bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding knee biomechanics during physical activity and the implications for individuals with knee osteoarthritis and total knee replacements
Authors: Wozencroft, PhD, CTRS Angela J. , Pfeiffer, MS Julie L. , Milner, PhD, FACSM Clare E.
Published: August 2018

Evidence-based research on pain management techniques, exercise, and aquatic therapy programs provides guidance for recreation therapists working with patients with orthopedic impairments such as osteoarthritis (OA) and total knee replacements (TKRs). However, substantiated recommendations for specific physical activities to be used with this population are not available. This leaves recreation therapy (RT) practitioners with inadequate direction on the appropriate activities to prescribe to their patients. This research note is an abbreviation of a larger study (J.L.P. et al., unpublished data, 2014) and examines the knee joint kinematics and kinetics in healthy older adults during golf and bowling with comparisons made between those experienced during walking and stair ascent and descent. Understanding the knee biomechanics in a healthy population is an important first step in gathering scientific evidence needed to advance our field. Future research examining knee biomechanics related to various recreation activities will be instrumental in allowing RT specialists to develop practice guidelines for men and women with OA and TKR in the future.
Book review
Authors: Kunstler, ReD, CTRS Robin
Published: August 2018

Therapeutic Recreation Processes & Techniques: Evidenced-Based Recreational Therapy (7th Edition) by David R. Austin
Benefits of a structured swim program for children diagnosed within the autism spectrum disorder
Authors: Gaskell, MS, CTRS Jennifer , Janssen, EdD, RTC, CTRS Maridith A.
Published: August 2018

There is a persistent increase in the number of children who are diagnosed with a form of autism. Many therapeutic programs and interventions available have been known to be beneficial for individuals with disabilities. Therapy in the aquatic setting has been useful for the healing purposes of individuals with musculoskeletal or neuromuscular conditions for many years. Clinicians are now beginning to expand the use of aquatic therapy to a new population, which is children with autism, for healing purposes and as an early intervention. A single-subject design was utilized using the Aquatic Behavior Observation Scale (ABOS) to assess and measure behavioral changes for each of the three subjects while participating in an aquatic observation. The ABOS instrument measured the areas of 1) oriented to present; 2) social and communication skills; 3) control of emotions; and 4) responses to stimuli. Levels of responsiveness in each subcategory varied from participant to participant, and observation-by-observation. Data collected from this study suggest that the subjects diagnosed within the autism spectrum were able to demonstrate mild improvements during the application of the intervention.
Application of the core areas of environmental health to recreation therapy practices
Authors: Ratnapradipa, PhD, MCHES Dhitinut , Barger, BA Alexandra , Yang, PhD, CTRS Heewon
Published: August 2018

Because recreation therapists work in a broad range of settings to promote the well-being of individuals, it is important for them to have an understanding of the role of the environment on individuals’ health. Environmental health is a very broad field, encompassing all aspects of the environment and its impacts on social, emotional, and physical health. It can be divided into 11 core areas: air quality (indoor and outdoor), water quality, radiation, food safety, emergency preparedness, healthy housing, infectious diseases and vector control, toxicology, injury prevention, waste and sanitation, and weather and climate change. This informative article discusses six of the 11 environmental health core areas that recreation therapists and their clients might frequently encounter. This article also provides brief guidelines on preventive actions that can be taken by recreation therapists to reduce the potential risks identified.
Regulatory requirements for recreational therapy in nursing homes
Authors: De Vries, DHA, MPA, CTRS Dawn
Published: August 2018

More recreational therapists than ever are practicing in long-term care and skilled nursing facilities (SNFs). Despite this increase in recreational therapists working in SNFs, there continues to be significant confusion about regulatory requirements, as well as practice and coverage issues. This article intends to provide information on regulatory, coverage, and practice issues related to recreational therapy in nursing homes.
A description of a community-based treatment program designed to address physical health issues associated with severe and persistent mental illness
Authors: Tankel, BS, CTRS Ron
Published: August 2018

This article describes the ongoing impact of a community-based mental health program to address physical health issues associated with severe and persistent mental illness (SPMI). This program developed over a period of 6 years in response to clients' increased participation and motivation. As participants' level of physical wellness improved, there was a demand for more advanced and varied levels of activity. This article demonstrates that people with SPMI responded positively to a structured and supportive group process for improving physical health and wellness.
Using the Dementia Practice Guidelines in a home setting: A case study
Authors: Stocco Marianna , Zahl, PhD, CTRS Melissa L.
Published: August 2018

