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.

Mindfulness with Debbie Tiger at ATRA.

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Photo credit: CanStockPhoto

Debbie Tiger, M.S., CTRS presented a training session titled: Mindfulness as therapeutic recreation intervention. It was presented Tue. Sept. 13th in the Chicago-area at the ATRA annual conference.

I had plugged her session earlier during my session on Rec Therapy for children with Abuse-reactive needs. DBT was on the models I covered and mindfulness training is one of the four main skill sets taught in DBT.

Debbie provided a great session!

Mindfulness is about focusing on the here and now.

I had packed up all my stuff earlier on this date and put it in my car (because I was leaving, right after this session).

The student (Peg Connolly scholarship winner) reminded us to turn in our CEU forms at the front desk before we left to get credit. And then I realized, I didn’t have my CEU sheet with me.

I felt worried I wouldn’t get credit for this .90 session. Which is okay, because I have an abundance of CEUs and don’t need to have them. But I do like having CEU transcripts to keep as record of my trainings. The speaker provided some mindfulness practice exercises during this session as well. I tried really hard to focus on the moment and do the exercises without letting my mind wander to the CEU form, which was difficult. But it provided me with some awareness of how my patients could feel during therapy sessions with me when their mind is just someone else. I did get the benefit of getting my mind off my CEU form for a while and letting it go and using radical acceptance. After the session, I ran up to 3rd floor parking lot, got my CEU form, got it back and got credit! I told Debbie Tiger about my experience in the hallway after this session and how I actually benefited from it (by experiencing what a patient is dealing with – having mind someone else while in hospital setting).

One student at this session had passed the NCTRC exam a few days before the conference. She was hoping to get CEUs at this conference, but didn’t have her official “CTRS” credential yet. I told her it would still have been nice to have her CEU form as record of attendance in sessions. I made that mistake once when I didn’t need CEUs in the past.

 

Okay – back to this session

  • Mindfulness benefits include:
  • Better emotional regulation
  • Better emotion expression,
  • Better self-care
  • Better functioning in a variety of areas: social, emotional, mental, spiritual and functioning.

 

People with PTSD are often hypervigilant. They are overthinking. Mindfulness can help with this.

She showed popular mindfulness pictures that are often on facebook of the dog who is happy because he is in the moment with his owner and the man who is unhappy because his mind is all over the place.

Is your “Mind Full” are your being “mindful?”

Jon Zinn (2003) defined mindfulness along the lines of: a person is not mindful when she is not in the moment.

Debbie shared that we will never have this moment again. That once it is gone it is gone for good. She argued about enjoying the moment and being present.

 

Danny Pettry: it kind of reminds me of that Stephen King book, “The Langoliers.” They are these creatures that eat up the past.

 

She provided a few practice exercises:

  • 3-5-7 breathing
  • Hand on stomach breathing
  • 4-7-8 breathing for sleep
  • Focusing on a single minute (without buzzer on watch) just look at phone/ or watch/ or clock when you think it has been minute
  • Band of light exercise
  • Thought diffusion
  • Mindful of emotions

 

Mindfulness is good for when people just perseverate on something and can’t get rid of the thought. She suggested thought clouds of seeing the thought float away or letting it float down a stream or on billboards along the road that you drive by and can’t see anymore. Let those unwanted thoughts go – which is easier said than done.

 

She also talked about:

Radical acceptance of thoughts and emotions and what is happening.

 

She talked about the recreational therapist being present in the moment now. In example: if the patient screamed and cussed and hit you the day before. Then you might be still dwelling on some of those thoughts and it might be difficult to be with the patient today. Do not let yester’days thoughts about it cloud my mind.

She recommended yoga!

She talked about mindful communication.

 

She also talked about how mindfulness played a part in the Leisure Ability Model

 

At the end of this session, she played a neat youtube video that she thought reflected on being in the moment.

Here it is:

Video by Shea Glover: “you’re beautiful”

Danny Pettry’s: Rec Therapy for Children presentation at ATRA.

I had the wonderful opportunity to provide a training session today (Mon. Sept. 12, 2016) at the American Therapeutic Recreation Association’s annual conference in Chicago.

I presented on: “Rec Therapy for children (ages 7 to 12) with abuse-reactive needs at a residential treatment facility.” This area has been my major focus and specialization area. I’ve worked with this population and setting for 14+ years.

I had created 50 folders with slideshow handouts and other promotional items. Over 50 people attended this session because we ran out of folders. A few people had written their emails on a sheet of paper for me to email the presentation slideshow to them.

By the way – Here is a link with the presentation: www.dannypettry.com/9716trauma.pptx

NOTE: this slideshow alone just isn’t as good as the real presentation because I had added a lot additional information to each slide while speaking. Plus, I included recreational therapy group activity ideas.

Here are some pictures that were kindly taken by the room monitor, Ashley Martin who had won the Peg Connolly Scholarship to attend this year’s conference. She is finishing her degree at Indiana University! I thought that was awesome! I had completed my master’s degree at Indiana University. It is a really wonderful program.

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ATRA Conference – photo by Ashley Martin

I appear to be raising my hand in that picture? Here is a joke: I must have said, “Raise your hand if you think Danny is awesome?” Umm. no hands are raised in the picture below. please insert a fake laugh aloud at that joke now.

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I received a lot of praise from people after this session.

I didn’t receive any complaints, so that is always nice.

Several people that didn’t attend my session had spoken to me today saying they heard it was a good session, including: Colleen Cooke and Sydney Sklar and others that I can’t recall. But I do appreciate those people who passed along that it was a good session.