1. KNR 273: Leisure Ability Model
Stumbo & Peterson, 2009

2. Overview Significance of a professional philosophy
Leisure Ability Model
Means/end debate
Framework for evaluating models
Will be looking at several TR models
Will need to know Leisure Ability Model inside and outside
Be able to draw, describe, and label parts
Mark chapter 1 and 2 and memorize

3. Why is a professional philosophy important?
It guides practice
Tells you and others why you do what you do
Regardless of philosophy or model, will use APIE
Professional philosophies are often represented in models
Tell how programs are designed
Guides assessment

4. What is a model? Representative of something
Provides an image or picture
Practice models must do more
Should direct practitioners in intervening with clients
Should be based on theory
Austin, 1999
Ross & Ashton-Shaeffer in Stumbo (2001)
1st step to quality services = selection of model
2nd = operationalize the model & design programs with outcomes
First TR models = late 1960s & early 1970s
Were continuums & leisure oriented
Ball 1970; Frye & Peters 1972

5. Leisure Ability Model (Adopted by NTRS in 1982)
Originally by Peterson & Gunn, 1984
Modified by Peterson & Stumbo, 2000
Services should be based on client needs or deficits
Focus on needs related to leisure makes TR unique
Leisure is vital to overall quality of life and life satisfaction
Also know as TR Service Model, formulated by Gunn & Peterson in 1978
One of the most widely used models
Needs are based on analysis of clients served by agency. Nature of agency and mandate for service is also considered. (Clustered needs)
Clients are assessed individually

6. Listen to this!!!!
“This exclusive discipline focus on leisure behavior within the umbrella of health promotion makes the field of therapeutic recreation different and unique from all other health and human services. Therapeutic recreation has much to offer clients regarding their overall health and rehabilitation goals, and its specific contribution lies in the area of leisure functioning and leisure behavior.”
p. 28

7. Rationale for TR Services
Every human being needs, wants, and deserves leisure
Many, if not most, individuals experience barriers to full and satisfying leisure
Many PWD may experience more frequent, severe or lasting barriers than people without disabilities
Rationale/assumptions
They may experience those barriers simply due to the presence of their disability or illness. For some these barriers are so limiting that it ultimately effects their quality of life, health, and overall happiness.
Barriers include (BRAINSTORM):
Attitude that leisure is not important
Lack of skills
Inability to make decisions
Lack of motivations
Inappropriate social skills
See Page 16

8. Rationale for TR Services (Cont.)
Many individuals with disabilities will need the help of CTRS to eliminate, reduce, overcome, or compensate for their barriers
The reduction of barriers allows the individuals to participate in leisure experiences of choice

9. Ultimate Outcome of TR Services
“is the improved ability of the individual to engage in a successful, appropriate, and meaningful independent leisure lifestyle that, in turn, leads to improved health, quality of life, and well-being. When the individual can independently and successfully engage in leisure of his or her own choice, the individual has the chance to receive psychological, physical, and social benefits as well as the more global benefits of improved health, wellness, and quality of life.”
p. 29

10. Clients
Any individual with a physical, mental, social, or emotional condition that limits leisure functioning
Individuals with illnesses, disabilities, or conditions acknowledged by health and human services classification systems
Medical & psychiatric classification schemes
DSM IV
WHO, ICF
Healthy People 2010
Also includes legal offenders, at-risk youth
Deviation from social norms & become recipients of specialized services

11. Clients (Major groups)
Psychiatric and mental health services
35%
Geriatrics
30%
Physical medication services
18.4%
Developmental disabilities
13.6%
Riley & Connolly, 2007
May well be other groups in the future

12. Settings Any agency or center that serves the clients we discussed
Clinical, residential, community
Page 31-32

13. Settings (Major settings)
Hospitals
38.6%
Skilled nursing facilities
19.3%
Residential & transitional settings
15.0%
Community settings
14.4%
Partial/outpatient facilities
3.9%
Day care/day treatment
3.6%
Schools
1.9%
Correctional centers
1.4%
Riley & Connolly, 2007

14. Process
Selection, development, implementation, and evaluation of goal oriented services
Functional intervention
Leisure education
Recreation participation

15. Purpose of TR
Is to facilitate the development, maintenance, and expression of an appropriate leisure lifestyle
p. 33
Have you read this before? 1982 NTRS Definition/Philosophy
Who was president of NTRS at the adoption of this philosophy? Peterson

16. Leisure Lifestyle
Is the day-to-day behavioral expression of one’s leisure-related attitudes, awareness, and activities revealed in the context and composite of the total life experience
p. 14
Routinely engaged in as part of daily existence
Cannot be viewed independently of all other parts of life
Influenced by collective and accumulated life experiences.
Express lifestyle through the daily & lifetime choices they make about clothes, activities, living arrangements & environments, religious or spiritual beliefs, health practices, social behaviors, etc.
What is your leisure life style like?
What about someone in LTC? Substance abuse?

