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Therapeutic Recreation: Examination Questions and Answers, Exams of Advanced Education

Chamberlain College of Nursing Advanced Education

A valuable resource for students studying therapeutic recreation, offering a comprehensive set of questions and answers covering key concepts and theories. topics include observation methods, interview techniques, documentation principles, and charting methods. the q&a format facilitates self-assessment and knowledge reinforcement, ideal for exam preparation or general understanding of the subject matter. The detailed explanations enhance comprehension and application of the concepts.

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GROW THROUGH FLOW NCTRC EXAM

QUESTIONS AND ANSWERS

Duration Recording: - Correct Answers -When you are interested in how long a behavior

occurs, you record the amount of time that the client displays the behavior

Interval Recording: - Correct Answers -Indicates how frequently a behavior is displayed

during a specified time interval.

Continuous Recording: - Correct Answers -When the therapist records both the

beginning of the behavior and the end of the behavior, it is called

Theories and Concepts: Normalization: - Correct Answers -Making available to all

persons patterns of life and conditions of everyday life that are as close as possible to

the routine circumstances and ways of life

Theories and Concepts: Inclusion: - Correct Answers -• Inclusion is the acceptance of

all people regardless of their differences.

• It is about appreciating people for who they are because even though we are all

different, we are one.

• Inclusion allows people to value differences in each other by recognizing that each

person has an important contribution to make to our society

• Inclusion in recreation is more than allowing children with and without disabilities to

participate in the same activity.

• In order for inclusive services to be successful, inclusion must be a value that is

shared by all parties involved including: agencies, staff, families, participants, and the

greater community

Least Restrictive Equipment: Least Restrictive Equipment: - Correct Answers -The

objective is to use equipment that restricts functional movement the least amount, while

offering the maximum safety

Standardized Observation: - Correct Answers -o Two major forms:

1.) Standardized or norm-references instrument - measure of how an individual

performs in relation to others who are from the same classification of persons.

2.) Criterion referenced tests - measures achievement toward some established

standard.

o Reliability: produces stable results over time

o Validity: measures what it is designed to measure

Specific Goal Observation: - Correct Answers -o Assess a well-defined behavior.

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GROW THROUGH FLOW NCTRC EXAM

QUESTIONS AND ANSWERS

Duration Recording: - Correct Answers -When you are interested in how long a behavior occurs, you record the amount of time that the client displays the behavior Interval Recording: - Correct Answers -Indicates how frequently a behavior is displayed during a specified time interval. Continuous Recording: - Correct Answers -When the therapist records both the beginning of the behavior and the end of the behavior, it is called Theories and Concepts: Normalization: - Correct Answers -Making available to all persons patterns of life and conditions of everyday life that are as close as possible to the routine circumstances and ways of life Theories and Concepts: Inclusion: - Correct Answers -• Inclusion is the acceptance of all people regardless of their differences.

It is about appreciating people for who they are because even though we are all different, we are one.
Inclusion allows people to value differences in each other by recognizing that each person has an important contribution to make to our society
Inclusion in recreation is more than allowing children with and without disabilities to participate in the same activity.
In order for inclusive services to be successful, inclusion must be a value that is shared by all parties involved including: agencies, staff, families, participants, and the greater community Least Restrictive Equipment: Least Restrictive Equipment: - Correct Answers -The objective is to use equipment that restricts functional movement the least amount, while offering the maximum safety Standardized Observation: - Correct Answers -o Two major forms: 1.) Standardized or norm-references instrument - measure of how an individual performs in relation to others who are from the same classification of persons. 2.) Criterion referenced tests - measures achievement toward some established standard. o Reliability: produces stable results over time o Validity: measures what it is designed to measure Specific Goal Observation: - Correct Answers -o Assess a well-defined behavior.

o Might include observing an adult playing a card game or observing an adolescent square dancing. These activities make certain cognitive, psychomotor, or social demands on the client. o Role playing - client is told to act as though he/she normally would in the situation Naturalistic Observation: - Correct Answers -o No attempt to manipulate or change natural environment. o Keeping an on-going account of the client's behavior through written anecdotal notes o What to look for while completing observations:

