Assessing Strengths in TR/RT: Tools for Positive Change Part II

Dr. Lynn Anderson, CTRS, SUNY CortlandDr. Linda Heyne, CTRS, Ithaca College

2014 ATRA Webinar L2October 8, 2014

Department of Recreation, Parks and Leisure Studies

Session Description

At the heart of therapeutic recreation practice is the art of building strengths in the individuals we serve. Therapeutic recreation is historically grounded in the medical model of practice.A sea change has occurred in health and human services, which focuses on orienting services toward people’s individual strengths, assets, talents, and aspirations. In order to systematically build strengths, we must systematically assess them. These webinars (Parts I and II) focus on some of the tools and approaches that can be used to assess the internal and external strengths of our participants. The session will help orient TR/RT toward strengths-based practice by giving CTRSs practical tools for positive change.

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Webinar Outlines

Webinar L1: Part I (October 1)

Webinar L2: Part II (today)

• Introduction and brief overview of the strengths approach• A model and framework for assessment in strengths-based TR/RT practice• The ecological approach to strengths-based assessment• Tools for assessment of internal and external strengths: Leisure Domain• Tools for assessment of global outcomes of TR/RT services: Well-Being• Questions, discussion

• Brief overview of the strengths approach and a framework for assessment from Part I• Tools for assessment of internal and external strengths: Psychological/Emotional Domain• Tools for assessment of internal and external strengths: Cognitive Domain• Tools for assessment of internal and external strengths: Social Domain• Tools for assessment of internal and external strengths: Physical Domain• Tools for assessment of internal and external strengths: Spiritual Domain• Questions, discussion

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Session Objectives

Define the strengths approach in health, recreation, and human services and its impact on practice

Compare and contrast TR/RT assessment from a strengths versus a deficits approach and identify important differences

Identify internal and external strengths and at least six assessment tools to measure and describe them, using an ecological approach

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Principles of a Strengths-Based Approach

Every individual, group, family, and community has strengths Difficulties are also sources of opportunity and challenge We do not know the upper limits of a participant’s capacity to

grow and change – never assume we do! Collaboration (not expert domination) with participants Every environment is full of resources Context matters Hopefulness matters Strengths can be nurtured (thus, must be

assessed, planned, focused on, and evaluated)

Internal and External Strengths

Internal Strengths•Interests and preferences•Attitudes and beliefs•Talents and abilities•Skills and competencies•Knowledge•Aspirations and goals•Character strengths/virtues

THE PERSON

External Strengths and Resources

•Family support and involvement

•Friendships and social support

•Home resources

•High expectations and positive attitudes

•Community and environmental resources

•Opportunities for participation and contribution (inclusive communities)

THE ENVIRONMENT

Assessment in a Deficits Approach Assessment in a Strengths Approach

Defines the diagnosis as the problem; questions are pursued related to problems, needs, deficits, and symptoms

Defines a holistic portrait: what the participant wants, desires, aspires to, dreams of; participant’s talents, skills, and knowledge

Searches for the nature of the participant’s problems from the perspective of the professional; analytical

Gathers information from the standpoint of the participant’s view of the situation; ethnographic

Is interrogative in nature

Is conversational in nature

Focus is on diagnosis to determine level of function

Focus is on the here and now, leading to a discussion about the future and how the person has managed so far

Participant is viewed as lacking insight regarding the problem, illness, or diagnosis

Participant is viewed as a unique human being who will determine his or her own wants within the environment

Assessment in a Deficits Approach Assessment in a Strengths Approach

Participant is a passive container for interventions as professionals direct decision-making

The relationship with the participant is primary to the process, where joint decision-making is key

Places the participant in diagnostic or problem categories using generic, homogenous language

Strengths assessment is specific, unique and detailed, individualized to the participant

Emphasizes compliance and management of problems and needs, with formal services seen as the solution

Explores the rejuvenation and creation of natural helping networks and social supports

Controlled by the professional Participant ownership

The professional dictates, “What I think you need to learn and work on”

The professional asks, “What can I learn from you about your life?”

Examples of how assessment shifts in the strengths approach

Assessment Focus- Deficits Approach Assessment Focus - Strengths Approach

Problems Goals, dreams, aspirations, and strengths

Functional deficits Functional abilities

Problems with leisure lifestyle Leisure interests, preferences, talents, skills, knowledge, and goals

Leisure barriers Leisure facilitatorsBehavior problems Social competenceDepression, anxiety, and other negative emotions

Positive emotions

Stressors Relaxers and soothers (calming inducers)

Social isolation and loneliness

Social resources, social networks, and community mapping

Family deficits and problems

Family strengths, dreams, and goals; family traditions; shared family interests and activities

Components of Strengths-Based Assessment

What is the participant’s current

situation? 

What are the participant’s internal

and external strengths and resources?

  

 What will it take to reach the dream?

What are the participant’s goals,

dreams, and aspirations?

 Where does the

participant want to be?

  

 

Development of a Plan

What to Assess:Use Strengths-Based Models as an Assessment Framework

Domains for AssessmentDomain Outcome for ParticipantsLeisure Domain “I find enjoyment in my leisure experiences

and they positively impact other areas of my life.”

Psychological/Emotional Domain

“I feel happy and perceive I am in control of my life.”

Cognitive Domain “I think in a focused way and learn eagerly.”

Social Domain “I relate well to others and belong to valued social groups.”

Domains for AssessmentDomain Outcome for ParticipantsPhysical Domain “I do and act in my daily life with vitality and

no barriers.”

Spiritual Domain

“I live my life hopefully, in harmony with my values and beliefs.”

Overall Outcome: Well-Being

“I experience a state of successful, satisfying, and productive engagement with my life” (Hood & Carruthers, 2007).

Overall Outcome: A Flourishing Life

Enhanced environmental resources and personal strengths that cultivate growth, adaptation, and inclusion

Domains for Assessment:

Psychological/EmotionalOutcome for Participants

“I feel happy and perceive I am in control of my life.”

Positivity Test

10-item scale to help people measure the level of positive to negative emotion they experience, called their “positivity ratio”

Mood MeterMeasures and tracks moodsDesigned to develop emotional intelligenceBased on decades of research from Yale

Yale Center for Emotional Intelligence: http://ei.yale.edu/

Mood Meter

Ways of Savoring Checklist

Ways of SavoringProvides quantitative information about ten different dimensions of savoring

Sharing With OthersMemory BuildingSelf-CongratulationComparingSensory-Perceptual SharpeningAbsorptionBehavioral ExpressionTemporal AwarenessCounting BlessingsKill-Joy Thinking

Supports Intensity Scale

Home LivingCommunity LivingLifelong LearningEmploymentHealth and SafetySocial Activities

www.aaidd.org

Domains for Assessment:Cognitive

Outcome for Participants

“I think in a focused way and learn eagerly.”

Mindful Attention Awareness Scale

MAASProvides quantitative information about one’s level of mindfulness in day to day experiences

The HOME Inventory

Home Observation for Measurement of the Environment

Measures the quality and quantity of stimulation and support available to a child in the home environment

Several versions available (toddler to teen)

Domains for Assessment:

SocialOutcome for Participants

“I relate well to others and belong to valued social groups.”

Home & Community Social Behavior Scales

Designed to be completed by home- and community-based ratersSocial Competence scale includes 32 items that measure adaptive, prosocial skills on two subscales: Peer Relations, and Self-Management/Compliance

Lubben Social Network Scale

Six-item self-report scale Assesses perceived social support received by family and friends.

Circle of Friends

PURPOSES:

To identify who’s in the participant’s life – friends, acquaintances, and professionals

To assess participant’s satisfaction with social circle

To plan intentionally to build and sustain a circle of support

Domains for Assessment:

PhysicalOutcome for Participants

“I do and act in my daily life with vitality and no barriers.”

Borg Rating of Perceived Exertion Scale

Measures self-assessed perception of physical exertion based on sensations of…– Increased heart rate– Increased breathing– Increased perspiration– Muscle fatigue

6 20No exertion Moderate Maximum

Level of Intensity

Global Physical Activity Questionnaire

GPAQ collects information on three domains:– Activity at work– Travel to and from places– Recreational activities

http://www.who.int/chp/steps/GPAQ/en/

Walk Score

Walk Score measures the walkability of any address. Walk Score analyzes hundreds of walking routes to nearby amenities. Points are awarded based on the distance to the amenities in each category.

Domains for Assessment:

SpiritualOutcome for Participants

“I live my life hopefully, in harmony with my values and beliefs.”

Values in Action Signature Strengths Questionnaire

Measures character strengths and virtues48-item short formLong form online

Six Core Virtues and 24 Character Strengths

WisdomCuriosityLove of learningJudgmentIngenuityPerspective

CourageValorPerseveranceIntegrityZest and vitality

HumanityKindnessLovingSocial intelligence

JusticeCitizenshipFairnessLeadership

TemperanceSelf-controlPrudenceHumilityForgiveness

TranscendenceAppreciation of beautyGratitudeHopeSpiritualityHumor

(Peterson & Seligman, 2004)

Spirituality Index of Well-Being

Defines spirituality as a sense of meaning or purpose from a transcendent source12-item instrument that measures one’s perceptions of their spiritual quality of lifeTwo subscales: – 1) self-efficacy subscale – 2) life-scheme subscale

The HOPE Questions

Assesses spiritual aspects of care:

H = Sources of hope, strengths, comfort, meaning, love, peace and connection

O = Role of organized religion in participant’s life

P = Personal spirituality and practices

E = Effects of participant’s spirituality on medical care and end-of-life decisions

Resources for Assessments

Authentic Happiness website: https://www.authentichappiness.sas.upenn.edu/testcenter

Rehabilitation Measures Database: http://www.rehabmeasures.org/default.aspx

BUROS Institute of Mental Measurements: http://marketplace.unl.edu/buros/

ETS Test Collection: https://www.ets.org/test_link/about/

Resources

Anderson, L., & Heyne, L. (2012). Therapeutic recreation practice: A strengths approach. State College, PA: Venture Publishing, Inc.

Anderson, L., & Heyne, L. (2013). A strengths approach to assessment in therapeutic recreation: Tools for positive change. Therapeutic Recreation Journal, 46(2), 89-108.

Handout online