RECL 197 Study Guide

Rec 197: COURSE DESCRIPTION: Study and application of concepts and facilitation processes related to leisure education within therapeutic recreation settings. Includes instructional, leadership, counseling, and behavioral change processes utilized within clinical and community settings.

LEARNING OBJECTIVES:

                                               

I.      To identify content areas and practice interventions related to leisure education.

        A.      To describe models of leisure education in terms of major content areas.

B.            To demonstrate competence in implementing leisure education interventions in a grp setting

II.     To identify and practice effective techniques of education and group facilitation.

A.            To demonstrate the ability to present leisure education content according to principles,

which promote effective learning and involvement.

B.             To demonstrate group leadership skills which maximize the benefits of group interaction

III.                To identify and practice principles and processes related to effective counseling relationships in both individual and group setting.

          A.      To identify characteristics and conditions of effective counseling relationships, and to                                                          demonstrate skills in fostering these characteristics and conditions.

C.         To identify and practice techniques of effective communication within counseling relationships

          C.      To identify stages of group development

    D.      To demonstrate skill in utilizing leadership techniques to effectively work with various group dynamics.

D.         To demonstrate skills in goal setting and facilitating change within counseling relationships

        F.      To demonstrate basic competence in working with individuals from varying cultures.

        G.     To demonstrate basic competence in including families in therapeutic process.

IV.                To explore and understand major theoretical approaches and strategies related to the

intervention and change:

        A.      Values Clarification

B.            Cognitive approaches: cognitive distortions; cognitive-behavioral change; stress mgmt.

        C.      Behavioral approaches: behavioral modification; self-efficacy

        D.      Structural approaches: transactional analysis; Gestalt

        E.      Body/mind approaches: relaxation, sensory awareness

E.             Nonverbal approaches: visualization and imagery; adventure/initiative; horticulture

therapy; animal assisted therapy

        G.      Creative arts modalities: music, art, psychodrama, movement

        H.      Reality orientation: motivation; sensory stimulation; reminiscence; re-socialization

        I.       Social skills training: assertiveness training; conflict resolution

        J.       Ritual: personal milestones and celebrations

197 FACILITATION TECHNIQUES

COMPREHENSIVE FINAL EXAM PREPARATION

1. Be able to reproduce in entirety about the 4 Golden Rules of Facilitation and why each one is so very important.

1. Safety: physical, emotional, mental/cognitive, spiritual, social/cultural

2. Self-Awareness: you are the most important thing you bring to the therapy room. Lifestyle of personal growth, learning, and healing. The more you can tell if other people do.n

3. Relationships: All wounds are relational. How do you heal all wounds? Through relationships. Relationships are the central medicine.

Love yourself: first, know yourself. The more you learn about yourself the more you can love. Then you are more comfortable in your own body. People can feel when you love yourself. Makes you a better spouse. Improves our lives.

4. Goals: outcomes based, functional change --physical, emotional, spiritual, cognitive, social

-No judgement     -unconditional positive regard

2. Be able to reproduce in entirety a  current “magic square” evoked by Leslie  Temple.  Desire to…Fear of… (Not the Johari window).  Be able to talk about how this might be an effective technique to use and why. You cannot use the example provided in class.

MAGIC SQUARES

-tool to reveal the unconscious

-These are helpful because growth cannot happen without self-awareness, self-awareness brings choice for action, confusion

Confusion: a state that you put yourself into (state of mind)  when you reject the truth ( your truth, what you know is true and best for you)..

Illusion /delayed pattern

- Tool to reveal the unconscious

• Do not use the word “not” when completing the squares
• numbers are usually opposite of each other.
• Rank 1-4, 1 being the most aware, 4 being the least aware

	Issue	Opposite
Desire	Desire to find a Job	Desire to not find a Job
Fear	Fear of not finding a Job	Fear of finding a Job

	issue	opposite
desire	Desire to be rejected (4)	Desire to be loved (1)
fear	Fear of being rejected (2)	fear of being loved (3)

• here the individual began by identifying fear of being rejected first then did the opposite of it and moved on to fill in the ‘desire’ squares. Then numbered them according to what he/she was most aware of

# = Level (1, 2, 3, 4); 1 being least important;  4 being most important

Used to reveal the unconscious

Can not change without Self-Awareness

Level 4 (most important may lead to self sabotage)

3. Be able to reproduce in its entirety, the lecture about the Johari Window Model, and be able to write about its usefulness as a conceptual guide and awareness tool with clientele.

