Recreation & Leisure Participation Workbook€¦ · Web viewWe would like to extend a warm...

VA Palo Alto Healthcare System Creative Arts Therapies

Practicum Student Handbook&

Orientation Manual

https://vip.vba.va.gov/portal/VBAH/Home

Acknowledgements

This workbook has been gathered from numerous sources (which are cited throughout) as well as from feedback from Recreation Therapy Service staff and

San Jose State University Recreation Therapy students.

We would like to specifically acknowledge the assistance of Recreation Therapy Service staff-Kayla Forster and Andrew Duprey as well as SJSU students Lindsay

Space, Paige Potts and Margaret Vargas

Contents:

-Contacting Recreation Therapy Service Practicum and Internship Coordinators

-Welcome

-Recreation Therapy Service Sections Extended Care Polytrauma Rehabilitation

Mental Health Fitness and Wellness

-Maps to VA Facilities

-Network of Care

-Registering as a Volunteer

-Creative Arts Practicum Student application process at VAPAHCS

-Orientation to Recreation Therapy Service Orientation Checklist Safety Infection Control Professional Conduct

Boundaries Confidentiality Communication

-Shadowing Assignment Sheet

-Practicum Log

-Recommended Reading/Homework Assignments

-Appendices Application for Practicum Medical Terminology Quizzes VA Fact Sheets

Contacting Recreation Therapy and Voluntary Service Coordinators.

Practicum Coordinators:Andrew Duprey, Recreation Therapist

Polytrauma Network SiteVA Palo Alto Healthcare System

3801 Miranda Avenue (11K/PAD)Palo Alto, CA 94304

(650) 493-5000 x63289 (desk)(650) 444-8714 (VA Cell)[email protected]

Kayla Forster, RTC, CTRS Recreation Therapist

Fitness & Wellness ClinicVA Palo Alto Health Care System

3801 Miranda Avenue (11K/MPD)Palo Alto, CA 94304

650-493-5000 ext: 23472 (desk)650-269-2897 (VA Cell)[email protected]

Internship Coordinator:Bria Heymach, CTRS Recreation

TherapistEmployee Fitness & Wellness

CoordinatorVA Palo Alto Healthcare System

3801 Miranda Avenue (11K/PAD)Palo Alto, CA 94304

650-493-5000 x69957 (Desk)[email protected]

Voluntary Service Coordinator:Jammu L. Owens

Voluntary Service SpecialistVA Palo Alto Health Care System

(650) 858-3903 Direct Line, or(650) 493-5000 x61905

(650) 849-0252 (fax)[email protected]

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mailto:[email protected]



Welcome

We would like to extend a warm welcome to you, as a student in the Creative Arts Therapies! Each of us was mentored and proctored in our professional journeys and we look forward to doing the same for you as you explore the exciting and challenging professions of Recreation, Art and Music Therapy.

About VA Palo Alto Health Care System i

The VA Palo Alto Health Care System (VAPAHCS) consists of three inpatient facilities located at Palo Alto, Menlo Park, and Livermore, plus seven outpatient clinics in San Jose, Capitola, Monterey, Stockton, Modesto, Sonora, and Fremont. These facilities provide some of the world's finest medical care and cutting-edge technology.

VAPAHCS is a teaching hospital, providing a full range of patient care services with state-of-the-art technology as well as education and research. Comprehensive health care is provided in areas of medicine, surgery, psychiatry, rehabilitation, neurology, oncology, dentistry, geriatrics, and extended care.

VAPAHCS operates nearly 900 beds, including three nursing homes and a 100-bed homeless domiciliary - all to serve more than 85,000 enrolled Veterans.

VAPAHCS is home to a variety of regional treatment centers, including a Polytrauma Rehabilitation Center, Spinal Cord Injury Center, a Comprehensive Rehabilitation Center, a Traumatic Brain Injury Center, the Western Blind Rehabilitation Center, a Geriatric Research Educational and Clinical Center, a Homeless Veterans Rehabilitation program, and the National Center for Post Traumatic Stress Disorder (PTSD).

