Coping Skills Program Plan

Jackque Sheppard

Facility Description

Eva Carlston Academy

Eva Carlstons facility is located in an urban residential neighborhood of Salt Lake City. The location was chosen to provide exposure to a range of activities from theater performances to culinary classes and outdoor sports. The facility consists of three homes housing up to sixteen girls each. Each home has its own kitchen schoolroom dining room and common areas. The grounds also hold an indoor pool tennis court fitness center dance studio garden challenge course field library art studio and music room. !ealthcare based residential treatment center for girls Services offered include" individual therapy family therapy recreational therapy group therapy and addictions # substance abuse treatment $http"%%evacarlston.com%therapy%& 'ission" (ur mission is to provide the treatment and support necessary to help these girls heal and find their place their passion and their purpose in life. $Eva Carlston )cademy mission from http"%%evacarlston.com%admissions%& *ision" +e envision a generation of young women who believe in themselves and who possess the character self,discipline and courage to be productive members of their communities. $-ulshear .anch )cademy vision from http"%%www.fulshearranchacademy.com%our,program.php& *alues" unconditional acceptance dedication to evidence,based outcome therapies compassion and family involvement $values from -alcon .idge .anch http"%%www.falconridgeranch.com%mission,statement.html and Cottonwood Treatment Center http"%%cottonwoodtreatment.com%about%mission,vision,and, values,/%& Eva Carlston )cademy serves girls between 0/,01 with any of the following issues" depression anxiety defiance # behavioral issues )2!2 learning issues emerging personality disorders self,harm addictions eating disorders suicidal ideation substance abuse bipolar disorder trauma low self,esteem adoption and attachment issues emotional physical and sexual abuse non,verbal learning disorders $3L2s& or pervasive developmental disorders $422s&. $http"%%evacarlston.com%admissions%&

Service Delivery Model

Service 2elivery 'odel" Leisure and +ell,5eing 'odel )s indicated by the name the Leisure and +ell,5eing 'odel $L+'& was developed with the long 6term goal of well,being. -or the model well,being is defined as a state of 7successful satisfying and productive engagement with ones life and the reali8ation of ones full potential9 $Carruthers # !ood /::; p. <&. To meet this goal it aims to highlight clients strengths instead of their limitations and allow the T.S to provide services accordingly. The L+' is structured with two main components that work together at increasing well,being through therapeutic recreation services. The first being 7enhancing leisure experiences9 and the second being 7developing resources9 $Carter #*an )ndel /:00&. Enhancing leisure experiences is an important component because the quality of the leisure is what will create well,being= not all leisure experiences are positive and supportive of personal growth. The L+' lists five ways of enhancing leisure experience including savoring leisure authentic leisure leisure gratifications mindful leisure and virtuous leisure $Carter # *an )ndel /:00&. Savoring leisure involves choosing leisure experiences that have been historically positive for the client because positive emotion leads to outcomes that contribute to well,being $Carruthers # !ood /::;&. Authentic leisure is that which is as Carruthers and !ood $/::;& say 7reflective of essential aspects of the self9 $p.0:&. )uthentic leisure will be chosen based on an individual and their personal strengths interests and goals $Carruthers # !ood /::;&. Leisure gratifications create 7flow9 a state in which a person feels completely engaged and 7at home9 $Carruthers # !ood /::; p. 00&. )nother way of enhancing leisure experience is

mindful leisure. Mindful leisure is being fully engaged and conscious of the current experience. )ccording to Carruthers and !ood $/::;& mindful leisure will lead to better ability to deal with lifes daily stressors. Lastly virtuous leisure will help build meaning in ones life through contribution to the community and world. *irtuous leisure allows a person to feel accomplished and to develop a sense of purpose in life. These five ways of enhancing leisure experiences will make leisure positive rewarding and allow for personal growth as well as various other outcomes leading to overall life satisfaction and well,being. )s previously mentioned the second component of the L+' is developing resources. .esources are sources of support that can be within or outside of an individual $Carter # *an )ndel /:00&. The model gives five resources that contribute to well,being and arm the T.Ss with direction for providing services. The resources include psychological social cognitive physical and environmental $Carter # *an )ndel /:00&. Psychological resources include 7capacity for happiness emotion regulation self, awareness self,determination competence optimism and sense of meaning9 $Carruthers # !ood /::; p. <&. These things develop an individual internally and contribute to well, being. Social resources refer to social connectedness and human interaction both of which are thought to be fundamental needs of an individual that affect things like happiness and confidence. Cognitive resource is an individuals neural functioning. >t is their energy for challenging and stimulating cognitive activity. Carruthers and !ood $/::;& say that engagement in challenging activities help individuals adapt to loss in cognitive functioning through disease and disability. Physical resources include things that aid in daily living such as 7physical health fitness mobility energy and vitality9

$Carruthers # !ood /::; p. ?&. )ctivities geared toward these things promote positive emotion and growth leading to greater well,being. The last suggested resource of focus is environmental. Environmental resources are those present in an individuals daily life that affects their well,being. This includes social communities. >t is crucial that relationships are supportive and genuine to provide pleasurable experiences and positive interactions with others. The Leisure and +ell,5eing 'odel is based on the shift in thought from elimination of an individuals problems to a celebration of their strengths. The L+' ultimately prepares a T.S to use an individuals strengths interests and goals in developing a personali8ed treatment plan that will provide outcomes conducive to increasing well,being. Carruthers and !ood $/::;& speak of the growing $theory& of positive psychology and its focus on 7human capacity character virtues and happiness.9 They say 7the goal of therapy is to build a positive spiral of emotion and action in clients that energi8es and empowers them to take on increasingly greater opportunities and challenges in important valued life domains9 $p.0&. The model focuses on what an individual can do $their strengths& and not what they cant. +ell,being is the most important thing for the Leisure and +ell,5eing 'odel and is generally the ultimate distal goal of therapeutic recreation treatment delivery using this model. Carruthers and !ood see two great contributors to this goal" positive emotion and cultivation of an individuals potential $/::;&. The first positive emotion is simply 7the presence of positive mood and experiences lack of negative mood and experiences9 $Carruthers # !ood /::; p.?&. They believe that when there are more feelings of happiness and positivity than sadness and negativity is when a person is really satisfied

with their life. Cultivation of ones potential is what an individual needs in addition to the positive feelings. !appiness is great but for true well,being Carruthers and !ood $/::;& say one needs 7a process of ongoing self,discovery cultivation of personal strengths creation of contexts that support development and finding meaning in life9 $p. @&. +ell, being cannot be reached merely with moments of positive emotion= there must be a search for ones self and a discovery by the individual of the real self. 4ositive psychology focusing on individual strengths and maximi8ing well,being through positive emotion and cultivation of potential are the theoretical underpinnings of the Leisure and +ell,5eing 'odel and the basis for all the model aims to accomplish. The Leisure and +ell,5eing 'odel will provide the structure for the delivery of Eva Carlston )cademys therapeutic recreation services for many reasons. -irst the L+'s goal of well,being perfectly aligns with Eva Carlstons mission to provide the treatment and support necessary to help our girls heal and find their place their passion and their purpose in life. )s previously mentioned well,being is achieved through the personal discovery of self and cultivation of strengths. 3aturally finding passion and purpose in life would be steps on this Aourney towards well,being. )lso at Eva Carlston we value unconditional acceptance and agree with the ideologies of promoting strengths helping develop supportive resources and positive emotion that the L+' includes. 5eing that Eva Carlston )cademy serves girls with traumatic backgrounds and maAor diagnosis such as depression personality disorders self,harm addictions abuse low self,esteem eating disorders and more the Leisure and +ell,5eing 'odel is the right delivery model for this facilitys therapeutic recreation program. .esidents with these diagnoses would greatly benefit from establishing resources in their lives that they

can 7draw upon in time of need9 $Carter # *an )ndel /:00 p. 0;& as well as being taught how to savor leisure and have gratifying mindful authentic and virtuous leisure experiences. >ndividuals with backgrounds such as Eva Carlstons residents have possibly never experienced positive fulfilling leisure. Similarly the Leisure and +ell,5eing 'odels outline for developing an individuals psychological cognitive physical social and environmental resources help improve things such as capacity for happiness communication skills physical fitness concentration emotional regulation relationship skills self,awareness and optimism $Carruthers # !ood /::; p. /0&. These are all things that would increase the well,being and life satisfaction of adolescent girls with diagnoses such as those at Eva Carlston. Eva Carlston )cademy carefully selected the Leisure and +ell,5eing 'odel as the service delivery model for the therapeutic recreation program at our facility for these reasons. The model aligns with our facilitys mission supports the future we envision for our residents and provides a foundation for service delivery that will have direct benefits for the individuals we serve.