Johari Window

-theory to understand dimensions of the self

-how to heal

-without self awareness you cannot grow

-Ways to help get out what is unknown to others and known to self is by: sharing, disclosing, opening up or be around others

-To learn what is known to others; unknown to self: give feedback, invite feedback read self help books and therapy, share, disclose, open, be around others

-Tool to reveal unconscious

-right language

-have language that affects your body

• #1 square is the one you are most aware of/ relate to the most
• growth cannot happen without self awareness because it brings choice for action

4. Be able to fill out a Johari window and explain the draw a diagram about way

that this model offers a visual representation of a particular goal as shown in lecture.                                     

-known to all	-unknown to others, known to self (hidden info)
-known to others; unknown to self (denial)	-unknown to all (unconscious) shadow

EXAMPLE JOHARI WINDOW:

Known to Self _ _ _ _ _ _ _ _ _ _ _ _ Known to Others Known to Self _ _ _ _ _ _ _ _  _ _ _ _ Unknown to Others Unknown to Self _ _ _ _ _ _ _ _ _ _ _ _ Known by others Unknown to all	Known to all Unknown to others (hiding): Self Disclosure Unknown to Self Unknown to all (shadow): Unconscious
Known to all                 I Unknown         I       to              I    others                   I                   I                   I _ _ _ _ _ _ _ _ _ _ _ _ Unknown to Self                   I                   I _ _ _ _ _ _ I _ _ _ _ _                   I                   I  Shadow                   I (Window is you)	Enlightened (Known to all)

• Theory to conceptualize the self
• Means to understand how and grow
• Awareness of self in the Johari window
• Increase size of “Known to all”- ULTIMATE GOAL

Ultimate Goal from first square of window to “unknown to all”  expand “known to all : Be honest with others, open to talk, and share feelings, trusting others; be vulnerable- allow disclosure

• Decrease size of “shadow: unconscious”

• the unconscious is not rational; it is absurd
• when you desire/fear something but don't know what it is; your unconscious through (thoughts, actions, tones) takes over = self sabotage *self fulfilling prophecy* ( you have to accept all of yourself)

• 1- Self
• 2- Denial (invite feedback, read, therapy)
• 3- Hide to others (share, disclose, open up)
• 4- Unconscious (anything we reject)

**The ultimate goal is to have “Known to ALL” be cover the entire box, for everything to be known al feel FREE and TRANSPARENT

5. Know the basic tenets, authors, and terms related to all major theoretical approaches and strategies related to the Recreation Therapy. Use your compiled Theory Grid to study.

• Motivational Interviewing Theory
• Key Authors
• William R. Miller
• Stephen Rollnick
• Key Terminologies & Concepts
• Motivational Interviewing
• A form of collaborative conversation for strengthening a person's own motivation and commitment to change.
• Person Centered/ Client Centered
• client is the person to decide how to change his/or her behavior
• Psychotherapy: treatment of emotional, behavioral, personality, and psychiatric disorders based on verbal and nonverbal communication with patient
• Summary
• method is based on the notion that clients are often ambivalent about change and this affects their readiness to change their behavior.
• The therapist’s task is to facilitate expression of both sides of the ambivalence impasse, and guide the client toward an acceptable resolution that triggers change
• 4 Guiding Principles acronym RULE
• resist the righting reflex
• understand and explore the client’s motivation
• listen with empathy
• empowering the client and encouraging hope and and optimism
• RT Application
• effective in:
• maladaptive behavior (problem drinking, gambling, HIV risk behaviors..)
• promoting adaptive health behavior change (exercise, diet, medication adherence)