General appearance
Motor activity
Interpersonal interaction
Body language o Areas of observation: Personal appearance, posture & movement, manner, facial expressions, general level of activity, intentional activity, cognitive ability, communication. Casual Observation: - Correct Answers -o Type of non-systematic observation in which we engage on a daily basis. o It is responding to our environment in a somewhere random fashion and out of our personal bias and background. o Not skilled, directed or purposeful. Skilled Observation: - Correct Answers -o Carefully completed in an organized manner and are as free as possible from personal bias. o Knowing what to look for & what to expect, learn to disregard irrelevant information. o Unobtrusive so as not to alter or change client's behaviors. Anecdotal Records: - Correct Answers -• Provide factual description if actual behavior in natural situations that are significant indicator of total behaviors

Allows recording in non-standardized form
Issues: o Can be time consuming o Hard to be objective o Difficulty in deciding level of detail to record
Techniques: o Determine in advance what to observe o Develop procedures for coding o Train observers Interview: - Correct Answers -• The interview has three purposes:

Opportunity to gain information from the client and to observe the client
Begin to develop a relationship, or gain rapport with the client
Orientation to the program or programs available to the client

Areas for information seeking during interviews:

Readiness for treatment
Degree of rationality

Self-disclosing: - Correct Answers -allows personal disclosure on the part of the helper with the intent of providing the client with an opportunity to perceive the helper as another human being who has encountered situations, thoughts or feelings similar to those faced by the client Subjective vs Objective data - Correct Answers -Subjective Data: what "client" tells you Objective Data: anything else you or others observe Types of affect/facial expressions: - Correct Answers -• Flat affect = none

Broad affect = wide range
Blunted = little, very slow
Inappropriate = range, but inconsistent and inappropriate
Restricted= one type Principles of Quality Client Documentation: - Correct Answers -1.) Consistency and Accuracy of Information 2.) Conciseness in Client Documentation 3.) Clarity in Client Documentation Consistency and Accuracy of Information: - Correct Answers -must be accurate, objective and consistent
Objectivity: only info that is factual and objective.
Accuracy: needed in correct spelling, grammar and punctuation
Behavioral Language: focus on clients behavior, descriptive action words and meaningful language
Consistency in Information: client to client, and between clients and specialists Conciseness in Client Documentation: - Correct Answers -Short, succinct sentences are recommended, also consistent Clarity in Client Documentation - Correct Answers -Using meaningful phrases and making sure it is clear to the reader
Meaningful phrases: descriptive, behavioral terms
Technical Guidelines: legible and written with ink, only approved abbreviations o Mistaken entry: simply cross out the word with a single horizontal line, write "error" and initial/date it. o Signing notes: every note should be signed with professional credentialing (i.e. CTRS) o Abbreviations: only ones approved by agency
Writing styles: inappropriate wording (i.e. a lot of = many, several), absolutes (i.e. all the time = frequently), redundant phrases (i.e. necessary requirements = requirements) Charting Methods: - Correct Answers -Four Major types: 1.) Narrative Format Source Oriented Medical Records (SOMR) 2.) Problem Oriented - Problem Oriented Medical Record (POMR) 3.) Focus Charting (DARP) 4.) Charting by Exception (CBE)

Narrative Format Source Oriented Medical Records (SOMR) Charting - Correct Answers -Each professional group or source typically keeps data separate from the other professional groups or sources

Separates recordings according to discipline
Sections of the chart are designated for medical notes, nursing notes, TR notes etc.
- Side = easier for each discipline to record all data in one place
- Side = places data in too many locations making it fragmented & cumbersome to retrieve data & more difficult for a team approach.
Unstructured
The following need to be included: a) Change in patients condition b) Patients response to treatment or medication c) Lack of a change in condition d) Patient or family members response to teaching Problem Oriented Medical Record (POMR) Charting - Correct Answers -Organized around the client's problems rather than source of data:
Is a comprehensive evaluation
Five parts:

Data base: data collected during assessment
Problem list: analysis of data base establishes a problem list, in numbered order with date.
Initial plan: outlines an approach to be used to meet each of the identified problems.
Progress notes: record the results of interventions/client progress. Using SOAP, SOAPIE or SOAPIER forms
Discharge summary: noting problems and resolutions Subjective, Objective, Assessment and Plan (SOAP) Focus Charting (DARP) Charting - Correct Answers -Method for organizing information in the narrative portion of the client's record to include data, action and response for each identifies concern.

