Anderson & Heyne, 2013, ATRA Annual Conference

*To access powerpoint slides and handout, use the QR Code above or use this web address: http://colfax.cortland.edu/nysirrc/links-articles-interest.html

Strengths-Based Therapeutic Recreation Assessment

INTERNAL STRENGTHS

EXTERNAL STRENGTHS

Assessment Source of Assessment Assessment Source of Assessment

Domain: Leisure Discover Your Passions Interview

McGill, J. (1996). Developing leisure identities. Toronto, ON: Leisurability Publications.

Recreation Inventory for Inclusive Participation

Schleien, S., Ray, T., & Green, F. (1997). Community recreation and people with disabilities: Strategies for inclusion. Baltimore, MD: Paul Brookes Publishing.

Strengths Discovery Assessment

Clark, H. (2007). Strengths Discovery Assessment Process for working with transition aged youth and young adults at http://www.fldoe.org

Inclusivity Assessment Tool

Inclusive Recreation Resource Center at www.inclusiverec.org

Ways of Savoring Checklist

Bryant, F., & Veroff, J. (2006). Savoring: A new model of positive experience. Mahwah, New Jersey: Lawrence Erlbaum Assoc. Inc.

Leisure Resource Asset Mapping

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

Leisure Diagnostic Battery

Venture Publishing at www.venturepublish.com

Domain: Psychological/Emotional Positivity Test

Fredrickson, B. L. (2013) at www.positivityratio.com/single.php

Supports Intensity Scale

American Association for Intellectual and Developmental Disabilities. (2005, 2009). The Supports Intensity Scale. Washington, DC: AAID.

Domain: Cognitive Mindful Attention Awareness Scale

Brown, K., & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848.

HOME Inventory Caldwell, B. M., & Bradley, R. H. (2003). Home Observation for Measurement of the Environment: Administration Manual. Tempe, AZ: Family & Human Dynamics Research Institute, Tempe, AZ: Arizona State U.

Domain: Social Home & Community Social Behavior Scale

Merrell, K., & Caldarella, P. (2008). Home and Community Social Behavior Scales (HCSBS). Baltimore, MD: Paul Brookes Publishing.

Circle of Friends

Falvey, M., Forest, M., Pearpoint, J., & Rosenberg, R. (1997). All my life’s a circle. Toronto, Ontario, Canada: Inclusion Press.

Domain: Physical Borg Rating of Perceived Exertion Scale

Borg, G. (1998). Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics.

Walk Score® Walk Score® at www.walkscore.com

Domain: Spiritual VIA Strengths Assessment

Peterson, C., & Seligman, M. (2004) at http://www.viacharacter.org/www/

The HOPE Questions

Anandarajah, G., & Hight, E. (2001). Spirituality and medical practice: Using the HOPE questions as a practical tool for spiritual assessment. American Family Physician, 63(1), 81-89.

Global Outcomes of Well-Being and Quality of Life Assessment Source of Assessment

Satisfaction with Life Scale

Diener, E. (1984, 1993) at http://internal.psychology.illinois.edu/~ediener/SWLS.html

Subjective Happiness Scale Lyubomirsky, S. (2013) at http://sonjalyubomirsky.com/subjective-happiness-scale-shs/

Quality of Life Profile On-Line

University of Toronto at www.utoronto.ca/qol/profile/adultVersion.html

The Well Being Index (WBI)

Therapeutic Recreation Journal (manuscript by Dr. Jeff Witman et al. in revision)

64 • TherapeuTic recreaTion pracTice: a STrengThS approach

Figure 4.3 Flourishing through Leisure Model: A

n Ecological Extension of the Leisure and Well-B

eing Model

Facilitation of leisure skills and knowledge:

• Savoring leisure* • Interests, preferences

• Authentic leisure*

• Talents, abilities• Leisure gratifications* • Skills and com

petencies• M

indful leisure* • Leisure know

ledge• V

irtuous leisure* • A

spirations

Facilitation of leisure environments:

• Real choices for leisure• Typical lifestyle rhythm

s• Social support• Inclusive environm

ents - Physical accessibility - A

dministrative inclusivity

- Programm

ing inclusivity

PER

SON

in the ENV

IRO

NM

ENT

What the Therapeutic R

ecreation Specialist Does

Outcom

es the Participant Experiences

Enhancing the Leisure Experience

Developing Strengths and R

esources

Facilitation of psychological and emotional

strengths:• Capacity for happiness*• Em

otion regulation*• Self-aw

areness/self-acceptance/self-congruence*• A

utonomy/self-determ

ination/goal directedness*• Com

petence*• O

ptimism

*

Facilitation of psychological and em

otional resources:• Positive behavioral supports• N

atural cues• Q

uiet spaces in public areas• H

igh expectations and positive attitudes• O

ther supports and accomm

odations

Play

Recreate

PerceiveFeel

Facilitation of cognitive strengths:• A

bility to attend*• Concentration*• Follow

ing directions*• M

emory*

• Problem solving

• Goal setting*, aspiration discovery

Facilitation of cognitive resources:• Environm

ental cues• Environm

ent modifications

• Quiet spaces in public areas

• Activity adaptations

• Other supports and accom

modations

ThinkLearn

Facilitation of social strengths:• Com

munication skills*

• Interpersonal skills*• Reciprocal-relationship skills*, friendship skills• Leadership and citizenship skills• Social confidence*

Facilitation of social resources:• Inclusivity and diversity• O

pportunities to engage in meaningful

social roles• Trained staff• Peer support developm

ent• O

ther supports and accomm

odations

Relate

Belong

Facilitation of physical strengths:• Physical health*• M

obility*• Fitness—

endurance, strength, flexibility*• Energy and vitality• Physical activity skills

Facilitation of physical resources:• Safe environm

ents• U

niversal design• A

dapted equipment

• Affordability, equitable resource distribution

• Hom

e recreation resource development

• Comm

unity recreation resource developm

ent

Act

Do

Facilitation of spiritual strengths:• H

ope and inspiration• Sense of m

eaning and purpose• Peace of m

ind• Reflection and w

isdom• Self-actualization• Sense of connectedness/feeling a part of

something bigger

• Other character strengths and virtues

Facilitation of spiritual resources:• Culture of hope, support, and

encouragement

• Proximity to nature

• Quiet places in public areas

• Places of spiritual nourishment

• Beauty and aesthetics in the environment

Believe

Value

Participant’s goals, dream

s, and aspirations

Well-B

eing

Environmental resources and

personal strengths that cultivate grow

th, adaptation, and inclusion

LEISURE

WELL-BEIN

G

I find enjoyment in m

y leisure experiences and they positively

impact other aspects

of my life

COG

NITIVE

WELL-BEIN

G

I think in a focused w

ay and learn eagerly

PHYSICA

LW

ELL-BEING

I do and act in my

daily life with vitality

and no barriers

SPIRITUA

LW

ELL-BEING

I live my life hopefully,

in harmony w

ith my

values and beliefs

SOCIA

LW

ELL-BEING

I relate well to others

and belong to valued social groups

PSYCHO

LOG

ICAL &

EM

OTIO

NA

LW

ELL-BEING

I feel happy and perceive I am

in control of m

y life

I experience a state of successful,

satisfying, and productive

engagement w

ith m

y life*

A Flourishing Life

* From the Leisure and W

ell-Being M

odel (Carruthers & H

ood, 2007; Hood &

Carruthers, 2007)

from Anderson, L., & Heyne, L. (2012)

Strengths-Based Assessment in TR: Tools for Positive Change

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

2013 ATRA Annual Conference

Pittsburgh, Pennsylvania

(Dan

Wilk

ins a

nd th

e nt

h D

egre

e, 2

007)

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. This session focuses on some of the assessment tools and approaches that can be used to assess the internal and external strengths of our participants. The session will help orient therapeutic recreation specialists toward strengths-based practice by giving them practical tools for positive change

Session Objectives

Define the strengths approach Compare and contrast assessment from a strengths versus deficits approach Identify internal and external strengths that can be assessed in therapeutic recreation practice, and at least six tools that can be used to assess them using an ecological approach

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)

Strengths versus Deficits Approach Deficits Approach

Strengths Approach

Person is a “case” or a “diagnosis”

Person is unique with talents and resources

Emphasis is on what is wrong, missing, or abnormal; emphasis is on problems

Emphasis is on strengths, resources, capabilities, aspirations, and adaptive processes

Participant is viewed as a problem needing to be fixed; intervention is problem focused

Participant is viewed as potential waiting to be developed; intervention is possibility focused

Professional is the expert concerning the individual’s life

Individuals, families, and communities are viewed as the experts

Expert professional interprets the person’s story to arrive at a diagnosis

The professional knows the person through the person’s story and interpretation of events