• Transactional Analysis Theories
• examines how the interaction between 2 individual’s ego states (parent, child, adult) are being changed through means of communication
• examines individual’s personality and social interaction
• improves communication
• KEY TERMS
• Adult, Child, and Parent ego states
• Communication
• Personality
• —Social Interaction
• Transactions
• Principles
• Give respects to self and others
• Accept personal responsibility for one’s own experiences.
• Recognition and respect for each personal experience
• Focus on positive and optimistic
• Key Author
• Eric Berne
• Created by Eric Berne, due to the influence of  Sigmund Freud’s studies on ego states (Id, ego, and super-ego)
• 3 ego states
• Parent Ego State: feelings, thoughts, behaviors come from parent interaction
• : influence from parents, friends, etc on child
• 2 forms of parenting: nurturing and controlling
• Child Ego State: behaviors, thoughts, feelings from childhood
• positive, negative experiences
• taking care of self (wants and needs)
• Adapted: please others
• Natural: spontaneous and free
• Adult Ego State: direct response to the here and now
• spontaneous and aware of capacity for intimacy
• controls neg. and pos. dialogue from parent and child egos
• 3 Transactions
• Reciprocal or complementary:
• Communication in same ego state.
• Adult to adult
• —Crossed:
• Communication in different ego states.
• Adult to child
• —Ulterior  (most complex):
• Explicit social conversation that occurs in parallel with psychological transaction.
• Ex: Adult words but hidden child language or movement.
• RT Application
• Group therapy
• Family groups
• Rational-emotive therapy
• Reality therapy
• Social Skills Training
• Verbal communications
• Attitude, tone, listening, and responses.
• Relationships (family, partners, friends, etc).
• Clinical and community. Private, safe, and quiet setting (Private room/classroom).
• Diagnosis: Anxiety, depression, PTSD, and mood disorders

• Attachment Theory
• Key Author
• John Bowlby
• biological parents absent. raised by nanny for first 4 years.
• Characteristics of Attachment
• Proximity Maintenance:The desire to be near the people we are attached to
• Safe Haven: Returning to attachment figure for comfort and safety in face of fear or threat
• Secure Base: attachment figure acts as a base of security from which the child can explore the surrounding environment
• Separation Distress: anxiety that occurs in the absence of attachment figure
• Secure Attachment:
• Secure Attachment in Children:
• Able to separate from parent
• Seek comfort from parent when frightened.
• Return of parent is greeted with positive emotion.
• Prefers parent to strangers.
• Secure Attachment in Adults:
• having trusting lasting relationships
• high self-esteem
• comfortable sharing feelings with friend or partner
• seek out social support
• Ambivalent Attachment in Children:
• wary of strangers
• greatly distressed when parent leaves
• Are not comforted by return of parent
• Ambivalent Attachment in Adults:
• reluctant to become close to others
• worry that partner does not love them
• distraught when relationship ends
• Avoidant Attachment in Children:
• may avoid parents
• does not seek comfort or contact from parents
• show little or no preference between parent and stranger
• Avoidant Attachment in Adults:
• problems with intimacy
• invest little emotion in social or romantic relationships
• unable or unwilling to share thoughts with others
• Disorganized Attachment
• age 2: may show mixture of avoidant and resistant behavior
• age 6: may take on parental role
• RT Application
• Depression, social anxiety, eating disorders, negative core beliefs, children of foster-care, history of abuse, PTSD, etc
• interventions including building trust, promoting communication and healthy relationship standards

• Validation Theory
• Key Author:
• Naomi Feil
• Summary
• explains that many very old disoriented people (often diagnosed as having Alzheimer type dementia) are in the final stage of life, trying to resolve unfinished issues in order to die in peace
• gives elderly opportunity to express desire either verbally or nonverbally
• Key Terms:
• Validation:
• reflecting person’s feelings
• helping them to express unmet needs
• restoring well-established social roles
• facilitating feelings of well-being and stimulating interaction with others
• Key Principles:
• In late life, the way a human being has lived is of parallel importance to the physical condition of his or her brain
• built on empathetic attitude and a holistic view of individuals
• 3 basic components
• 1.Age specific, movements reflect human needs, & classifies behavior in 4 progressive stages
• 1.Malorientation
• 2.Time confusion
• 3.Repetitive motion
• 4.Vegetation
• 2.Based on basic, empathetic attitude that respects & values older adults without judgment
• 3.Includes specific techniques for individual, based on needs and his/her phase of resolution
• RT Application
• Alzheimer's and dementia

• Psychodrama
• Key Author
• Developed by Jacob L. Moreno, M.D.
• Basic Elements
• Protagonist: person representing the theme in the group
• The auxiliary egos: group members who assumes the roles of significant others in the drama.
• The audience: witnesses to the drama
• The stage: the space the drama takes place.
• The director: The person who is guiding the work
• 3 distinct phases
• 1. The warm-up : Group themed is identified and a protagonist is picked.
• 2. The action: The problem is dramatized and explores new methods of resolving it.
• 3. The Sharing: expressing connections with the protagonist work.
• Benefits
• Allows the patients to be in a safe environment and allow different roles and behaviors.
• Settings could be small groups to encourage involvement.
• Allows people to engage and incorporate ideas and issues without judgment

• Cognitive Behavioral Therapy
• Key Authors
• Albert Ellis, Ph.D (mid 1950’s)
• Aaron T. Beck (1960)
• Maxie C. Maultsby, Jr., M.D. (1960s)
• Michael Mahoney, Ph.D.
• Donald Michenbaum Ph.D.
• David Burns, M.D.
• Summary:
• Focuses on exploring the relationship between a person’s thoughts, feelings, and behaviors.
• •Help people become more aware of when they make negative interpretations and how their behavior reinforces that negative thinking.
• •By working together, the therapist and client can develop constructive ways of thinking that will produce healthier behaviors and beliefs.
• Key Terminology:
• ABC Model-the construct stating that one’s problems do not originate from events but from the beliefs one hold about those events.
• Arbitrary Inferences-the distorted view of making conclusions without the basis of supporting and relevant evidence; part of Aaron Beck’s cognitive therapy
• Automatic Thoughts-ideas (usually outside one’s awareness) triggered by a particular event that lead to emotional reactions
• Cognitive Restructuring-the process of replacing negative thoughts with positive thoughts and beliefs
• Label and Mislabeling-the distorted view of basing one’s identity on imperfections and mistakes made in the past.
• Overgeneralization-the distorted process of forming rigid beliefs based on a single event and then applying them to subsequent events
• Personalization-the tendency of individuals to relate events to themselves when there is no basis for this connection
• Polarized thinking-a cognitive error based on an all-or-nothing framework. There are no gray areas in polarized thinking
• Rationality-A way of thinking that will help us attain our goals
• Role Playing-the process of helping a client work though irrational beliefs by practicing new behaviors
• Selective Abstraction-the distorted view of forming conclusions based on an isolated detail of an event
• Key Concepts
• Cognitive Events—thoughts (including self-statements)
• •Cognitive Structures—beliefs and belief systems
• •Cognitive Processes—information processing (the acquisition, storage, retrieval, and utilization of information)
• Key Principles
• •CBT is based on an ever-evolving formulation of the patient’s problems and an individual conceptualization of each patient in cognitive terms
• •CBT requires a good client-therapist relationship.
• •CBT emphasizes collaboration and active participation.
• •CBT is goal-oriented and problem focused.
• •CBT initially emphasizes the present.
• •CBT is educative; it aims to teach the client to be his/her own therapist, and emphasizes relapse prevention.
• •CBT aims to be time limited.
• •CBT sessions are structured.
• •CBT teaches patients to identify, evaluate, and respond to their dysfunctional thoughts and beliefs.
• •CBT uses a variety of techniques to change thinking, mood, and behavior.
• RT Application
• Depression
• Anxiety disorders
• Bipolar disorder
• Eating disorders
• Schizophrenia
• Group Therapy
• One-on-One treatment

Psychoanalytic Theory:

• Key Author:
• Sigmund Freud
• 3 levels of mind:
• Conscious: info about yourself and environment that you are aware of
• Ego: boss or executive part of personality, mediates between the demands of the id, superego and reality
• Pre conscious: represents ordinary memory. not aware of the info at any given time; however, can retrieve it pull it into the conscious mind
• Superego: morals and sense of right and wrong represents ideals and provides a stand for judgement
• Unconscious: reservoir of feelings, thoughts, urges, memories outside of our conscious awareness or that we find unacceptable for our conscious minds
• Id: animalistic and most basic instincts, sexual and aggressive drives, operates on the pleasure principle
• Defense Mechanisms
• Denial
• an outright refusal or inability to accept some aspect of reality that is troubling. For example:"this thing has not happened" when it actually has.
• Splitting;
• a person cannot stand the thought that someone might have both good and bad aspects, so they polarize their view of that person as someone who is "all good" or "all bad". Any evidence to the contrary is ignored.
• For example: "My boss is evil", after being let go from work, when in reality, the boss had no choice in the matter and was acting under orders herself. Splitting functions by way of Dissociation, which is an ability people have in varying amounts to be able to wall off certain experiences and not think about them.
• Projection;
• a person's thought or emotion about another person, place or thing is too troubling to admit, and so, that thought or emotion is attributed to originate from that other person, place or thing.
• For example:"He hates me", when it is actually the speaker who hates. A variation on the theme of Projection is known as"Externalization". In Externalization, you blame others for your problems rather than owning up to any role you may play in causing them.
• Passive-aggression;
• A thought or feeling is not acceptable enough to a person to be allowed direct expression. Instead, that person behaves in an indirect manner that expresses the thought or emotion.
• For example: Failing to wash your hands before cooking when you normally would, and happen to be cooking for someone you don't like.
• Acting out;
• an inability to be thoughtful about an impulse. The impulse is expressed directly without any reflection or consideration as to whether it is a good idea to do so.
• For example: a person attacks another person in a fit of anger without stopping to consider that this could seriously wound or disfigure that other person and/or possibly result in legal problems.
• Fantasy; engaging in daydreams about how things should be, rather than doing anything about how things are.
• For example: Daydreaming of killing a bully, instead of taking concrete action to stop the bully from bothering you
• Displacement;
• An unacceptable feeling or thought about a person, place or thing is redirected towards a safer target.
• For example, it may feel unsafe to admit anger towards a parent, but it is perfectly safe to criticize the neighborhood he or she lives in.
• Isolation/Intellectualization;
• Overwhelming feelings or thoughts about an event are handled by isolating their meaning from the feelings accompanying the meaning, and focusing on the meaning in isolation.
• For example, you cope with the recent death of a parent by reading about the grieving process.
• Repression;
• A milder form of denial; You manage uncomfortable feelings and thoughts by avoiding thinking about them. You are able to admit that you feel a certain way (unlike in denial), but you can't think of what might have led up to that feeling, and don't really want to think about it anyway.
• Reaction Formation;
• You react to uncomfortable, unacceptable feelings or ideas that you have (but aren't quite conscious of really), by forming the opposite opinion. For example; you unconsciously hate your parent, but your experience is to the contrary; you are only aware of loving feelings for your parent.
• Rationalization;
• where you choose to do something on emotional grounds (because it feels good) but you don't want to admit that, so you make up reasons after the fact to justify your choice.
• Workaholism;
• where you avoid dealing with problems by burying yourself in work. Workaholism could be considered a form of Distraction (see below), but distraction is something you choose to do, and many workaholics don't perceive their devotion to the office as a choice so much as a duty
• Psychosexual Stages

Feminist Therapies

• Key Authors:
• Laura S. Brown 1989, 1991, 1994
• Carol Zerbe Enns 1997
• Judith Worell 1992, 1997, 2001, 2003
  Jean Baker Miller 1976, 1991, 1997
• Key Terminology:
• Egalitarian
•  Believing that all people are equal and deserve equal rights and opportunities.
• Bibliotherapy
• Therapy technique used that has lead to greater client satisfaction
• Uses books as therapy in the treatment of mental or psychological disorders
• Resocialization:
• cognitive reconstructing of the clients belief system
• client will learn to be assertive or to increase self esteem
• Learn to take on non-traditional roles and develop new coping strategies
• Learn new solutions to their difficulties, which may increase well being

• Key Principles:
• personal is political
• egalitarian relationships
• View client as his/her own expert
• Inform client of therapy process and his/her role and rights in the process
• Focuses on client goals, not on therapist goals
• Minimize power differential in the counseling relationship à power-sharing process
• privileging of women's experiences
• empowerment
• Treating clients as unique individuals rather than assuming all individuals share the same “realities”
• Individual’s reality is constructed and shaped by multiple oppressions such as gender, race, culture, socioeconomic class, sexual orientation, and ability
• Social justice and being aware of culture diversity, is essential in this theory
• --1 --Complexity of people's lives should be understood
• --2--Viewing clients in the setting of their lived experience
• --3--To achieve a less quantifiable outcome, such as... improving self esteem, improved quality of life, involvement in social action, and awareness of oppression and socialization
• Summary
• Both the patient and dem
• incorporates the psychology of women, developmental research, cognitive-behavioral techniques, multicultural awareness and social activism in a coherent theoretical and therapeutic package
• a way to minimize gender and cultural bias where traditional psychotherapeutic theories failed and to change social, political, and cultural beliefs about women’s roles in the world
• “It is a theory that not only listens to, but privileges, the voices and experiences of those who have been defined as “other” by dominant cultures….”

