Facilitation Technique Category: Massage Therapy

Activity Title: Massage/ Aroma therapy

Source: Saffini, T. (2002, January 7). Massage. Retrieved September 21, 2016, from

//www.recreationtherapy.com/tx/stress.htm
Equipment: Aroma Therapy machine, a relaxing room or patio, relaxing music, relaxing scented and
unscented body lotion, pillows and towels.
Activity Description: Massage in general increases circulation, decreases stress, anxiety and pain. Aroma
therapy also decreases stress and anxiety by promoting relaxation. For this therapy the client will
receive a 10-15 minute massage on one part of the body (i.e. hands, feet, neck, shoulders, or back)
which is to be determined by both the client and the CTRS. The CTRS will position the client in a
comfortable position (sitting or lying) using pillows for comfort then he/she will begin the soft tissue
massage using the body lotion. Once the massage is done the CTRS will then use the towels to wipe off
the excess lotion from the clients body.
Leadership Consideration: Since this is a hands on activity the CTRS may need the help of a massage
therapist, CTRS assistants and/or volunteers. Although massage techniques are very easy to learn it is
important that the person performing the massage has attended the appropriate course/certification
and is aware of the appropriate techniques used with clients according to their diagnosis.
Adaptations: For clients with Cerebral Palsy massage is very beneficial as it may help reduce spasticity
or muscle tone to improve relaxation. It is important to be aware of any allergies the client may have
before using any scented products. No special adaptive equipment is needed but if the client is
wheelchair bound it is recommended to transfer the client out of the wheelchair and position him/her
on whichever position is most relaxing.
Adaptations: For clients with Autism it is necessary to have the proper education on the types of autism
there are in this spectrum. Some clients may have sensory disorders, they may seek light or deep
pressure, some may be sensitive to any type of pressure and some may just not want to be touched. As
part of the sensory disorder some clients may also be sensitive to scents. It is important that the CTRS
becomes familiar with the patients needs in order to choose the proper massage technique and if this
activity may be beneficial to the patient at all.
Adaptation References:

LaPlante, C. (2009, September 21). Massage therapy helps calm & center children on the autism
spectrum. Retrieved September 21, 2016, from
https://www.amtamassage.org/articles/3/MTJ/detail/1846
Massage. (2016). Retrieved September 21, 2016, from http://www.cerebralpalsy.org/aboutcerebral-palsy/treatment/therapy/massage-therapy

Facilitation Technique Category: Expressive Arts as Therapeutic Media

Activity Title: What makes you smile? Window paint
Source: KLammer, S. (n.d.). Expressive arts inspiritation. Retrieved October 5, 2016, from

http://intuitivecreativity.typepad.com/expressiveartinspirations/self-expression-therapyactivities.html
Equipment: An easy to reach window within the facility, different color washable paint, different size
brushes, painting aprons and towels to clean up messes.
Activity Description: Because sometimes it is not easy to verbalize thoughts and feelings, the CTRS may
choose to use expressive arts during the therapy session. Expressive arts can help clients express
themselves without the use of words. It is important to realize that self-expression does not have to be
pretty and that the therapist can only guide the activity .The point of this activity is to have the
participants paint something that makes them smile. Every participant will get a chance to paint on the
window. If the window is big enough a few participants can paint at the same time. The CTRS should
divide the window space so that everyone gets the same amount. In the end, the facility will have a
happy colorful window and the participants will smile every time they see it.
Leadership Consideration: Training in expressive arts modalities, expressive arts certificate.
Adaptations for participants with a genetic disorder such as Down syndrome: These participants may
have decreased fine motor skills due to developmental delays. If this is the case, a variety of stencils may
be used in order to capture the clients emotions. The developmental delays from Down syndrome may
also contribute to sensory disorders. Therefore, it would be a good idea to have the participants paint
with their hands and fingers for sensory integration.
Adaptations for participants who suffer from depression: It may be a good idea to use bright happy
colors such as red, orange and yellow as an effort to brighten their mood. Also, instead of a window the
CTRS may have the participants use a mirror to draw on, this way every time the client sees him/herself
they will also smile.
Adaptation References:

Gremillion, A. S. (2011, September 8). How color impacts emotions and behaviors. Retrieved
October 5, 2016, from https://99designs.com/blog/tips/how-color-impacts-emotions-andbehaviors/
Lashno, M., OTR. (n.d.). Sensory Integration: Observations of Children with Down Syndrome
and Autistic Spectrum Disorders. Retrieved October 6, 2016, from
https://www.kennedykrieger.org/patient-care/outpatient-programs/sensory_integration

Facilitation Technique Category: Stress relief

Activity Title: Deep Diaphragmatic Breathing
Source: Morin, K. (2013, March 13). 23 Science-Backed Ways to Reduce Stress Right Now.

Retrieved October 20, 2016, from http://greatist.com/happiness/23-scientifically-backed-waysreduce-stress-right-now

Equipment: A quiet room or preferable a calm outdoor setting
Activity Description: Stress may cause serious psychological and physical harm, these include:
depression, anxiety, pain and heart disease. Stress relief techniques can reduce the negative effects of
stress. The diaphragm is a major breathing muscle which tends to be misused due to improper
breathing. Diaphragmatic breathing helps with oxygen efficiency, rebalances the autonomic nervous
system, aids with lymphatic drainage, decreases anxiety and helps with muscle relaxation.
A group of 10-20 participants will sit in a circle. Close their eyes. Focus on the sounds of nature (or if
indoors picture a calm landscape). Sit up right with a straight back. Then instruct them to slowly inhale
air through their nose. Air should travel from the nose to the stomach. Once the stomach is filled with
air, slowly exhale through the mouth. Repeat this for 5 minutes.
Leadership Consideration: The CTRS should have certification in stress management techniques.
Adaptations for the older population with osteoarthritis: People who suffer from arthritis disease
would need to sit on a comfortable chair with proper back support for comfort. If the clients have a
fused forward posture (kyphosis) due to arthritis, tactile cues may be needed as having poor posture can
limit the use of the diaphragm muscle.
Adaptations for adults who suffer from multiple sclerosis: If the client uses a wheelchair and has
limited upper body mobility, it is important to position him/her as straight as possible using pillows or
foam wedges. This will help the client obtain diaphragmatic efficiency.

How Sit-Straight worksGood support starts with a stable base. (n.d.). Retrieved October 20,
2016, from http://www.alimed.com/sit-straight-cushions/
Adaptation References:

Bibby, L. (2014, July 23). Five health benefits of breathing with your diaphragm. Retrieved
October 20, 2016, from http://www.breathingremedies.co.uk/2014/07/23/five-health-benefitsof-breathing-with-your-diaphragm/
Eliaz, I., MD. (2011, June 8). Why Stress Management Is So Important for Your Health. Retrieved
October 20, 2016, from http://www.mindbodygreen.com/0-2557/Why-Stress-Management-IsSo-Important-for-Your-Health.html
How Sit-Straight worksGood support starts with a stable base. (n.d.). Retrieved October 20,
2016, from http://www.alimed.com/sit-straight-cushions/