VAPAHCS maintains one of the top three research programs in the VA with extensive research centers in geriatrics, mental health, Alzheimer's disease, spinal cord regeneration, schizophrenia, Rehabilitation Research and Development Center, HIV research, and a Health Economics Resource Center.

An affiliation with the Stanford University School of Medicine, as well as other universities, provides a rich academic environment including medical training for physicians in virtually all specialties and subspecialties. Over 1,300 University residents, interns, and students are trained each year.

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About Recreation Therapy Service

VAPAHCS has one of the largest and most dynamic Recreation Therapy Services in the country. Each day, the 59-member staff provides therapeutic programs as an integral part of the clinical treatment teams in extended care, mental health, fitness and wellness clinic, and specialty programs including the Homeless Veteran Rehabilitation Program, The Men’s and Women’s Trauma Recovery Program, Western Blind Rehabilitation Center, Polytrauma Rehabilitation Center, and Spinal Cord Injury Center.

The Recreation Therapy Team in 2011Our FocusTo be a premiere Recreation Therapy Service provider within VAPAHCS through a commitment to excellence; as a valued treatment modality with a commitment to research, education and customer satisfaction; using evidence based treatment, consumer driven programs, and the psychosocial rehabilitation model.

The Recreation Therapy Service within VAPAHCS serves Veterans by providing planned therapeutic interventions to enhance rehabilitation, improve functional level and achieve optimal wellness through a comprehensive continuum of quality care.

Recreation Therapy Code of Ethical ConductThe health and safety of our patients, employees, and community is our top priority. We put Veterans first regardless of their individual backgrounds, beliefs, cultures, and religion. Our service advocates or encourages Veterans to participate in the highest level of their care possibleii

7

http://www.polytrauma.va.gov/facilities/Palo_Alto.asp

http://www.polytrauma.va.gov/facilities/Palo_Alto.asp

http://www.paloalto.va.gov/wbrc/index.asp

http://www.paloalto.va.gov/MentalHealth/MentalHealth.asp

http://www.paloalto.va.gov/ec.asp

http://www.paloalto.va.gov/images/rt2011_1200x827.jpg

Recreation Therapy Service Sectionsiii:

Recreation Therapy Service is divided into five sections, Extended Care, Polytrauma, Rehabilitation, Mental Health and Fitness.

Extended CareRecreation therapy staff working in Extended Care are responsible for the provision of daily programs and activities for hospitalized Veterans residing on these units. The diversity of programming is based on the assessed needs of the individual Veteran, family involvement towards independent recreation participation, quality of life, and specific functional domains.

Recreation therapy provides clinical support to the following programs:

Sub Acute Care Units (Palo Alto and Livermore) Community Living Centers (CLC Menlo Park and Livermore) Specialized Dementia Care Units (Menlo Park and Livermore)

PolytraumaThe Palo Alto Polytrauma Rehabilitation Center (PRC) is one of 5 facilities in the country designed to provide intensive rehabilitative care to Veterans and Service members who experienced severe injuries (including brain injuries) to more than one organ system. Palo Alto also houses a Polytrauma Network Site (PNS)- one of 23 facilities designed to provide long-term rehabilitative care. For more information about Polytrauma, visit the national Polytrauma System of Care page. Creative Arts Therapists in Polytrauma focus on the skills needed to successfully re-integrate into the veteran's home community.

Specialty programs supported by recreation therapy include:

7D Comprehensive Rehabilitation Center (inpatient acute rehabilitation) Polytrauma Transitional Rehabilitation Program (PTRP) Polytrauma Network Site (PNS)

Rehabilitation Recreation therapists working in the specialized section are responsible for the planning, implementation and evaluation of therapeutic services which are provided on the inpatient and outpatient specialty programs. These programs focus on the rehabilitative needs of the hospitalized veteran with discharge goals of increased functioning in a community environment, increased interest and involvement within various recreation pursuits, and successful re-entry into previous interests.

Specialty programs supported by recreation therapy include:

Spinal Cord Injury Center (SCI inpatient and home care) Western Blind Rehabilitation Center (WBRC)

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http://www.polytrauma.va.gov/index.asp

http://www.paloalto.va.gov/ec.asp

Mental Health

Recreation therapists working in mental health are responsible for planning, implementing and evaluating prescribed therapeutic and self-directed/recreation programs to meet the needs of the psychiatric inpatient and outpatient programs in conjunction with the respective treatment teams. Therapists in these programs are responsible for developing therapeutic programs based on individual patient goals/need(s). They also receive referrals from interdisciplinary team members for specific intervention and/or services. CCP, CTC and MHICM are community based programs, which focus on assisting veterans in integrating into their local community. Some are case managers and provide follow up services in the community.

Mental health programs supported by the service include:

Inpatient Psychiatry Addiction Treatment Services Community Care Program Geropsychiatry (Menlo Park) Community Transition Center (CTC) Mental Health Intensive Care Management (MHICM) National Center for Post Traumatic Stress Disorder which consists of the Men's and Women's Trauma

Recovery Programs Homeless Veterans Rehabilitation Program (HVRP)

Fitness and WellnessRecreation therapy staff working in this section is responsible for a variety of fitness and wellness programs including aquatic therapy, individualized exercise programs, cardio/universal weight equipment instruction, and facilitated exercise classes (aquatic and land based). Programs are based on a continuum of care through 1:1 therapeutic intervention, completion of an assessment, developing treatment programs with a wellness education emphasis, and transitioning patients into self-directed fitness participation. Recreation therapists also coordinate organized sporting events for both inpatients and outpatients including VA and community based softball, basketball, and golf. Recreation therapists work with veterans in achieving the highest level of independence by transitioning them to self-directed fitness participation.

Recreation therapists are active in Managing Obesity for Veterans Everywhere (MOVE program). This involves providing patient education in making healthy lifestyle choices and facilitating exercise classes to assist with weight loss. After an individualized care plan is developed, a clinic time is assigned to patients for treatment.

Recreation therapy works in the following areas:

Fitness and Wellness Facilities (Weight Room) Management Obese Veterans Everywhere (MOVE) Program Aquatic Fitness Employee Fitness and Wellness

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http://www.paloalto.va.gov/hcservices/RecTherapyAquatic.asp

Creative Arts Practicum Student process at VAPAHCSiv

OVERVIEW:The process for applying and completing a practicum at the VAPAHCS in Recreation Therapy is fairly straightforward. You will need to:

1. Contact the Practicum Coordinator at the number listed in this packet and set an appointment to meet with them.

2. Complete the Practicum Application and forward it to the coordinator. 3. Complete, with the coordinator, the orientation to Recreation Therapy Service. 4. Complete the Voluntary Service Application. This generally requires two to three separate visits to

Voluntary Service over a month. 5. Discuss with the coordinator your goals for practicum and your university's requirements. From this

discussion, you will be assigned to shadow therapists. The goal is to have each practicum student shadow one therapist in each section, but this may not always be possible.

6. Log each of your shadowing experiences, keeping track of your time. 7. Log your time with Voluntary Service. 8. Before the end of your practicum, meet with the coordinator to complete your practicum evaluation.

