Facilitation Technique Category: Anger Management

Activity Title: Belly Breath Exercises: Ready to increase energy and decrease
tension.
Source: COPD Foundation. (n.d.). Retrieved from
http://www.copdfoundation.org/What-is-COPD/Living-with-COPD/BreathingTechniques.aspx
Equipment: Small pillows, mat, comfortable clothes, and quiet environment.
Activity description: Anger management is a very helpful treatment that
improves angers tolerance and control of participants. Belly breath exercises are
simple but powerful techniques that increase energy and decrease tension. The
purpose of this activity is to teach participants the basic steps of belly breath
exercises in order to promote relaxation and decrease physical/cognitive symptoms
of anger. First, the instructor will explain and demonstrate all steps of belly breath
exercises before participants engage in the activity. Second, the instructor will give
the command Lie flat on your back to get a proper sense of deep breathing. Third,
participants will proceed to have some small pillows available to decrease strain by
tucking them under the back (neck and knees). The regular sequence of breathing
in that position will generate a small rise in the belly upon inhaling and a slight fall
upon exhaling. Fourth, the instructor will provide the following second command
Place your hands palm down on your stomach at the base of the rib cage. Fifth,
participants will continue with placing the palms of their hands on their abdominal
just below the chest, middle fingers hardly touching each other, and take a gentle
deep breath. (As the diaphragm pushes down, the belly will slightly increase
causing the fingertips to isolated somewhat). Six, proceed to sitting position and the
instructor will provide the following commands: 1. Sit up aligned. Exhale. 2. Inhale
while, relax the abdominal muscles. The impression is like the belly is filling with air.
3. After filling the abdominal area, keep inhaling. Fill up the central of your chest.
Feel your chest and rib cage enlarge. 4. Hold the breath in for a short time, and then
begin to exhale very slowly. 5. As the air is getting out, relax your upper body.
Begin to pull your belly in to force out the residual breath. 6. Close your eyes, and
focus only on your breathing. 7. Relax your physically and mentally. 8. Let all
thoughts go. 9. Complete the session after 5 minutes of performing the excs.
Seven, the instructor will finish the activity by reviewing all steps and giving
feedback to participants.
Leadership considerations: CTRS will be the instructor in this activity with a
minimum requirement of specialized training on numerous breathing excs. Also,
staff/volunteers/recreational therapist students could be part of the team in order to
carry out this activity. The staff to participants ratio should be1:1, 1:2, 1:3, and 1:4
depending on the particular client. Instructions/education include energy
conservation techniques (such as rest periods between sets) in order to promote

endurance/relaxation, postural awareness during breathing excs to improve proper

sequence of tasks, environmental barriers, valsalva maneuver, etc. Some
precautions should be into consideration including do not allowing participants to
force expiration, highly prolonged expiration, or the use of accessory muscles to
initiate inspiration.
Adaptations: Participants with Borderline Personality disorder: According to
National Alliance of Mental Illness, Borderline personality disorder (BPD) is a
disorder categorized by difficulties regulating feeling. This struggle leads to severe,
unstable mood swings, impulsivity and unpredictability, deprived self-image and
complicated personal relationships. Some good adaptations for these individuals
could be during session do not let them alone since they tend to attempt against
themselves, teach some relaxation techniques before performing breathing excs
since this population tend to have a strong mood changes. Promote one-to-one
session or group session during breathing excs depending on the behavior, etc.
Adaptations: Participants with Mitochondrial disease: Mitochondrial illnesses
result from malfunctioning of the mitochondria, specialized sections current in every
cell of the body excluding red blood cells. Depending on which areas are impaired,
symptoms may contain loss of gross motor (control/coordination), muscle weakness
and subjective pain level, gastro-intestinal complaints and swallowing
complications, poor growth, cardiac disease, liver disease, diabetes, respiratory
difficulties, seizures, sensory problems, etc (United Mitochondrial Disease
Foundation). There are many adaptations for this population during breathing excs
such as promote participation during early time since they can easily fatigue,
promote support for posture/alignment during breathing excs due to low muscle
tone/strength. Provide VCs/TCs for proper sequence of tasks and correct hand
placement due to impaired vision/hearing.