Attribution Theory

• Key Author:
• Fritz Heide
• Summary
• theorizes that people formulate explanations for their own and other’s successes
• Important Key Terms
• Attribution –the process by which individuals explain the causes of behaviors and events (in social psychology)
• Locus of Control (internal/external) – indication of whether a person can control their own way to successes and failures to personal characteristics and behaviors or there are external circumstances causing the control
• Internal Locus of control – within person
• External Locus of Control – in situation
• Stability (stable/unstable) – indication of whether a person believes the causes of success or failure can be easily changed
  
• Controllability  (controllable/uncontrollable)- indication of whether a person believes the behavior or circumstance is something he or she has the power to personally alter or whether that person believes it is out of his/her control 
• Internal Attributions- places the cause of events with us
• External Attributions- place the cause with the situation in which the event occurred
• Self Serving Bias- tendency to attribute successes to internal causes and failures to external causes
• Fundamental Attribution error- tendency to overestimate the role of personal dispositions and overlook situational causes
• Self- Efficacy -  A person's beliefs regarding whether one has the power to create change with personal actions 
• Key Principles
• 3 Causal dimensions
• Stability (stable or unstable)
• Locus of Control (internal versus external)
• Controllability
• 4 Determinants of Successes or Failure
• Ability- stable internal factor
• effort- unstable internal factor
• task difficulty- a stable external factor
• luck- an unstable external factor
• 3 stage process
• Behavior is observed or perceived
• Behavior is determined to be deliberate
• Behavior is attributed to external and internal causes
• RT Application
• Help clients gain confidence in their skills and abilities through providing opportunities for success
• Rapid assessments on how clients feel about different activities and attributions allows for RTs to be able to start designed treatment as soon as possible to fit clients’ needs
• Client and RT will be able to work together to achieve common goals and objectives
• Helps increase perception of control, willingness to try and make changes, be cooperative, and have a greater degree of freedom → independent functioning in leisure time and activities

Peer Teaching Self-Efficacy Theory (SET)

• Key Author
• Bandura, A.
• Summary
• Briefly defined as the belief that through positive thinking one can execute a certain course of action to attain a specific goal.
• Associated with Bandura's Social Learning Theory.
• Determines how people think, feel and self motivate.
• Strong senses of self-efficacy can enhance accomplishment and personal well-being as well as vice versa.
• Key Principles
• Mastery Experience
• Positive previous experience in an endeavor
• Vicarious Experiences
• Positive experience from viewing others similar to self succeed at feat
• Social Persuasion
• Positive belief in one’s self to succeed from encouragement from others
• Somatic and Emotional State
• State of being before and after the fact
• RT Application
• Rehabilitative counseling (Strauser, 1995)
• Targeting  populations with lowered self-efficacy
• Populations with disabling conditions.
• Populations under career development.
• Older populations and fall situations (Cheal & Clemson, 2001)
• Target increase self-efficacy in older population’s ability to be mobile with reduced risk of falling.