SHADOWING:Shadowing is generally a one or two time event, designed to give you a fell for the unit, population served and the therapists. Your initial appointments with therapists will be set by the coordinator during discussions with you, in your initial meeting. You and the therapists may schedule more meetings, simply inform the coordinator. When you have an initial appointment to shadow a therapist, please prepare/understand the following ahead of time:

1. What is the dress code for the unit you will be on? Appropriate attire will vary by program and activity. 2. Where is the unit, how do you get there, what time and day is your appointment, and where will you

meet the therapist?3. Confirm the appointment the week and day before. If you have to cancel, please contact the therapist

and the coordinator as soon as possible4. Plan to be 10 minutes early5. Research and read about the population you will be observing, focusing on what assessments are

typically used and the type of therapeutic interventions you might expect to see. Sources for reading may be found in the appendix of this workbook.

6. Bring this workbook with you to all practicum experiences. Also bring reading material to keep you engaged, if the therapist has to attend to other matters during your shadowing time. It may be good to let the therapist know "I have reading I can do, if you need to step away while I am here".

On the unit you will need to adhere to the unit policy. If you need to leave early, or have other complications, please inform the therapist. You should receive the following from the unit therapist:

1. A brief safety orientation to the unit, including fire, evacuation, etc as well as safety concerns about the veterans served

2. A brief description of the unit, how Recreation Therapy fits into the unit and a description of the group or individual session you will be observing that day.

3. A brief description of the charting/paperwork requirements on the unit and how they address those requirements.

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During the interactions, your responsibility is to follow the instructions of the therapist. Protocol for observing:1. Observe, only interact with the therapist or the veterans as you are instructed to. Do not participate in

the activity, unless instructed to do so. 2. Observe, before and after you observe is the time to ask questions. However, ask questions if you are

unclear about what you should be doing.3. Look for the following:

a. How the therapist runs the 1:1 or group sessionb. How the veterans reactc. Be thinking what you would put into a progress note.

4. If there is another student observing with you please refrain from socializing with one another.5. If you notice that you are avoiding being with the veterans or feel unsure how to interact

appropriately, talk to the therapist or coordinator, to help you learn how to better be with the veterans.

6. Make sure you balance your time/energy/efforts/attention with ALL of the veterans as there can be a tendency to attend to one or two clients (unless you are purposefully working 1:1).

7. If you must leave early, let the therapist know, please don’t leave without telling someone.

After the interaction you should have the opportunity to:1. Debrief with the therapist. Discuss your observations and ask questions about the interactions you

observed.2. Discuss with the therapist what paperwork will be completed by the RT and how it will be done. 3. Write a shadow progress note or assessment and discuss it with the therapist.

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Veteran Integrated Service Networks (VISN)

Polytrauma System of Care

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VA Palo Alto Healt Care SystemDivison and CBOC Locations

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Divisions

Menlo Park Division795 Willow Road

Menlo Park, CA 94025Phone: (650) 614-9997

Driving Directions

Palo Alto Division3801 Miranda Avenue

Palo Alto, CA 94304Phone: (650) 493-5000

Driving Directions

Livermore Division4951 Arroyo Road

Livermore, CA 94550Phone: (925) 373-4700

Driving Directions

Community Based Outpatient Clinics (CBOCs)

Capitola CBOC1350 41st Avenue, Suite 102

Capitola, CA 95010-3906Phone: (831) 464-5519

Driving Directions

Fremont CBOC39199 Liberty StreetFremont, CA 94538

Phone: (510) 791-4000Driving Directions

Modesto CBOC1524 McHenry Avenue

Modesto, CA 95350Phone: (209) 557-6200

Driving Directions

Monterey CBOC3401 Engineer LaneSeaside, CA 93955


San Jose CBOC80 Great Oaks Boulevard

San Jose, CA 95119Phone: (408) 363-3000

Driving Directions

Sonora CBOC13663 Mono WaySonora, CA 95370


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http://www2.va.gov/directory/guide/facility.asp?ID=5201









Stockton CBOC7777 South Freedom RdFrench Camp, CA 95231Phone: (209) 946-3400

Palo Alto Palo Alto Campus Map:

Menlo Park Campus Map

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Recreation Therapy Practicum Student Checklist