Adaptations References
COPD Foundation. (n.d.). Retrieved from http://www.copdfoundation.org/What-isCOPD/Living-with-COPD/Breathing-Techniques.aspx
Hapiness Program. (n.d.). Retrieved from
http://us.programs.artofliving.org/n/breathing-exercises/?
keyword&campaignid=293753693&adgroupid=21259520573&feeditemid&cn
ame=breathing-us-lp-02&targetid=kwd37243570540&gclid=CMDK4djis88CFQMmhgodfOsHEQ
National Alliance of Mental Illness. (n.d.). Retrieved from http://www.nami.org/LearnMore/Mental-Health-Conditions/Borderline-Personality-Disorder

United Mitochondrial Disease Foundation . (n.d.). Retrieved from

http://www.umdf.org/site/c.8qKOJ0MvF7LUG/b.7934627/k.3711/What_is_Mitoc
hondrial_Disease.htm

Facilitation Technique Category: Therapeutic Use of Humor

Activity Title: Emotions and Humor: Positive and happy mood
Source: ll, D. W. (2006). Exploring Emotions through Activities.
Equipment: Pencils and papers
Activity description: Therapeutic use of humor promotes playfulness and it is the
best expression for being optimistic. Humor helps to improve empathy and gives a
different perception. Emotions and humors activity in particular promotes positive
and happy mood. The purpose of this activity is to increase the influence of the
humor in participants mood. First, the instructor will explain the directions of the
activity step by step. Second, have the participants divided in groups size of two to
ten members. Third, instructor will provide the following command: Write your best
answer in spaces provided. Fourth, participants will answer the following questions:
What is the best joke you have ever heard? List numerous funny cinemas: Mention
some funny books, stories, or comics: List funny animations: Explain an anecdote
when something humorous happened that you did not expect. What makes you
laugh? What ways can you increase funniness in your daily routine? How do you feel
after having a good humor experience? List some ways in which you can increase
humor throughout your days? Fifth, instructor will allow participants to share their
answers and will engage in discussion questions including: What did you learn about
this activity? How does humor impact your behavior? What would routine be like
without humor? Why is it incorrect to make jokes about: gender, race,
physical/cognitive disability, sexual orientation, age, or religion? Six, instructor will
conclude the activity by reviewing the content and providing some feedback.
Leadership considerations: CTRS will be the instructor in this activity. Also,
staff/volunteers/recreational therapist students could be part of the team in order to

carry out this activity. The staff to participants ratio should be1:1, 1:2, 1:3, and 1:4
depending on the particular client. Some precautions should be into consideration
including: allowing use of colored pencils for inspiration. Explain words/phrases as
needed to prevent misunderstanding. Provide correct humor and joke supplies for
participants to interact. Establish a humor report board with jokes, questions and
pictures. Let all participants to engage in the board construction. Instructor/staff will
prevent any demeaning or incorrect humor.
Adaptations: Participants with Alzheirmers Disease: According to
Alzheimers association, Alzheimer's is a type of dementia that causes difficulties
with memory, thinking and performance. Symptoms/signs usually start slowly and
progress worse over time, and developed severe enough to restrict with activities of
daily living. Since clients with Alzheimer have the main problems regarding new
learned information one good adaptation for the activity would include recall
answers from the past not recent events. Also, give short and simple commands
during the activity. Using contrasting colors will help this population, they can use
different colors for different moods, objects, or experiences in order to identify and
locate the information, etc. A great adaptation could be verbalizing the answers
instead of writing down since they lose the ability of writing (Alzheimer Society).
Adaptations: Participants with Huntington's disease: The condition is an
inherited illness that causes the progressive degeneration of all nerve cells in the
brain. This disease has a big impact on a person's activities of daily living and
usually results in involuntary movement, critical thinking (cognitive) and psychiatric
conditions (Mayo Clinic, 2014). Some adaptations for people with this condition will
be for example, you can point to symbols/objects on a board to indicate your mood,
experiences, etc. Using communication aidscan to facilitate communication is
speech is an issue. Also, the use of computers will allow participants to points at
objects instead of writing long sentences. The use of crayons instead of pencil since
they present involuntary hands movements in order to promote better gross motor
coordination, etc

Adaptations References
Alzheimers Association. (n.d.). Retrieved from
http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
ll, D. W. (2006). Exploring Emotions through Activities.
Mayo Clinic. (n.d.). Retrieved from http://www.mayoclinic.org/diseasesconditions/huntingtons-disease/basics/definition/CON-20030685
NHS. (n.d.). Retrieved from http://www.nhs.uk/Conditions/Huntingtonsdisease/Pages/Lifestyle.aspx