Client-centered approach to documentation
Utilizes a column formal
Advocates state the "Focus" is much more comprehensive then "Problem"
Focus = current concern or behavior, or a significant event in client status
Includes four categories:

Data - subjective and/or objective information supporting the stated focus or describing observations at the time of significant events
Action - a description of the actions taken by the therapist in the form of interventions or programs
Response - a description of the client's response to the interventions, activities, or situation. It can include a statement that treatment plan goals have been attained. Client outcomes are included in this section
Plan - next interventions to be implemented

Client Goals: - Correct Answers -• General objectives

Broad in nature and may be contrasted with objectives
Proposed changes in the individual or their environment
A broad statement of desired behavior that the participant will demonstrate
Set in a positive term; sense of direction
i.e. increase social interaction with others Client Objectives: - Correct Answers -• Specific behavioral objectives
Describe proposed changes in the individual client or in the client's environment.
States what the participant will do
A statement that describes an outcome
A course of action to meet a goal
Clear and descriptive of observable behavior
Written in terms of participants behavior
Narrowly written and deal with very specific, objective and measurable behaviors.
i.e. initiates conversation with others during social recreation activities without staff prompting
most common type is behavioral objectives because they translate into client outcomes Objectives have: - Correct Answers -Criterion Condition Behavior Behavior - Correct Answers -A specific behavior to be demonstrated by participant - verb Criterion - Correct Answers -The measurable outcome how well must it be done, correctness, time span, percentage, what is acceptable or successful performance ▪ The criterion in the behavioral objective delineates the exact amounts and nature of the behavior that can be taken as evidence that the objective has been met. ▪ A criterion is a precise statement or standard that allows individuals to make judgments based on the observable, measurable behavior
I.e. after ten lessons (condition) the participant will swim (behavior) one length of the pool (criteria). Condition - Correct Answers -When and where the behavior will occur - a given or a restriction Stres - Correct Answers -Relationship between person and environment that is appraised by the person as taxing or exceeding his or her resources or endangering his or her well-being.
A state that results from an actual or perceived imbalance between the demand and the capability of the individual to cope with and/or adapt to that demand that upsets the individual's short-or-long term homeostasis.
When stress is perceived, people engage in a cognitive appraisal process:

o Primary - Appraise the risk or threat o Secondary - Appraise options for responding Stress - Coping - Correct Answers -The process of dealing with stress and your response to the stress

Any effort to master conditions of harm, threat or challenge and bring the person back into equilibrium.
Four buffers to help manage stress with recreation/leisure:

Sense of competence
Nature and extent of exercise
Sense of purpose
Leisure activity

Cognitive and behavior efforts to manage external and/or internal demands (i.e. stress)
Two types of coping:

Problem-focused
Emotion-focused Attribution Model: - Correct Answers -• The casual analysis of behavior

The process by which a person attributes or makes casual inferences "to what I attribute my success and failures".
People formulate explanations for their own and others successes and failures.
Involves two dimensions: 1.) Stability (stable/unstable) 2.) Locus of control (internal/external)
Involves four determinants of success or failure: o Ability (stable-internal) o Effort (unstable-internal) o Task difficulty (stable-external) o Luck (unstable-external). Learned Helplessness: - Correct Answers -A perceived lack of control over events
no matter how much energy is expended, the situation is futile and you are helpless to change things
people learn to be helpless and become dependent
behaviors and outcomes are out of one's control
occurs when people are exposed to repeatedly to uncontrollable events and being to learn that responding is futile
When people learn that responding does not work they cease to explore other behavioral options Perceived Freedom: - Correct Answers -When a person does not feel forced or constrained to participate and does not feel inhibited or limited by the environment
Means that the activity or setting is more likely to be viewed as leisure when individuals attribute their reasons for participation to themselves (i.e. actions are freely chosen) rather than determined externally by someone else of by circumstances.