Cognitive Behavioral Therapy - Change Process

• Key Author:
• Aaron Beck (1921) • Concept that people’s cognitions influence the way they react to life situations •
• First used to treat clients with major depression •
• Now, CBT is used to treat anxiety disorders, personality disorders, eating disorders, and substance abuse
• Summary
• Focus is to help clients develop a healthy lifestyle through recreation involvement
• This theory identifies the series of stages that clients experience in making a behavioral change
• The Stages of Change- Transtheoretical Model
• Precontemplation
• No intention of changing his/her behavior
• May not have considered the need to change behavior
• May have tried to change & gave up
• People in this stage are difficult to engage in rehabilitation
• Contemplation
• Individual has acknowledged a problem exists
• Begin to think about making a change
• Cannot find the time/energy to make the change
• Preparation
• Close to taking action
• Move from thinking about the reasons why they cannot change behavior → thinking about possible ways to change behavior
• May consider several changes
• May develop a plan to change
• Action
• Begin to follow the plan they developed
• Maintenance
• Individual has made a behavioral change in his/her lifestyle
• Termination
• The behavior has become so ingrained that it is now a routine part of life
• Emotional Stages of Change
• Denial
• Difficulty  accepting that he/she has a problem or sick
• Anger
• Become angry after experiencing denial “Why me?”
• Bargaining
• Make bargains with themselves, others, and even to God(s)
• This is a form of postponing the inevitable
• Hopeful that the situation will pass
• Depression
• Begin to recognize severity of situation → depressed  
• Acceptance
• Reaches the point where he/she accepts the reality of situation
• RT Application
• Location in the cycle determines willingness to change
• Asking the client to create a timeline or collage that reflects his/her lifestyle & efforts to change
• Ex: client dealing with substance abuse

Resiliency or Hardiness Theory

• Key Author
• Susan Kobasa
• Key Terms
• Personal Hardiness
• Challenge
• Opportunity to grow; not a threat
• Personal Control
• Competent and able to make choices
• Sense of Commitment
• Better relationships (home, family, friend, etc.)
• Easier to work with others
• Stress
• negative and positive responses to overwhelming situations
• Burnout
• extended exposure to stress, cause of psychophysiological illnesses
• Coping
• consciously tolerating, reducing, or attempting to solve a stressor
• Key Principles
• Four personality traits (Susan Kobasa)
• “A feeling of commitment and involving oneself”
• “intensive connection with their environment”
• “having internal locus of control and of life”
• “having a sense of meaning”
• Resilience
• “…general ability for flexibility and ingenious adaptation to internal and external stressors… for efficient coping, adjusting to adversity and maintaining a sense of meaning in life.”
• RT Application
• Rehabilitation
• Recovering from traumas such as traumatic brain injuries
• Occupational Stresses
• Dangerous jobs: military leaders, EMTs, police
• Day-to-Day Life
• Develop personal hardiness to deal with stress
• Experiences

—Reality Therapy

• —focuses on what realism, responsibility, and right-and-wrong, rather than actions resembling those of a mental disorder.
• Key Author
• —Developed in the 70’s by Dr. William Grasser
• —Form of cognitive behavioral therapy
• —Founded on the principles of Choice Theory
• —Behavior is driven by 5 needs: survival, love, power, freedom, and fun
• —Change from “Deadly Habits” to “Caring Habits”

— Clients

• —Do not have a mental illness
• —Have not had any positive relationships in the past with adults
• —Tend to be misunderstood and passive
• —May suffer highly sensitive issues/ social condition
• —AIDs, racial and cultural conflict, sexual identity

Key Concepts

• —Planning and Commitment
• —Utilize client’s strengths
• —Emphasis on choice and responsibility
• —Focuses on what clients can control; their own actions & behavior
• —Focus on the present and not to dwell on the past
• —Not a victim of the past if you choose to not be
• —Transference is rejected
• —Therapists strive to be themselves, no hidden agenda

— Techniques

• —Behavior -oriented methods
• —Contract method
• —Role- playing
• —Confrontation of the client

—How can Reality Therapy be used in RT?

• — Help create positive setting/outlook for clients to accomplish their goals
• —Patients, veterans, amputees

—Family Therapy

• —a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development.

Background

• —Formal development began in the late 1940’s and early 1950’s
• —1942- founding of the American Association of Marriage Counselors
• —Worked on by the US, UK, and Hungary
• —Influence by:
• Milton H. Erickson
• — hypnotherapy, strategic therapy, brief therapy
• —Gregory Bateson
• —Systems theory, cybernetics
• —Nathan Ackerman
• —psychoanalytic

— Key Concepts/ Process

Key Concepts

• —Have a perspective and analytical framework
• —Focus on relationship patterns
• —What goes on between individuals instead of within
• —Main interest is in maintenance or solving problems
• —Not to identify a single cause

Process

• —May focus on analyzing specific previous instances of conflict
• —Suggest alternative ways of response
• —Directly address the sources of conflict
• —Point out patterns that the family has not noticed—

Techniques

• —Structural therapy- Identifies and Re-orders the organization of the family system
• —Strategic therapy- looks at patterns of interactions between family members
• —Systemic/ Milan therapy- Focuses on belief systems
• —Narrative Therapy- Restoring of dominant problem—saturated narrative, emphasis on contect, separation fo the problem from the person
• —Trangenerational Therapy- Transgenerational Transmission of unhelpful patterns of belief and behavior
• —Genogram– a display of a person’s family relationships and medical history

How can Family Therapy be used in RT?

