LEI4724

Activities Portfolio # 8

Michelle Wilson

Facilitation Technique Category: Therapeutic Reminiscence

Activity Title: Question Ball
Source: Reminiscence Activities for Recreation Therapy,
http://www.recreationtherapy.com/tx/txrem.htm
Equipment: Beach Ball, markers
Activity Description: Therapeutic reminiscence is the purposeful process of helping participants retrieve
memories of past events. Therapeutic reminiscence involves recalling of past events through the use of
props and sensory cues such as music, movies or scrapbooks is now one of the most commonly used
psychosocial interventions in dementia care (Datillo, 2016). The purpose of this activity is reminiscing,
interaction and socialization. First, the CTRS will write questions all over the beach ball. Examples, who
taught you how to drive, what is your favorite color, tell us about your best childhood friend, what is your
favorite animal, what is your favorite season and why? Second, gather a small group of participants in a
circle and toss the ball to a participant. Third, instruct the participant to answer the question that their
right thumb is touching. Fourth, have the participant read the question to the group and allow for time to
answer the question to the best of their ability. Fifth, allow for other participants to comment if they
would like. Lastly, have the participant toss the ball to someone else in the circle. Finish the session by
processing with the participants by reviewing the steps of the activity, benefits, expectations, difficulties,
how they felt before and after the activity and how they can compare this activity to their lives and
discuss their goals.
Leadership Considerations: The CTRS is the instructor for this activity and is demonstrating the
activity prior to the session. It is recommended that the CTRS have a certification and/or knowledge in
reminiscence therapy. The CTRS should be CPR/First Aid certified. The staff to participant ratio should
be 1:1, 1:3, 1:4, 1:8. Before starting the session the CTRS should review expectations, rules and goals
with the participants. The CTRS should demonstrate and explain the reminiscence activity. The CTRS
and staff should give the participants enough time to answer the questions to the best of their ability and
have room for discussion for the group.
Adaptations: Participants with Alzheimers Disease: Alzheimers disease is a neurological disorder
that is progressive and causes memory loss and cognitive decline and is associated with a characteristic
dementia syndrome. The progression is usually slow with multiple cognitive deficits along with decline
in memory (Butcher, 2014). Dementia is the loss of cognitive functioning thinking, remembering and
reasoning behavioral abilities to such an extent that it interferes with a persons daily life and activities
(www.nia.nih.gov). The cause of Alzheimers and dementia vary but there is a loss of connection
between neurons secondary to plaque and tangles. Other characteristics of dementia and/or Alzheimers
is the loss words aphasia, inability to recognize people agnosia, and the inability to perform motor
tasks apraxia like dressing, grooming and bathing. Adaptations for participants with AD would to make
sure there is a structured session, providing time for participants to answer questions. Depending on the
cognitive level they may need another staff member to catch and throw the ball. Group size may need to
be decreased depending on cognitive functioning and whether the participant is having hallucinations or
delusions. Have room for adaptive mobility equipment wheelchairs, canes and walkers secondary to
balance deficits. Participants may need frequent reminders of what they are doing and why, so a staff
member will need to assist the participant for the frequent questions and disruption to the group.
Depending on the location of the session, it may need to occur in a lock down unit secondary to some
participants may wonder or walk out of the room. Appropriate signage for the participants to read to

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orient them to place and time. Other participants and staff members may consider wearing name tags so
that the participant is able to identify with the staff and their peers.
Adaptations: Participants with schizophrenia: Schizophrenia spectrum and other psychotic disorders
are complex in nature. Each diagnosis has a specific set of symptoms found in one or more of five
categories: delusions, hallucinations, disordered thinking or speech, grossly disorganized or abnormal
motor behavior (including catatonia), and negative symptoms. All of the disorders in SSD are diagnosed
based on the symptoms described above and based on the prevalence and length of time of the symptoms
were present (Dattilo, 2016). Participants with schizophrenia may need medication management to
manage delusions and hallucinations. Participants may need close monitoring by another staff member
depending on the complexity of the disorder and to manage disruptions from the group. In conjunction
with TR the participant may also need cognitive adaptation training to use strategies to compensate for the
cognitive deficits and improve daily functioning. Participants need consistency with the same session
time and treatment team or staff and positive reinforcement.

