improvement When participants independently access
enjoyment and create environments conducive to enjoyment, functional improvements should result
Enjoyment motivates people to do things that push them beyond present ability
Self-Determination & Enjoyment Enhancement Summary Assumptions
Promoting self-determination, intrinsic motivation, manageable levels of challenges, and investment of attentions results in the outcomes of enjoyment and functional abilities
Increased in the level of enjoyment and functional abilities is associated with the perceptions of self-determination in leisure
Summary (Cont.) Mission: Self-determination &
enjoyment Also functional improvement Means/ends model
Definition of TR The purpose of TR is to treat physical,
social, cognitive, and emotional conditions associated with illness, injury, or chronic disability through a variety of interventions
Summary (Cont.) Service areas
Self-determination Intrinsic motivation Perception of manageable challenge Investment of attention Enjoyment Functional improvement
Strengths Tightly connected
to existing theories
Strong grounding in psychological theory
Concerns Difficult to
interpret and apply
Definition of TR not go with model
Confounded with attachment to functional improvement
Focus on DD?
Little consensus on the meaning of enjoyment
Focus on control Cultural bases of
fostering control Focuses on micro-
system of the person
Concerns (Cont.) Lack of linkages
among components Closed system with
each component interdependent
No clear entry point, assumed facilitation strategy box in upper left
Is material in boxes, process, outcomes, or combo of both
One Minute Paper Clear Muddy General comments