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TR Practice: Art, Science, or Magic?

TR Practice: Art, Science, or Magic?. Chapter 13 HPR 453. TR: Roots and Now. Early Civilization – Play and recreation were healing to ill and injured Florence Nightingale – arts, music, humor, pets, writing, conversation in recovery of ill, injured, and dying soldiers

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TR Practice: Art, Science, or Magic?

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  1. TR Practice:Art, Science, or Magic? Chapter 13 HPR 453

  2. TR: Roots and Now • Early Civilization – Play and recreation were healing to ill and injured • Florence Nightingale – arts, music, humor, pets, writing, conversation in recovery of ill, injured, and dying soldiers • Recreation contributes to health and QoL • Art, Science or Magic????

  3. TR Practice as Art • “All Recreation is Therapeutic” • CTRS seeks to supplement, alter, or counteract effects of illness or injury • Introduces media to supplement body’s healing and health capacity • Encourages individual to be autonomous and seek meaningful experiences • Results in improvement in health or condition

  4. Based on aesthetics of environment and value of self-expression and creativity to cause one to feel good (or at least better) • Arrange interventions in a way to effect sense of quality or goodness • The participant interprets the value • Art for art’s sake or as recreation as a means unto itself

  5. TR Practice as Science • “TR as the Means to Outcomes or Ends” • More recent phenomenon due to internal and external forces • Definition of science – The observation, identification, description, experimental investigation, and theoretical explanation of phenomena” American Heritage Dictionary (1994) • Through research phenomena and theories are tested and explained

  6. Scientific investigation of TR Practice and formal training programs began in 1950s • Which interventions were effective? • What skills do practitioners need to be effective? • Development of cause and effect and perspective on importance of constancy of purpose and consistency of approach

  7. Important Developments • Internally – • Body of knowledge • professional organizations • education and training programs • definition of TR • observation and investigation of the practice of TR • accreditation process

  8. Practice as a Science Milestones • Autonomous credentialing program – NCTRC • Based on scientific analysis of TR job functions and knowledge needed to perform the functions • Born of efforts to provide prof self-regulation • Educational prerequisites, internship under qualified professional (CTRS), job knowledge test • 1st real measure of consistency of professional practice

  9. 1991 National Consensus Conference on Benefits of TR in Rehabilitation • Temple University and National Institute of Disability Rehabilitation Research (NIDRR) • Studied efficacy in TR in rehabilitation • Consistent, uniform Tx outcomes of TR with specific populations

  10. External Developments • Standardization and accreditation of healthcare – JC, CARF • Regulatory accountability – Healthcare Financing Administration (HCFA) now CMS • Concerns centered on quality delivered • Costs skyrocketing -> Insurance industry imposed restrictions on access to healthcare • Evolution of technology/Consumers’ access to information

  11. People living longer, surviving catastrophic injuries and illnesses and better informed on options for healthcare • TR exists in scientific arena due to these factors

  12. More recent developments… • Development of evidence-based protocols or practice guidelines • 2003 – ATRA Dementia Practice Guidelines for Recreational Therapy • Theoretical framework and scientific evidence to support efficacy of treatment approaches • Pending Guidelines • Pain, Obesity, Stroke or other neurological events

  13. Important to monitor trends in healthcare for direction of research and scientific inquiry • Worldwide health initiatives such as WHO ICF • Move away from disease to health and health-related domains, how the individual is impacted by internal body functions and structures, activity participation, performance, and functioning in relation to social perspective and environment’s impact on functioning = Health and Health Promotion and role of TR

  14. TR as Magic • Holistic or Spiritual Perspective of TR • Magic defined – “Possessing distinctive qualities that produce unaccountable or baffling effects” American Heritage Dictionary (1994) • Some practitioners practice more by doing what they know works – results through power of charisma, charm, persuasiveness of personality • Mysterious qualities connected to healing

  15. Mind-Body Connection such as acupuncture, chiropractic, naturopathic medicine, energy-based modalities such as yoga, Reiki or guided imagery, autogenics • Used for centuries yet lack scientific evidence so they are “magical” • Enter “Mind and Behavior” – If you believe you can, can you? • Have we as practitioners affected the person by design, or was it really magic that caused the change?

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