Adaptation References
Alzheimers Disease Fact Sheet. Retrieved October 28, 2016. From
https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet.
Butcher, J., Hooley, J., Mineka, S. (2014). Abnormal Psychology. Sixteenth edition. Upper Saddle
River, NJ. Pearson Education, Inc.
Cognitive Adaptation Training for Schizophrenia. Retrieved October 28, 2016. From
http://www.div12.org/psychological-treatments/treatments/cognitive-adaptation-training-cat-forschizophrenia/
Dattilo, J., & McKenney, A. (2016) Facilitation Techniques in Therapeutic Recreation. Third edition.
State College, PA: Venture Publishing, Inc.
Psychology Works Fact Sheet: Environmental Adaptations to Dementia. Retrieved October 28, 2016.
http://www.cpa.ca/docs/File/Publications/FactSheets/PsychologyWorksFactSheet_Environmental
AdaptationsToDementia.pdf.
Porter, Heather. (2015). Recreational Therapy for Specific Diagnoses and Conditions. Enumclaw, WA:
Idyll Arbor, Inc.
Using Equipment and making adaptations at home. Retrieved October 28, 2016.
From
https://www.alzheimers.org.uk/site/scripts/documents_info.php?
documentID=157.

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Activities Portfolio # 8

Michelle Wilson

Facilitation Technique Category: Therapeutic Use of Magic

Activity Title: Vanishing Coin
Source: How to Make a Coin Disappear, www.wikihow.com/make-a-coin-disappear and
https://www.youtube.com/watch?v=QYukHodKnF8
Equipment: 3 sheet of construction paper (2 of the same color and one a different color), clear glass cup,
pencil, scissors, glue stick, coin, table
Activity Description: Magic as a therapeutic intervention is primarily designed to teach participants how
to be a magician. The use of magic as a therapeutic intervention involves teaching people to perform
magic tricks while developing a repertoire of tricks to specifically address participant treatment goals.
Therefore, as participants practice and learn how to perform selected tricks, they work on their individual
therapeutic goals. Participants must demonstrate patience and a variety of cognitive, social, physical and
emotional skills. Specific outcomes that may be addressed through learning magic tricks have resulted in
improved strategic abilities, social interaction skills, attention span, mastery and competence, fine motor
skills, and self-esteem as well as reductions in symptoms of depression (Datillo, 2016). First, instruct the
participants to prepare the paper cover for the glass. Place the glass top down on one of the construction
paper. Trace around the top of the cup. Second, cut out the shape of the glass that was just traced.
Remove the glass from the paper, and then use the scissors to cut out the circle that was traced on the
paper. Third, attach the cover to the glass. Take you glue stick and trace around the top of the glass.
Stick the circle that was just cut out on the top of the glass, so that the glass is covered with the paper.
Trim any excess edges. Fourth, on the other colored construction paper cut out a rectangle the same size
of the glass, to make your cover for the glass. Tape it around the glass. Fifth, prepare for the
performance. Have the other sheet of construction paper the same color as the circle that was cut out, the
coin and your glass cover ready. Sixth, start your performance. Place the coin on the sheet of paper. Tell
the audience that you will make the coin disappear. Next, cover the glass. Taking you cover, place it over
the glass, move the glass and the cover over the coin and then remove the cover. Show the audience that
the coin is no longer there. Lastly, tell the audience that you will make the coin reappear. Cover the
glass, move the glass and the cover over to reveal the coin and uncover the glass. Finish the session by
processing with the participants by reviewing the steps of the activity, benefits, expectations, difficulties,
how they felt before and after the activity and how they can compare this activity to their lives and
discuss their goals.
Leadership Considerations: The CTRS is the instructor for this activity and is demonstrating the
activity prior to the session. It is recommended that the CTRS have a certification and/or knowledge in
therapeutic magic. The CTRS should be CPR/First Aid certified. The staff to participant ratio should be
1:1, 1:3, 1:5. Before starting the session the CTRS should review expectations, rules and goals with the
participants. The CTRS should demonstrate and explain the magic trick.
Adaptations: Participants with Guillain-Barre Syndrome: Guillain-Barre is an autoimmune disease
that affects the peripheral nervous system. It is characterized by symmetrical muscles weakness and/or
paralysis that begins in the legs and rises upward affecting upper extremities, respiratory function and
facial muscles. Reflexes are absent and autonomic dysfunction is frequently affected with fluctuations in
heart rate and blood pressure (Dattilo, 2016). Paresis usually begins from five days to three weeks after