.eferences Carruthers C.4. # !ood C. $/::;&. 5uilding a life of meaning through therapeutic recreation" The leisure and well,being model part >. Therapeutic ecreation !ournal" #$%#&" '()*'+(. Carruthers C.4. # !ood C. $/::;&. 5uilding a life of meaning through therapeutic recreation" The leisure and well,being model part >>. Therapeutic ecreation !ournal" #$%#&" '+,*-'.. Carter '. B. # *an )ndel C. E. $/:00&. Therapeutic ecreation/ A Practical Approach. Long Crove >L" +aveland 4ress >nc.

Diagnostic Protocol

0. 0iagnostic 1rouping/ -eeding and Eating 2isorders -eeding and eating disorders are characteri8ed by impaired physical health or psychosocial functioning due to a persistent disturbance of eating or eating,related behavior that alters the consumption or absorption of food. -eeding and eating disorders include pica rumination disorder avoidant%restrictive food intake disorder anorexia nervosa bulimia nervosa and binge,eating disorder. /. Specific 0iagnosis/ )norexia 3ervosa )norexia nervosa is an eating disorder characteri8ed by significantly low weight $for age sex development and physical health& due to ongoing restriction of energy intake. This weight loss is accomplished through self,induced vomiting= misuse of laxatives diuretics or enemas= dieting= fasting= or excessive exercise. >ndividuals will often have an intense fear of gaining weight and a disturbance in the way they view their body weight and shape. <. 2dentified Pro3lems/ 4ossible suicidal ideation low self,esteem poor self,image anxiety social isolation obsessive,compulsive behaviors mood swings poor coping skills and poor family relationships. D. 0efining Characteristics40iagnostic Criteria %from 0SM*5&/ 0. .estriction of energy intake relative to reEuirements leading to a significantly low body weight in the context of age sex developmental traAectory and physical health. Significantly lo6 6eight is defined as a weight that is less than minimally normal or for children and adolescents less than that minimally expected. /. >ntense fear of gaining weight or of becoming fat or persistent behavior that interferes with weight gain even though at a significantly low weight. <. 2isturbance in the way in which ones body weight or shape is experienced undue influence of body weight or shape on self,evaluation or persistent lack of recognition of the seriousness of the current low body weight. Specify whether" .estricting type" 2uring the last < months the individual has not engaged in recurrent episodes of binge eating or purging behavior $i.e. self,induced vomiting or the misuse of laxatives diuretics or enemas&. This subtype describes presentations in which weight loss is accomplished primarily through dieting fasting and%or excessive exercise. 5inge,eating%purging type" 2uring the last < months the individual has engaged in recurrent episodes of binge eating or purging behavior $i.e. self, induced vomiting or the misuse of laxatives diuretics or enemas&.

Severity of anorexia nervosa from mild to extreme is based on 5'>.

F. Etiology %from 0SM*5&/ Temperamental" individuals that display obsessional traits or develop anxiety disorders in childhood are at an increased risk of developing anorexia nervosa. Environmental" the prevalence of anorexia nervosa is associated with cultures and settings in which thinness is valued and is more common in high,income countries. Cenetic and physiological" There is an increased risk of anorexia nervosa among first,degree biological relatives of individuals with the disorder.

The onset of the disorder is often associated with a stressful life event. elated 7actors/ 'any individuals with anorexia nervosa will also display signs of depression obsessive,compulsive behaviors drug and alcohol abuse bipolar and anxiety disorders. )norexia nervosa is most prevalent in females at a ratio of about 0:"0 female to male and usually begins during adolescence or young adulthood. ?. Process Criteria/ Stress management self,esteem program coping skills program leisure education and family therapy. ;. 8utcome Criteria/ 0. /. <. D. 2ecrease feeling of hopelessness. >mprove self,image through identification of body image thinking errors. 2evelop family support system to increase likelihood of successful recovery. 2evelop stress management techniEues to increase ability to identify and control anxiety. F. Client will have the ability to identify positive methods of coping with eating disorder. ?. Client will have the ability to verbally connect behaviors of disorder with negative health effects. 1. esources/ )merican 4sychiatric )ssociation. $/:0<&. 0iagnostic and statistical manual of mental disorders $Fth ed.& )rlington *)" )merican 4sychiatric 4ublishing. Stumbo 3.B. # 4eterson C.). $/::@&. Therapeutic recreation program design/ Principles and procedures. $Fth ed.&. San -rancisco C)" 4earson 5enAamin Cummings. B. Sheppard T.S CT.S (ctober 0D /:0<

Intervention Protocol

Coping Skills Program

1eneral Program Purpose/ To develop the knowledge and ability of clients to use positive coping skills to handle stressful situations better communicate regulate mood and prevent relapse. Program 1oals/ 0. Educate clients on positive vs. negative methods of coping. /. 2evelop a greater understanding of how current coping methods affect daily life. <. 2evelop client ability to practice positive coping strategies when faced with challenges of their disorder. 0eficits the Program Might Address/ 4oor coping skills 4oor family relationships 'ood swings Social isolation (bsessive,compulsive behaviors )nxiety eferral Criteria/ Gpon admission Contraindicated Criteria/ Currently bingeing and%or purging weight severity level severe or extreme or suicide risk 2ntervention Techniques/ To follow" Starry Starry 3ight Coping Skills 5ingo Hour 4ersonal Coping Skills List !a,!a and >ndoor .ock Climbing.

Starry Starry ight

Population/ Those who have been through difficult times or are in need of coping skills training. Age/ 0/I 1roup Si9e/ 0 or more Setting Considerations/ ) large amount of table space is needed for individuals to work on their art. Location should be in a somewhat Euiet place free of distractions. Soft background music could be played while individuals work. 1roup Stage Considerations/ +ith adaptation this intervention could be used in any stage however it may be best not to use it in a forming stage as group members may not know each other well enough to feel completely comfortable during processing. Purpose41oals/ To further clients knowledge of coping skills by encouraging thought about things that help them during difficult times. Supplies :eeded/ (il pastels 5lack paper Example of *an Cohs Starry :ight 2ntervention 0escription/ Cive each participant a half a sheet of black paper and a pack of oil pastels. Show them *an Coghs Starry :ight painting and talk about the history of the painting. 2iscuss with participants the following discussion Euestions. Cive participant time to complete their artwork and process what they included in their picture. ,!istory" >n September 0111 before his 2ecember breakdown that resulted in his hospitali8ation in )rles he painted Starry 3ight (ver the .hone. *an Cogh wrote about this painting" J... it does me good to do whats difficult. That doesnt stop me having a tremendous need for shall > say the word 6 for religion 6 so > go outside at night to paint the stars.J The painting depicts the view outside his sanitarium room window at Saint, .Kmy,de,4rovence $located in southern -rance& at night although it was painted from memory during the day. Special Considerations or is;s/ Some group members may feel uncomfortable sharing and talking about their artwork consider allowing individuals to volunteer to share instead of reEuiring everyone share. Possi3le 0iscussion <uestions/ *an Cogh painted this during a difficult time in his life. -or hope and inspiration he looked to the stars. +hat do you look to for help in difficult timesL +hat is helping you in your current situationL 6Talk about the symbolism of the color on the black paper and relate the color they choose to their hope and inspiration

during a dark time. M)s the participant completes their pastel have them think about these Euestions and allow them to add pictures symbols or words to their starry night to represent the things that give them hope. Possi3le 1roup or 2ndividual Assignments/ Encourage individuals who may feel uncomfortable sharing their artwork with the group to write about their thoughts later in a Aournal. Modification or Adaptations/ Hou may use a variety of other mediums for this intervention such as using crayons colored pencils or maga8ine clippings instead of oil pastels. Source/ http"%%rectherapyideas.blogspot.com%search%label%copingN/:skillsLupdated, maxO/:0<,:1,:1T:F"::"::,:?"::#max,resultsO/:#startO/F#by,dateOfalse

Activity Analysis
)ctivity" Starry Starry 3ight 4hysical )spects"
!. What is the primary body position required? _____lying down __X___sitting _____kneeling _____standing _____other"_________________ _

3. What types of movement does the activity require? _____bending _____punching _____stretching _____catching _____standing _____throwing _____walking _____hitting . What are the primary senses required for the activity? __X___touch __X___sight _____taste __X___hearing F.