With approximately 70 percent of individuals with dementia living outside skilled care, the need for quality care is imperative. One such indicator for quality of care when working with individuals with dementia is the use of nonpharmacological interventions to treat disturbing behaviors. Disturbing behaviors within dementia are currently classified as passive behaviors or agitation. These behaviors are more about communicating unmet needs. Within recreational therapy, the Dementia Practice Guidelines for Recreational Therapy: Treatment of Neuropsychiatric Behaviors (DPG) provided protocols to assist the practitioner in providing interventions to treat passive behaviors and agitation. This case report used the DPG on a single female living in a family member’s home. Results indicate improvement in passive behaviors, she engaged not only in sessions but also in the home environment.
Website review
Authors: Sardina, MS, CTRS Angie
Published: August 2018

Promoting Positive Behavioral Health: A Nonpharmacologic Toolkit for Senior Living CommunitiesAvailable at: http://www.nursinghometoolkit.com/
Name games: The need for our titles and professional philosophies to coincide
Authors: Austin, PhD David R
Published: August 2018

The central thesis of the article is that the time has come to end the “name games” that have too long occupied our profession. The two philosophical positions that exist within our profession are presented and it is suggested that neither philosophy endorses the term “therapeutic recreation.” It is further suggested that each philosophical position should adopt a more appropriate title to represent its philosophy and that both should be recognized as unique professions.
Effects of a swim program for children with autism spectrum disorder on skills, interest, and participation in swimming
Authors: Lawson, PhD, CTRS Lisa Mische , Foster, OTD, OTR-L Lauren , Harrington, MOT, OTR-L Margaret C. , Oxley, MOT, OTR-L Christy Ann
Published: August 2018

The purpose of this study was to determine if a sensory-based, learn-to-swim program improved swim skills and increased physical activity of children with autism spectrum disorder (ASD). Forty-two children with ASD (39 male/three female) participated in eight, 30-minute Sensory Supported Swimming© lessons. Researchers tested swim skills at the first and last lessons and parents completed surveys about their children. Results indicated parents felt their children were more physically active both during swim lessons and outside lessons. Children had increased interest in swimming, and parents planned to begin or increase family swimming activities. Swim skills of all children improved, 74 percent improved at least one level. The learn-to-swim program with sensory supports was effective in improving swim skills and increasing physical activity of children with ASD.
A case study of two recreation programs serving soldiers on Warrior in Transition Units
Authors: Frisch, MS, CTRS Andrea , Ardovino, PhD, CTRS, CPRP Patricia
Published: August 2018

This case study examined recreation programs on two US military installations serving soldiers who were injured during Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn, and were on Warrior in Transition Units. The recreation programs were the Adaptive Reconditioning program at Schofield Barracks in Hawaii and the Resiliency Through Art program on US Army Garrison in Vicenza, Italy. Data from demographic questionnaires, interviews, and documents were analyzed and revealed three themes: the civilian world, compliance, and masculinity.
Therapeutic Recreation Empowering Kids: Exploring best practices in transition
Authors: Wilder, PhD, CTRS-L Allison , Craig, PhD, CTRS-L Patricia J. , Frye, MS, CTRS-L Matthew S.
Published: August 2018

The purpose of this article is to describe the collaborative components of a school and community-based recreation therapy (RT) program designed to support the educational, developmental, and transitional needs of students with disabilities in the K-12 public school system in New Hampshire. The program, Therapeutic Recreation Empowering Kids (TREK), is one of three core service areas of the University of New Hampshire's Northeast Passage, community-based adaptive sport and RT organization. This article focuses on TREK's transition services, which align with many of the recommended best practices in transition. TREK services are delivered in school and community settings by state licensed Certified Therapeutic Recreation Specialists to students with disabilities, in accordance with their individualized education plans. Beginning as early as elementary school, through the use of purposeful RT interventions, community integration, and meaningful inclusion, the TREK therapist facilitates valued transition outcomes. In furtherance of these outcomes, the TREK therapist functions as a critical broker in establishing and maintaining mutually beneficial cross-system collaborative partnerships. The purpose of these partnerships is explored, demonstrating how the TREK program facilitates recreation therapists' ability to successfully partner with K-12 public school personnel, community providers and the families of students, all of which potentiate synergistic partnerships toward accomplishing mutual transition goals. A case example is provided to illustrate ways in which the program impacts those involved and encourages continued collaboration.
Aquatic activity and emotional experience in adults with severe mental illness
Authors: Walter, MS, CTRS Alysha A. , McCormick, PhD, CTRS Bryan P.
Published: August 2018

This study examined the relationship of aquatic activity to positive and negative emotion in individuals with a severe mental illness (SMI). Individuals with SMI have been found to experience decreased positive emotions and higher negative emotions as compared to controls. It was hypothesized that aquatic activity participation would be associated with greater positive emotion and lower negative emotion post participation. Eighteen participants with a severe mental illness were recruited from a community mental health center. The study employed a pre-post design with a structured aquatic activity designed for moderate physical exertion. Participants demonstrated statistically significant increase in positive emotion and decrease in negative emotion pre to post activity. The findings of this study provide support for the potential effect of aquatic activities in psychiatric rehabilitation.
Recreational therapy services with individuals recovering from spinal cord injury in inpatient rehabilitation: A cost-effectiveness analysis
Authors: Hawkins, PhD, LRT/CTRS Brent L. , Williams, EdD, LRT, CTRS Richard S. , Shores, PhD Kindal A. , Loy, PhD, LRT, CTRS David P. , Landry, PhD Craig E. , Barrett, MS, LRT, CTRS James L.
Published: August 2018

