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Katie Koplow U0700381 PRT 3360 Assessment and Documentation Primary Childrens Behavioral Health at Wasatch Canyons Campus

Intermountain Healthcare system Written Plan of Operation: Purpose: -Recreational Therapy Services are a vital part of the community-based treatment at Primary Childrens Behavioral Health at Wasatch Canyons. The TRS provides therapeutic interventions that help meet the needs of latency-aged children (ages 6-14) coming from diverse cultures. These interventions address the severe emotional, behavioral and psychiatric problems this diagnostic group faces. A specific treatment plan is created to meet individual needs while providing opportunities to learn about enhanced leisure opportunities and expand resources to help develop coping skills. The Recreational Therapy Department has a role in providing treatment interventions through evidence-based research and helps with the need to optimize patient health and provide resources so they can make decisions about their care and live a life of enhanced well being. Philosophy: -Recreational Therapy assesses, plans, implements, and evaluates treatment through client engagement in a variety of group and individual experiences. The interventions are used to improve social functioning, coping skills, language skills, develop personal awareness, expression and understanding of emotions, leisure resources and knowledge of how to achieve a greater quality of life. Team Mission: -To be a model Recreational Therapy program for the Intermountain health care system by continually learning and providing extraordinary care in all its dimensions. The Recreational Therapy program will be designed to provide a safe, effective, and age appropriate programing and treatment for all levels of the spectrum based off evidence based research and to promote and atmosphere of staff/client trust, accountability, mutual respect and excellence. Human Resources: -The RT department is managed by a Master Therapeutic Recreation Specialist (MTRS) and Certified Therapeutic Recreation Specialist (CTRS). The manager of RT reports to the Primary Childrens clinical director and is supervised by Intermountain Health Care working with the program service director, medical director, nursing staff and the social work and psychology departments. The Manager of RT is responsible for insuring that staff is meeting ATRA standards of practice, NCTRC job analysis and that staff is working within in their scope of practice. The Manager provides opportunities for professional development that helps staff develop knowledge, skills and abilities to improve their patient outcomes. -The R.T. managers are in charge of monitoring the programs and ensuring that their clients are meeting their goals. A weekly staff meeting will be held to work on staff communication, share concerns and make sure that treatment is being provides in a timely and appropriate manner. Staff is expected to document and communicate assessments and evaluations with the team and include input from other members of the treatment team when providing therapy A yearly assessment of staff competencies will be required and the department will continually work to

improve department goals, and create systematic routine and establish methods for providing the best form of treatment for clients. -A formative evaluation based on established goals and a summative evaluation that determines the effectiveness of the treatment plan will be used when evaluating the clients functional outcomes and satisfaction. -The RT department is devoted to their profession and the purpose of their job. In order to help this profession they work with recreational therapy students by allowing internships that allow them to experience the profession. An internship coordinator will help with the application process and in identifying supervisors for those students during their practicum. The RT department also finds value in membership to professional organizations. Along with the required State licenses and national certifications, registrations are required as part of the job description. This paperwork is maintained with the Human Services Department and the Manager of RT. The RT is required to adhere to the ATRA Code of Ethics. Scope of Care: Patients with sever emotional, behavioral and psychiatric problems, especially those on the Autism Spectrum Disorder. Those specifically diagnosed with Autism Spectrum Disorder mush have two features associated with their diagnosis according to the Diagnosis and Statistical Manual of Mental Disorder: impairment in social interaction and communication, and behavior. Families of patients as it related to clients treatment Children latency age, mixed gander ages 6-14. Program Description: 1. An assessment is conducted upon admission to Wasatch Canyons within 48 hours. The assessment will have clear and concise objective questions and will be culturally appropriate for the clients strengths and limitation in the following areas of functioning: physical, cognitive, social, behavioral, emotional, leisure/play. Further assessments will be considered from: a physician, treatment team recommendations, and noted referral from other therapist within the RT department when gathering all data to create a treatment plan. The assessment will be conducted using standardized assessment procedures as appropriate either by: structures interviews, direct observation, performance testing, standardized testing, information from others and record review. 2. Goals and objectives will be established based on assessed needs and become part of the master treatment plan for the client. These will be effectively communicated to others and systematically reviewed and revised. The treatment plan will be developed to provide therapies that will help meet the needs of the patient, incorporating the physical, social, emotional, intellectual, spiritual, cultural, recreation, and health and wellness needs of the client that are appropriate by the assessment. Services are provided in group settings, individual treatment, and family therapies following the leisure and well being model to enhance a greater quality of life.