You need a repertoire of skills to be self-capable.
Meet own needs/goals Experiential Learning Model - Correct Answers -The process of making meaning from direct experience.
Experiential Learning is learning from experience.
The experience can be staged or left open.
Staged experiential learning is often called a Dynamic Learning Experience (DLE) Kolb's model of experiential learning: - Correct Answers -Act Reflect Conceptualize Apply Repeat in a cycle Neulinger's Theory of Leisure: - Correct Answers -• A psychological "state of mind" that encompasses freedom of choice and internal motivation
Individuals can be said to be in a state of leisure if they simply perceive that they have the freedom to choose activities and are motivated by an activity for its own sake, not just for its consequences
Interactions are between: o Perceived freedom o Perceived constraints o Interactions contribute to outcomes Attitude Model - Correct Answers -A learned predisposition to respond in consistently favorable and unfavorable manner: o Beliefs o Attitudes o Intention o Behavior Theory of Reasoned Action (TRA): - Correct Answers -• Derived from the attitude model
Can predict actions based on personal attitude and perception of how others will view them
Used as a basis for the practices of health education
Developed in the 1960's
Tool for observing behavior and developing interventions based on those observations
Person intention is the main factor
Intention is a function of attitude and subjective norm:

Attitude: concerns a person's belief that their behavior will produce a beneficial outcome
Subjective norm: whether key people in the person's life support the behavior, and whether the subject Is inclined to agree with them Theory of Planned Behavior (TPB): - Correct Answers -• Developed in the 1980's

A persons intention of doing something is the main factor in determining whether he will actually do it
Behavior attention does not necessarily result in action
Builds on TRA by adding a their indicator of a person's intent: Perceived behavioral control: - Correct Answers -Whether the person believes he can control the conditions necessary for change to occur Health Belief Model (HBM): - Correct Answers -• Health is defined in WHO's constitution as a state of complete physical, mental and social well-being
Not merely the absence of disease or infirmity
Recognizes the person with the disability (PWDs) can be healthy
Used as a basis for the practices of health education
Developed in the 1950's
Take health action to avoid consequences
Four key beliefs that make a person more likely to perform a specific behavior:

The person believe that the condition which the behavior will address is a threat
The person is prompted to perform the behavior, either by people or by messages
The person is confident he is able to carry out the behavior
The person believes that the benefits of doing the specified behavior outweigh the negatives Transtheorietical Model/Stages of Change: - Correct Answers -• Six stages of behavior change and advocated various interventions to keep clients motivated:
Pre-contemplation - client does not feel they have a problem. ▪ Interventions would involve making him/her aware of the problems
Contemplation - client admits a problem, but is still not sure if he/she wants to change. ▪ Interventions would include encouraging the subject to make specific plans to change.
Preparation/commitment - client realizes a need to change and gathers information. ▪ Interventions would include setting goals; awareness of the positives vs. the negatives of change
Action - client follow a plan for change behaviors. ▪ Interventions involve providing feedback and support.
Maintenance - client sees the benefits of the new behaviors. ▪ Interventions including helping in case of relapse; continues feedback and support
Termination - client can't imagine ever doing the old behavior. ▪ Interventions include proving help when needed and continuing to offer support. Social Cognitive Theory (SCT): - Correct Answers -• Grew out of Social Learning Theory (SLT)

Introduced in the mid-1980's
Follows the realization that people learn by watching others
Behavior is influenced by three things:

The characteristics of the person
The characteristics of the behavior

Stereotyping - making assumptions about an individual based on ideas about a group
Prejudice - a negative opinion about someone based simply on that person's race, gender, or religion
Bias - preference for one over another
Discrimination - unfair treatment of someone based on personal prejudice Medical Model - Correct Answers -Focuses on the individual and pathology and includes identification of underlying disorder, interventions, treatment and cures.
Assumes that the impairment or condition a person has is the key problem.
The response is to "cure" or "care"
Health is the opposite end of the continuum from disease, illness and or disability and focuses on functional ability, morbidity and mortality.
Believes that is the individual has a disability, he/she is not capable of being healthy.
The medical model promotes the view of a disabled person as dependent and needing to be cured or cared for, and it justifies the way in which disabled people have been systematically excluded from society. The disabled person is the problem, not society. • Poor health → optimal health
Dr. prescribes TR treatment
Recreation is treatment - as a means to an end, is more clinical Public Health Model - Correct Answers -Focuses on achieving good health and a sense of well-being
Basic human rights
Proposes that opportunities (diagnosis/treatment) to achieve health and well-being should be available to all groups Activity Therapy Model - Correct Answers -TR is prescribed, similar to medical model
"blurring" of different departments including music therapy, art therapy, occupational therapy, dance therapy) Ecological Model - Correct Answers -Addresses the environment, what has to change in the environment
Looks at the individual needs and environment needs
The people around you: community and family
Changes can occur encompassing both the promotion of abilities and the elimination and individual barriers Person-Centered Model - Correct Answers -Believes that people have the capacity to be rational thinkers who can assume responsibility for themselves and whose behavior will be constructive when given freedom to set directions in life.
People are seen as motivated by a basic tendency to seek growth and self- enhancement.
The role of the helping professional in person-centered therapy is to display unconditional positive regard.
The helper never tells the client what to do, is non-judgemental and nondirective.
The therapeutic relationship is key.

Human Service Model (2) - Correct Answers -1.) Long-term Care model:

To maintain one's functioning, to be divisional
To enable individuals whose functional capabilities are chronically impaired to be maintained at the maximum level of health & well-being. 2.) Therapeutic Milieu Model:
Where every person & interaction can be therapeutic.
Everyone has equal impact.
Emotional problems are often the product of unhealthy interactions with one's environment
Staff are organized as a caring community
Primary therapist = most effective relationship Educational Training Model - Correct Answers -Gain vocational skills
Focuses on the acquisition of knowledge and skills that are required to become a contributing member of society
Used in sheltered workshops, vocational rehab centers, day-care centers, school
Heavy emphasis on classroom-like framework Community Model - Correct Answers -Focuses on steps that communities can take to develop preventative programs to effect change
Special Recreation: o the provision of recreation programs and services that are provided for people who require special accommodations because of unique needs they have owning to some physical, cognitive, or psychological disability
Social Recreation: o Non-clinical approach for disabled in the community o Recreation as an end to itself Social Model - Correct Answers -Impairment is seen as not vitally important
The environment attitudes of others, and institutional structures are the problems
Prejudice, discrimination, inaccessible building
This model was enthusiastically received by the disability movement Rehabilitative Model - Correct Answers -Activities of Daily Living: Activities related to personal care
These Include: bathing, showering, dressing, getting in and out of bed or a chair, using the toilet, and eating 10
A plan of care must be developed that allows for meeting both the physical and psychosocial needs of the client/patient
Two types of goals:

Rehabilitative - the goal of restoring independence
Habilitative - helping the person function at their highest level

Cognitive: TBI - Cognitive, physical and social-emotional - Correct Answers -An injury to the brain caused by an external force 11 • often leads to coma; confusion, disorientation, mood swings, aphasia

