It was easy for me to join the MS Society. I belonged to several other professional organizations and it seemed only fitting to join one that could truly help me cope. The MS society sent me many articles designed to help recently diagnosed patients adjust to their illness. One article suggested that MS patients should contact a recreation therapist to structure a new leisure lifestyle. Somehow, I saw an irony that I could contact somebody like myself for adapting my leisure lifestyle.

Leisure pursuits go hand in hand with leisure assessments. If I were to assess myself, as a professional therapist, I would see an individual who pursued a full leisure lifestyle. I have always been into gardening and I have many fond memories of my gardening experiences. I grew up as a cyclist who could ride a bicycle over one hundred miles a day. I rode my bicycle around the Finger-lakes, the Catskills, Adirondacks, Green Mountains, Cape Cod and Maine. Often I carried camping equipment on my bike and thought that bicycle camping in various mountain areas was the road to nirvana. I have hiked, cross-country skied, and gone caving. During the past, I have paddled numerous lakes, rivers and ponds in my canoe. I listen and look for birds, plants and other wildlife from the deck of my boat. At home I read, draw and listen to music. I like to cook and I like to eat. I like to socialize and maintain many friendships going back to my youth.

Part of the assessment process includes writing goals and measurable objectives. These are based on both subjective and objective data. If interviewed during a TR assessment my subjective response or comments would reflect the sentiments below: “I want to continue my lifestyle. I want to go for long walks, canoe trips and live life to the fullest. I realize that walking is not so easy anymore, yet I feel that I can do almost everything else.”

The (SOAP) assessment process that compiles subjective and objective data to form a recreation plan seems to personally work for me. I am able to establish my own goals TR goals. I seek to address my physical, social, affective and cognitive functioning in the following ways:

Goal 1: To maintain or improve my current leisure lifestyle.

Goal 2: To maintain my current level of socialization activities.

Goal 3: To develop skills that promote physical functioning, balance, and range of motion.

Goal 4: To study, learn and write about Multiple Sclerosis, recreation, nature and adoptive children.

Objective 1: Given the proper equipment, resources and opportunities, I will continue to engage in activities such as gardening, paddling, cooking and camping 2-3 times per week for the next year.

Objective 2: During the course of each day, I will engage in socialization activities such as interactive conversation, with friends and colleagues for up to 60 minutes daily.

Objective 3: Following physical therapy and instruction, I will independently engage in 30 minutes stretching exercises two times daily.

Objective 4: Given the appropriate resources and materials, I will demonstrate learning through writing activities and public presentations related to MS, therapeutic recreation, adoption and nature.

Plan: I will encourage myself to engage in activities of interest. I will adapt specific activities such as canoeing as needed for safety and success. I will follow the prescribed medical plan as directed.

My, it was easy to dream. Now I am using a wheelchair that has lateral supports to hold me up. My goals and objectives are more in keeping with the most basic things like using scoop spoons and plates, sleeping on a hospital bed that turns me, preventing pressur sores, and managing my bodily needs. I find leisure in the small things, like waiting for a para-transit bus or counting lady bugs on the wall.

It all started when I fell down the stairs. I was bruised, sore and somewhat bewildered about the fall. I began having difficulty walking. My right foot was dragging with every step. The big toes on my feet kept making holes in brand new socks. During meetings at work, I had trouble seeing the written text on various documents. I could barely visualize the print well enough to read it. I began to use a magnifying glass. I was embarrassed by my sight deficit and felt like I needed new glasses. I was not sure what was wrong with me. I wondered if I was having some sort of psychological or emotional difficulty. I felt like I was going a bit mad.

Later that day, I asked the employee health nurse at my job if I could possibly have MS. I was not serious until she said, “Charlie, I don’t know. Perhaps you should see a neurologist.” A neurologist? What is a neurologist? I went to see my doctor for a possible referral. After a quick physical and reflex exam I was given a referral to see a Neurologist.

The neurologist’s office is a different kind of place. The brochures and magazines in the waiting room are mostly about Alzheimer’s disease and Multiple Sclerosis. I nervously chuckled to myself, thinking that this visit was nothing more than a big mistake. I met the doctor who interviewed me by asking questions about my medical history and lifestyle. I asked her about my MS like symptoms. She then had me walk on my heels, walk on my toes, walk a straight line, and follow her thumbs as she moved them. She closely examined my face and said that it appeared to be palsied on the left side. She gave me a test where I had to touch my nose with my index finger. Then she noticed that my right leg was “out of alignment”.

I needed a Magnetic Resonating Imaging (MRI) test to rule out Multiple Sclerosis. I was stunned and in disbelief. All of my foot dragging, stumbling, slurred speech and blurred vision could not possibly be MS. How was I going to proceed with my plans to adopt a little girl from China? What would happen in regards to my career? Why me? I could not believe it. My attitude allowed me to maintain a level of optimism, but I sat there in a fog listening to the doctor and followed her instructions for reading about MS on the world-wide-web. My life suddenly appeared to be heading in the direction of uncertainty.

I took on a new job as a therapeutic recreation director in a long term care facility. I passed my pre-employment physical. Therapeutic recreation is a helping profession. We adapt leisure activities for people with physical, cognitive, and social/emotional deficits. We help people overcome barriers to a leisure lifestyle. I work in a facility for older people with disabilities. I help design therapeutic gardens and recreation therapy programs. I am a professional therapist with the real prospect of becoming a resident in the very place I work.

I thought back to my studies in recreation therapy with a whole new perspective. As a student, I learned a little bit about recreation for MS patients. Stretching, mild exercise, range of motion activities, social activities and achieving successful outcomes are the basic tenets for working with MS patients. According to the literature, MS patients have symptoms including muscle spasms, loss of sensations, and difficulty with bladder control. We are noted for presenting physical and emotional changes. This was the beginning of a long and arduous road.

Now, nine years later, I am a quadriplegic looking for leisure.

Since we are near the time when voting on the ATRA name change will begin, I want to offer some final thoughts I have in support of the motion to change the name of the organization to the American Recreational Therapy Association (ARTA). 

While I very much appreciate all of the thoughtful and heartfelt comments so many have posted, it seems the focus of comments has moved towards our personal opinions and loyalties and away from what is the best “business” decision regarding the name of the organization in the market place of health care and human services and facts that support this decision.  Our beliefs and loyalties are very important and they drive much of what we do, but if we vote on whether to support or not support changing the name of the organization based mostly on the discourse among those who have posted to the ATRA Members’ Forum or based primarily upon our personal opinions or loyalties we risk making a mistake with a very important decision for the future of this organization and its voice as a national professional organization.  In other words we run the risk of making a decision based upon personal beliefs or loyalties or talking among professional colleagues that may be inconsistent with our marketplace and employers.  The results can be devastating to the organization and the profession it represents.

Several have commented on the desire to have “one voice for the profession”.   Since 1966 we have had the National Therapeutic Recreation Society (NTRS) to represent the interests of “therapeutic recreation” and it looks like some form of this organization will be around for some time in the future to represent “TR”.   ATRA was founded to represent the needs of recreational therapists in health care and human service agencies that could not be adequately represented by NTRS and it has done well with the resources it has available.  Consider where recreational therapy might be today if we didn’t have ATRA for the past 25 years.  The role and value of two national organizations representing “therapeutic recreation” has been debated the entire history of ATRA.  Many joint efforts between the organizations to have “one voice for the profession” on particular issues of mutual concern have met with very limited success.  It is time to change the name of ATRA to ARTA so the name is consistent with the purpose, mission, vision, values, definition and resource priorities of the organization.   Having two national “TR” organizations is unnecessary, redundant and confusing.  If ATRA became ARTA it would reduce confusion by having only one organization representing TR, NTRS.  ARTA would represent RT as ATRA does today.  ARTA and NTRS could still work together on issues of mutual interest to attempt to present “one voice for TR”, when that is in the best interests of the organizations.   With ARTA we would have a name for the organization that is not only consistent with the current focus, priorities and resource allocations of ATRA, but also consistent with all stakeholders (including health care policy makers) use of the term ‘recreational therapy.’

 In the 25 year history of ATRA we have seen the numbers of members grow when the organization was new and then decline, we have seen the numbers of those certified by NCTRC grow and then decline, we have seen the numbers of those employed as recreational therapists, as reported by the U.S. Department of Labor, and the number of recreational therapists employed in hospitals steadily decline over the past thirty years.  During this time, we have also witnessed the numbers of other allied health disciplines grow to meet increased demand for their services.  We have also witnessed the financial health of their professional organizations, which has not only sustained the organizations in challenging times, but also advanced their interests in the marketplace and with employers and other stakeholders.   Can we afford to allow this professional decline of recreational therapy to continue? 