_____reaching __X___grasping _____skipping/hopping _____running _____smell

+hat is the amount of coordination and movement between body parts reEuired by the activityL 'uch 0 / < D F Little

?.

+hat is the degree of hand,eye coordination needed for the activityL 'uch 0 / < D F Little

;.

+hat is the degree of strength needed for the activityL 'uch 0 / < D F Little

1.

+hat is the degree of speed needed for the activityL 'uch 0 / < D F Little

@.

+hat is the degree of endurance needed for the activityL 'uch 0 / < D F Little

0:.

+hat is the degree of energy needed for the activityL 'uch 0 / < D F Little

00.

+hat is the degree of flexibility needed for the activityL 'uch 0 / < D F Little

Social )spects" 0. +hat is the primary social interaction pattern reEuired in the activityL PPPPP>ntraindividual $action taking place within the mind or action involving the mind and part of the body= reEuires no contract with another person or external obAect& PPPPPExtraindividual $action directed by a person toward an obAect= reEuires no contact with another person& PPQPPP)ggregate $action directed by a person toward an obAect while in the company of other persons who also are directing actins toward obAects= action is not directed toward each other= no interaction reEuired among participants& PPPPP>nterindividual $action of a competitive nature directed by one person toward another& PPPPPGnilateral $action of a competitive nature among three or more persons one of whom is an antagonist= interaction is in simultaneous competitive relationship& PPPPP 'ultilateral $action of a competitive nature directed among three or more persons with no one person as an antagonist& PPPPP>ntragroup $action of a cooperative nature by two or more persons intent upon reaching a mutual goal action reEuires positive verbal and nonverbal interaction& PPPPP>ntergroup $action of a competitive nature between two or more intragroups& /. +hat is the minimum $fewest& number or maximum $greatest& number of people reEuired for the activityL PP0PPPminimum number PP3(3EPPPmaximum number

<. +hat clothing is needed to be socially appropriateL 3ormal modest clothing $Aeans and a t,shirt& D. !ow much physical proximity is reEuired by the activityL
Close 0 / < D F 2istant

F. !ow much physical contact is reEuired by the activityL

'uch 0 / < D F Little

?. +hat degree of communication is reEuired by the activityL

!igh

<

Low

;. +hat degree of noise is generated by the activityL

'uch 0 / < D F Little

Cognitive )spects" 0. !ow many rules are reEuired in the activityL

'any

<

-ew

/. !ow complex are the rules to understandL

Complex 0 / < D F Simple

<. +hat degree of strategy is reEuired in the activityL

'uch 0 / < D F Little

D. +hat degree of complexity is involved in scoringL

'uch 0 / < D F Little

F. +hat degree of long,term memory is reEuired in the activityL

'uch 0 / < D F Little

?. +hat degree of short,term memory or immediate recall is reEuired in the activityL

'uch 0 / < D F Little

;. +hat degree of verbali8ation of thought process is reEuired in the activityL

'uch 0 / < D F Little

1. +hat degree of concentration is reEuired in the activityL

'uch 0 / < D F Little

@. +hat degree of concrete thinking is reEuired by the activityL

'uch 0 / < D F Little

0:. +hat degree of abstract thinking is reEuired by the activityL

'uch 0 / < D F Little

00. To what degree are each of the following skills used in the activityL
.eading +riting 'ath Spelling 'uch 'uch 'uch 'uch 0 0 0 0 / / / / < < < < D D D D F F F F Little Little Little Little

0/. To what degree does the participant need to identify or use the followingL
-orm and Shape Colors Si8e 3umber 5ody 4arts 2irectionality 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)ffective )spects" 0. To what degree does the participant have the opportunity or outlet to express the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

/. To what degree must the participant control or inhibit the expression of the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)dministrative )spects" 0. +hat type of leadership style is reEuired by the activityL PPPPPspecific activity,skill expertise PPQPPPsupervisory PPPPPgeneral activity,skill expertise PPPPPno specific leadership type

/. +hat type of eEuipment is needed for the activityL PPQPPPspecific commercial product $specify" black paper and oil pastels & PPPPPcan be made $specify" & PPPPPno eEuipment reEuired <. +hat type of facility is reEuired by the activityL PPPPPspecific natural environment $specify" PPPPPPPPPP &

PPPPPspecific created environment $specify" PPPPPPPPPP & PPQPPPno specific environment reEuired D. +hat is the duration of the activityL PPPPPset time PPQPPPnatural end PPPPPcontinuous F. +hat is the number of participants reEuired for the activityL PPQPPPany number can participate PPPPPfixed number or multiple $specify" PPPP &

Coping Skills !ingo

Population/ Those in need of coping skills training. Age/ Can be adapted for any age. 1roup Si9e/ / or more Setting Considerations/ 4repare a table for bingo to be played on. 1roup Stage Considerations/ +ith adaptation this intervention could be used in any stage. Purpose41oals/ To further clients knowledge of coping skills through learning of different ways%methods of coping. Supplies :eeded/ 5lank bingo cards $each should have boxes FxF& +riting utensils 5ingo markers $can be almost anything small& 4ri8e for bingo winners 2ntervention 0escription/ 2iscuss ways of coping and allow group members to list ideas or positive ways that they cope in difficult times. Each time a new idea is shared have everyone in the group fill in a box somewhere on their bingo card with that coping strategy. (nce all the boxes are filled hand out bingo markers and playR )s a facilitator make a list of the coping strategies that are shared so you can read them off randomly to play. 4articipants put a marker on the box that the facilitator reads and wins by having F boxes in a row $vertically hori8ontally or diagonally& marked. Special Considerations or is;s/ This game may produce competitiveness and%or hurt feelings of non,winning participants. 5e conscientious of participants who have trouble controlling anger and consider making the pri8e available to all participants. Possi3le 0iscussion <uestions/ Suestions that can be used to help clients come up with coping strategies for their bingo cards are" +hat is a way you lift your mood when you are feeling down stressed upset etc.L +ho is a person that helps you when you are in a difficult situationL +here do you go to make you feel more at easeL +hat kinds of activities help get your mind off of a difficult situationL Possi3le 1roup or 2ndividual Assignments/ Encourage group members to think about or Aournal about" Specific times in their life they could use one of the coping strategies talked about. ) time they used a negative way of coping and the possible outcome had they

used a positive strategy like those shared in group. ) new coping strategy that a group member brought up that they would like to try using.

Modification or Adaptations/ >t the group is unable to come up with coping strategies on their own or with some guidance you can prepare the bingo cards already filled in with a variety of positive ways of coping. Source/ http"%%www.pinterest.com%pin%</@<@?0?:/0?<1/;:0%

Activity Analysis
)ctivity" Coping Skills 5ingo 4hysical )spects"
!. What is the primary body position required? _____lying down __X___sitting _____kneeling _____standing _____other"_________________ _

3. What types of movement does the activity require? _____bending _____punching _____stretching _____catching _____standing _____throwing _____walking _____hitting . What are the primary senses required for the activity? __X___touch __X___sight _____taste __X___hearing F.

_____reaching __X___grasping _____skipping/hopping _____running _____smell

+hat is the amount of coordination and movement between body parts reEuired by the activityL 'uch 0 / < D F Little

?.

+hat is the degree of hand,eye coordination needed for the activityL 'uch 0 / < D F Little

;.

+hat is the degree of strength needed for the activityL 'uch 0 / < D F Little

1.

+hat is the degree of speed needed for the activityL 'uch 0 / < D F Little

@.

+hat is the degree of endurance needed for the activityL 'uch 0 / < D F Little

0:.

+hat is the degree of energy needed for the activityL 'uch 0 / < D F Little

00.

+hat is the degree of flexibility needed for the activityL 'uch 0 / < D F Little

Social )spects" 0. +hat is the primary social interaction pattern reEuired in the activityL PPPPP>ntraindividual $action taking place within the mind or action involving the mind and part of the body= reEuires no contract with another person or external obAect& PPPPPExtraindividual $action directed by a person toward an obAect= reEuires no contact with another person& PPPPP)ggregate $action directed by a person toward an obAect while in the company of other persons who also are directing actins toward obAects= action is not directed toward each other= no interaction reEuired among participants& PPPPP>nterindividual $action of a competitive nature directed by one person toward another& PPPPPGnilateral $action of a competitive nature among three or more persons one of whom is an antagonist= interaction is in simultaneous competitive relationship& PPQPPP 'ultilateral $action of a competitive nature directed among three or more persons with no one person as an antagonist& PPPPP>ntragroup $action of a cooperative nature by two or more persons intent upon reaching a mutual goal action reEuires positive verbal and nonverbal interaction& PPPPP>ntergroup $action of a competitive nature between two or more intragroups& /. +hat is the minimum $fewest& number or maximum $greatest& number of people reEuired for the activityL PP/PPPminimum number PP3(3EPPPmaximum number

<. +hat clothing is needed to be socially appropriateL 3ormal modest clothing $Aeans and a t,shirt& D. !ow much physical proximity is reEuired by the activityL
Close 0 / < D F 2istant

F. !ow much physical contact is reEuired by the activityL

'uch 0 / < D F Little

?. +hat degree of communication is reEuired by the activityL

!igh

<

Low

;. +hat degree of noise is generated by the activityL

'uch 0 / < D F Little

Cognitive )spects" 0. !ow many rules are reEuired in the activityL

'any

<

-ew

/. !ow complex are the rules to understandL

Complex 0 / < D F Simple

<. +hat degree of strategy is reEuired in the activityL

'uch 0 / < D F Little

D. +hat degree of complexity is involved in scoringL

'uch 0 / < D F Little

F. +hat degree of long,term memory is reEuired in the activityL

'uch 0 / < D F Little

?. +hat degree of short,term memory or immediate recall is reEuired in the activityL

'uch 0 / < D F Little

;. +hat degree of verbali8ation of thought process is reEuired in the activityL

'uch 0 / < D F Little

1. +hat degree of concentration is reEuired in the activityL

'uch 0 / < D F Little

@. +hat degree of concrete thinking is reEuired by the activityL

'uch 0 / < D F Little

0:. +hat degree of abstract thinking is reEuired by the activityL

'uch 0 / < D F Little

00. To what degree are each of the following skills used in the activityL
.eading +riting 'ath Spelling 'uch 'uch 'uch 'uch 0 0 0 0 / / / / < < < < D D D D F F F F Little Little Little Little

0/. To what degree does the participant need to identify or use the followingL
-orm and Shape Colors Si8e 3umber 5ody 4arts 2irectionality 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)ffective )spects" 0. To what degree does the participant have the opportunity or outlet to express the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

/. To what degree must the participant control or inhibit the expression of the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)dministrative )spects" 0. +hat type of leadership style is reEuired by the activityL PPPPPspecific activity,skill expertise PPPPPsupervisory PPQPPPgeneral activity,skill expertise type /. +hat type of eEuipment is needed for the activityL PPPPPspecific commercial product $specify" & PPQPPPcan be made $specify" bingo cards and markers & PPPPPno eEuipment reEuired <. +hat type of facility is reEuired by the activityL PPPPPno specific leadership

PPPPPspecific natural environment $specify" PPPPPPPPPP & PPPPPspecific created environment $specify" PPPPPPPPPP & PPQPPPno specific environment reEuired D. +hat is the duration of the activityL PPPPPset time PPQPPPnatural end PPPPPcontinuous F. +hat is the number of participants reEuired for the activityL PPQPPPany number can participate PPPPPfixed number or multiple $specify" PPPP &

"our Personal Coping Skills #ist

Population/ Those in need of coping skills training. Age/ 0/I 1roup Si9e/ 0 or more Setting Considerations/ Can be done in any setting as long as there is a place to write. 1roup Stage Considerations/ This intervention could be used in any stage. Purpose41oals/ -or clients to learn the pros and cons of different types of coping strategies and be able to identify those that they most commonly use in their own life. Supplies :eeded/ +riting utensil >ndigo 2aya 7Coping Skills9 and 7Hour 4ersonal Coping Skills List9 worksheets 2ntervention 0escription/ Co over 7Coping Skills9 worksheet. .ead the pros and cons for each type of coping. (n 7Hour 4ersonal Coping Skills List9 have participants write down things they could do or already do for each type of coping. !ave participants share their thoughts. Special Considerations or is;s/ Possi3le 0iscussion <uestions/ +hat type of coping do you think that you use most oftenL 2oes it make a difference if you use only one type of coping vs. using manyL 6 !owL Possi3le 1roup or 2ndividual Assignments/ Encourage group members to experiment using new types of coping if they tend to stick to one. Modification or Adaptations/ Source/ http"%%www.indigodaya.com%wp,content%uploads%/:0<%:/%Coping,skills,flyer.pdf

Activity Analysis
)ctivity" Hour 4ersonal Coping Skills List 4hysical )spects"
!. What is the primary body position required? _____lying down __X___sitting _____kneeling _____standing _____other"_________________ _

3. What types of movement does the activity require? _____bending _____punching _____stretching _____catching _____standing _____throwing _____walking _____hitting . What are the primary senses required for the activity? __X___touch _____sight _____taste __X___hearing F.

_____reaching __X___grasping _____skipping/hopping _____running _____smell

+hat is the amount of coordination and movement between body parts reEuired by the activityL 'uch 0 / < D F Little

?.

+hat is the degree of hand,eye coordination needed for the activityL 'uch 0 / < D F Little

;.

+hat is the degree of strength needed for the activityL 'uch 0 / < D F Little

1.

+hat is the degree of speed needed for the activityL 'uch 0 / < D F Little

@.

+hat is the degree of endurance needed for the activityL 'uch 0 / < D F Little

0:.

+hat is the degree of energy needed for the activityL 'uch 0 / < D F Little

00.

+hat is the degree of flexibility needed for the activityL 'uch 0 / < D F Little

Social )spects" 0. +hat is the primary social interaction pattern reEuired in the activityL PPPPP>ntraindividual $action taking place within the mind or action involving the mind and part of the body= reEuires no contract with another person or external obAect& PPQPPPExtraindividual $action directed by a person toward an obAect= reEuires no contact with another person& PPPPP)ggregate $action directed by a person toward an obAect while in the company of other persons who also are directing actins toward obAects= action is not directed toward each other= no interaction reEuired among participants& PPPPP>nterindividual $action of a competitive nature directed by one person toward another& PPPPPGnilateral $action of a competitive nature among three or more persons one of whom is an antagonist= interaction is in simultaneous competitive relationship& PPPPP 'ultilateral $action of a competitive nature directed among three or more persons with no one person as an antagonist& PPPPP>ntragroup $action of a cooperative nature by two or more persons intent upon reaching a mutual goal action reEuires positive verbal and nonverbal interaction& PPPPP>ntergroup $action of a competitive nature between two or more intragroups& /. +hat is the minimum $fewest& number or maximum $greatest& number of people reEuired for the activityL PP0PPPminimum number PP3(3EPPPmaximum number

<. +hat clothing is needed to be socially appropriateL 3ormal modest clothing $Aeans and a t,shirt& D. !ow much physical proximity is reEuired by the activityL
Close 0 / < D F 2istant

F. !ow much physical contact is reEuired by the activityL

'uch 0 / < D F Little

?. +hat degree of communication is reEuired by the activityL

!igh

<

Low

;. +hat degree of noise is generated by the activityL

'uch 0 / < D F Little

Cognitive )spects" 0. !ow many rules are reEuired in the activityL

'any

<

-ew

/. !ow complex are the rules to understandL

Complex 0 / < D F Simple

<. +hat degree of strategy is reEuired in the activityL

'uch 0 / < D F Little

D. +hat degree of complexity is involved in scoringL

'uch 0 / < D F Little

F. +hat degree of long,term memory is reEuired in the activityL

'uch 0 / < D F Little

?. +hat degree of short,term memory or immediate recall is reEuired in the activityL