The purpose of this study was to examine the cost of delivery of inpatient therapeutic services in relation to their influence on change in functional independence (as measured by the Functional Independence Measure [FIM]) of people with spinal cord injuries (SCIs). Participants included adults with SCI (N = 549) who received treatment during inpatient rehabilitation at the study site during a 7-year span. Results from ordinary least squares multiple regression analysis indicated that recreational therapy (RT) significantly predicted both total and motor FIM scores, while occupational therapy (OT) predicted motor FIM change. When costs of service provision and change in motor FIM scores were compared, RT required fewer units of treatment to predict change in motor FIM scores and was less costly per unit than OT. Although not causal, findings provide evidence of the benefits of RT and lend support to the continued use of RT in inpatient rehabilitation programs.
ICF-based improvements in body structures and function, and activity and participation in chronic stroke following a yoga-based intervention
Authors: Van Puymbroeck, PhD, CTRS, FDRT Marieke , Allsop, MS, CTRS Jared , Miller, PhD, PT Kristine K. , Schmid, PhD, OTR Arlene A.
Published: August 2018

Purpose: The purpose of this study was to understand the perceived outcomes following a yoga intervention for individuals with chronic stroke, framed within the context of the International Classification of Functioning, Disability, and Health.Method: Twenty-six individuals with chronic stroke participated in one of five focus groups immediately following completion of an 8-week yoga intervention.Results: Primary themes emerged related to body structure and function (with subthemes of improved emotional regulation, increased stability and range of motion, and unexpected improvements in body function), and improvements in activity and participation. The improvements in body function led to participants more fully participating in their lives.Conclusions: While rehabilitation is not typically offered in the chronic poststroke period, the participants in this yoga study perceived changes in body functions, activity, and participation that they associated with the yoga intervention. Larger studies need to quantify these changes to make specific policy recommendations.
Arts-based reminiscence through visual art and narrative analysis: An intergenerational exploration
Authors: Mills, BA Emily J. , Seifert, PhD Lauren S. , Adams, MFA Clare Murray
Published: August 2018

Objective: To celebrate memory through intergenerational reminiscence that led to the creation of Keepsake Boxes and to the cultivation of lively narratives about them. In Western cultures, adults more than 65 years of age are often subjected to negative and condescending attitudes. Yet they are one of our greatest resources—possessing life experience and wisdom. The current research study sought to oppose ageism and affirm the value of aging adults through reminiscence, expressive art, visual analysis, and narrative analysis. In an intergenerational collaboration, a multimethod and trans-disciplinary approach was used to investigate an arts-based reminiscence activity. With a focus on problem solving, the authors drew upon theory, research, and methods from art, psychology, gerontology, and literary analysis. Dialogic process, narrative analysis, qualitative research techniques, and visual methods were cultivated. All participants took an art class that focused on one of their chosen, significant memories. The researchers used both narrative and visual methods to respond to participants’ artwork and narrative explanations. This project provides an example of the use of multiple methodologies within a trans-disciplinary framework to help engage adults across generations in reminiscence and reflection. It reasserts a positive role of art activities in elder life and of intergenerational collaboration in arts-based research.
Book review
Authors: Hawkins, PhD, LRT, CTRS Brent L.
Published: August 2018

Leisure and Aging: Ulyssean Living in Later Life (5th edition), by Francis A. McGuire, Rosangela K. Boyd, Megan Janke, Begum Aybar-Damali. Sagamore Publishing, 2013, 311 pages.
Physical activity levels, mood, and combat-related acquired brain injury: A cross-sectional examination of Operation Iraqi Freedom and Operation Enduring Freedom service members
Authors: Hirst, MS, CTRS Julianne M. , Porter, PhD, CTRS Heather
Published: August 2018

A significant number of military service members are returning from Operation Iraqi Freedom and Operation Enduring Freedom with acquired brain injuries, and these injuries have been significantly linked with depression symptomology. The primary purpose of this study was to examine the relationship between current levels of participation in leisure-time physical activity (LTPA) and self-reported depressive symptoms in adults with a combat-related acquired brain injury. The study also examined if differences exist in reported levels of LTPA and depressive symptoms between demographic groups and the perceived psychosocial benefits of participation in LTPA for adults with a combat-related acquired brain injury. A cross-sectional survey design using self-reported measures was used; 33 participants completed the survey. Results indicate that there was no significant correlation between current level of participation in LTPA and self-reported depressive symptoms. A diagnosis of post-traumatic stress disorder was the only demographic variable significantly correlated with higher self-reported depressive symptoms. Participants ranked “improved mood” as the highest perceived benefit of LTPA and “decreased anxiety” the lowest. Additionally, the perceived benefits of “improved mood,” “decreased anger,” and “increased self-esteem” were significantly correlated with lower levels of self-reported depression.
Developing a therapeutic recreation identity: A graduate researcher's personal narrative of grant writing and program design
Authors: Doyle, MS, CTRS Annalise
Published: August 2018

