The Efficacy on Therapeutic Recreation in Building Social and Life Skills by Virginia Coco

Ms. Virginia Coco is a PhD student in Community Resources and Development at Arizona State University.

Read what she is doing:


Violence and Barriers to Meaningful Relationships

A MSRT student at Temple University. shared that she had been introduced to Robert Waldinger’s TED Talk: What Makes a Good Life? Lessons from the longest study on happiness.
Here is a link to the video:
The student shared, “His main point states that in life, our happiness is most influenced by meaningful relationships.”
She asked: “My question to you is how, in our practice, can we best promote meaningful relationships for our participants when there may be barriers due to violence? What kinds of interventions do you use to help various populations that may become more reclusive due to past abuse, gender violence, etc.? In what ways can we address this issue with participants?”
Here is my response:


I provide services for children (both male and female) between (ages 7 to 12) who have abuse-reactive needs. Children admitted to the unit have experienced some type of traumatic in their life.

 It is a Psychiatric Residential Treatment Facility. The typical stay is 6 to 9 months.

Some of the common needs among patients include:


  • Lack of interpersonal skills (possibly from learned behaviors)
  • Lack of assertiveness skills (often resorts to physical, verbal aggression)
  • Lack of a social support system (no identified foster family or adoptive family)
  • Lack trust in others
  • In addition, patients may have other conditions, like Autism Spectrum Disorder (ASD)
  • Some children have Reactive Attachment Disorder (RAD) – this is where they had neglect at an early age and fail to learn how to have emotional connections and relationships


Trauma-Focused Cognitive Behavior Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT) are the two primary treatment modalities. There is evidenced-based research that demonstrates that these two approaches are effective.

Both TF-CBT and DBT have a focus on interpersonal skills.

  • In the TF-CBT mode, there is a phase called, enhancing social skills
  • In the DBT model, there interpersonal skills are one of the four main skill sets taught.


We identify our intervention as “interpersonal skills training or social skills training.”

We in recreation therapy have a lot to offer in this domain.


We use a lot of recreation activities as means to achieve outcomes.

  • Sports: taking turns, good sportsmanship, being part of a team/ group
  • Board games: taking turns, being a good sport,
  • Social activities: ballroom party for Halloween or ice cream social
  • Education/ classroom settings: to teach skills. Using pictures of children in different social situations
  • The listening game: Teach what paraphrasing is. Get a book like “The conversation starts.” Read a question to a group member. Group member answers. Randomly select a different group member to paraphrase what the first group member said to indicate he (or she) listened and then ask that group member a question.
  • Assertiveness training: Teach the children to ask for what they want or to express their feelings with use of I-statements.
  • Cinema therapy card game: Play a movie. Ask children questions from the card game that get the kids to point out social skills, emotions in characters
  • Community re-entry outings: passes to local parks, zoos, water parks, mall, or other places.
  • Emotional support: being able to recognize emotions in others and be able to offer support
  • Family-based recreation therapy: with rec therapist: Mental health therapist/ counselor provide family therapy. and the rec therapist often supervise the community re-entry outings before a new family is on their own with a patient. The rec therapist can implement games and activities to help the family and child to get to know each other, and supervises passes in the community.


The recreation therapist serves as a role-model, a coach, a facilitator, and evaluates progress.

The therapeutic value of hugging

hugHugging. (video at the end)

Research shows that hugging releases endorphins, lowers blood pressure, lowers cortisol (stress hormones), improves sleep, and increases social connectedness. How amazing!?

I can vaguely recall that a country (possible Germany around World War II had any many woman to have babies and then give them over to the state. The babes were kept along in cribs without social interaction. If I recall right, their aim was to build soldiers out of these kids. However, most of them died due to the lack of social interaction and human contact. We humans are social animals. Those who did survive ended up having delays in areas of their life. Disclaimer: I don’t have a source for this.

Some of my tips: ask first. Respect boundaries. I [Danny Pettry] provide services for children with abuse-reactive needs. They often have poor boundaries and need to be taught boundaries because they haven’t learned. As a rule for people in the helping field (like recreational therapists) hugging patients is often an ethical no-no. However, sometimes it might be appropriate (in example: rec therapist giving hug to resident in nursing home on her birthday who lacks a family). At our facility, we provide side-hugs for children and teens if they ask for it. The reason for hugging on the side opposed to front is due to the kids past experience with abuse and to avoid having any body parts pressing against a person.

My mentor Jack Canfield argues to lean in to the right when you hug a person so both hearts can be together as one.

I must admit I am very akward about hugging and touching. I did participate in hugging exercises during a breakthrough to success training with Jack Canfield.

You may want to share this video with others who could benefit from it:

Read a post at Happyologist (based on the United Kingdom) on the shocking truth about hugs: