I provide services for children (both male and female) between (ages 7 to 12) who have abuse-reactive needs. Children admitted to the unit have experienced some type of traumatic in their life.
It is a Psychiatric Residential Treatment Facility. The typical stay is 6 to 9 months.
Some of the common needs among patients include:
- Lack of interpersonal skills (possibly from learned behaviors)
- Lack of assertiveness skills (often resorts to physical, verbal aggression)
- Lack of a social support system (no identified foster family or adoptive family)
- Lack trust in others
- In addition, patients may have other conditions, like Autism Spectrum Disorder (ASD)
- Some children have Reactive Attachment Disorder (RAD) – this is where they had neglect at an early age and fail to learn how to have emotional connections and relationships
Trauma-Focused Cognitive Behavior Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT) are the two primary treatment modalities. There is evidenced-based research that demonstrates that these two approaches are effective.
Both TF-CBT and DBT have a focus on interpersonal skills.
- In the TF-CBT mode, there is a phase called, enhancing social skills
- In the DBT model, there interpersonal skills are one of the four main skill sets taught.
We identify our intervention as “interpersonal skills training or social skills training.”
We in recreation therapy have a lot to offer in this domain.
We use a lot of recreation activities as means to achieve outcomes.
- Sports: taking turns, good sportsmanship, being part of a team/ group
- Board games: taking turns, being a good sport,
- Social activities: ballroom party for Halloween or ice cream social
- Education/ classroom settings: to teach skills. Using pictures of children in different social situations
- The listening game: Teach what paraphrasing is. Get a book like “The conversation starts.” Read a question to a group member. Group member answers. Randomly select a different group member to paraphrase what the first group member said to indicate he (or she) listened and then ask that group member a question.
- Assertiveness training: Teach the children to ask for what they want or to express their feelings with use of I-statements.
- Cinema therapy card game: Play a movie. Ask children questions from the card game that get the kids to point out social skills, emotions in characters
- Community re-entry outings: passes to local parks, zoos, water parks, mall, or other places.
- Emotional support: being able to recognize emotions in others and be able to offer support
- Family-based recreation therapy: with rec therapist: Mental health therapist/ counselor provide family therapy. and the rec therapist often supervise the community re-entry outings before a new family is on their own with a patient. The rec therapist can implement games and activities to help the family and child to get to know each other, and supervises passes in the community.
The recreation therapist serves as a role-model, a coach, a facilitator, and evaluates progress.