17. Leisure Lifestyle (cont.)
Implies that an individual has sufficient skills, knowledge, attitudes, and abilities to participate successfully in and be satisfied with leisure and recreation experiences that are incorporated into his or her individual life pattern. (Peterson & Stumbo, 2000, p. 7)

18. Leisure Lifestyle as an Outcome Means Client …
Has reduced functional limitations that prohibit leisure involvement (or has learned how to overcome these barriers)
Understands and values the importance of leisure
Incorporates leisure into daily life
Is competent in a variety of leisure activities
Has adequate social skills for involvement with others

19. Leisure Lifestyle as an Outcome Means Client …
Is able to choose between several leisure options and make decisions for leisure participation
Is able to locate and use leisure resources
Has increased perceptions of choice, responsibility, and independence with regard to leisure
p. 70

20. In other words….
TR is helping individuals with disabilities and/or illnesses develop and more freely express their leisure choices
AND
The outcome of TR services is the improved ability of the individual to make and act on choices for leisure that are rewarding and successful

21. Psycho-Social Theories of Leisure Behavior
Perceived freedom & personal choice
Intrinsic motivation
Self-efficacy, locus of control, & causal attribution
Optimal experiences (flow)
Remember I said models/philosophies must be based on theory
Has been some controversy because when Leisure Ability was originally formulated, there was no mentioned theory. Theory was added in 1999 TRJ article and 2000 text.
I really don’t like learned helplessness
Learned helplessness= events in life are outside of control and person stops trying to make changes (psychological barrier)
Try to decrease learned helplessness & increase control, choice, and motivation
Latest edition removed learned helplessness

22. Leisure Ability Model 3 major categories of service See p. 34
Functional Intervention
Leisure Education
Recreation Participation
See p. 34
Functional intervention used to be treatment, but changes because all areas c/b goal oriented and treatment
Agency will provide services in more than one category.

23. Functional Intervention
Focus is on improving functional behaviors which are prerequisites to, or necessary part of, leisure involvement
Baseline abilities that are prerequisite to typical leisure behavior
4 domains
Physical
Mental/cognitive
Emotional/affective
Social
Look at functional areas which might keep client from participating in leisure
If on treatment team, may work on functional areas the team is working on
Baseline
Physical (coordination, endurance, mobility, strength, eye-hand coordination, balance)
Cognitive (memory, orientation, attention span, reading ability, ability to follow directions)
Emotional (anger management, emotional control, emotional expression)
Social (minimal social expectations….behaviors that are inappropriate for any individual under any circumstance, refrain from biting, kicking & hitting others, from screaming, spitting, caressing strangers, appropriate public behavior, staying dressed, not being agressive)

24. Sample Functional Behaviors Addressed by TR Intervention
Depression: decreased energy level; inability to express emotions appropriately, decreased stamina
Dementia: minimal orientation; limited attention span
Intellectual disability: delayed motor and social development; limited attention span
Spinal Cord Injury: minimal strength; endurance; depression
Many of the areas we discussed with the disability review.
Not usually address pathology, but limitation from pathology or secondary disabilities (when a disability imposes other limitations)
Functional problems may not be the client’s major area of need. Sometimes functional behaviors can be changed, sometimes they can not.
Use activities that are selected to address areas (activity analysis)

25. Functional Intervention
Role of CTRS
Therapist
Degree of Control
Intervention mostly controlled by therapist
Degree of Freedom in Participation
Obligatory behavior, constrained, prescribed, dependent, extrinsically rewarded
Control. Client does have control and choice in becoming actively involved in the treatment process. The client may help select treatment goals.
Can be part of interdisciplinary team by contributing to general treatment goals & addressing specific leisure-related goals

26. Leisure Education
Focus on the development and acquisition of various leisure-related skills, attitudes, and knowledge
4 components
Leisure Awareness
Social Interaction Skills
Leisure Activity Skills
Leisure Resources
See p. 43
In many ways the leisure education component may be the most important program for many clients.
Uses an educational model…behavior can change when people learn new knowledge & skills
Illness or disability is not primary concern, behavioral grown and change are sought