'uch 0 / < D F Little

;. +hat degree of verbali8ation of thought process is reEuired in the activityL

'uch 0 / < D F Little

1. +hat degree of concentration is reEuired in the activityL

'uch 0 / < D F Little

@. +hat degree of concrete thinking is reEuired by the activityL

'uch 0 / < D F Little

0:. +hat degree of abstract thinking is reEuired by the activityL

'uch 0 / < D F Little

00. To what degree are each of the following skills used in the activityL
.eading +riting 'ath Spelling 'uch 'uch 'uch 'uch 0 0 0 0 / / / / < < < < D D D D F F F F Little Little Little Little

0/. To what degree does the participant need to identify or use the followingL
-orm and Shape Colors Si8e 3umber 5ody 4arts 2irectionality 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)ffective )spects" 0. To what degree does the participant have the opportunity or outlet to express the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

/. To what degree must the participant control or inhibit the expression of the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)dministrative )spects" 0. +hat type of leadership style is reEuired by the activityL PPPPPspecific activity,skill expertise PPPPPsupervisory PPPPPgeneral activity,skill expertise PPPQPPno specific leadership type

/. +hat type of eEuipment is needed for the activityL PPQPPPspecific commercial product $specify" worksheet and pen or pencil & PPPPPcan be made $specify" PPPPPPPPPP & PPPPPno eEuipment reEuired <. +hat type of facility is reEuired by the activityL PPPPPspecific natural environment $specify" PPPPPPPPPP &

PPPPPspecific created environment $specify" PPPPPPPPPP & PPQPPPno specific environment reEuired D. +hat is the duration of the activityL PPPPPset time PPQPPPnatural end PPPPPcontinuous F. +hat is the number of participants reEuired for the activityL PPQPPPany number can participate PPPPPfixed number or multiple $specify" PPPP &

$a%$a
Population/ Those in need of coping skills training. Age/ FI $works well with adolescent girls& 1roup Si9e/ ? or more $the bigger the group the more challenging and funR& Setting Considerations/ +ould work well outside on a grassy field but a room that will allow all members to lie on the ground would work also. 1roup Stage Considerations/ This intervention could be used in any stage except forming. This intervention is best if group members know and are very comfortable with each other. Purpose41oals/ -or clients to have fun and reali8e that humor is a great coping strategy. Supplies :eeded/ 3one 2ntervention 0escription/ Everyone lies down so that their head rests on another personTs tummy= the group should all be interconnected by heads and tummies. Set a mock JseriousJ tone. (ptional" Eyes closed. The challenge is 3(T to laugh. The other part of the challenge is for the first person to say out loud J!aRJ The second person says J!a,haJ and so on. The group tries to see how far the J!aJ gets along the line before someone laughs. )fter a few attempts this generally descends into a wave of uncontrollable laughter. Special Considerations or is;s/ 5e aware and mindful of potential body self,conscious issues. This activity does not allow for personal space which should be made known to participants. Possi3le 0iscussion <uestions/ !ow can humor be used as a coping strategyL >n what situations would humor be a good way to copeL Possi3le 1roup or 2ndividual Assignments/ Encourage group members to write about a few ways they can incorporate more humor or laughter into their lives. Modification or Adaptations/ +ith a group that may have body concerns or where it is inappropriate for close contact there may be some success in sitting% laying in a circle or another formation that doesnt involve touching. Source/ http"%%www.wilderdom.com%games%descriptions%!a!a.html

Activity Analysis
)ctivity" !a,!a 4hysical )spects"
!. What is the primary body position required? __X___lying down _____sitting _____kneeling _____standing _____other"_________________ _

3. What types of movement does the activity require? _____bending _____punching _____stretching _____catching _____standing _____throwing _____walking _____hitting . What are the primary senses required for the activity? __X___touch _____sight _____taste __X___hearing F.

_____reaching _____grasping _____skipping/hopping _____running _____smell

+hat is the amount of coordination and movement between body parts reEuired by the activityL 'uch 0 / < D F Little

?.

+hat is the degree of hand,eye coordination needed for the activityL 'uch 0 / < D F Little

;.

+hat is the degree of strength needed for the activityL 'uch 0 / < D F Little

1.

+hat is the degree of speed needed for the activityL 'uch 0 / < D F Little

@.

+hat is the degree of endurance needed for the activityL 'uch 0 / < D F Little

0:.

+hat is the degree of energy needed for the activityL 'uch 0 / < D F Little

00.

+hat is the degree of flexibility needed for the activityL 'uch 0 / < D F Little

Social )spects" 0. +hat is the primary social interaction pattern reEuired in the activityL PPPPP>ntraindividual $action taking place within the mind or action involving the mind and part of the body= reEuires no contract with another person or external obAect& PPPPPExtraindividual $action directed by a person toward an obAect= reEuires no contact with another person& PPPPP)ggregate $action directed by a person toward an obAect while in the company of other persons who also are directing actins toward obAects= action is not directed toward each other= no interaction reEuired among participants& PPPPP>nterindividual $action of a competitive nature directed by one person toward another& PPPPPGnilateral $action of a competitive nature among three or more persons one of whom is an antagonist= interaction is in simultaneous competitive relationship& PPPPP 'ultilateral $action of a competitive nature directed among three or more persons with no one person as an antagonist& PPQPPP>ntragroup $action of a cooperative nature by two or more persons intent upon reaching a mutual goal action reEuires positive verbal and nonverbal interaction& PPPPP>ntergroup $action of a competitive nature between two or more intragroups& /. +hat is the minimum $fewest& number or maximum $greatest& number of people reEuired for the activityL PP<PPPminimum number PP3(3EPPPmaximum number

<. +hat clothing is needed to be socially appropriateL )nything that will still be appropriate lying down,perhaps no short skirts or dresses. D. !ow much physical proximity is reEuired by the activityL
Close 0 / < D F 2istant

F. !ow much physical contact is reEuired by the activityL

'uch 0 / < D F Little

?. +hat degree of communication is reEuired by the activityL

!igh

<

Low

;. +hat degree of noise is generated by the activityL

'uch 0 / < D F Little

Cognitive )spects" 0. !ow many rules are reEuired in the activityL

'any

<

-ew

/. !ow complex are the rules to understandL

Complex 0 / < D F Simple

<. +hat degree of strategy is reEuired in the activityL

'uch 0 / < D F Little

D. +hat degree of complexity is involved in scoringL

'uch 0 / < D F Little

F. +hat degree of long,term memory is reEuired in the activityL

'uch 0 / < D F Little

?. +hat degree of short,term memory or immediate recall is reEuired in the activityL

'uch 0 / < D F Little

;. +hat degree of verbali8ation of thought process is reEuired in the activityL

'uch 0 / < D F Little

1. +hat degree of concentration is reEuired in the activityL

'uch 0 / < D F Little

@. +hat degree of concrete thinking is reEuired by the activityL

'uch 0 / < D F Little

0:. +hat degree of abstract thinking is reEuired by the activityL

'uch 0 / < D F Little

00. To what degree are each of the following skills used in the activityL
.eading +riting 'ath Spelling 'uch 'uch 'uch 'uch 0 0 0 0 / / / / < < < < D D D D F F F F Little Little Little Little

0/. To what degree does the participant need to identify or use the followingL
-orm and Shape Colors Si8e 3umber 5ody 4arts 2irectionality 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)ffective )spects" 0. To what degree does the participant have the opportunity or outlet to express the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

/. To what degree must the participant control or inhibit the expression of the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)dministrative )spects" 0. +hat type of leadership style is reEuired by the activityL PPPPPspecific activity,skill expertise PPPPPsupervisory PPPPPgeneral activity,skill expertise PPPQPPno specific leadership type

/. +hat type of eEuipment is needed for the activityL PPPPPspecific commercial product $specify" PPPPPPPPPP & PPPPPcan be made $specify" PPPPPPPPPP & PPQPPPno eEuipment reEuired <. +hat type of facility is reEuired by the activityL PPPPPspecific natural environment $specify" PPPPPPPPPP &

PPPPPspecific created environment $specify" PPPPPPPPPP & PPQPPPno specific environment reEuired D. +hat is the duration of the activityL PPPPPset time PPQPPPnatural end PPPPPcontinuous F. +hat is the number of participants reEuired for the activityL PPQPPPany number can participate PPPPPfixed number or multiple $specify" PPPP &

Indoor &ock Clim'ing

Population/ Those in need of coping skills training. Age/ 0/I 1roup Si9e/ / or more Setting Considerations/ This activity reEuires an indoor rock climbing facility. 1roup Stage Considerations/ This intervention could be used in any stage except forming. This intervention would be best suited for groups that are somewhat acEuainted. Purpose41oals/ -or clients to develop knowledge of coping skills through participation in a challenging physical activity. Supplies :eeded/ .ock climbing facility Climbing shoes )ppropriate clothing $active wear& 5elay device Carabiner .ope !arness Chalk $optional& 2ntervention 0escription/ Croup members will learn the basics reEuired to safely climb. )fter becoming comfortable in the mechanics and safety procedures of top,rope climbing group members can begin climbing routes of their ability with a partner. .ock climbing as a physical intervention can help develop a clients ability to cope with challenges and be resilient. .ock climbing and other types of adventure activities can be used to address trust creating options moving beyond self,imposed limits and exploring relationships. Clients will learn to identify their strengths and use those strengths to achieve positive outcomes. >n addition the sport of rock climbing introduces the concept of using physical activity as a positive method of coping. Special Considerations or is;s/ 5efore group members can climb they must be taught climbing basics by a Eualified instructor. This includes" safety eEuipment belaying and beginner climbing techniEues. This activity reEuires high cognitive functioning as well as a high level of mobility. This activity could be exceptionally challenging for someone afraid of heights or who has a hard time trusting others. Possi3le 0iscussion <uestions/ +hat kinds of obstacles did you have to overcome during rock climbingL +hat or who helped you get past those obstaclesL !ow do you think the skills you learned today rock climbing can help you in other situationsL

Possi3le 1roup or 2ndividual Assignments/ Encourage group members to Aournal about their rock climbing experience. Modification or Adaptations/ >ndividuals should only climb as high as they feel comfortable= there is no reEuirement to reach the top. >ndividuals who may be uncomfortable having another group member belay them may feel better having a more experienced staff member belay while they climb. >n addition group members who are unable to safely belay can have a valuable experience if they climb only. Source/ http"%%www.tapg.aee.org%tapg%treatment%interv%txoutcomes http"%%www.rei.com%learn%expert,advice%getting,started,rock,climbing.html

Activity Analysis
)ctivity" >ndoor .ock Climbing 4hysical )spects"
!. What is the primary body position required? _____lying down _____sitting _____kneeling __X___standing _____other"_________________ _

3. What types of movement does the activity require? __X___bending _____punching __X___stretching _____catching __X___standing _____throwing __X___walking _____hitting . What are the primary senses required for the activity? __X___touch __X___sight _____taste __X___hearing F.

__X___reaching __X___grasping _____skipping/hopping _____running _____smell

+hat is the amount of coordination and movement between body parts reEuired by the activityL 'uch 0 / < D F Little

?.

+hat is the degree of hand,eye coordination needed for the activityL 'uch 0 / < D F Little

;.

+hat is the degree of strength needed for the activityL 'uch 0 / < D F Little

1.

+hat is the degree of speed needed for the activityL 'uch 0 / < D F Little

@.

+hat is the degree of endurance needed for the activityL 'uch 0 / < D F Little

0:.

+hat is the degree of energy needed for the activityL 'uch 0 / < D F Little

00.

+hat is the degree of flexibility needed for the activityL 'uch 0 / < D F Little

Social )spects" 0. +hat is the primary social interaction pattern reEuired in the activityL PPPPP>ntraindividual $action taking place within the mind or action involving the mind and part of the body= reEuires no contract with another person or external obAect& PPPPPExtraindividual $action directed by a person toward an obAect= reEuires no contact with another person& PPPPP)ggregate $action directed by a person toward an obAect while in the company of other persons who also are directing actins toward obAects= action is not directed toward each other= no interaction reEuired among participants& PPPPP>nterindividual $action of a competitive nature directed by one person toward another& PPPPPGnilateral $action of a competitive nature among three or more persons one of whom is an antagonist= interaction is in simultaneous competitive relationship& PPPPP 'ultilateral $action of a competitive nature directed among three or more persons with no one person as an antagonist& PPQPPP>ntragroup $action of a cooperative nature by two or more persons intent upon reaching a mutual goal action reEuires positive verbal and nonverbal interaction& PPPPP>ntergroup $action of a competitive nature between two or more intragroups& /. +hat is the minimum $fewest& number or maximum $greatest& number of people reEuired for the activityL PP/PPPminimum number PP3(3EPPPmaximum number

<. +hat clothing is needed to be socially appropriateL )ctive clothing D. !ow much physical proximity is reEuired by the activityL
Close 0 / < D F 2istant

F. !ow much physical contact is reEuired by the activityL

'uch 0 / < D F Little

?. +hat degree of communication is reEuired by the activityL

!igh

<

Low

;. +hat degree of noise is generated by the activityL

'uch 0 / < D F Little

Cognitive )spects" 0. !ow many rules are reEuired in the activityL

'any

<

-ew

/. !ow complex are the rules to understandL

Complex 0 / < D F Simple

<. +hat degree of strategy is reEuired in the activityL

'uch 0 / < D F Little

D. +hat degree of complexity is involved in scoringL

'uch 0 / < D F Little

F. +hat degree of long,term memory is reEuired in the activityL

'uch 0 / < D F Little

?. +hat degree of short,term memory or immediate recall is reEuired in the activityL

'uch 0 / < D F Little

;. +hat degree of verbali8ation of thought process is reEuired in the activityL

'uch 0 / < D F Little

1. +hat degree of concentration is reEuired in the activityL

'uch 0 / < D F Little

@. +hat degree of concrete thinking is reEuired by the activityL

'uch 0 / < D F Little

0:. +hat degree of abstract thinking is reEuired by the activityL

'uch 0 / < D F Little

00. To what degree are each of the following skills used in the activityL

.eading +riting 'ath Spelling

'uch 'uch 'uch 'uch

0 0 0 0

/ / / /

< < < <

D D D D

F F F F

Little Little Little Little

0/. To what degree does the participant need to identify or use the followingL
-orm and Shape Colors Si8e 3umber 5ody 4arts 2irectionality 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)ffective )spects" 0. To what degree does the participant have the opportunity or outlet to express the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

/. To what degree must the participant control or inhibit the expression of the followingL
Boy Cuilt 4ain )nger -ear -rustration 'uch 'uch 'uch 'uch 'uch 'uch 0 0 0 0 0 0 / / / / / / < < < < < < D D D D D D F F F F F F Little Little Little Little Little Little

)dministrative )spects" 0. +hat type of leadership style is reEuired by the activityL PPQPPPspecific activity,skill expertise PPQPPPsupervisory PPPPPgeneral activity,skill expertise PPPPPno specific leadership type

/. +hat type of eEuipment is needed for the activityL PPQPPPspecific commercial product $specify" PPPPPPPPPP & PPPPPcan be made $specify" PPPPPPPPPP & PPPPPno eEuipment reEuired <. +hat type of facility is reEuired by the activityL PPPPPspecific natural environment $specify" PPPPPPPPPP & PPQPPPspecific created environment $specify" PPPPPPPPPP &

PPPPPno specific environment reEuired D. +hat is the duration of the activityL PPPPPset time PPQPPPnatural end PPPPPcontinuous F. +hat is the number of participants reEuired for the activityL PPQPPPany number can participate PPQPPPfixed number or multiple $specify" any number best if in multiples of /&

Staff Training4Certification equirements/ Two Therapeutic .ecreation Specialists must be present during group sessions. T.Ss must be state licensed as a T.S or 'T.S and nationally certified as a CT.S. Staff must be C4. and first aid certified. Staff must be ')T trained. is; Management Considerations/ Sharps counted at beginning and end of each group session staff to client ratio 0"D and all staff must undergo criminal background check. E=pected Program 8utcomes/ 0. 2evelop family support system to increase likelihood of successful recovery. /. 2evelop stress management techniEues to increase ability to identify and control anxiety. <. Client will have the ability to identify positive methods of coping with eating disorder. D. Client will have the ability to verbally connect behaviors of disorder with negative health effects. Program Evaluation/ Completion of client goals pre, and post,program interviews with clients observation on,going program evaluation and Euality improvement. B. Sheppard T.S CT.S 'arch ; /:0D

