Practice Models Chapter 14 HPR 453 Questions you are and will be asked What is TR What are anticipated outcomes of TR What strategies or interventions are used to bring about the outcomes ID: 673524
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Slide1
Therapeutic Recreation Practice Models
Chapter
14
HPR 453Slide2
Questions you are and will be asked…
What is TR?
What are anticipated outcomes of TR?
What strategies or interventions are used to bring about the outcomes?
What is the profession’s scope of practice?
What is unique about TR?
How does TR fit into health and human service delivery systems?Slide3
Practice Models are PhilosophiesThey guide therapists
Foundation for public policy
Foundation for research
Foundation for further development of the profession
2 Types of Practice Models
Content Models
Practice ModelsSlide4
Content and Process Models
Content Models identify the “what” or substance of TR services
Process models identify the “how” or means (procedures for design and delivery)
There are numerous Models and selection should be made carefully – It guides everything done in practice to produce outcomes for clientsSlide5
Differing Philosophies result in Different Concepts of Leisure
End vs. Means to End
Leisure Orientation – Outcomes related to leisure behavior body of knowledge
Therapy Orientation – Outcomes related to change or improvement in functional behaviors (medical, psychiatric, psychological, and human development) body of knowledgeSlide6
Currently TR delivered primarily in healthcare arenaModels must be congruent with medical model, nonmedical models, public policy, professional association, accrediting bodies (JC and CARF), societal trends
Limitations
– Models are static diagrams – practice is multifacetedSlide7
Models1978 – Gunn and Peterson - TR Service Model (
Leisurability
Model)
Late 70s & early 80s – Philosophical views continued to be discussed (Recreation vs. Treatment vs. both vs.
Leisurability
)
Mid to late 80s shift from leisure to healthcare models
Therapy oriented (means) vs. Leisure oriented (outcomes)Slide8
Shift from Medical Model to Wellness
Pew Health Commission (1995)
Paradigm shift from illness, cures, and separation of mind and body to…
Holistic Health (mind and body), wellness and prevention
WHO defines health as …”a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Slide9
Coding SystemsICD-10 is mainly used to classify causes of death
ICF classifies health – based on psychosocial model
ICF mainstreams the experience of disability and classifies it as one dimension of a person
Treatment has shifted from “process” to “outcomes”Slide10
Healthy PEOPLE 2010usdhhs, 2000
2 GOALS FOR NATION’S HEALTH AGENDA
INCREASE QUALITY AND YEARS OF HEALTHY LIFE
ELIMINATE HEALTH DISPARITIES
“Quality of life reflects a general sense of happiness and satisfaction with our lives and environment. General quality of life encompasses all aspects of life including health, recreation, culture, rights, values, beliefs, and aspirations, and the condition of a life which contains these elements”Slide11
TR Practice ModelsLeisure Outcome Models
Leisurability
Model – anticipated outcome is a satisfying leisure lifestyle – independent functioning of an individual in leisure experiences and activities of their choice – This leads to improved health, quality of life and well-being
Supposes that TRSs assist person’s with illness and/or disabilities to overcome leisure barriers
Continuum ModelSlide12
Health and Wellness Outcomes Models
Health Protection/Health Promotion Model (Austin, 1991 and continually updated)
The goal of TR is for clients to achieve the highest level of health
The purpose of TR is identified as enabling a client to recover from a threat to health (health protection) and to achieve optimal health (health promotion)
Prescriptive activity, recreation and leisureSlide13
TR Service Delivery Model and TR Outcome Model (Carter, Van Andel and Robb, 1995)
Meant to be used together – Outcome Model is an extension of TR
Service Delivery Model
The purpose of TR is the maintenance or improvement of the health status, quality of life an/or functional capacities of clients through the use of specially designed recreation or experiential activities and processes”
Overall outcome is
QoL
– Health status is intermediate outcomeSlide14
TR Outcome ModelPrimary Components
Functional capacities/potential
Health status/wellness
Quality of life
Leisure function represents a complex interaction of all the domains working together
QoL
is interrelated to functional capacities and wellnessSlide15
Tr service delivery model
Goal – Empower the client to achieve her or his desired goals and optimally experience a sense of fulfillment, satisfaction, mastery and well-being
Diagnosis/Needs Assessment
Treatment/Rehab
Education
Prevention/Health Promotion