27. Leisure Awareness Cognitive appreciation of leisure
Content includes, but not limited to:
Knowledge of leisure
Self-awareness in relation to leisure
Leisure and play attitudes
Related leisure participatory and decision-making skills
Can be separate or combined programs
See page 45-48
Provide examples
Knowledge of leisure: benefits, barriers, difference between leisure and other behaviors like work, leisure as a context to meet people and experience new things, concept of leisure lifestyle, balance between leisure, work and other obligations, personal responsibility in leisure
Self-awareness: actual & perceived abilities or limitations, effects of disability on leisure, past & current leisure patterns and activities, satisfaction with current leisure, effects of family & friends on leisure development
Attitudes: Origins of beliefs about leisure, relationship between attitudes and behavior, appropriateness of former leisure attitudes with current lifestyle
Participatory: Decision-making skills, leisure planning skills, long-term coping and adaptation strategies, reducing and managing stress thru planning and decision-making, asking appropriate questions about accessibility, asking for assistance

28. Social Interaction Skills
Communication skills
Assertiveness, active listening, empathy
Relationship-building skills
Friendship development, cooperation, competition
Self-presentation skills
Manners, hygiene, grooming, appropriate attire
See page 49-52
Much of leisure is social. Need to be able to apply a variety of social skills in a diversity of settings.
Past focus included large & small groups
Communication: negotiation, disagreements, conflict, & compromise; conversational skills, expressing feelings & thoughts, information seeking skills
Relationship: greeting & initiation, locating leisure partners, self-disclosure & privacy issues, developing & maintaining social networks, reciprocal social support
Self-presentation: Politeness, sharing, turn taking

29. Leisure Activity Skills
Develop a repertoire of diverse leisure skills
Two categories
Traditional
Nontraditional
See page 52-56
Traditional: Sports, dance, aquatics, drama, music, arts & craft, games, hobbies
Nontraditional: Social interaction, spectating, fitness, relaxation & meditation, eating, food preparation, intimacy & dating, shopping, home improvement, pets & plants, computer & Internet activities, travel, home decorating & maintenance, conversations

30. Leisure Resources Activity opportunities Personal resources
Family and home resources
Community resources
State and national resources
Knowledge
Utilization
See pages 57-60
ATM, How use telephone book, etc.
Both knowledge and utilization
Activity opport.: Vast number of acts. that are available
How to use phone book to locate information
How to use an ATM
Could be separate program or part of leisure skills
Volunteer opportunities

31. Leisure Education Role of CTRS Degree of Control
Instructor, advisor, counselor
BUT cautions about use of term counselor
Degree of Control
Responsibility shared between CTRS & client

32. Recreation Participation
Focus on providing an opportunities for fun, enjoyment, and self-expression within organized delivery systems
Leagues, tournaments
Special Events
Activities requiring specialized equipment
Opportunities for self-initiated activity
Allow client to practice newly acquired skills and/or experience enjoyment and self-expression
May be part of leisure lifestyle
Assume have activity skills and participatory abilities

33. Recreation Participation Goals
Increase ability to assume responsibility for personal leisure participation
Increase ability to make and follow through on decisions, regarding leisure involvement
Increase competence in leisure skills through practice and involvement
Increase sense of mastery through attainment and performance of skills
1. May not have as specified goals as functional intervention or leisure education

34. Recreation Participation Roles
Practice and application of skills
Inclusionary program
Normalization of institutional routine
Focus on “well” aspects of client
Expression of leisure lifestyle
Diversion or palliative purposes
Fun & belonging
Adjust to routine in hospital. Allows degree of normalcy
Distraction, alleviation from boredom, release of emotions, doing things other than watching TV while in treatment. Can strongly justify rec. part. prgs.
Hutchinson, LeBlanc, & Booth, 2006 argue for the value of RP & should not be underemphasized.

35. Recreation Participation
Role of CTRS
Leader, facilitator, supervisor
Degree of Control
Opportunity for participation provided for client
Degree of Freedom
Independent, self-regulated, intrinsically rewarding
This is traditional definition of leisure
This is area that has caused a lot of debate
Remember the vote to decide on what philosophy in 1982?
Treatment
Recreation
Continuum

36. Leisure Ability Model
Programs/interventions based on individual client need that is related to leisure
All populations
All settings
May need services in 1, 2, or all 3 areas
Apply to settings and populations, including community based (NH, SRA, substance abuse, etc……show how this model works in those settings.
Think back to APIE presentations
Class brainstorm strengths & weaknesses of model

37. Leisure Ability Summary
Assumptions (Rationale):
Leisure is a need & right of all individuals
Many individuals experience constraints & barriers to leisure
TR services are designed to facilitate individuals’ independence in leisure functioning
Mission: Leisure
Leisure is end product or outcome
Sylvester, Voelkl & Ellis, 2001
Ross & Ashton-Schaeffer in Stumbo, 2001
( ) = Peterson & Stumbo’s terms