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an infectious illness, surgery or immunization and paralysis within three to four weeks. GBS affects the
sensory functioning and motor functioning but varies depending on the progression of the disease.
Participants with GBS may need assistance from another participant or staff member to assist with fine
motor skills, like cutting out the circle or tracing the cup depending on the location of the paralysis or
paresis. Decreasing the session time is important secondary to the patient having low endurance or
activity tolerance and autonomic dysfunction. Providing rest breaks and performing the activity seated in
a chair is important due to weakness usually starts in the feet and legs, for safety and comfort limited
standing is imperative. Participants may need medication to manage pain prior or post session.
Participants will need space for mobility devices, wheelchairs and walkers, if in wheelchairs the
participants may need a pressure relief cushion to prevent pressure ulcers.
Adaptations: Participants with Osteoarthritis: Osteoarthritis is one of the most common types of
degenerative joint diseases. OA is considered wear and tear arthritis if usually is asymmetrical and only
affects one joint instead of both, for example it may only affect the right knee but the left knee, hips and
shoulder may not be affected. OA is the reduction or break down of cartilage in a joint that causes the
bones to rub against each other that eventually causes pain, swelling, tenderness and loss of motion in the
joint (Dattilo, 2016). OA can affect any joint space and can have a variety of causes from injury, genetics,
occupation, age, weight and athletics. Adaptations for participants with OA would be to have chairs
present depending on the location of the OA, the participant may need to sit and rest depending on the
pain level or may have impaired mobility and may need a cane or walker for support. Participants will
need medication to relieve joint pain prior or post the activity. Participants may need education on joint
care and an exercises/stretching routine prior to the session. Again depending on the location of the OA,
the participant may need a partner or staff member to assist with fine motor skills and/or gripping the
glass secondary to limited range of motion. Participants may also need adaptive equipment like
specialized scissors, pencils or a gripper to assist with fine motor skills. After the session participants
may need cryotherapy to decrease joint pain.

Adaptation References
Dattilo, J., & McKenney, A. (2016) Facilitation Techniques in Therapeutic Recreation. Third edition.
State College, PA: Venture Publishing, Inc.
How to Make a Coin Disappear. Retrieved October 27, 2016.
From http://www.wikihow.com/Make-a-Coin-Disappear.
Mann, Denise. Assistive Devices: Living Better with Arthritis. Retrieved October 28, 2016. From
http://www.webmd.com/osteoarthritis/features/living-easier-arthritis-devices#1.
Porter, Heather. (2015). Recreational Therapy for Specific Diagnoses and Conditions. Enumclaw, WA:
Idyll Arbor, Inc.
Tempest-Roe, Jane. (2000). After GBS Information for Patients Recovering from Guillian-Barre
Syndrome. GBS Support Group of the United Kingdom. Retrieved October 28, 2016. From
http://www.giavelli.eu/NEUROPATIA/Pdf/B_aftergbs.pdf .

LEI4724

Activities Portfolio # 8

Michelle Wilson