(Anderson & Heyne, 2012; Saleeby, 2006)

Strengths versus Deficits Approach Deficits Approach Strengths Approach

The professional develops a treatment plan for the individual

Aspirations of the individual, family, and community are the focus of the work to be done—the plan is developed in collaboration

A framework and vocabulary is developed to describe problems

A framework and vocabulary is developed to describe strengths

Play, recreation, and leisure are viewed as superfluous experiences only tangentially related to improving a person’s health

Play, recreation, and leisure are viewed as integral to well-being, and are essential to recovery and rehabilitation

Absence of illness or dysfunction is the goal

Well-being, thriving, and high quality of life are the goals

Medical model is used Ecological model is used

(Anderson & Heyne, 2012; Saleeby, 2006)

Strengths – The Heart of TR Practice

A definition of strength: –The quality or state of being strong; vigor; power of resistance; vigor of action; a strong or valuable attribute; a source of power or encouragement; sustenance.

(Webster’s Dictionary)

Internal strengths External strengths and resources

Internal Strengths – Aspirations and goals – Interests and preferences – Passions – Talents – Skills and competencies – Knowledge – Character strengths and

virtues

External Strengths & Resources

– Family support – Social support, friends – Community resources – Home resources – Opportunities for

participation and contribution

(inclusive communities) – High expectations and

positive attitudes

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

Strengths-Based Assessment • Focus is on internal and

external strengths • Participant is potential waiting

to be developed • A framework is used to assess

and describe strengths • Understanding strengths leads

to understanding how to plan • Ecological approach

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 facilitators Behavior problems Social competence Depression, 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

Rationale for Strengths-Based Assessment

To get to know the individual – what makes this person tick? What is meaningful to this person?

To begin to develop a positive relationship with the individual and her/his support system

To establish baseline

To measure outcomes

To provide the “right” services

To focus on solutions, not on problems

How does new research on brain functioning inform TR assessment practice?

Integration of psychology and neurology (fMRI, PET, QEEG…..)

Focus is power – The act of paying attention creates chemical

and physical changes in the brain.

Expectation shapes reality – People’s preconceptions have a significant

impact on what they perceive.

Attention density shapes identity – Repeated, purposeful, and focused attention

can lead to long-lasting personal evolution.

Other theoretical underpinnings of strength-based assessment in TR Ecological approach and a social model of disability Well-being and quality of life Positive psychology: – Flourishing – Learned optimism – Broaden and build theory – Flow

Self-determination Normalization and social role valorization Social support Community building

Definition of Assessment Assessment is a treasure hunt!

Therapeutic recreation assessment is the systematic process of learning about a person, his or her strengths, and his or her aspirations for recreation and well-being.

Through assessment, collaborative planning about the person’s future goals and dreams in relation to leisure becomes possible.

Principles in Strength-Based Assessment

Assessment …… is strengths-based and person-centered is individualized, based on the participant’s world view focuses on well-being and quality of life through leisure looks at the whole person in her or his environment (authentic and ecological) is based on the aspirations and goals of the participant uses multiple methods and seeks to understand multiple variables always involves the participant and his or her circle of support

Assessment is a treasure hunt!

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 Assessment Domain Outcome for Participants Leisure 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 Assessment Domain Outcome for Participants Physical 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:

Leisure

Outcome for Participants

“I find enjoyment in my leisure

experiences and they positively impact other areas of my life.”

Discover Your Passions Interview

Interview questions designed to ascertain what most interests and excites a participant in leisure For example:

• What lights you up? • When do you seem and feel most alive? • What helps you feel a sense of purpose? • When do you seem most focused and

unaware of distractions? • What inspires you to talk or get excited? • When was a time you felt at peace with

yourself?

