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