STUDENT NAME:________________________________ SCHOOL:______________

1. Getting Started Complete Staff InitialsMeet with Practicum Coordinator to discuss:a. RT application completed ________ ________b. Schedule with each section (see attachment) ________ ________c. RT Svc Orientation ________ ________d. VAVS Process ________ ________e. Determining current level of education/training ________ ________

2. SHADOWING IN SECTIONS

a. Mental Health Sectiona. Appointment made-

With___________ Day_______ Time____ Location__________________b. Safety orientation ________ ________

b. Polytrauma Section ________ ________a. Appointment made-

With___________ Day_______ Time____ Location__________________b. Safety orientation

c. Fitness/Wellness Sectiona. Appointment made-


d. Long Term Care Sectiona. Appointment made-


e. Rehabilitation Sectiona. Appointment made-


f. Service Chief or designeea. Appointment made-


3. EVALUATIONa. Blank school evaluation ________ ________b. Evaluation sent to each therapist involved ________ ________c. Evaluations returned ________ ________d. Final evaluation sent to the school ________ ________

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Recreation Therapy Service-Practicum Shadowing LogUnit:_____________________________________________ Date:______________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________

[ ] Safety Orientation [ ] Unit Briefing [ ] Discussion of RT on the unit[ ] Shadowing ______ group or _______ assessmentStudent Observation:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Unit:_____________________________________________ Date:______________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________


Unit: _____________________________________________ Date:_____________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________

[ ] Safety Orientation [ ] Unit Briefing [ ] Discussion of RT on the unit[ ] Shadowing ______ group or _______ assessmentStudent Observation:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Recreation Therapy Service-Practicum Shadowing LogUnit:_____________________________________________ Date:______________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________


Unit:_____________________________________________ Date:______________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________


Unit: _____________________________________________ Date:_____________________ Student name: ____________________ Student Signature: _______________________ Therapist: _________________________ Therapist Signature: ______________________Time In: ____________ Time Out:_____________ Total Hours:_________________


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Recommended Reading/Assignments:Depending on the unit you are on, the therapist

may assign these readings, or other readings

1. Veterans Health Initiative-Caring for War Wounded: http://www.publichealth.va.gov/docs/vhi/oef_oif.pdf

2. Veterans Health Initiative-Traumatic Brain Injury http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf

3. Veterans Health Initiative-Post-Traumatic Stress Disorder: Implications for Primary Care http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf

4. Veterans Health Initiative-Traumatic Amputation and Prosthetics: http://www.publichealth.va.gov/docs/vhi/traumatic_amputation.pdf

5. Leisure Competence Measure: Page 667-675 in Assessment Tools for Recreational Therapy and Related Fields: Fourth Edition; Burlingame, Joan & Blaschko 2010 (red book)

6. Bus Utilization Skills Assessment (BUS): Page 319-325 in Assessment Tools for Recreational Therapy and Related Fields: Fourth Edition; Burlingame, Joan & Blaschko 2010 (red book)

7. Polytrauma Rehabilitation Family Education Manual http://www.polytrauma.va.gov/downloads/Family_Ed_Manual.pdf

8. The Community Integration Questionnaire (CIQ): http://www.tbims.org/combi/ciq/ciq.pdf

9. ROBOT: http://www.tbi-sci.org/pdf/robot.pdf Resource Options Back on Track A Comprehensive Guide To Northern California for Individuals with Disabilities

10. Insignia of the United States Armed Forces: http://www.defense.gov/about/insignias/index.aspx

Pages Assigned:___________ Date:_______________










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http://www.defense.gov/about/insignias/index.aspx

http://www.defense.gov/about/insignias/index.aspx

http://www.tbi-sci.org/pdf/robot.pdf

http://www.tbims.org/combi/ciq/ciq.pdf

http://www.publichealth.va.gov/docs/vhi/traumatic_amputation.pdf

http://www.publichealth.va.gov/docs/vhi/traumatic_amputation.pdf

http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf

http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf

http://www.publichealth.va.gov/docs/vhi/oef_oif.pdf

http://www.publichealth.va.gov/docs/vhi/oef_oif.pdf

APPLICATION FOR PRACTICUM VA Palo Alto Health Care System

Recreation Therapy Service

NAME: ______________________________________________________________________________

ADDRESS: ___________________________________________________________________________

PHONE NUMBERS: Home: ________________________ Work: __________________________

Cell: _________________________ Other: __________________________

EMAIL Address: _______________________________________________________________________

