By Danny W. Pettry II, M.Ed., LPC, NCC, CTRS-BHS

The Current Model is Re-Active to a problem that is further upstream.

Here is the start of the stream to the bottom of the steam in steps 1 to 10:

1. Start: Person has unhealthy environment.
2. Person thinks negative thoughts.
3. Person feels bad.
4. Person makes unhealthy life and leisure choices
5. Results: These choices result in disabling conditions, illness, addictions, and other mental health related problems.
6. Person gets admitted to treatment services (including recreational therapy)

Recreational Therapists (RT) Process starts at step # 7 in this equation.

7. RT provides individualized assessment for this person.
8. RT works with person to create plan treatment with measurable goals
9. RT implements interventions to help person to reach these pre-determined goals
10. Person has improved functioning, health, and wellness

 Here is an fictional example of the stream from 1 to 7:

1. Environment: Person is exposed to substance abuse or other traumatic related experiences. Their environment is invalidating.
2. Person’s thoughts: Person thinks life is unfair. They lack hope.
3. Person’s feelings: they’re hurt, afraid, anxious, and angry. They’re suffering.
4. Person’s choices: they make harmful choices like self-harm (cutting) or start using substances.
5. Person is suffering
6. Treatment: They get end up being admitted to inpatient acute care at psychiatric hospital or psychiatric residential treatment.
7. Recreational Therapists (and allied treatment professionals) get involved. 

Recreational Therapy could take a few steps back and be more Pro-Active to prevent the problem in the first place, opposed to being Re-Active and providing treatment for the problem. 

Which would be more effective in the mid 70s?

• Choice 1: Doctors work really hard to restore and save children have traumatic automobile accidents (which is the number one cause of deaths in children in the 70s) -This is a Re-Active Approach.
• Choice 2: Forget the Emergency Room (ER) treatment to this problem. By that time is often too late for any treatment. The problem needs address prior to ER treatment. Fix the environment: Unsafe automobiles. The good news is, actions were taken. Car seats for children became mandatory by law in all 50 states. Children are surviving as a result of this Pro-Active Approach.

Of course, Choice # 2 (Pro-Active) is always the better option.

• Better brain surgeons OR. helmets that prevent the trauma?
• Faster fire trucks OR fire proofed buildings and fire extinguishers?
• Better respirators to treat Covid-19 OR Prevent/ Avoid getting it in the first place?
• Better respiratory therapy treatments or protect your lungs health in the first place?

Prior to the polio vaccine, people wanted better, more effective, portable iron lungs.

 A Pro-Active Recreational Therapy Mode:

Recreational therapists are caring professionals.

Recreational therapists are dedicated to improve (client/ patient/ student)’s outcomes.

RT (APIE) process starts at (step 7 in the stream from 1 to 10 listed above) right after a person is admitted to treatment as a re-active approach to a problem that has been developing for a while.

Could we as a profession start to look upstream to the root cause of the problem before it gets to this point?

Recreational Therapy is NOT a setting (in example Clinical or Community)

The Recreational Therapy (RT) – APIE process can be implemented further upstream at the root of the problem. .

The author of this blog, Danny Pettry, believes there are a lot of opportunities for Recreational Therapists to become Preventative/ Pro-Active Practitioners.

Example of APIE earlier up the stream 

Pro-Active/ and Preventative Approach:

• Assessments could begin at step # 1, at the start of the stream (the environment). RTs don’t have to do this alone. They can create a treatment team with allied professional to address these problems too.  The team could even (and probably should) include researches, the community, and legislators. What is causing the problems? What is working for those who are succeeding? Can we model that success in these settings?

• Planning could start with ways to increase success, health, wellness, and life and leisure skills for people in this environment. Take the best research and studies and evidenced-based practices into account. Develop outstanding programs that are aimed at remarkable outcomes. The ultimate goal is less admissions for the the problem (in example: less people admitted to substance abuse treatment or jail). Less people dying from poor choices and more of them living healthy lives.

• Implementing these programs and services at this point are more pro-active and preventative in nature.

• Evaluation: Did this work? Are there less people with a need for (in example: substance abuse/ addictions) in this area? If so, great. If not, what we can do differently? What can we do more of? What can we do less of? What is something new we could do that we’ve never tried before?

RTs can Target Any Domain:

Mental health/ behavioral health needs have been discussed above.

The preventative approach could focus on any of the recreational therapy domains: social, physical, cognitive, or emotional.

Here is an example of preventative physical health needs: