Rec 243 * Interventions and Protocols* Fall 2012

Kate Basile * Quick Reference Sheets* 12/12/12

Social Skills Training

Introduction: Social skills are necessary tools that allow for individuals to adequately interact
within society. Typically social skills training occurs when people exhibit a definitive lack in
areas such as communication, appropriate behavior, and regulation of emotions, and can be
taught in group as well as individual settings. Social skills represent the ability to perform those
behaviors that are important in enabling a person to achieve social competence. A wide range of
instructional strategies are applied directly to the training of clients based on their type and level
of assistance that they need to attain these goals. This includes, but is not limited to: positive
reinforcement, demonstration, modeling, role-playing, discussion groups, video feedback,
homework assignments, etc. (Stumbo 2011).

Key Concepts: Social skills training, aims to help individuals with serious and persistent
mental disabilities or illnesses to perform those physical, emotional, social, vocational, familial,
problem-solving, and intellectual skills needed to live, learn and work in the community with the
least amount of support from agents of the helping professions (Anthony, 1979). Social skills
training is used to enable individuals to learn specific skills that are missing or those that will
compensate for the missing ones. In addition, social skills training also allows individuals to
successfully participate in leisure activities as they most often occur in social contexts and
environments. As social skills are very attainable to teach, they can be taught by many different
people in a wide range of professions. It comes down to the extent and level of functioning of
individuals and needed skills that determine in which setting would be most appropriate for them
to learn.
Process: Social skills training is implemented based on the type of skills that one needs to be
trained in. These skills could be in peer relations, self-management, academics, compliance, or
assertion. Once the social skills deficits of an individual are assessed, the appropriate
intervention is chosen. After years of refinement, a third and final model for assessing and
teaching social skills became recognized and is now used today. The process includes these eight
steps: selecting the group targeted for social skills, select the behaviors/skills to be taught, task
analyze the silenced behavior, assess the degree to which the targeted person(s) possesses the
targeted skills, if the skill is not exhibited a teaching strategy must be selected, implement that
teaching strategy, reassess the skill achievement of the person(s), and finally, if mastered, target
the next skill to be learned (Stephens, 1978).

Use with particular individuals:

Settings: Social skills training may be given as an individual or as a group treatment, usually one
to two times a week. Sessions can occur in Clinical Facilities for individuals that have some sort
of mental disorder. All disciplines in the mental health, counseling and rehabilitation professions
have the ability to gain competence and confidence as a trainer of social skills. Social skills
training can also occur in Schools for kids who have Autism Spectrum Disorder, where they are
conducted by teachers. No matter what the situation though, training must take place in settings
with appropriate peers for newly acquired skills to generalize and to be maintained (Shores,
1987; Simpson, 1987).
Participants: Social skills training has been used as an effective intervention for individuals
with disabilities and/or illnesses. As they are quite teachable, social skills can be taught in a vast
majority of circumstances. They are able to aid in the improvement of these skills in a wide
range of individuals from children to behavioral problems to those with intellectual as well as
learning disabilities due to the identification of the skill deficiencies. These include a lack of
knowledge, practice/feedback, cues, reinforcement, and interfering problem behaviors.
Implications for TR: Social skills training requires therapeutic recreation specialists to take on a
variety of roles. Their main role is helping individuals overcome deficits in social skills (Smith
1988). They also must apply one of two operations to their social skills instruction: creating their
own, customized social skills activities/programs/curricula, or utilize commercially available
resources or curricula. In order to do this they must take on the most important role of reviewing
exactly what social skills need to be taught to their specific client(s). As leisure is one of the
main components in TR and through it, social interaction plays a large role, social skills are
fundamental to individuals leisure involvement and peer acceptance. The TRS may conduct a
therapy session for individuals lacking social skills by including social skills instruction, leisure
education, and self-esteem. Social skills training in TR allows for an individual to improve on
their communication of feelings and needs, as well as the quality relationships with others. This
allows for the possibility of improvement in overall quality of their participation in leisure.
References:
Anthony WA (1979) Principles of Psychiatric Rehabilitation. Baltimore: University
Park Press.

Stumbo, Norma J. & Wardlaw, Brad (2011). Facilitation of Therapeutic Recreation Services: An
Evidence-Based and Best Practice Approach to Techniques and Processes. State College, PA:
Venture Publishing, Inc.
Smith, S. L. (1998). Teaching the fourth R-Ralationships. Pointer; 32(3), 23-33.

