The documentation of Recreation Therapy and Leisure Opportunities in Long-term Care The Recreation Therapy discipline at Sunnybrook Health Sciences Centre (SHSC) has undergone a series of research initiatives to ensure a patient focused philosophy is integrated into their practice. The purpose of the study is the development of documentation procedures that will enable the recreation therapy practitioners to engage in authentic and professional documentation of the residents??? experiences in recreation therapy and leisure opportunities based on a patient focused philosophy. This research project followed an action research methodology and was guided by a hermeneutic framework adapted from Karkainen and Eriksson (2004). The recreation therapists at SHSC were involved in all aspects of the project as co-research participants. This project employed a variety data collection techniques including focus groups, a hermeneutic dialogue, self-reflective activities and active application sessions. The information collected through the various data collection phases in this project led to the creation of a new documentation framework and associated sample documentation, which allow for a more patient focused documentation process. A series of quality indicators were also developed in this project to help authentically express the experiences in leisure and recreation of the residents living at SHSC. This research project has added to the growing base of knowledge focused on the integration of a patient focused care philosophy into the recreation therapy practice at SHSC.

This evaluative study examined the impact of recreational therapy interventions on intrinsic motivation and holistic functioning among adults at a substance use treatment facility. West (2001) identified motivation as a key variable in treating substance use disorders, and self-determination theory, specifically intrinsic motivation, provided a useful framework for this study. Intrinsic motivation is grounded in self-determination theory and defines various motivation types and how to increase participants' engagement. Holistic functioning is another tool in assessing a participant's recovery. For this evaluation, four domains were specifically assessed: (a) physical, (b) leisure, (c) social, and (d) daily living functioning. These quality of life components are affected heavily during prolonged substance use. Results suggest that recreational therapy interventions utilizing a self-determination framework improves participants' intrinsic motivation and holistic functioning in a substance use treatment setting.

The purpose of this study was to identify the knowledge and skills required for competent therapeutic recreation practice in Canada. Research participants were 244 members of therapeutic recreation professional associations in Canada. Results from this study indicated that significant differences in competency areas exist between certified and non-certified therapeutic recreation practitioners, between practitioners with a degree and diploma, between practitioners in varying demographic regions in Canada and between practitioners with varying years practicing in the profession of Therapeutic Recreation. Implications for therapeutic recreation practice and future research are presented for discussion.

M.A. (Clinical Psychology) / This study concerns itself with relaxation training and social support as alternative forms of treatment for hypertension in renal patients. following the success of these in the treatment of essential hypertension (Lagrone et al 1986). Three groups of renal dialysis patients were chased for the study. The first group underwent relaxation training, the second group participated in group therapy sessions whieh emphasized social support. and the last group acted as a control group. The following hypotheses were made: I. Renal dialysis patients that receive progressive muscle relaxation training will show a significantly lower systolic and diastolic blood pressure rate. 2. Renal dialysis patients that participated in a number of group therapy sessions will show significant decreases in both systolic and diastolic blood pressure.

The documentation of Recreation Therapy and Leisure Opportunities in Long-term Care The Recreation Therapy discipline at Sunnybrook Health Sciences Centre (SHSC) has undergone a series of research initiatives to ensure a patient focused philosophy is integrated into their practice. The purpose of the study is the development of documentation procedures that will enable the recreation therapy practitioners to engage in authentic and professional documentation of the residents’ experiences in recreation therapy and leisure opportunities based on a patient focused philosophy. This research project followed an action research methodology and was guided by a hermeneutic framework adapted from Karkainen and Eriksson (2004). The recreation therapists at SHSC were involved in all aspects of the project as co-research participants. This project employed a variety data collection techniques including focus groups, a hermeneutic dialogue, self-reflective activities and active application sessions. The information collected through the various data collection phases in this project led to the creation of a new documentation framework and associated sample documentation, which allow for a more patient focused documentation process. A series of quality indicators were also developed in this project to help authentically express the experiences in leisure and recreation of the residents living at SHSC. This research project has added to the growing base of knowledge focused on the integration of a patient focused care philosophy into the recreation therapy practice at SHSC.

This narrative inquiry explores therapeutic relationships in the practice of recreation therapy. Narratives were generated in Recreation Therapy’s self-reflective case review process at Sunnybrook Health Sciences Centre—a process developed to support team engagement in reflections on their therapeutic relationships. In total, three self-reflective case reviews were explored, and for each case review, four layers of analysis occurred. The first two layers used narrative analysis to restory reflections of the case review leader (layer one) and then reflections within the recreation therapy team (layer two). The third and fourth layers used analysis of narrative to explore theoretical ideas from person-centred care emerging inductively in the text (layer three), and then to restory the previous narratives using a relational theory lens (layer four). Exploration revealed the self-reflective case review process also strengthens therapeutic relationships within the recreation therapy team. In the recreation therapists’ narratives we hear relational notions of connection, disconnection, reconnection, mutuality, mutual empathy, authenticity, vulnerability, and support. This study engaged recreation therapists in an act of critical pedagogy as they engaged in critical self-reflection by exploring across layers of narrative that story their therapeutic relationships. The self-reflective case review process creates opportunity for the recreation therapy team to recognize, identify and name their experiences within therapeutic relationships, and to find their voices in the medical context of a hospital setting. When engaging in self-reflective processes, recreation therapy moves further away from treating individuals as objects, shifting practice toward connection and mutuality in therapeutic relationships.

This narrative inquiry explores therapeutic relationships in the practice of recreation therapy. Narratives were generated in Recreation Therapy’s self-reflective case review process at Sunnybrook Health Sciences Centre—a process developed to support team engagement in reflections on their therapeutic relationships. In total, three self-reflective case reviews were explored, and for each case review, four layers of analysis occurred. The first two layers used narrative analysis to restory reflections of the case review leader (layer one) and then reflections within the recreation therapy team (layer two). The third and fourth layers used analysis of narrative to explore theoretical ideas from person-centred care emerging inductively in the text (layer three), and then to restory the previous narratives using a relational theory lens (layer four). Exploration revealed the self-reflective case review process also strengthens therapeutic relationships within the recreation therapy team. In the recreation therapists’ narratives we hear relational notions of connection, disconnection, reconnection, mutuality, mutual empathy, authenticity, vulnerability, and support. This study engaged recreation therapists in an act of critical pedagogy as they engaged in critical self-reflection by exploring across layers of narrative that story their therapeutic relationships. The self-reflective case review process creates opportunity for the recreation therapy team to recognize, identify and name their experiences within therapeutic relationships, and to find their voices in the medical context of a hospital setting. When engaging in self-reflective processes, recreation therapy moves further away from treating individuals as objects, shifting practice toward connection and mutuality in therapeutic relationships.

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The purpose of this study was to explore the potential benefits of a primitive wilderness skills intervention (POST) on the therapeutic change process of adolescent females enrolled in a residential treatment center. A qualitative data analysis approach was used. A convenience sample of eight female adolescents was selected by therapist referral. The data were analyzed using open, axial, and selective coding. Data analysis was used to assess participants' progress in the therapeutic change. Further analysis revealed a core theme connecting participants' POST experience with feelings of self-empowerment and reflective connections to their individual therapeutic change process. Constructive enabling was the gerund provided to represent this core theme. Attributes of constructive enabling included the opportunity for creative expression, the recognition of and reliance on social resources, the application of individual effort in challenging situations, the completion of a finished product, and the facilitation of reflective thought.

Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.