(ritten Plan o) *peration

Eva Carlston Academy/ Eva Carlston )cademy is a healthcare based residential treatment center that serves girls between 0/,01 with any of the following issues" depression anxiety defiance # behavioral issues )2!2 learning issues emerging personality disorders self,harm addictions eating disorders suicidal ideation substance abuse bipolar disorder trauma low self,esteem adoption and attachment issues emotional physical and sexual abuse non,verbal learning disorders $3L2s& or pervasive developmental disorders $422s&. Mission+ (ur mission is to provide the treatment and support necessary to help these girls heal and find their place their passion and their purpose in life. ,ision+ +e envision a generation of young women who believe in themselves and who possess the character self,discipline and courage to be productive members of their communities. ,alues+ unconditional acceptance dedication to evidence,based outcome therapies compassion and family involvement. ecreational Therapy Program/ Purpose+ The recreational therapy program at Eva Carlston )cademy strives to help each and every girl reach her highest potential and find a state of satisfaction with life. .ecreational therapy is provided every day of the week to residents to help best meet their individual needs as well as enhance social leisure and family functioning. Mission+ To provide outcome,based therapies appropriate to individual client goals while maintaining a professional and supportive environment for both clients and staff. Scope o) Care+ -emale patients ages 0/,01 with any of the diagnosis listed in Eva Carlston )cademys admission criteria and their families when part of clients treatment. Administration/ Direction+ 2irector of .ecreational Therapy position will be held by a 'aster .ecreation Specialist $'T.S& and Certified Therapeutic .ecreation Specialist. .ecreational therapist presence is reEuired at daily treatment team meetings with other facility care providers to ensure cohesive and complete provision of services to clients. Standards o) Practice+ Therapeutic .ecreation Specialists will provide care that follows the guidelines of the )T.) Standards of 4ractice. Ethics+ Staff will adhere to the )T.) Code of Ethics. &isk Management+ The .ecreational Therapy 4rogram adheres to Eva Carlston )cademys facility risk management plan which includes risk management of all recreation resources on the grounds $pool tennis court fitness center dance studio and challenge course&. 4rogram guideline not mentioned in facility plan" during group therapy sessions staff to client ratio must remain 0"D. Program 0escription/

0. Assessment Process+ )ssessment shall be conducted within the first /D hours of admission by the Therapeutic .ecreation Specialist in a timely manner. )ssessments should be valid and reliable as well as culturally appropriate and successful in determining the clients strengths and limitations in areas of social behavioral emotional physical cognitive and leisure functioning.

/. Planning Process-Documentation+ 4lanning should include long and short,term goals determined for and with the client based on their assessment culture diagnosis and values. 2ocumentation should occur every time the therapist meets with the client and will include information relevant to progress with established goals and participation.

<. Implementation o) Services+ Services will be delivered by a Eualified staff member to meet pre,determined goals and obAectives. Services will be appropriate for client diagnosis age gender and culture. 4rograms will assist clients in developing coping skills stress management skills enhanced self,esteem social skills leisure benefits and enhanced family relationships.

D. Evaluation Process+ Evaluation should be an ongoing and systematic process of reviewing clients progress in treatment goals specific interventions and client satisfaction. >t may be helpful to include family and significant others in the evaluation process.

F. Discharge and .ransition Planning+ Summative evaluation should occur at the end of treatment to determine effectiveness of the individuals treatment plan. Should be a collaboration with the client family and treatment team that include recommendations for continued service or aftercare in consideration of patients needs.

?. &ecreation Services+ .ecreation services are provided for enhancement of client social and leisure skills relaxation and enAoyment. .ecreation facilities eEuipment and activities associated with the indoor pool tennis court fitness center dance studio garden challenge course field and off,campus trips should be available and appropriate to clients needs abilities and cultural background. -acilities should be clean and maintained to safety codes.

Coping S;ills Program/

Purpose+ To develop the knowledge and ability of clients to use positive coping skills to handle stressful situations better communicate regulate mood and prevent relapse. Program /oals+ 0. Educate clients on positive vs. negative methods of coping. /. 2evelop a greater understanding of how current coping methods affect daily life. <. 2evelop client ability to practice positive coping strategies when faced with challenges of their disorder. Evaluation4 esearch/ Coping Skills Program+ Evaluation is based on completion of client goals pre, and post,program interviews with clients observation and on, going program evaluation and Euality improvement. &ecreational .herapy Program+ Evaluation is based on results of Eva Carlston )cademy facility evaluation which includes patient and parent satisfaction Euestionnaires given at time of discharge as well as information gathered during discharge interviews. Evaluation also based on client goals being successfully met in treatment. &esearch+ .esearch is regarded as a responsibility in the .ecreational Therapy 2epartment at Eva Carlston )cademy as it contributes heavily to the advancement of the field of .ecreational Therapy. >ndividual therapists provide biannual research of the facilitys evidence,based practice. >uman esource Sta))ing &atio+ .ecreation Therapists will be hired at a ratio of 0 therapist" ? residents.. Sta)) Development+ +eekly staff meetings will be conducted by 2irector of .ecreational Therapy to address staff concerns as well as department goals individual program improvements opportunities for continuing education units and staff development. Certi)ications-#icenses+ State licensure and national certification is reEuired. .ecreational therapists will at minimum hold a Gtah State license as a Therapeutic .ecreation Specialist $T.S& and 3ational Certification as a Certified Therapeutic .ecreation Specialist $CT.S&. Pro)essional A))iliation+ >nvolvement in professional organi8ations is highly encouraged as involvement promotes ongoing education and awareness through changes and growth in the field of .ecreational Therapy. esources/ Facility+ Eva Carlston )cademy grounds hold an indoor pool tennis court fitness center dance studio garden challenge course and field for general activities as well as a library art studio and music room. Equipment- Supplies+ Eva Carlston )cademy has available to the recreational therapy program corresponding eEuipment for the facilitys outdoor and indoor leisure and recreation areas including challenge course eEuipment art supplies musical instruments gym eEuipment and team sport eEuipment. !udget+ Eva Carlston )cademy -inancial 'anagement 2epartment determines budget

annually for each program at the facility based on income and enrollment. Therefore the recreational therapy department budget ranges from UF :::,U0: ::: a year.

Assessment Protocol

Preparation 2ntervie6 >nterview will be conducted in a Euiet private well,lit room free from distractions. Client and interviewer should sit comfortably across from one another with no barriers dividing them if possible. /:,<: minutes are reEuired for the interview. 4aper and pen%pencil are encouraged to record important notes on client responses. )lso a list of intended interview Euestions is needed. Standardi9ed Assessment Leisure Satisfaction 'easure should be given in a Euiet private well,lit room free from maAor distractions. 'aterials needed are LS' manual score sheet and a pen%pencil. 0:,<: minutes should be given to fill out the assessment and F,0: minutes for scoring. Administration 2ntervie6 >ntroduction checklist" ,>ntroduce yourself ,State the purpose of the interview ,Let the client know what you know about their situation ,!elp the client feel at ease 5ody" ,Gse open ended Euestions attached ,.edirect when needed ,)sk for clarification or further explanation when client is vague ,Establish authority ,Express sensitivity understanding and sympathy for clients situation ,Gse natural transitions ,)sk only what is important to client treatment Close" ,5riefly summari8e your understanding of what the client has stated ,>nform client about how information from the assessment will be used ,2iscuss some options for treatment going forward ,)sk the client if they have any Euestions ,Cive assignments if necessary ,Establish a next time for meeting The interview should be stopped if client becomes disruptive or fatigued Standardi9ed Assessment The assessment may be self,administered by the client= however administrator should read directions to client for the LS' and answer any Euestions if the client will be unsupervised.

)lternatively if needed administrator may read the Euestions to the client and mark the answer they choose if client is unable to alone.