Rec 243 * Interventions and Protocols* Fall 2012

Kate Basile * Quick Reference Sheets* 12/12/12

Reminiscence Therapy
Introduction: Reminiscence is a therapeutic tool that is used to aid in the improvement of
psychological well-being through recalling details, events, memories, etc. about individuals
pasts. This form of therapy is conducted successfully in group as well as individual settings,
mostly with older generations. The idea that reminiscing could be therapeutic was first proposed
in the 1960s by Robert Butler, a prominent psychiatrist. Since the late 1990s, reminiscence
therapy studies have shown that this type of treatment has a small but significant positive effect
on ones mood, self-care, the ability to communicate, and well-being. Reminiscence therapy can
be conducted using a variety of thought-provoking stimuli such as photographs, music, familiar
objects, etc. which all have the ability to evoke different responses within the individuals
participating.

Key Concepts: Reminiscence is a, spontaneously occurring (social) human behavior of

recalling the past. Reminiscence therapy is applying this notion into a therapeutic setting and
using stimulating tools in order to get a response. The main purposes of reminiscence therapy are
to have a positive impact on mental and social health including memory, cognitive functioning,
emotional regulation and overall well-being. Research has concluded that there are 8 common
functions of reminiscence: identity, problem solving, death perception, teach-information,
conversation, bitterness revival, boredom reduction, and intimacy maintenance (Cappeliez,
Guindon, & Robitaille, 2008; Webster, 2003; Wong, 1995). Each of these types of reminiscence
has also been found to cause different emotions, both positive and negative. It is necessary for
the therapist to consider the appropriate type of reminiscence for their intended clientele in order
for it to be successful.
Process: Reminiscence therapy can be conducted in group as well as individual settings.
Typically conducted with the elderly and/or disoriented there are four stages to the process in
which the facilitator must conduct. The staging part of the process is where the facilitator must
fully attend to listening to the client(s) while also explaining the values and possible outcomes of
reminiscing. The client may or may not choose to participate if they feel like it will not be
beneficial. The facilitator must also provide both a physically and socially stimulating
environment which includes not only setting, but appropriate materials for stimulation (i.e.
photographs, music, movies, foods, smells, etc.) This is to ensure safety as well absence of
distraction. Maintaining interest and focus is also crucial which requires the facilitator to pay
attention to client(s) needs such as giving appropriate amount of response time as well as
positive reinforcement. The session ends based on the facilitator taking into account the client(s)
energy and comfort; they may end sooner than scheduled due to fatigue, discomfort, and
restlessness (Stumbo, 2011).

Use with particular individuals:

Settings: Reminiscence therapy programs can be found in settings that are treatment and
healthcare oriented such as Nursing Homes for senior citizens, community settings that may
include Senior Centers, and Retirement Residencies. Although less common with children adults,
reminiscence therapy may also occur in settings such as Memory Clinics.
Participants: Reminiscence therapy has been studied in a variety of populations and has been
proven successful for each; however, its roots in applying it to therapeutic techniques have
mostly been seen in aging populations. Reminiscence therapy has a wide range of outcomes
depending on the age group it is used with. For the older generations the main focuses are on
memory and cognitive adaptation. Although reminiscence therapy only aids in the possible
retrieval of information, it has been proven to help with depression in older adults and/or nursing
home residents and overall well-being. When used in younger populations it has the ability to
assist in improvement in cognitive functioning and memory development in children,
relationship satisfaction in couples, and even anxiety (Stumbo, 2011).

Implications for TR: Reminiscence therapy techniques are a tool that researchers say, can be
used by TR specialists to facilitate social interactions, reconstruct memories, and coping
mechanisms, as well as documented guidelines regarding how to incorporate reminiscence into
TR program planning (Stumbo, 2011). A therapeutic recreation specialist needs to be critical
when selecting the content of a program as well as select appropriate and interesting topics, and
to frame helpful questions in order for clients to maintain interest and focus. Reminiscing in
some clients may not occur spontaneously, or at an instant, especially in older patients, so it is
essential that the TR specialist to continually be playing a facilitator role as well as provide a
range of stimulants. No consensus has been established of how reminiscence should be applied
to TR. According to Shute though, Insufficient specification of curative aspects and risk factors
may result in psychological harm to certain participants. (1986, pg. 57) As a result of this, the
facilitator must be sufficiently prepared and take into account his or her clients personality
differences and histories in order to ensure a safe and effective therapeutic intervention (Stumbo,
2011).

References:
Cappeliez, P., Guindon, M., & Robitaille, A. (2008). Functions of Reminiscence and emotional
regulation among older adults. Journal of Aging Studies, 22, 266-272.
Stumbo, Norma J. & Wardlaw, Brad (2011). Facilitation of Therapeutic Recreation Services: An
Evidence-Based and Best Practice Approach to Techniques and Processes. State College, PA:
Venture Publishing, Inc.
Weiss, C.R., & Thurn, J.M. (1987). A mapping project to facilitate reminiscence in a long-term
care facility. Therapeutic Recreation Journal, 21 (2), 46-53.

