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Therapeutic Recreation Discharge planning as an aid to community re-entry in public residential treatment centers

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Alexa Cabullos

on 20 November 2012

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Transcript of Therapeutic Recreation Discharge planning as an aid to community re-entry in public residential treatment centers

Therapeutic Recreation Discharge Planning
Aiding Community Re-entry for Clients in
Residential Treatment Centers BY: ALEXA! This is Jackson! RT and the Three Hour Rule Physical, occupational, speech-language and orthotics/prosthetics therapy

RT not seen as a core therapeutic service

Due to this rule, Recreation Therapy is often NOT included in the discharge planning process Public RTPs vs. Private RTPs Public and private RTPs can be argued that they are different. Public:
Federally funded
Clients are "referred" through juvenile justice system, child services, court order, child protective services, or other mental health systems
Clients are predominantly male Private:
Private RTPs typically for-profit facilities
Funding comes from parents, sometimes insurance
Female youth are "well-represented"
Private RTPs also typically have a larger range of recreational therapies such as adventure activities, challenge courses and equine therapy. Discharge Planning Explained 1. Connects clients with appropriate resources based on their needs

2. Minimize, as much as possible, "relapse" or return to treatment

3. Prevent at-risk clients from becoming homeless and/or criminalized

4. Assist clients with community reintegration

5. Maintain goals they have achieved in treatment Types of Transitions: Sometimes clients need to be transferred to a more intense level of care.

Voluntary admittance, may choose to leave despite staff/medical advice

A patient has demonstrated non-compliance through the unsafe behaviors towards staff or other individuals. TR's Role in Discharge Planning: Hold a unique role where leisure activities can be a process of "meaning-making"

The TR philosophy, in an outcomes context, is to be able to help people find and insert meaning into the lives of the clients.

Existential outcomes are easier to find with this philosophy Recreation Therapy Discharge Plan: 1. Educating the participant about all the options available to her or him

2. Listening to the participant's story and make certain they have a strong voice in expressing preferences and making decisions

3. Emphasize community living may be able to provide healthier outcomes as opposed to institutional placements

4. Actively educate with other stakeholders in the clients life such as families, professionals and providers

5. Explore the degree in which the community may be able to support the individual through transition. Community Reintegration A discharge plan provided by a CTRS can aid the community reintegration aspect of resuming or developing a leisure plan after treatment

There is a need for more research that explores the philosophy that leisure has positive effects on health and well-being, and is important to mental health services

Most research is about the benefits of a community based mental health program for its participants. South Carolina State Hospital (1977) Community-based mental health service for psychiatric patients discharged from the South Carolina State Hospital
The program helped maintain a sense of belonging for the patients, especially if hospitalized for longer than 60 days
Institution seen as a "foreign environment"
Expressed a desire to live at home
Friends and family rejected him, he felt he "fit in" more with others from the hospital.
After being in an institution for a long period of time, many clients lose connection to community
Once able to establish a firm foot in one aspect of the community, will be able to reintegrate to other roles in the community The Reality: Therapeutic Recreation is still considered a new field

The 3 Hour Rule - limits flexibility with patients in hospital settings

Discharge planning take time to write, research and a lot of thorough planning

Following up with discharge plans

Some clients do not transition back to the community but to more intense levels of care Ah-Ha! Started by researching WT programs

Switched to Residential Treatment Centers Professional Practice Further progresses the field of TR being known as a billable service

Providing continuity of care as a form of social justice In Conclusion Recreation Therapy included in the discharge process is important, although there is a huge lack of empirical data supporting the CTRS's role in discharge planning.
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