2.  The recognition and interpretation of a stimuli that serves as the basis for understanding or for motivating a particular action or reaction

3.  Direct input creates our perception  Each fact we receive builds the case  What you see is what you get

4.  We make inferences about what we see and try to make a best guess  Prior knowledge and past experiences are critical  We develop a PERCEPTUAL HYPOTHESIS based on this prior knowledge

5.  We actively construct our perception of reality  Input enters and is combined with what we already know

6.  When things are presented in a familiar context, we rapidly judge  When we rapidly judge, we no longer look for details that we assume to be present

7.  Hypothesis testing occurs to make sense of the input coming in  The formation of an incorrect hypothesis will lead to errors in perception  Filtering incorrectly validates this hypothesis

8.  Previous experience working in a nursing home ◦ Diversion ◦ Quantity = Quality

9. The word RECREATION  Implies diversion  Implies fun, non clinical…….. Para professional provide recreation He saw some of the similar activities being conducted that he saw being offered in the nursing home

10.  Treatment Team Meetings ◦ Too much emphasis was placed by the CTRS in discussing the details of the activity and not enough emphasis on the outcome example: baking

11.  The patient played...  The patient had fun doing…  The patient enjoyed...

12.  Despite efforts to educate and highlight the therapeutic nature of what we were doing, the hypothesis was established filtering confirmed the hypothesis  “Patients have told me…”

13.  On the one hand, we believed that we were a good department that provided high quality, effective therapy.  On the other hand, we were being told we were nothing more than a service that is providing diversional activities to keep people busy.

14.  Focus on more supportive beliefs that outweigh the dissonant belief or behavior (He doesn’t know what he is talking about)  Reduce the importance of the conflicting belief (What he believes is not important)  Change the conflicting belief so that it is consistent with other beliefs or behaviors

15.  Part of the answer was close by (music therapy)  Part was to pay attention to what was valued

16.  Evidence  Outcomes  Best Practice

17.  Mission/purpose of unit  Length of stay  Available resources (space/budget/staff)  Assessment  Activity Analysis  A belief that there was evidence

18.  To bring it in line with other disciplines  To improve patient care  To change perception

19.  Research to validate current interventions  Research (or lack of research) that does not support the use of some interventions  Research to add additional interventions

20.  Limited studies to directly link specific RT interventions with desired outcomes ◦ Diagnosis ◦ Interdisciplinary treatment goals ◦ Setting

21.  Studies that directly connect an intervention with the exact desired outcome for the exact population  Studies that show an intervention with similar characteristics linked to the exact desired outcome for the exact population ◦ Intervention ◦ Outcome ◦ Population

22.  Creation of an outcomes tool that consisted of 4 questions ◦ The Therapist Was Respectful ◦ Goals Of The Session Were Explained ◦ The Session Kept My Interest ◦ The Session Helped Me Make Progress Towards My Treatment Goals As Well As Patient Comments

23.  There were 204 surveys completed in a 3 month period  A report was created that summarized the findings  The overall rating was 4.6/5

24.  The report examined the 4 variables for each intervention (group).  Particular attention was paid to the question asking the patient to rate to what degree the session helped them achieve their overall treatment goals (4.5/5).  There were 46 patient comments made and 44 were positive comments (95.65%).

25.  Formal presentation of evidence to support clinical practice to psychiatric leadership team  Outcome Measure ◦ Each session for 3 months  Development of departmental treatment team report guidelines

26.  The patient played...  The activity  The game  The patient came to recreation  The patient engaged in…  The session  The structured task  The patient came to therapy

27.  Invited MD’s to monitor report in treatment team (forced filtering)  Recent Vacancy