This personal narrative describes the process of a graduate student finding her professional identity as a recreational therapist through the grant writing and research process. The student details her experience of designing and implementing a therapeutic Zumba® program for youth at an afterschool program. The narrative attempts to shed light on the learning processes that occur during the experience and offers advice to other students developing their professional perspective.
White water kayaking, positive affect, and perceived self-awareness: A case study of a veteran of the Vietnam era
Authors: Hartman, MS, CTRS Kristen , Porter, PhD, CTRS Heather
Published: August 2018

Veterans from Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and the Vietnam era have sustained multiple injuries and disabilities as a result of their service, including Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), and depression. The use of outdoor recreation as a therapeutic modality for civilians with TBI has been found to correlate with greater self-awareness and positive affect, however, scarce literature exists regarding its use and outcomes for veterans. To explore this, a veteran from the Vietnam era reporting a history of depression who is involved with a white water kayaking group completed a series of surveys designed to measure its effect on perceived self-awareness and positive affect. The case study reported that involvement with the white water kayaking group improved his perceived self-awareness. The case study also reported the highest positive affect and lowest negative affect immediately after traveling down the river during a white water kayaking river trip. More research in this area is needed.
“Vorrei Prendere Il Treno!” (I Want to Take the Train): A narrative about how one Inclusive Recreation Services study abroad course helped students to understand challenges people with disabilities confront while traveling abroad
Authors: McKenney, EdD, CTRS Alexis
Published: August 2018

It was Florida International University's most unusual study abroad course this year. Compared to most study abroad programs that focus on art and culture, the Inclusive Recreation Services course, taught in Miami, FL; Florence, Italy; and Paris, France, focused on challenges people with disabilities confront while traveling. In addition to learning about disability groups, attitudes about disabilities, accessibility and recreation programming, and the Americans with Disabilities Act, this class included a review of, and comparison to, Italian and French disability laws, as well as hands on experiences designed to give students a perspective gained from experiencing challenges associated with accessing buildings, roads, and public transportation in cities with extensive histories. This article provides a description of select learning activities and information learned presented in a narrative format.
An exploration of recreational therapy in the Veterans Health Administration polytrauma system of care
Authors: Ferrante, CTRS Morgan , Porter, PhD, CTRS Heather R.
Published: August 2018

Polytraumatic injuries, defined as two or more injuries sustained in the same incident that affect multiple body parts or organ systems and result in physical, cognitive, psychological, or psychosocial impairments, emerged during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). These injuries are complex and require special care. In response, the US Veterans Health Administration established the polytrauma system of care (PSC) in 2005. Current research identifies recreational therapy (RT) is a primary healthcare service within the PSC; however, given its recent creation, little is known about the role and function of RT in this setting. This study explored the role and function of RT in the PSC using a Delphi design across five PSC sites in the United States, with special emphasis on RT assessments used, diagnoses seen, RT interventions applied, RT outcomes targeted, RT discharge planning processes, and team collaboration. Seven of a possible 30 recreational therapists participated yielding a 23 percent response rate. The results may serve as a springboard for identifying best practices, strengthening evidence-based practice, and advancing RT research in polytrauma care.
The recreational therapy faculty shortage: A crisis for the profession
Authors: Van Puymbroeck, PhD, CTRS, FDRT Marieke , Austin, PhD, FDRT, FALS David R.
Published: August 2018

A national shortage of doctorally prepared faculty is threatening the health and longevity of the field of recreational therapy. As more faculty reach retirement age, there are few new doctorally trained recreational therapists available to fill this gap. In 2014 alone, more than 15 faculty positions were available, and there was only one new PhD on the market. When existing faculty move to fill these positions, gaps are created in university recreational therapy programs across the country. This article reviews how substantial and potentially damaging this shortage is and provides a number of suggestions for addressing the shortage. These suggestions include retaining senior faculty, increasing the number of doctorally prepared recreational therapists, and recruiting new faculty.
Book review
Authors: Kensinger, PhD, CTRS Kari
Published: August 2018

Recreational Therapy: An Introduction (Fourth Edition), by David R. Austin, Michael E Crawford, Bryan P. McCormick, and Marieke Van Puymbroeck. Sagamore Publishing, 2014, 318 pages.
Book review
Authors: Dieser, PhD, CTRS, tLMHC Rodney B.
Published: August 2018

