Assessing Strengths in TR/RT: Tools for Positive Change Part II Dr. Lynn Anderson, CTRS, SUNY Cortland Dr. Linda Heyne, CTRS, Ithaca College 2014 ATRA Webinar L2 October 8, 2014 Department of Recreation, Parks and Leisure Studies

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. These webinars (Parts I and II) focus on some of the tools and approaches that can be used to assess the internal and external strengths of our participants. The session will help orient TR/RT toward strengths-based practice by giving CTRSs practical tools for positive change.

Webinar Outlines Webinar L1: Part I (October 1) Webinar L2: Part II (today) Introduction and brief overview of the strengths approach A model and framework for assessment in strengths-based TR/RT practice The ecological approach to strengths-based assessment Tools for assessment of internal and external strengths: Leisure Domain Tools for assessment of global outcomes of TR/RT services: Well-Being Questions, discussion Brief overview of the strengths approach and a framework for assessment from Part I Tools for assessment of internal and external strengths: Psychological/Emotional Domain Tools for assessment of internal and external strengths: Cognitive Domain Tools for assessment of internal and external strengths: Social Domain Tools for assessment of internal and external strengths: Physical Domain Tools for assessment of internal and external strengths: Spiritual Domain Questions, discussion  

Session Objectives Define the strengths approach in health, recreation, and human services and its impact on practice Compare and contrast TR/RT assessment from a strengths versus a deficits approach and identify important differences Identify internal and external strengths and at least six assessment tools to measure and describe 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)

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) Recreation as a strength THE ENVIRONMENT Recreation as a context to build strengths

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

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 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 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: 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”

Mood Meter Measures and tracks moods Designed to develop emotional intelligence Based on decades of research from Yale Yale Center for Emotional Intelligence: http://ei.yale.edu/

Mood Meter

Ways of Savoring Checklist 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 18

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 22

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

Lubben Social Network Scale Six-item self-report scale Assesses perceived social support received by family and friends.

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 Level of Intensity 6 20 No exertion Moderate Maximum

Global Physical Activity Questionnaire GPAQ collects information on three domains: Activity at work Travel to and from places Recreational activities http://www.who.int/chp/steps/GPAQ/en/

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) 34

Spirituality Index of Well-Being Defines spirituality as a sense of meaning or purpose from a transcendent source 12-item instrument that measures one’s perceptions of their spiritual quality of life Two subscales: 1) self-efficacy subscale 2) life-scheme subscale

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 36

Resources for Assessments Authentic Happiness website: https://www.authentichappiness.sas.upenn.edu/testcenter Rehabilitation Measures Database: http://www.rehabmeasures.org/default.aspx BUROS Institute of Mental Measurements: http://marketplace.unl.edu/buros/ ETS Test Collection: https://www.ets.org/test_link/about/

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. Handout online 38