3. Treatment will be provided to help the patient develop skills in coping management, expressing and understanding emotions, learning social and language skills, preventing object fixation and repetitive behaviors, dealing with hypersensitivity and hyposensitivity. Program Interventions include: Coping skills Aquatic therapy Self-injury management Social Skills Understanding emotions The outcomes of the programs will be: 1. Based on the level of functioning of the individual the RT will provide methods and resources to help the individual develop coping skills and provide them with resources to help during difficult situations, especially routine change. 2. The RT will help develop the clients knowledge of authentic leisure and cognitive resources. 3. Client will demonstrate new resources when place into a strange situation and required to use coping skills to help them handle the change in routine. 4. Based on the level of functioning of the individual the RT will provide aquatic therapy to help improve physical resources and enhance ultimate leisure and causing an increased well being. Client will demonstrate new skills by showing improvement in swimming skills, ability to adapt to the change in environment and routine. 5. Based on the level of functioning of the individual the RT will provide self-injure and destructiveness resources by developing savoring leisure activities and improving psychological resources that help improve self-awareness and help the client understand the consequences to their actions. Client will demonstrate skills by showing an understanding for the consequences to their behavior and showing the therapist new skills to help prevent self-injury. 6. Based on the level of functioning of the individual the RT will provide social skills resources by developing psychological, social and environmental resources. 7. This will help the client develop resources to help engagement with others in an appropriate way. The RT will provide mindful leisure opportunities to help them understand current personal issues that prevent social interactions and build upon their virtuous leisure skills so they can use their strengths to help them confidently engage with others. Client will demonstrate new skills by successfully interacting with 5 people in five different settings 8. Based on the level of functioning of the individual the RT will provide activities that help clients express, understand and explain their emotions. RTs will work on developing psychological, cognitive resources and social resources so that client can have resources to help develop interpersonal skills and social connectedness by being able to understand and interpret others emotions. Client will express 10 different emotions, identify 10 different emotions and interpret 10 different emotions off 10 different people. 4. Discharge planning is provided for patients to help them understand and maintain the skills and resources acquired through our program after leaving. This plan will help maintain appropriate coping skills, lifestyle and improve quality of life. RT will complete discharge summaries based off initial goals and objectives. This will help client see what is the next step and how to achieve that, along with follow-up recommendations and after care. This summary will include current functional level, further treatment goals and objectives and recommendation for continued service or aftercare according to their needs, cultural adaptation, living situation, support system, leisure needs, financial needs, skills and resources.

Specific Program Design: Program: Coping skills resources for children with Autism General Statement of Purpose: To provide programs that improves the ability of the client to cop in a positive manor during difficult situations including times of being overwhelmed, intensified sensory input, and environmental factors, especially during routine change. Expected outcomes: Based on the level of functioning of the individual the RT will provide methods and resources to help the individual develop coping skills and provide them with resources to help during difficult situations, especially routine change. Client will demonstrate new resources when place into a strange situation and required to use coping skills to help them handle the change in routine. Based on the level of functioning of the individual the RT will provide social skills resources by developing psychological, social and environmental resources. This will help the client develop resources to help engagement with others in an appropriate way. The RT will provide mindful leisure opportunities to help them understand current personal issues that prevent social interactions and build upon their virtuous leisure skills so they can use their strengths to help them confidently engage with others. Client will demonstrate new skills by successfully interacting with 5 people in five different settings

Risk management considerations: -Therapist will be aware of outburst and violent reactions when clients are placed in new situations -Therapists will need to ensure that the surrounding areas are clear of any materials that could be used to cause harm to others. -Objects that could be used as a fixation should be eliminated but some children might not be able to function without them. -Therapists should be considerate of the lighting and noise in the room. The client should be able to handle loud noises and communicate that different lighting is bothersome but while giving instructions and teaching this could be a major distraction. Resource Management: -The RT department will be responsible for monitoring the use of resources and establishing methods for identifying resource management problems. The cost per unit of serves will be assessed also. The RT staff also has to determine the clients treatment status including initiation, continuance, revision and discontinuance of RT services. The resources will also be used appropriately during course of treatment and the benefits from the use of TR resources should not create more problems. Program Evaluation and Research: -Patient satisfaction results are reported to the Manager of RT and quality improvement indicators are developed when appropriate. The profession is responsible to routinely evaluate and conduct research to maintain accountability and demonstrate outcomes. -Programs will be based off evidence-based practice and will have research to back their intended outcomes. Programs will be evaluated and research will be used to improve service delivery. -With therapeutic recreation as an evolving practice it is the professionals responsibility to routinely evaluate and conduct research to maintain accountability and demonstrate outcomes to

help validate the profession and share their knowledge with others. This facility has professional affiliation with URTA, ATRA and follows the DOPL K. Koplow, TRS, CTRS November 2, 2013

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