38. Summary (Cont.) Definition of TR (Purpose) Service Areas
To facilitate the development, maintenance, and expression of an appropriate leisure lifestyle for individuals with physical, mental, emotional or social limitations
Service Areas
Functional Intervention
Leisure Education
Recreation Participation
1. Service areas were added by SK

39. Leisure Ability Strengths
Extensive use in field (most widely used)
Acceptability & utilization in field
Flexibility (settings & population)
Services based on client needs
Stood test of time
Oldest
Fostered consistency in practice
Brought profession together
Most recognized
Recognizes importance of recreation participation
Stumbo & Peterson, 1998 (TRJ)
Bullock, 1998 (TRJ) Researcher response
Yaffee, 1998 (TRJ) Practitioner response
A. Rec Part. (respite from other tx., experience enjoyment & self expression)

40. Strengths (Cont.) Referenced in NCTRC & accreditation
Common sense approach to TR
High degree of merit
Tied to leisure theory
Graphics clear, concise & comprehensive
Good clarity of terms
Good for program design (1-1 or group)
Austin (1999)
Sylverster, Voelkl & Ellis, 2001
Ross & Ashton-Shaeffer in Stumbo, 2001

41. Leisure Ability Concerns
Based on nondisabled adult leisure behavior
Some terms ill defined (leisure lifestyle)
Focuses on leisure instead of therapy
Too broad
More empirical research is needed
Widely debated
Problems with conceptual/theory
Recreation participation is not reimbursable service
Problems with theory (Bullock, 1998, TRJ, Researcher Response)
Not until 1998 stated
Missing theoretical constructs from disability literature
Disability literature is questioning independence vs. interdependence
Questions about learned helplessness
Questions little on choice and flow as ultimate goal
Lacks strong tightly woven theoretical base
Recommends Normalization, Social Role Valorization, Self-Determination, Interdependence & Inclusion
Yaffe problems : Maslow s/b included

42. Concerns (Cont.) Recreation participation as role of CTRS
Lack of attention to health & independent functioning outside of leisure
Programs designed for 1 outcome
Linear conceptualization
Not in concert with current health cares’ focus on functional outcomes
Include Austin, 1999 here
In regard to theory: Lack of theoretical underpinnings, descriptive theory which is an OK first step, 1998 theory applied & those are too limited & not integrated
Sylvester, Voelkl, & Ellis 2001
1 outcome may not be necessary or practical
They however, think role assumed by CTRS in recreation participation may be necessary
Linear conceptualization (functional before others) SK not sure that applies.
Ross & Ashton-Shaeffer in Stumbo 2001
Notes problems with theoretical bases
Based on adults without disabilities; doesn’t necessarily apply to adults with disabilities, children, diverse ethnic & cultural backgrounds, or different lifestyles.

43. Is Therapeutic Recreation a means to an end or an end in itself?

44. Means means… Instrumental
Tool to produce some other outcome (eg. Improve health, decrease depression)
Recreation as an agent (means) of change
Means is anything that contributes to the attainment of an end. It receives it value in proportions to its utility for yielding an end. A means, therefore, is subordinate to an end and has no value unless directed toward one.
Ross & Ashton-Schaeffer in Stumbo 2001
Last quote was from Mobily 1985

45. Means (Cont.)
Means orientation indicates change or improvement of functional behaviors as the desired end.
Draws from a medical, psychiatric, psychological and human development body of knowledge
1. Peterson, 1989 as quoted in Ross & Ashton-Schaeffer in Stumbo 2001

46. End means…
Intrinsic
Leisure or recreation is the outcome that TR services aim to produce
End is anything that is valuable in its own right and is done for its own sake. An end is good for its own sake

47. Ends (Cont.)
Implies that the ultimate outcome is related to leisure behavior
Draws on the body of knowledge related to leisure
Some models regard leisure as both a means & an end
Both a tool and a product of TR services
1. Peterson 1989

48. Can TR be both at the same time?
Does the Leisure Ability Model emphasize one over the other? Which? How?
Mobily, Weissinger, & Hunnicutt, 1987
Historical piece
Your reading

49. Criteria to Evaluate TR Practice Models
Easy to follow (graphic depiction, clarity of terms & concepts)
Accommodates a variety of clients & settings
Flexibility in types of services
What is the end goal? Purposes
Underlying assumptions
Theoretical bases
Direction for research & practice
Could you explain TR with this model?
Could you design programs?
Have students brainstorm before show slide
Give copies to use to evaluate the models they will read
NOTE CHANGES FROM WHAT I HANDED OUT BEFORE

50. One Minute Paper
Clear
Muddy
General Comments