Rec 243 * Interventions and Protocols * Fall 2012

Kate Basile * Quick Reference Sheets * 12/12/12

Art Therapy
Introduction: Art is a therapeutic tool that aids to improve health and enhance well-being through

self-expression. Although a relatively young discipline, art therapy was first considered to be
therapeutic around the mid-20th century, and not until 1940 was it considered to be a profession.
Adrian Hill, a UK artist is acknowledged as using the term art therapy first to describe the
therapeutic application of image making. He discovered the therapeutic benefits of drawing and
painting while recovering from tuberculosis and even spread it to other fellow inpatients. Around
the same time in the US, psychologist Margaret Naumberg also began to use art history, but more
in terms of phycology. Art therapy today includes, but is not limited to, a vast number of other
approaches such as: person-entered, cognitive, behavior, gestalt (form or shape), narrative,
Adlerian (psychoanalysis), and Family (Systems).
Key Concepts: Art therapy has dual origins in art and psychotherapy making a universal
definition hard to come by. When it is being used as art as therapy, it is the physical process of
creating art, while when it is art in therapy it is considered the analysis of it. The main purpose
of art therapy, through a strengths-based approach, is to assist in rehabilitation through restoring
the self. Art therapy, Involves the use of different art media through which a patient can express
and work through their issues and concerns that have brought them into therapy (Case 1992).
Although having a strong foundation on mental health, art therapy is not limited to just that as it
has been proven to exhibit physical benefits from patients, such as those with neurological
disorders. Through the use of sensory experiences, symbolic expression, emotional expression,
life enhancement, cognitive development and social connectedness, certified therapists are able
to use their knowledge of the human mind and apply it to activities that are most beneficial to
patients.
Process: Art therapy is conducted in a variety of situations, both individual as well as group,
depending on the community of people that is being worked with. The therapist or facilitator
must first assess the client to find out what they are going through, find out any other important
information that could be relevant in dictating what programs and techniques to be used, or if art
therapy is even a good option for them at all. When it comes to the use of art as a technique, a
facilitator may use one of two approaches. The first is to be process intensive, in which the art
therapist uses art as a means to help his or her patient(s) to discover something about themselves.
Art is used as a catharsis, an emotional journey to which self-actualization and discovery are the
outcomes. The second approach is to focus on what a person is consciously or unconsciously
expressing through creating art as well as being shown it. From this the therapist can attempt to
figure out the underlying problems that the patient may be suffering from.

Use with particular individuals:

Settings: Art therapy is employed in many Clinical Settings such as Hospitals, with diverse
populations. Art therapy can be found in non-clinical settings as well, such as in Art Studios and
in Workshops that focus on creativity development. Art therapists work with children,
adolescents in Schools, adults and provide services to individuals, couples, families, groups, and
communities.
Participants: Art therapy has proven to be a very effective intervention for a wide variety of age
ranges as well as circumstances. The use of art therapy allows people who have suffered from
personal trauma, loss, abuse and relationship issues to use it as a gateway to expression of
thoughts and feelings. For those with physical, cognitive, and neurological problems, art has
demonstrated a range of physical benefits. The calm nature of art makes it a naturally therapeutic
tool for people of all ages due to its minimal need for skill and is an open ended intervention;
people can create it in almost any way.

Implications for TR: Art therapy is a specialized field that many professionals are experts and
certified in. Therapeutic recreation specialists are certified specialists but have the ability to
implement a wide range of interventions in different areas geared towards a certain population of
people. Art therapy, when used by a TRS, may come in the form of using activities such a
drawing, paints, crafts, clay, etc. For a TRS using art as a means of therapy can be considered to
be a fun activity, possibly even an ice breaker. It is not necessarily intended used as an in depth
exercise to gain information about a persons cognitive functioning or mental status to further
improve on the issues they have. When providing art for the purpose of constructively filling
leisure time, that is not art therapy. (Case, 2010) Recreation therapy is a process in which many
different leisure activities and interventions are implemented to specific groups of people with
the intention of remediating their level of functioning and independence in life activities. Art is
just one of numerous tools that allow therapeutic recreation specialists to do this.

References:
Case, Caroline, & Dalley, Tessa (1992). The Handbook of Art Therapy. New York, NY: Routledge.
Rubin, Judith A., (2010). Introduction to Art Therapy. New York, NY: Taylor & Francis Group.