Cognitive Impairment → attention deficit, inability to plan
Physical Impairments → aphasia, apraxia, ataxia, perceptual deficits
Social-Emotional Impairments → impulsivity, depression, lowered inhibition
TR: help to reintegrate into the community, become aware of resources, and develop physical well-being, develop support systems, ameliorate depression and loss of independence through creative arts & social events; computer games, physical games reading. Cognitive: Learning Disability - Correct Answers -i.e. - Dyslexia
Deficits in language development
Hyper activity: ADHA and ADD
Thought process difficulty, low attention span, distractible, behavior problems in school, low self-esteem.
TR: Provide choice, challenge, & age appropriate activities which are structured for success. Physical: Spina Bifida: - Correct Answers -• Defective closure of spinal canal causing protrusion of spinal cord.
Can cause paralysis & can have an emotional impact.
Three major types: o Myelomeningocele: an out pouching of the spinal cord through the back of the bony vertebral column that has failed to form. o Meningocele: an out pouching consisting of only the coverings of the spinal cord and not the cord itself o Spina Bifida Occulta: the failure of the back arch formation.
TR: Wheelchair activities: utilize skills to promote independence, leisure education, community re-integration & exercises to strengthen muscles. Physical: Muscular Dystrophy: - Correct Answers -Progressive, inherited disease, gradual wasting of muscle tissue.
Can lead to wheelchair use, & cause socially impaired interactions. o Pseudohypertrophic (Duchane) MD = enlargement of fatty infiltration - causes contractures and deformities of joints. In w/c by 12 years of age o Facioscapulohumeral MD = weakness is upper arms, shoulders, angled forward and lack of facial ability o Limb girdle MD = late childhood to middle age - weakness of proximal muscles of the pelvic and shoulder girdles. o Oculopharyngeal = 40 to 70 - weakness of eye and throat muscles
TR: Maintain muscle tone, promote movement, accomplishment, exercise, aquatics, assistive devices, and promote creativity through crafts. Physical: Spinal Cord Injuries - Correct Answers -The higher up the injury occurs, the greater damage.
Includes loss of sensation below injury

Cervical
Thoracic
Lumbar Sacral Physical: Spinal Cord Injuries - Cervical - Correct Answers -When spinal cord injuries occur in the neck area, symptoms can affect the arms, legs, and middle of the body.
The symptoms may occur on one or both sides of the body.
Symptoms can also include breathing difficulties from paralysis of the breathing muscles, if the injury is high up in the neck Physical: Spinal Cord Injuries - Thoracic - Correct Answers -When spinal injuries occur at chest level, symptoms can affect the legs.
Injuries to the cervical or high thoracic spinal cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining normal body temperature.
Autonomic Dysreflexia - at or above T o Sweating, flushing above the injury, severe headache, nasal congestion, and nausea o medical emergency Physical: Spinal Cord Injuries - Lumbar/Sacral - Correct Answers -When spinal injuries occur at the lower back level, symptoms can affect one or both legs, as well as the muscles that control the bowels and bladder Nervous System: Multiple Sclerosis - Correct Answers -20-40 years of age for onset
Symptoms: muscle spasms, loss of sensation, bladder control.
Physical & emotional changes.
TR: Social activities, success-oriented, Range of Motion. Nervous System: Cerebral Palsy - Correct Answers -Brain paralysis
Neuromuscular disorder
Several types due to location of brain damage: o Spasticity: Feature of altered skeletal muscle performance in muscle tone involving hypertonia; it is also referred to as an unusual "tightness", stiffness, and/or "pull" of muscles. o Athetosis: involuntary motor movement o Ridgity o Ataxia: poor balance o tremor • speech disturbance and stiffness
non-progressive: is not degenerative
TR: relaxation, water aerobics, social activities, Increases self confidence Nervous System: Epilepsy (seizures) - Correct Answers -• Grand mal: A grand mal seizure (also known as a tonic-clonic seizure) features a loss of consciousness and violent muscle contractions.
Petit mal: A petit mal seizure is the term commonly given to a staring spell, most commonly called an "absence seizure." It is a brief (usually less than 15 seconds) disturbance of brain 13 function due to abnormal electrical activity in the brain.