Cultural Competence in Recreational Therapy: Working with African Americans, Chinese Americans, Japanese Americans, Hmong Americans, Mexican Americans, and Puerto Rican Americans, by Jearold W. Holland. Idyll Arbor, 2014, 197 pages.
Advocating for the profession: Your role in supporting HR 1906, the Access to Inpatient Rehabilitation Therapy Act of 2015
Authors: Williams, EdD, LRT, CTRS, FDRT Richard , Skalko, PhD, LRT/CTRS/FDRT Thomas
Published: August 2018

Public policy advocacy is critical to the profession of Recreational Therapy. Currently, HR 1906, the Access to Inpatient Rehabilitation Therapy Act of 2015 has been introduced to the US House of Representatives. Essentially, if enacted into law, the bill will amend the Social Security Act to include Recreational Therapy among the therapy modalities that constitute an intensive rehabilitation therapy program in an inpatient rehabilitation hospital or unit. The designation of RT among the therapy modalities allows the rehabilitation treatment team to access RT services for use in the 3-hour rule.
A brief review of loneliness: Correlates, consequences, and considerations for recreational therapists
Authors: Rozek, PhD Ellen , Richeson, PhD Nancy E.
Published: August 2018

Loneliness is a complex human experience that most people experience in their lifetimes. The authors review how the construct of loneliness is defined and how it is distinguished from the concept of social isolation. Common risk factors that predict loneliness such as gender, marital status, and age are discussed. Potential consequences for people who are lonely can be emotional, physical, and cognitive. Research on these functional outcomes is reviewed. Because loneliness is a prevalent human experience, recreational therapists are likely to encounter individuals who may be dealing with loneliness. The authors discuss how recreational therapists can use this information in clinical practice.
A Flex-Model for long-term assessment of community-residing older adults following disasters
Authors: Rosenkoetter, PhD, RN, CNS, FAAN Marlene M. , McDonough, PhD, RN JoEllen , McCall, PhD, RN Amber , Smith, DNP, RN Deborah , Looney, PhD Stephen
Published: August 2018

For the rapidly growing older adult population, disaster consequences are frequently life disruptive and even life threatening. By 2050, it is estimated that the global older adult population will reach 22 percent of the total. With declining health, this population poses a particular risk needing to be addressed in emergency preparedness and disaster recovery. The purpose of this article is to describe a Flex-Model (F-M) for the long-term assessment of older adults following a disaster. An F-M is a series of three-dimensional representations of an archetype with flexible components, both linear and parallel, that can be adapted to situations, time, place, and needs. The model incorporates the Life Patterns Model and provides a template that can be adjusted to meet the needs of a local community, healthcare providers, and emergency management officials, regardless of the country or region, during the months after a disaster. The focus is on changes resulting from the disaster including roles, relationships, support systems, use of time, self-esteem, and life structure. Following a baseline assessment, each of these life patterns is assessed through the model with options for interventions over time. A pilot study was conducted in Georgia to gain information that would be helpful in developing a more specific assessment tool following a severe winter storm. While this is a local study, the findings can nevertheless be used to refine and focus the F-M for future implementation. Results indicated that older adults used high-risk heating and lighting sources and many were totally responsible for their own welfare. Findings have implications for emergency preparedness and long-term recovery.
World Health Organization Disability Health Assessment 2.0 for Health Monitoring: Examining the potential use of the WHODAS 2.0 as a health screening tool among older adults in rural North Carolina
Authors: Warren, MS, CTRS Amanda , Williams, EdD, LRT/CTRS/FDRT Richard
Published: August 2018

Unless measures are taken, escalating healthcare costs and an aging population will increasingly contribute to financial burdens on federal and state healthcare budgets. With the help of appropriate supports, many older adults can remain in their homes and communities and delay expensive long-term care placements. An important aspect of aging in place is health monitoring so that health issues can be addressed before they escalate. The WHODAS 2.0 is a standardized assessment tool that may be valuable for recreational therapists and others to use to monitor health and functional status of community-dwelling older adults.
A comparison of recreational therapy and child life practice: Similarities, differences, and opportunities
Authors: Cooper, MSRT, CTRS, CCLS Victoria L. , Porter, PhD, CTRS Heather R.
Published: August 2018

Transdisciplinary care and collaboration among team members is necessary and essential to maximize patient outcomes. Collaboration is the most effective when professionals understand the unique role of each discipline. This is potentially more difficult when disciplines overlap in some services provided, or when an individual on the team is dually certified. In pediatric care settings, this is often the case for recreational therapy (RT) and child life (CL). The purpose of this study is to highlight the benefits of transdisciplinary care, as well as summarize similarities and differences between the two fields based on profession-based documents. Findings indicate 28 unique areas of RT practice, 18 grey areas (items found in both RT and CL profession-based documents with shades of differences), eight items found in one profession that are highly likely to occur in both professions, and 31 areas of similarity. Items of similarity do not raise concern, as the items appear to be common among many healthcare professions, such as developing a therapeutic relationship and conducting an assessment. Differences stem from underlying principles of each profession. RT is primarily a treatment/therapy-based profession (eg, functional skill development), whereas the foundation of CL is a helping-based profession (eg, coping within the hospitalized environment). RT must effectively deliver a message of its unique contribution to the healthcare landscape with special emphasis on functional skills development, client and family education and counseling, and community integration and transition training related to maximizing healthy engagement in play, leisure, recreation, and community activities post hospitalization for continued recovery, development, and prevention. Methods of disseminating findings and strengthening RT evidence-based research in pediatric acute care are provided, along with suggested opportunities for collaborative research.
Family Battle Buddies Program: A therapeutic program for reintegrating National Guard families
Authors: Dawson, MA, CTRS Shay , Gilbert, PhD Kathleen , Gilbert, PhD Rebecca , Beckmeyer, PhD Jonathon , McCormick, PhD Bryan
Published: August 2018

It is widely documented that military deployment contributes to family stress, yet little attention has been given to the psychosocial stressors associated with the reintegration phase post-deployment. Challenges associated with reintegration include role ambiguity, communication breakdown, conflict, and increased risk for parental divorce. The Family Battle Buddies Program (FBBP) was developed as an evidenced-based practice approach to address the reintegration phase of military life for returning National Guard families. In this report, the authors detail the theoretical foundations and specific program components of the FBBP.
Recreational therapy competencies for working with older adults
Authors: Richeson, PhD, CTRS, FDRT Nancy E. , Sardina, MS, CTRS Angie
Published: August 2018

This article explores the work of the American Therapeutic Recreation Association's (ATRA's) Geriatric Treatment Network (GTN). For the past 4 years, the GTN has worked to develop recreational therapy competencies for older adults based on recommendations from the Institute of Medicine (IOM) report, which stated that the existing workforce was ill equipped to meet the needs of an aging America. Industry-wide competencies developed by the Association for Gerontology and Higher Education (AGHE) and the Partnership for Health in Aging (PHA) are highlighted as necessary knowledge needed for a trained workforce. To adequately meet the needs of older adults, the recreational therapist is encouraged to find resources and educational opportunities to implement industry-wide and recreational therapy competencies.
Calling professionals to action
Authors: Wise, PhD, CTRS James B.
Published: August 2018

Professionals who advocate for cleaving the present therapeutic recreation practice along philosophical lines are called to step forward and lead preparations for the separation. The primary and most crucial task facing each group of advocates is developing a philosophical foundation. A foundation is critical because it guides every aspect of a practice including the identification of requisite knowledge, skills and abilities to excel as practitioners, and determination of the profession’s name and practitioners’ title. Developing philosophical foundations for the two desired practices and completing the concomitant tasks ensures the formation of viable practices that can benefit everyone.
Activity-in-a-Box for engaging persons with dementia in groups: Implications for therapeutic recreation practice
Authors: Cohen-Mansfield, PhD Jiska , Hirshfeld, MA, CTRS Karen , Gavendo, BA, CTRS Rachel , Corey, BA, CTRS Erin , Hai, MEd Tasmia
Published: August 2018

Therapeutic recreation (TR) activities benefit the affect and behavior of persons with dementia. The authors examine the perceived utility of an Activity-in-a-Box methodology as part of a larger study examining the impact of group activities on persons with dementia. The box contained items such as a program protocol and materials adapted to the abilities of persons with dementia. This article reports about the perceptions of 10 TR staff concerning the utility of the Activity-in-a-Box format. Staff reported that materials were very useful and enumerated multiple benefits, including: enhancing therapists’ ability to engage participants in different activities, facilitating new types of activities for staff members to try, and a useful tool for training. The authors recommend further investment in enhancing the scope and the quality of Activities-in-a-Box materials.
The truth about strengths-based practice: Not a new paradigm for recreational therapy—But an important one
Authors: Austin, PhD, FDRT, FALS David R. , McCormick, PhD, CTRS, FDRT, FALS Bryan P.
Published: August 2018