Scoring 2ntervie6 Suestions of the interview should be divided into ? categories" social functioning physical functioning emotional functioning cognitive functioning spiritual functioning and leisure functioning based on what they are trying to determine about the client. Looking back on clients answers to Euestions from each category the therapist should decide where to place them on a scale 0,0: with 0 being they have absolutely no ability to function in that category 0: being they have excellent ability to function in that category. Scoring should result in a number from 0,0: in each category that reflects the therapists finding about the clients functioning. Category scores below D reEuire placement in a corresponding program while scores above ? indicate good client functioning. Standardi9ed Assessment Therapist will determine ? sub,scores" ,). 4sychological" )dd scores from Euestions V 0 / < and D then divide by D. ,5. Educational" )dd scores from Euestions V F ? ; and 1 then divide by D. ,C. Social" )dd scores from Euestions V @ 0: 00 and 0/ then divide by D. ,2. .elaxation" )dd scores from Euestions V 0< 0D 0F and 0? then divide by D. ,E. 4hysiological" )dd scores from Euestions V 0; 01 0@ and /: then divide by D. ,-. )esthetic" )dd scores from Euestions V /0 // /< and /D then divide by D. )reas with scores greater than D show a high amount of satisfaction in that area scores less than / show low satisfaction. Analysis and Interpretation Category scores of the Leisure Satisfaction 'easure indicate where the clients leisure needs are being met and where interventions may help increase the clients level of satisfaction. Leisure should be satisfying the following things" ,4sychological" psychological benefits such as a sense of freedom enAoyment involvement and intellectual challenge ,Educational" intellectual stimulation learning about oneself and ones surroundings ,Social" rewarding relationships with other people ,.elaxation" relief from the stress and strain of life

,4hysiological" a means to develop physical fitness stay healthy control weight and otherwise promote well,being ,)esthetic" leisure is pleasing interesting beautiful and well designed 5ased on these category descriptions low scores will provide a place to begin establishing client goals. )ssessment interview information and scores provide a look at the clients functioning in all of the domains as well as their strengths limitations likes dislikes and needs. Low scores should be taken into consideration when deciding program placement. -or example clients with low social functioning and%or low social leisure satisfaction could be placed into a social skills or leisure education programs to help these categories of low fulfillment. .esults of full assessment and program placement are documented in the clients record and treatment plan. .esults and placement decisions are also reported to the rest of the treatment team to contribute to a more comprehensive treatment and better contribution to client goals. 2iscussions of client information should be relevant to treatment obAectives and considerate of clients confidentiality and privacy.

&eporting

B. Sheppard T.S CT.S 2ecember 0? /:0<

Assessment Scenario

Client is a 0; year old Caucasian female diagnosed with anorexia nervosa at the age of 0D. She has also exhibited signs of depression. Client uses excessive exercise and strict low calorie diet as a means of losing weight. !er parents have little involvement in her life and constantly fight with one another. She is also especially competitive with her older sister who is /0. The client often compares herself to her sister and believes she is not as smart or beautiful as her. The client is not social at school and has few friends. She often wishes she was popular and envies the lives and looks of other female classmates. She works in a well,known clothing store where coworkers similarly ignore and exclude her from conversations. !er boss often treats her unfairly and heavily reprimands her for small mistakes. 2espite these things she is an excellent student. Class concepts come Euite easily to her and she enAoys learning. She is a talented artist and hopes to go to college in the next year to pursue that interest. She also has had a stable ? month relationship with her boyfriend who is completely understanding and supportive of her though she often doubts she is deserving of his love and adoration. She finds peace and relaxation in outdoor activities but rarely feels she has the time to engage in them.

Intervie0 1uestions

2ntroduction/ >ntroduce self $recreational therapist& Explain the purpose of the interview Let them know what you already know about their situation <uestions/ 0. Tell me about yourselfL /. +here are you fromL +hat is it like thereL <. Tell me about your family how many siblings do you haveL D. +hat are your siblings likeL !ow would you describe your relationship with themL F. !ow would you describe your relationship with your parentsL ?. !ow much time do you spend with your family how often do you see your family membersL ;. 2o you currently have a boyfriend or girlfriendL Can you describe your relationship with that personL 1. Tell me about schoolL @. +hat is your school workload likeL 0:. +hat do you enAoy about schoolL 00. +hat about school do you not likeL 0/. 2escribe how you do in school with grades. +hat actions of yours contribute to or cause those gradesL 0<. 2o you have a AobL +hat do you do for workL 0D. Can you describe what your relationship is like with the people you work withL 0F. +hat kinds of things do you do when you have free timeL 0?. +hat kinds of things do you do for recreationL 0;. 2o you ever use recreational activities to copeL 01. )re there any activities that you dont do currently but wish you couldL +hat prevents you from doing those activitiesL 0@. +hat is keeping you from doing those activitiesL /:. +ho do you spend your free time withL +ho do you involve in your leisure activitiesL

/0. +hat kinds of things do you enAoy that reEuire you to be creativeL Examples" art building or making things crafts cooking fixing things etc. //. 2o you participate in any spiritual or religious activitiesL Can you describe themL /<. 2o you see spirituality the same as religionL /D. +hat kind of time commitment do your religious% spiritual activities reEuireL /F. +hat kinds of things add stress to your lifeL /?. +hat do you do to handle those stressesL /;. 2o you think this is a healthy or unhealthy method for copingL /1. Can you describe what you do when you are angry or frustratedL /@. !ow do you act when you are feeling sad or downL <:. +hat does it look like when you are in a good moodL +hat are you doingL <0. !ow do you relax when you are having a tough dayL </. Can you describe what a typical day in your life looks likeL <<. !ow does what you do now in your life differ from a year or two agoL +hat things are the sameL <D. +here do you see yourself a year or two from nowL +hat do you hope to be doingL <F. +hat do you think are the reasons you are at this facilityL <?. >s there anything you feel you need help with or would like to improve on while you are hereL Closure/ Summari8e the interview Explain how information will be used 2iscuss possibilities going forward and assignments if necessary Thank them for sharing and ask if they have Euestions

Assessment Summary

0emographics/ 'iEuelle Smith 2(5" <%0/%@? )ge" 0; 2ate of Evaluation" 00%/:%0< 2iagnosis" )norexia nervosa 2nterests/ )rt $ceramics and painting& outdoors $especially hiking& sports $dance lacrosse& reading and music 7unctional A3ilities/ Social Functioning+ Client has few friends and support systems. (nly person of support is boyfriend. She feels envy towards people around her especially females. -inds she is uncomfortable with people around her and generally retreats or remains Euiet. Physical Functioning+ Extremely physically active runs and does other muscle strengthening exercises twice a day sees herself in good physical health other than a low 5'> and low weight. Emotional Functioning+ Client usually copes by working out or talking to her boyfriend. >s often overwhelmed by life events and is stressed by a busy schedule and lack of time to do activities of enAoyment. !as only her boyfriend to use for emotional support. Seems to have low self,esteem and self,worth by the way she doesnt believe she deserves the positive things in her life and has self, deprecating thoughts. Cognitive Functioning+ Client loves to learn and challenges herself in school by taking )4 classes. )lso has the ability to self,reflect. Spiritual Functioning+ -inds a spiritual connection with nature and the outdoors. !as no religious activities and does not find religion part of her spiritual functioning. #eisure Functioning+ Leisure Abilities: Likes physical activities having to do with fitness is able to do very strenuous exercises such as running playing sports and hiking. Leisure Barriers: Time physical health $5'> and weight are often a concern&. Leisure Behaviors/ Participation Patterns: (ften participates in leisure alone and for the purpose of coping with negative feelings and stress. Leisure Attitudes: *alues leisure in her life and sees the benefits of making time for positive leisure activities. Client is willing to try new leisure activities.

Strengths/ Client excels in school gets good grades has a desire to further her education in college and is physically active. Limitations/ Low body weight%5'> uses eating as a source of control uses excessive exercise as a method of coping. Precautions4Considerations/ Low 5'> and weight previously has used excessive strenuous physical activity $especially running& as a method of losing weight. E=pectations for See;ing Treatment/ (nly expectation of client for treatment is to gain weight. :eeds/ >ntroduction to new positive coping strategies increased positive leisure activity development of strong family and social support systems. B. Sheppard T.S CT.S 2ecember 0? /:0<

.reatment Plan

1oals and 83?ectives/ 2iagnosis" anorexia nervosa 0. To practice positive coping strategies )fter one week of coping skills program client will be able to verbally list five positive methods of coping to the therapeutic recreation specialist. 5y discharge client will identify one positive coping strategy she can use in her own life and demonstrate using it over a negative strategy F:N of the time as determined by the therapeutic recreation specialist. /. To engage in healthy leisure activity to increase ability to use leisure as a positive coping strategy Gpon completion of leisure education program client will be able to identify six leisure activities she can do in her own home as Audged by the therapeutic recreation specialist and family. 2uring the month of 2ecember client will attend and engage in a yoga class at least eight times. )ttendance must be verified by yoga instructor or recreational therapist. B. Sheppard T.S CT.S 2ecember D /:0<