Communication: Right CVA - Correct Answers -Left hemi: loss of perceptual/intellectual functioning, logic, visual and spatial depth, difficulty in perceiving around them. o TR: use words rather than gestures, keep environment clear of distractions, leisure education. Communication: Left CVA - Correct Answers -Right hemi: affects the right side; affects speech, may cause aphasia o Impaired emotions, social interactions, poor memory, difficulty with spoken language & written communication o TR: use demonstration, modeling, reality orientation Communication: Autism - Correct Answers -Onset in childhood

Primarily exhibiting the following qualities: o inability to develop normal social relationships o delay in speech development o non-communicative use of speech (echolalia) o insistence on sameness o stereotypical play o lack of imagination
Echolalia: the automatic repetition of vocalizations made by another person
Echopraxia: the automatic repetition of movements made by another person.
1/3 have epilepsy
75% Mental Retardation.
TR: need structure; may need to address family needs - respite Psychological: Anxiety Disorders: - Correct Answers -Fear or panic with no apparent reason.
Approx. twice as many females have panic disorders, posttraumatic stress disorder, generalized anxiety disorder, agoraphobia and other specific phobias
Obsessive/compulsive behaviors: obsessive thoughts and/or compulsive behaviors/rituals
Phobias: unrealistic fears of: flying, heights panic; all affect functioning.
Post-traumatic Stress Disorder (PTSD): headaches, loss of memory
TR: stress management, expressive activities, exercise Psychological: Personality Disorder: - Correct Answers -Chronic & longstanding & environmental distorted view of relating to others & ourselves.
Cluster A (Odd, bizarre, eccentric) o Paranoid PD, Schizoid PD, Schizotypal PD
Cluster B (Dramatic, erratic) o Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD
Cluster C (Anxious, fearful) o Avoidant PD, Dependent PD, Obsessive-compulsive PD
Types: o Paranoid: characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. o Anti-social: a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal.

o Borderline: instability of mood, interpersonal relationships, & self-image. Mood change during the day/several times a day. Feelings of emptiness/boredom. Will try suicide for attention.

TR: help make decisions, challenging activities, modeling, contracts Psychological: Mood Disorders: - Correct Answers -Depression: loss of appetite, sleep disturbance, lack of motivation, low self-esteem
TR: short term activities, success oriented
Manic: Endless energy, expertise in area, know famous figure.
TR: set limits, provide structure
Bi-polar: (manic-depressive): fluctuating moods, lithium to control; from manic>to>depressed
Schizophrenia: A break from reality, disorder in thinking/reality o Delusional, bizarre behaviors & hallucinations. (thorazine & stalizine) o Hallucinations may occur in any sensory modality (e.g., auditory, visual, olfactory, gustatory, and tactile), but auditory hallucinations are by far the most common and characteristic of Schizophrenia. o Auditory hallucinations are usually experienced as voices, whether familiar or unfamiliar, that are perceived as distinct from the person's own thoughts o Auditory hallucinations, talking to self, "I'm Jesus", feel others are out to get them, lack of social skills.
TR: social skills training, stress management, coping skills Psychological: Eating Disorders - Correct Answers -• Anorexia: Thin - force self to vomit up meals to stay thin, organ damage
Bulimia: gorge & perge, onset to young women, poor self-image
TR: Leisure Education, social skills, express feelings, values clarification, family groups, meal planning, No physical work Psychological: Chemical Dependency - Correct Answers -Drug/Alcohol
The leisure education component of TR programming is extremely important for individuals with substance-related disorders. Given the fact that most drug users have passive and sedentary lifestyles
TR: Leisure Education, fitness, social skills, provide choice, set limits, have rules, values clarification Psychological: Prison - Correct Answers -Sex offenders, murderers etc.
TR: health, fitness, social skills, choice, limits Psychological: Organic Brain Syndrome - Correct Answers -Acute & chronic; physical changes to brain, memory loss, emotional instability, mood changes, poor judgement, confusion, & disorientation.

Therapeutic Recreation: Examination Questions and Answers, Exams of Advanced Education

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GROW THROUGH FLOW NCTRC EXAM

QUESTIONS AND ANSWERS