 The recognition and interpretation of a stimuli that serves as the basis for understanding or for motivating a particular action or reaction

 Direct input creates our perception  Each fact we receive builds the case  What you see is what you get

 We make inferences about what we see and try to make a best guess  Prior knowledge and past experiences are critical  We develop a PERCEPTUAL HYPOTHESIS based on this prior knowledge

 We actively construct our perception of reality  Input enters and is combined with what we already know

 When things are presented in a familiar context, we rapidly judge  When we rapidly judge, we no longer look for details that we assume to be present

 Hypothesis testing occurs to make sense of the input coming in  The formation of an incorrect hypothesis will lead to errors in perception  Filtering incorrectly validates this hypothesis

 Previous experience working in a nursing home ◦ Diversion ◦ Quantity = Quality

The word RECREATION  Implies diversion  Implies fun, non clinical…….. Para professional provide recreation He saw some of the similar activities being conducted that he saw being offered in the nursing home

 Treatment Team Meetings ◦ Too much emphasis was placed by the CTRS in discussing the details of the activity and not enough emphasis on the outcome example: baking

 The patient played...  The patient had fun doing…  The patient enjoyed...

 Despite efforts to educate and highlight the therapeutic nature of what we were doing, the hypothesis was established filtering confirmed the hypothesis  “Patients have told me…”

 On the one hand, we believed that we were a good department that provided high quality, effective therapy.  On the other hand, we were being told we were nothing more than a service that is providing diversional activities to keep people busy.

 Focus on more supportive beliefs that outweigh the dissonant belief or behavior (He doesn’t know what he is talking about)  Reduce the importance of the conflicting belief (What he believes is not important)  Change the conflicting belief so that it is consistent with other beliefs or behaviors

 Part of the answer was close by (music therapy)  Part was to pay attention to what was valued

 Evidence  Outcomes  Best Practice

 Mission/purpose of unit  Length of stay  Available resources (space/budget/staff)  Assessment  Activity Analysis  A belief that there was evidence

 To bring it in line with other disciplines  To improve patient care  To change perception

 Research to validate current interventions  Research (or lack of research) that does not support the use of some interventions  Research to add additional interventions

 Limited studies to directly link specific RT interventions with desired outcomes ◦ Diagnosis ◦ Interdisciplinary treatment goals ◦ Setting

 Studies that directly connect an intervention with the exact desired outcome for the exact population  Studies that show an intervention with similar characteristics linked to the exact desired outcome for the exact population ◦ Intervention ◦ Outcome ◦ Population

 Creation of an outcomes tool that consisted of 4 questions ◦ The Therapist Was Respectful ◦ Goals Of The Session Were Explained ◦ The Session Kept My Interest ◦ The Session Helped Me Make Progress Towards My Treatment Goals As Well As Patient Comments

 There were 204 surveys completed in a 3 month period  A report was created that summarized the findings  The overall rating was 4.6/5

 The report examined the 4 variables for each intervention (group).  Particular attention was paid to the question asking the patient to rate to what degree the session helped them achieve their overall treatment goals (4.5/5).  There were 46 patient comments made and 44 were positive comments (95.65%).

 Formal presentation of evidence to support clinical practice to psychiatric leadership team  Outcome Measure ◦ Each session for 3 months  Development of departmental treatment team report guidelines

 The patient played...  The activity  The game  The patient came to recreation  The patient engaged in…  The session  The structured task  The patient came to therapy

 Invited MD’s to monitor report in treatment team (forced filtering)  Recent Vacancy