UNIVERSITY:______________________________ YEAR IN PROGRAM: _________

Please list the class (if any) you are doing hours for and the number of hours needed:

_________________________________________________________________________________________

Please rank order your preferences (if any) for:

Long Term Care: ____ Polytrauma____ Fitness/Wellness_____

Mental Health_____ Rehabilitation_____ No Preference_____

PREVIOUS PRACTICUM OR RECREATION EXPERIENCE

Site: _______________ Hours:____________ Population: _______________

Site: _______________ Hours:____________ Population: _______________

RECREATION THERAPY COURSES TAKEN TO DATE

______________________________________________________________

_________________________________________________________

DAYS AND HOURS AVAILABLE FOR PRACTICUM:

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

BEGINNING AND END DATES OF PRACTICUM:______________________________________Please mail your completed form to :Andy Duprey, Practicum Student Coordinator-Recreation Therapy Service 11K Palo Alto-3801 Miranda Ave, Palo Alto, CA 94304Or E-mail to [email protected] call (650) 493-5000 x63289 or (650) 444-8714 if you have questions. …………………….thank you

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RT SVC USE

TherapistDate

Time Email sent


Recreation Therapy Practicum/InternshipMedical Terminology Quiz #1

Acquired Brain Injury __________________________________________________________________________Cerebral Vascular Accident__________________________________________________________________________Aneurysm__________________________________________________________________________Guillian-Barre Syndrome__________________________________________________________________________Contracture__________________________________________________________________________Apraxia__________________________________________________________________________Dysphagia__________________________________________________________________________Echolalia__________________________________________________________________________Aphasia__________________________________________________________________________Dysarthria__________________________________________________________________________Perseveration__________________________________________________________________________Ataxia__________________________________________________________________________Tracheostomy__________________________________________________________________________

Enteral Feeding________________________________________________________________________Cranioplasty________________________________________________________________________Lability________________________________________________________________________Concrete Thinking________________________________________________________________________Prosthesis________________________________________________________________________Coma____________________________________________________________________Post Concussion Syndrome________________________________________________________________________Disorientation________________________________________________________________________Agitation________________________________________________________________________Ankle Foot Orthosis____________________________________________________________________(m)TBI________________________________________________________________________Anhedonia________________________________________________________________________Coup-Contrecoup________________________________________________________________________

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Recreation Therapy Practicum/Internship Medical Terminology Quiz #2

NKA Fx SOB

NPO GCS HOB

S/P p HTN

UTI ADL PMH

Hx WNL B

I tid bid

I&O CAD prn

CNS L c/o

PVS CVA CHI

D/C RUE LOA

R DOI LLE

ROM MVA s

c Dx

LOC

Arrow upArrow down

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Homework Assignments:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________24

References/End Notes

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i http://www.paloalto.va.gov/about/ accessed 1.11.12

iihttp://www.paloalto.va.gov/hcservices/RecreationTherapy.asp accessed 1.11.12

iii http://www.paloalto.va.gov/hcservices/RecTherapyService.asp accessed 1.12.12

iv Adapted from SJSU Practicum Packet August 2007

http://www.paloalto.va.gov/hcservices/RecTherapyService.asp%20accessed%201.12.12

http://www.paloalto.va.gov/hcservices/RecreationTherapy.asp%20accessed%201.11.12

http://www.paloalto.va.gov/about/

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