Strength Discovery Assessment

Process for uncovering and identifying young people’s strengths and resources Informal semi-structured interviews with participant, family member, and key support personnel – “strengths chats”

Strength Discovery Assessment Interests and preferences Values and traditions in one’s life Skills, abilities, and competencies Personal attributes (e.g., sense of humor, resilient) Dreams/aspirations Strategies in the past that have worked best at home, school, or in the community Settings that are most comfortable Family members, relatives, friends, and other informal key players valued by and/or in this young person’s life Formal key players involved in his/her life Priority needs and goals across transition domains

Ways of Savoring Checklist

Ways of Savoring Provides quantitative

information about ten different dimensions of savoring

Sharing With Others Memory Building Self-Congratulation Comparing Sensory-Perceptual Sharpening Absorption Behavioral Expression Temporal Awareness Counting Blessings Kill-Joy Thinking

Leisure Diagnostic Battery

Leisure Diagnostic Battery

– Assesses an individual's "leisure functioning”

Perceived Leisure Competence Perceived Leisure Control Leisure Needs Depth of Involvement in Leisure Playfulness Scale Barriers to Leisure Involvement Knowledge of Leisure Opportunities Test Leisure Preference Inventory

Recreation Inventory for Inclusive Participation

Part I: Appropriateness of recreation activity/setting

Part II: Activity/discrepancy analysis

PART III: Specific activity requirements (adaptations and teaching procedures)

Recreation Inventory for Inclusive Participation

Leisure Skill Inventory +/- Inventory for Participant with Disability

STEPS (Activity Analysis) Teaching Procedure and Adaptations/Modifications

1. 1.

2. 2.

3. 3.

4. 4.

5. 5.

etc. etc.

Inclusivity Assessment Tool

Measures the physical and social aspects of inclusion at a recreation agency

Inclusion U Online training qualifies you as a “CIA” (Certified Inclusivity Assessor) to use the IAT

IAT Checklists, User Manual, and Tool Kit

60” circle

Leisure Resource Asset Mapping

Creates a visual map of the recreation resources available to a participant

Domains for Assessment:

Psychological/Emotional

Outcome 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”

Supports Intensity Scale

Home Living Community Living Lifelong Learning Employment Health and Safety Social Activities

www.aaidd.org

Domains for Assessment: Cognitive

Outcome for Participants

“I think in a focused way

and learn eagerly.”

Mindful Attention Awareness Scale

MAAS Provides 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:

Social

Outcome 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 raters. Social Competence scale includes 32 items that measure adaptive, prosocial skills on two subscales: Peer Relations, and Self-Management/Compliance.

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:

Physical

Outcome 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

No exertion Moderate Maximum

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:

Spiritual

Outcome for Participants

“I live my life hopefully, in harmony

with my values and beliefs.”

Values in Action Signature Strengths Questionnaire

Measures character strengths and virtues 48-item short form Long form online

Six Core Virtues and 24 Character Strengths Wisdom

Curiosity Love of learning Judgment Ingenuity Perspective

Courage •Valor •Perseverance •Integrity •Zest and vitality

Humanity Kindness Loving Social intelligence

Justice •Citizenship •Fairness •Leadership

Temperance Self-control Prudence Humility Forgiveness

Transcendence Appreciation of beauty Gratitude Hope Spirituality Humor

(Peterson & Seligman, 2004)

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

Domains for Assessment:

Overall Well-Being Outcome for Participants

Well-Being

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

A Flourishing Life

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

Life Satisfaction Scale

Measure of general life satisfaction

Subjective Happiness Scale

A single composite score for global subjective happiness Available online and in pdf on Positive Psychology Lab website

Quality of Life Profile ON-LINE (University of Toronto)

Assesses the degree to which a person enjoys the important possibilities of his or her life

BEING – who one is

– Physical Being – Psychological Being – Spiritual Being

BELONGING – connections with one’s environment

– Physical Belonging – Social Belonging – Community Belonging

• recreational programs • community events and

activities BECOMING -- achieving personal goals, hopes, and aspirations

– Practical Becoming – Leisure Becoming – Growth Becoming

The Well-Being Index (WBI)

18 statements based on the Flourishing through Leisure model

I relate well to others

I live my life hopefully

I have a sense of meaning and purpose

I find enjoyment in my leisure experiences

Ecological Approach to Assessment

Participants viewed as part of their larger environments Search for internal strengths and external strengths and resources in social and physical environments Spend time getting to know not only the participant, but the participant’s home, school, work, community, and other contexts of his or her life Understand how participants interact with the context of their lives Learn what changes need to be made on the part of the participant or the environment to help him or

her reach goals and achieve well-being

Ecological Assessment

This is what we know about the

person

This is what we know about the

environment

Spiritual

Psychological and emotional

Leisure

Cognitive

Social

Physical

Goals and

dreams Friends

Expectations

Home

Community resources

Family

Opportunities for inclusion

Work/ School

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. University of Pennsylvania Authentic Happiness website: – www.authentichappiness.sas.upenn.edu

Handout online