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.

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at the 2015 NAAP Education Summit in Kentucky, LinkedIn, and snowball sampling. Eligible participants who provided informed consent were interviewed by phone from August 2015 to February 2016. Data were analyzed using both hand coding and NVivo 10.0 software. Results showed the value of relevant certifications and the importance of training in a range of topics, especially dementia care. Connection to others and the environment emerged as key themes. This study is significant because it explores professional development in the long-term care environment, which can facilitate positive social change to provide the elderly, especially those in cognitive decline, with a comforting environment for special needs. This study contributes to the knowledgebase to inform the development of educational and training opportunities for activities professionals, especially those caring for individuals with severe / end-stage dementia.