It can be debated whether changing the name to ARTA will affect the numbers of members or the financial health of the organization or the organizations’ ability to support and advance the interests of recreational therapists in health care and human service agencies, but, are our personal opinions, personal preferences or loyalties for the term recreational therapy or therapeutic recreation, our dream of ‘one profession’  or the  desire to maintain the status quo going to continue to limit the opportunity to explore change that may very well improve the organization and the support for members and the profession?  Can we afford the risk of not trying something different to improve the national organization representing recreational therapists in health care and human service agencies?   Can we afford the risk associated with continuing to do the same thing over and over while expecting different results that we have not seen in the entire history of NTRS and ATRA?  Can we continue to allow personal opinions and loyalties to limit us from making a “business” decision that may enable us to better reach our potential to help more patients and consumers?  What do we really risk by changing the name to ARTA and trying a different approach to advance the recreational therapy profession?   Maybe we risk our future, by not changing to ARTA.

I am voting for ARTA with the hope of an improved future for recreational therapists in health care and human service settings.

The American Therapeutic Recreation Association (ATRA) is the largest national membership organization representing the interests and needs of recreational therapists. Recreational therapists are healthcare providers who use recreational therapy interventions for improved functioning of individuals with illness or disabling conditions. ATRA was incorporated in the District of Columbia in 1984 as a non-profit, grassroots organization in response to growing concern about the dramatic changes in the healthcare industry. As a result of this response, ATRA has grown from a membership of sixty individuals in June 1984 to over 2,000 in 2009. 1.

The American Art Therapy Association (AATA) is an organization of diverse, engaged and creative professionals dedicated to the belief that the creative process involved in making art is healing and life enhancing. Their culture is one of inclusion of people from all backgrounds, open to new concepts and artistic expression that continues to expand the effectiveness of art as a healing therapy. They are rooted in the experience of those who began this field and honor their legacy. The Association serves its members and the general public by promoting standards of professional competence and developing and increasing knowledge in the field of art therapy. The Association represents more than 5,000 members and 36 AATA State and Regional Chapters that conduct meetings and activities to promote art therapy on the local level. 2.

Names and acronyms give people a handle on organizations and disciplines. Changing acronyms leads to confusion. ATRA is a relatively young acronym. What if all TR organizations follow suit? NYSTRA may become NYSRTA, WVTRA may become WVRTA, NETRA may become NERTA, WSTRA may become WSRTA and ITRA may become IRTA. These fine organizations are all chapters of the American Therapeutic Recreation Association (ATRA). This petty nonsense detracts from real issues facing the profession.

The American ART Therapy Association, AATA, did not get bogged down in such trivial minutiae. Presently, they are attaining licensure for creative art professionals throughout America. New York State Healthcare administrators inform me that this is “Golden” because it insures third party reimbursement, jobs and good salaries. Suddenly, art therapists are up there with OTs and PTs. Music and Dance therapist are licensed in New York too.

1. ATRA Website 2009
2. AATA Website 2009
csourby@msn.com

While I personally favor the name change from ATRA to ARTA, I am not surprised that many have spoken against the name change because we have used the TR expression in the titles of our national organizations since the mid-1960s and therefore we have grown accustom to the term. But I do believe we now need to open our minds to the possibility of changing our name simply because it is to our advantage to do so because it will place us in a position to have others understand our profession and what we do. The Federal government already refers to our profession as recreational therapy. For example, the Occupational Outlook Handbook and Centers for Medicare and Medicaid Services (CMS), among other Federal units, employ recreational therapy when referring to us. So does the Joint Commission (JC). I can testify that Congressmen, Senators, and their staffers also are familiar with the term “recreational therapy, “ but are puzzled when they hear “therapeutic recreation.” Perhaps this is because they are familiar with OT, PT and MT so it is natural that they would relate to RT. ATRA itself has used the term recreational therapy with the Medicare Project and in the ATRA Guidelines for Competency Assessment and Curriculum Planning for Recreational Therapy Practice. If you read the mission, vision, and definition of ATRA you will find recreational therapy is the term employed. So RT seems to already be the preferred term not only by governmental and accreditation bodies but by ATRA itself. This, I believe, is because people can relate to the term and understand it is similar to OT, PT and MT – sister disciplines in which “therapy” is the central theme and is modified by the terms occupational, physical, or music. Similarly the central feature of our profession is the provision of therapy using the powerful medium of recreation through the employment of the RT Process of Assessment, Planning, Implementation, and evaluation (i.e., “A-pie process”) in both community and institutional settings. So while we may have grown accustom to TR, for the sake of our profession it is now time to change to RT.

Ode to Quality Care

Urine, urine on the floor,
We’re in, we’re in, don’t get out much any more,
Friends fall asleep in their oat meal,
Nurses revive them and document how they feel,
Dirty walls, plastic flowers, scratchy sheets,
Tattered trousers, over cooked beets,

Memories, caths and rolling bags of pee,
Alzheimer’s. dementia, strokes and laughs of glee,
Doctors, bedsores and dietary aides,
Help me, help me, please,
Visitors speak to the administration,
My life speaks of frustration,

The walls have ears, the windows gather dust,
I try to escape but, they call cops,
My ankle bracelet keeps me on the unit,
My meds prevent wandering too far,
Oh how I wish to drive a car,

The coffee is cold,
The shower is too hot,
I want to smoke but, two dollars is all I got,
My son put me here for a try,
Ten years have crept by,

Recreation Therapy tries to keep my mind alert,
Creative Forcasting, Word Games and Activities from Hell,
The lady who dribbles with soiled bloomers likes to flirt,
Socialization in day rooms that smell,

I wish I lived at home,
That be nice,
But instead I am a resident here,
Roaches on my tray,
Thicket in my soup,
How did I get stuck in this goop?

csourby@msn.com

ATRA or ARTA?

Members of ATRA is being aske to comment on a proposed name change from ATRA to ARTA with emphasis on Recreation Therapy.

If you are a member of ATRA you will want to submit your comments:

1.)    On the ATRA website (www.atra-online.com) home page, click the “Networking” tab.  Then click Members’ Forum.  There is a forum regarding the Name Change where you may submit comments.

 
or

 
2.)    You may email Dr. Jean Folkerth, ATRA Newsletter Editor and Dr. Folkerth will include the comments, both pro and con, in the upcoming ATRA Newsletter.

ATRA members AND non-members are invited to share your thoughts and comments here on this blog.

What do you think? 

In my work place I provide what I consider Therapeutic Recreation services using the TR leisure ability model.  As I work primarily with residential teens that stay for up to two years I focus a lot on leisure skill and social skill development and not as much on recreation therapy services.

NATURE SCAVENGER HUNT
Acorn
Animal Tracks
Caterpillar
Clover
Driftwood (small piece)
Feather
Fern
Flowers
Insect or bug
Items categorized by color or texture
Leaves (of trees native to the area)
Moss
Mulberries
Piece of litter left behind by someone else
Pine Cone
Pine Needles
Rocks
Sand
Shell
Snail
Tree bark from fallen branch
Worm

Tree’s rings reveal the annual rainfall. If there was plenty of water or just barely enough; the thickness of the ring gives a clue. We can count back the rings to 1492, if the stump is old enough. The rain is falling frequently around here this summer. The rabbits are eating daily, the bird baths seldom dry out. This might be a thick year

Recently 23 instructional videos produced by the Recreation Therapy Video (RTV) Project directed by Professor David R. Austin, Ph.D., CTRS, of Indiana University have been posted at the Indiana University web site.

Topics of the RTV videos range from an introduction to recreation therapy, provided by “To Serve a Purpose,” to developing such skills as engaging in therapeutic communications, making client observations, completing documentation, giving and receiving clinical supervision, and understanding models of practice. Three separate videos extensively cover the history of recreation therapy and another presents pioneers in recreation therapy.

The list of videos available are:

1. Adaptive equipment
2. Case studies
3. Clinical supervision
4. Computer use in therapeutic recreation
5. Documentation and behavioral observation
6. Effective listening
7. Feedback in learning and performance situations
8. History of therapeutic recreation parts I, II, III
9. Individual program planning
10. Interactions with people who have disabilities
11. Models of practice : health protection/health promotion model
12. Models of practice : leisure ability model
13. Nonverbal communication
14. Portraits of pioneers in therapeutic recreation
15. Professional ethics
16. Professionalism in therapeutic recreation
17. Quality of life
18. Safe transportation : safely transporting clients
19. Therapeutic communication
20. Therapeutic recreation history : the formative years
21. Therapeutic recreation history: the modern era
22. To serve a purpose
23. Transfer techniques

Over the course of this past several months I have heard from about six employees that they are having a difficult time finding someone to take their recreation therapist or activity director job opening.  They say that they have posted job openings at the Therapeutic Recreation Directory, Monster.com, local newspapers, etc and was not able to find a suitable candidate and/or very few people applied for the job.

There is a state psych hospital near where I work that has had extreme difficulty in finding a TR for their rec therapy position for several years!

I don’t know what the real answer is.  I can only speculate… can it be that the position is in a very rural area and no one wants to relocate to such a setting?  Can it be that people are “picky” with the types of jobs or places they are willing to work?  Are people not willing to “pay the dues” and work in lower paying or less desirable jobs?  Are the pay scale too low?  With more colleges dropping TR programs are there not enough TRs out there?

I also hear from others having gone through many interviews and not being selected.

What are your thoughts?  I envite you to post your comments and experiences with your job searches.

Charlie Dixon