Although Heyne and Anderson have offered their strengths-based approach as a sea change in the practice of recreational therapy, there is compelling evidence that the strengths-based approach has existed within recreational therapy for some time. In fact, recreational therapists should take pride in being among the early adopters of the strengths-based approach. Recreational therapy’s foundation in humanistic psychology, and subsequently in positive psychology, has always provided an orientation to practice in which therapists were encouraged to focus on client strengths and resources. In addition, the authors argue that Heyne and Anderson’s exclusive focus on strengths, to the neglect of client problems and concerns, does not represent the entire spectrum served by recreational therapists. Further, Heyne and Anderson have inaccurately characterized recreational therapists as following a medical model, which emphasizes only client problems or health conditions. Further, they erroneously portray recreational therapists as exerting dominance over clients. This representation is simply not in keeping with practices in recreational therapy. The authors suggest that Heyne and Anderson should be applauded for bringing attention to the importance of recreational therapists focusing on using a strengths-based approach to assist clients to move toward the achievement of optimal functioning and well-being. In doing so, however, they have failed to acknowledge that recreational therapists work along the full range of human functioning that includes helping clients to alleviate problems at one end of the spectrum to the promotion of optimal functioning at the other end. The roles of alleviating client health problems and issues and the promoting of optimal functioning are dual roles that recreational therapists do and should take.
A comparative study on the effects of Tai Chi and Matter of Balance on measures of balance and fall efficacy in older adults
Authors: Skalko, PhD, LRT/CTRS, FDRT Thomas K. , Burgess, LRT/CTRS Lacey A. , Janke, PhD, LRT/CTRS Megan
Published: August 2018

The purpose of this study was to compare two intervention strategies, Tai Chi (TC) (n = 12) and Matter of Balance (MOB) (n = 13) on balance and fall efficacy of older adults (≥65 years) as compared to a control group (n = 12). The study compared changes in balance and fall efficacy of the two strategies in an effort to evaluate fall reduction programs for future application. Participants were assessed via a pretest to post-test, 8-10 weeks apart using two balance tests: 8-Foot Up and Go test and the Multi-Directional Reach Test. Fall efficacy was measured with the Activities-specific Balance Confidence (ABC) Scale. Results from this study indicate that the TC group and MOB group were both effective in improving or maintaining balance and fall efficacy as compared to the control group. Results demonstrated trending toward TC as having a greater impact on participants’ overall balance measures.
An exploration of recreational therapy students’ attitudes toward adults with developmental disabilities
Authors: Prinzo, MS, CTRS Cara M. , Snethen, PhD, CTRS Gretchen
Published: August 2018

While more adults with developmental disabilities are living in the community, negative attitudes and stigma remain a barrier to independence and community integration. Both community members and healthcare providers harbor these attitudes, and thus may discriminate against this population. The adverse consequences of stigma particularly within the healthcare system have a negative impact on the health and well-being of adults with developmental disabilities. Because recreational therapists provide services that often promote independence and community integration, it is important to have an understanding of underlying attitudes toward this population. This article reports on the attitudes of recreational therapy undergraduate students toward adults with developmental disabilities and factors that may be associated with these attitudes. Based on correlational analyses, recommendations are made for recreational therapy curriculum to reduce stigmatizing attitudes.
Book review
Authors: Battle, CTRS, CDP Tameka S.
Published: August 2018

Therapeutic Recreation Leadership and Programming. Robin Kunstler, ReD, CTRS and Frances Stavola Daly, EdD, CTRS, CPRP. Champaign, IL: Human Kinetics. 2010.
Current status of assessment in recreational therapy practice
Authors: Kemeny, PhD, CTRS M. Elizabeth , Hutchins, EdD, FDRT, CTRS Deborah , Cooke, EdD, CTRS, CLL Colleen A.
Published: August 2018

Client assessment is the basis for program planning and implementation in recreational therapy. It is through the assessment process that individualized goals and objectives are formulated. Entry-level professionals must be proficient in the assessment process and have knowledge about various assessment tools. The purpose of this project was to conduct a survey of practicing Certified Therapeutic Recreation Specialists to determine what is current practice in terms of recreational therapy assessment across settings. It was hoped that this project would advance recreational therapy by informing educators and aiding current practitioners in their efforts to identify and use reliable and valid assessment tools in their practice setting.
The effects of exercise on depressive symptoms of individuals with dementia: A pilot study
Authors: Logan, MS, LRT/CTRS Deborah , Van Puymbroeck, PhD, CTRS, FDRT Marieke
Published: August 2018

Dementia is a disease that can affect individuals as they age, and for many individuals with dementia, there is a chance of additional comorbidities, such as depression. When these two health conditions occur simultaneously, it is more difficult to treat the depressive symptoms. To evaluate changes of depressive symptoms in residents of an assisted living facility who have the diagnosis of dementia, 10 days of 30-minute exercise sessions were conducted. Nonparametric statistics indicated a significant decrease in depressive symptoms for the seven participants in this exploratory pilot study. The results from this study indicate that a decrease in depressive symptoms is possible and can be facilitated by a recreational therapist via a structured exercise group. Further research ideas and implications for practice are described.
Companionship with a robot? Therapists’ perspectives on socially assistive robots as therapeutic interventions in community mental health for older adults
Authors: Piatt, PhD, CTRS Jennifer , Nagata, MS, CTRS Shinichi , Šabanović, PhD Selma , Cheng, MS Wan-Ling , Bennett, PhD Casey , Lee, MS Hee Rin , Hakken, PhD David
Published: August 2018

Lack of companionship, loneliness, and social isolation are often experienced by older adults diagnosed with clinical depression living independently within the community. Socially assistive robots (SARs), a relatively new concept within recreational therapy, may be one treatment modality that can address each one of these concerns. This exploratory study consisted of interviews with community mental health professionals, including a recreational therapist, to determine if they perceived SARs as an appropriate interdisciplinary clinical intervention for older adults diagnosed with clinical depression. Results indicated that SARs, especially those which can provide companionship and social interaction similar to animal assisted therapy, are an appropriate interdisciplinary intervention for this population and may have an impact on improving overall quality of life by decreasing loneliness and social isolation associated with clinical depression.
Book review
Authors: Richeson, PhD, CTRS, FDRT Nancy E.
Published: August 2018

Disrupt Aging: A Bold New Path to Living Your Best Life at Every Age. Jo Ann Jenkins. New York, NY: PublicAffairs. 2016, 272 pages
Effect of coloring on student stress levels
Authors: Powell, CTRS, BRLS April , Alcorn, CTRS, BRLS Katlyn , Lindsay, BRLS Kaitlin
Published: August 2018

The use of coloring as a form of therapy is relatively new and therefore there is limited research surrounding the topic. This study looked to increase the knowledge base surrounding this topic to better educate those who may find it useful, such as students, educators, or therapists. This study recruited participants aged 18-21 who were full time students at university living away from home. They were asked to complete a self-assessment of their stress levels before and after their participation in a stress induction procedure, as well as after participating in their assigned intervention for 20 minutes. There were three assigned treatments: mandala coloring, traditional coloring, and the control group. This study found statistically significant results supporting the mandala coloring group as an effective intervention for stress reduction. Although only the mandala pattern displayed statistically significant stress reduction, the traditional coloring pattern was able to provide some stress reduction to participants. The control group who sat passively for 20 minutes reported higher stress scores at the end of the study when compared to their initial baseline scores. The findings confirm that coloring is an effective form of therapy when it comes to reducing stress in the university student population.
Therapeutic alliance and the relationship with motivation for recreational therapy treatment
Authors: Zahl, PhD, CTRS-L Melissa L. , Passmore, EdD, CTRS-L, FDRT Tim , Cudd, MS, CTRS Taylor
Published: August 2018

Recreational therapists employ different techniques to facilitate changes in health status and behaviors of patients. One concept which is often overlooked is the potential collaborative process between recreational therapy (RT) and the patient, which is fostered by agreements on treatment goals, consensus on tasks of therapy, and a positive bond between the patient and therapist. RT, in general, appears to be beneficial to advancing a patient to greater wellness; however, patients may still have issues with compliance, dropout, and maintenance of change. To address issues of dropout, compliance, and maintenance, it may be important to investigate motivation for RT. The purpose of this study was to determine if Therapeutic Alliance (TA) was correlated with motivation, as described by Self-Determination Theory, and where possible differences occurred. The results of the study confirm that a correlation exists between TA and motivation, and if a recreational therapist is able to develop and maintain a stronger TA with an individual or patient, intrinsic motivation for participation in RT sessions may exist. The results also indicate that patients reporting weaker TA also have higher amotivation correlation and external regulation. Amotivation and external regulation result in high levels of reported extrinsic motivation toward participation in RT session. Further research is needed to determine if length of time participating in RT treatment impacts the development of TA resulting in changes in reported intrinsic motivation for RT treatment.
Cardio-kickboxing and dynamic balance in adults with developmental disabilities
Authors: Tapps, PhD, CPRP Tyler , Walter, MS, CTRS Alysha A. , Tapps, MS, CTRS Mary
Published: August 2018

This study examined the relationship between cardio-kickboxing and balance in individuals with developmental disabilities (DDs). Cardio-kickboxing is a combination of aerobics, boxing, and martial arts. In general, cardio-kickboxing has shown to improve balance in participants. To our knowledge, this is the first adult cardio-kickboxing program for participants with a DD. Twenty-one adults with development disabilities were randomly assigned to either an intervention group or a control group. Participants were tested at baseline, week four, and postintervention using the Four Square Step Test. Improvements were shown in balance (p < 0.0125) at postintervention testing. Results indicate that cardio-kickboxing may be a promising intervention to improve balance for individuals with DDs.
Psychosocial outcomes of participation in adaptive sports for adults with spinal cord injuries: A systematic review of the literature
Authors: Prout, MS, CTRS Brooke , Porter, PhD, CTRS Heather R.
Published: August 2018

This systematic review of the literature aims to determine the psychosocial outcomes of participation in adaptive sports for adults with spinal cord injuries (SCIs). The search yielded 68 articles, of which 14 met the inclusion criteria. Findings support the use of adaptive sports by recreational therapists to elicit positive psychosocial outcomes for adults with SCIs, although more research is needed. Recommendations for practice and future research are provided.