Facilitation Technique Category: Mindfulness

Title: Body Aware

Source: Datillo, J., & McKenney, A. (2016). Facilitation Techniques in Therapeutic Recreation
(3rd ed.). United States: Venture.
Equipment: Yoga Mat or Chair
Activity Description:
Mindfulness is a potentially powerful intervention that can be used by therapeutic
recreation specialists to help participants create a life of meaning, personal growth, and positive
emotion (Carruthers & Hood, "Mindfulness", p. 341). This therapeutic technique allows for
individuals to create a state of open awareness that comes from the acceptance of intentional
and nonjudgmental attention to the unfolding of present moment-to-moment external and
internal experiences (Carruthers & Hood, "Mindfulness", p. 342) Under mindfulness, there
are different techniques that individuals may practice. One of which involves creating a focus on
the body, through a body scan. The purpose of practicing a body scan is to ground a person in
the present moment and can increase awareness of various bodily sensations (Carruthers &
Hood, "Mindfulness", p. 353) through systematically and intentionally moving our attention
throughout the body (Kabat-Zinn, "The Body Scan Meditation from Coming To Our Senses").
This activity can be completed with one or many individuals. Generally, depending on
the size of the area that the activity is completed activity, the maximum number of individuals
will vary, however around 20 individuals maximum to 1 instructor. To complete the body scan,
have the participant choose whether he/she would prefer to be sitting or standing. Once the
participant has decided, be sure he/she is in a comfortable position. Ask them to take a minute or
two to close his/her eyes, breathe deeply and relax. In a calm tone, instruct the participant to
bring his/her focus to the present moment and the physical self. It is unnecessary to make any
body movements, however if the participant would like to, he/she may take some physical
action, if he/she feels comfortable.
Again, in a calm tone, lead the participant through the body scan. Ask him/her to bring
awareness to any particular part of your body, try beginning by recognizing what is happening in
his/her feet. Ask the participant what he/she notices, reminding him/her not to be judgmental.
Bring awareness to not only the surface, but also deep inside the muscles, consciously release
and relax those areas. When the participant feels ready, progress up the lower legs, bring
awareness to the lower legs and again notice the deep muscles, relaxing them. After the lower
legs, have participants bring awareness to these body parts in this sequence, the upper half of
his/her legs, then the buttocks, waist and lower abdomen. Followed by the middle abdomen,
sides, and back, then the chest, upper back, shoulders, upper and lower arms, and then the hands.
After you have focused attention on the hands and fingers, progress to the neck. Finally, have the
participant bring awareness to his/her face, jaw, eyes, ears, and skull. To finish this guided body
scan, take a few more breaths and turn his/her awareness back to the entire physical self
(Carruthers & Hood, "Mindfulness", p. 354).
Leadership considerations:

In order for the practice to have the best therapeutic outcomes, it is important for
professionals, whether it be a TR professional or other professional to possess knowledge and
skills necessary to provide effective mindfulness services. The person facilitating the activity
should regularly evaluate outcomes of mindfulness interventions to encourage the best
participant outcomes possible. The person facilitating the activity should also attempt to have a
soothing tone of voice. The facilitator should also have some prior knowledge to who will be
completing the mindfulness exercise, to appropriately adapt the activity for him/her. The
facilitator should also be aware of any medication or medical conditions that could arise in the
class, to know how to effectively treat it.
Adaptations:
Participants with Borderline Personality Disorder:
Borderline Personality Disorder is most often characterized by pervasive instability in
interpersonal relationships, moods, and self-image combined with marked impulsivity. (Porter,
"5. Borderline Personality Disorder", 2015) Individuals with Borderline Personality Disorder,
engage in unstable, chaotic relationships, and are unable to regulate their mood. This can cause
episodes of dysphoria. Dysphoria is a state of unease or generalized dissatisfaction with life.
An individual with Borderline Personality Disorder will reflect interpersonal stressors, which can
cause the inability to control the relationship of this with his/her reaction to it. The activity
should be adapted to have the instructor continue through the mindfulness body scan exercise,
regardless of interruption from an individual.
Provide these individuals with an extended warm up breathing exercises. If there is more
than one participant with borderline personality disorder, it may be beneficial to adapt the size of
the group. Instead of starting with a group of 10 individuals, begin one-on-one. Adapt the
atmosphere to be positive and uplifting. Have individuals in a sitting position to begin the
mindfulness exercise and then transition to laying down. Instruction is one of the most important
aspects of this activity, therefore, it may be beneficial to adapt the instruction set for the group by
following the instructional strategies of establishing objectives, developing instructional steps,
offer opportunities for practice, include instructional prompts, provide reinforcement, and
consider personnel.
Participants with a Visual Impairment:
A visual impairment can vary in severity, however In the United States, visual
impairment is defined as a visual acuity of 20/40 or less with best correction (Porter, "5.
Borderline Personality Disorder", 2015). A person diagnosed with low vision, is significant
visual impairment with visual acuity between 20/70 and 20/200 and is uncorrectable. While a
person diagnosed with legal blindness has visual acuity of 20/200 or less in the better eye with
best correction Due to the fact that mindfulness is completed with the eyes closed, a lot of
the cuing has to occur through the other senses, mainly the auditory and tactile system. Have the
client make body movement at the part of the body that is being focused on, such as a gentle
wiggling or concentration on that part of his/her body. Depending on the severity of the visual
impairment, be careful with choice of lighting, make sure the environment is well adapted with
controlled lighting.

Be sure signs have braille symbols in order for the individual to know where he/she is.
The most important adaptation would be to communication. Ensure that the instructor is verbal
about each aspect, allowing individuals who want to keep his/her eyes open to do so. Describe
to the individual items that will assist in him/her have better orientation of the surrounding
environment and activity. Try keep the physical environment consistent. Be sure to talk with
participants before the session to understand any possible anxieties he/she may have, as well as
any extra information that the as the facilitator you might need to know. When guiding the
mindfulness activity, face the individuals when speaking and be sure to enunciate wording. If the
individual brings a guide dog to the session, inform all that need to be informed that they should
not make fuss of or feed a guide dog before asking the owners permission. When guiding a
person with a visual impairment, be sure to adapt pace for him/her. Walking slightly ahead of
them, allow them to take your arm just above the elbow. Be sure to always ask before providing
assistance, as the individual may not require it (andrew.costello@tcd.ie, "Trinity College
Dublin").
Adaptation References:
-Carruthers, C. & Hood, C. (n.d.). Mindfulness. In Facilitation Techniques in
Therapeutic Recreation (3rd ed., p. 341-359). Venture Publishing.
-Kabat-Zinn, J. (n.d.). The Body Scan Meditation from Coming To Our Senses. Retrieved from
http://palousemindfulness.com/disks/bodyscan.pdf
-Porter, H. R. (2015). 5. Borderline Personality Disorder. In
Recreational Therapy for Specific Diagnoses and Conditions (pp. 5967). Enumclaw, WA: Idyll Arbor.
-Andrew.costello@tcd.ie, T. C. (n.d.). Trinity College Dublin.
Retrieved October 12, 2016, from
https://www.tcd.ie/disability/teaching-info/awareness-info/blind.php
- Dattilo, John. Inclusive Leisure Services. 3rd ed. State College, PA: Venture Pub., 1999. Print.