• Family oriented programs/events
• —Camps, retreats
• —It can provide a way for inclusion—

Behavioral Modification

• Key Authors
• B.F. Skinner’s Theory of Operant Conditioning
• method that uses positive and negative reinforcement to associate desired or undesired outcomes with certain behaviors
• Edward Thorndike’s Law of Effect
• certain behaviors are the result of pleasant or unpleasant consequences
• Key Terms
• Antecedent- comes prior to the (un)desired behavior; it is changeable and can be altered or removed in order to affect the behavior.
• Consequence- can be good or bad; occurs after the behavior occurs. Also referred to as: 
• Positive reinforcement: given when a desired behavior occurs and strengthens that behavior.
• Negative reinforcement: occurs when an unpleasant stimuli is removed for the desired behavior and strengthens behavior.
• Response cost: like a punishment, a positive stimulus is removed; designed to weaken undesirable behavior.
• Punishment: occurs when a negative stimulus is added to weaken behavior.
• Extinction: occurs when there is no reinforcement for behavior, thus weakening the response.
• Approaches and Techniques
• Modeling: This involves teaching an individual to emulate a certain behavior.
• Cueing: This involves reminding a person to perform a certain action at a given time.
• Discrimination: This teaches a person to behave in a certain way for a particular set of stimuli, but not for another. The reward, or reinforcement, occurs only after the appropriate response has been given.
• Substitution: When a current reinforcer no longer stimulates the desired behavior, a substitution may occur in which a new reinforcer is introduced.
• Satiation: This involves letting a person tire of performing an undesired behavior.
• Ex. letting a baby cry at night for a little while until he goes to sleep.
• Avoidance: This involves teaching a person to avoid an unpleasant situation.
• Fear reduction: This involves incrementally exposing a person to a stimulus that may induce fear at first. Eventually, the individual will no longer fear that certain stimulus
• RT Application
• obsessive-compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)
• depression
• social phobia
• bipolar disorder
• schizophrenia

Person Centered Therapy

• Key Author
• Carl Roger
• people have one basic motive in common - to self-actualize
• Self-actualization refers to a life-long process in which individuals seek to achieve their full potential and reach their goals and aspirations
• In order for self-actualization to occur, a person’s belief of who would they like to be (“ideal self”) has to match up with their actual behavior (“self-image”)
• Summary
• Purpose of person-centered therapy is to reduce the level of incongruence between the ideal and actual self  (self-actualization),
• increase a person’s feelings of self-worth, and help a person become a more fully functioning individual
• 3 important characteristics
• Congruence: The therapist's willingness to be honest and authentic. (a.k.a. genuineness) The therapist does not put on a facade.
• Unconditional positive regard: The therapist accepts the client entirely. Holds non-judgemental attitude towards client and is respectful towards client as a person.
• Empathy: The therapist understands the client’s thoughts and feelings from the client’s perspective. The therapist is willing and able to experience the world from the client’s point of view

Emotional Intelligence

• Key Author: John Mayer, Peter Salovey, and David Caruso

Dialectical Behavior Therapy

• Key Author: Dr. Marsha M. Linehan
• Summary:
• Originally developed to treat chronic and high-risk individuals with Borderline Personality Disorder.
• Since DBT’s development, research has shown that DBT is effective in treating a range of other disorders such as, substance dependence, depression, PTSD, and eating disorders.
• Overall, there are four major components of DBT
• Skills Training Group- Enhancing clients’ capabilities by teaching them behavioral skills.
• Individual Treatment- Enhancing clients’ motivation and applying the behavioral skills in their everyday lives.
• DBT Phone Coaching- Providing in-the-moment coaching for times when needed most.
• Therapist Consultation- Therapy for the therapist; designed to keep therapists motivated in order to provide the best treatment possible.
• Key Terms/Concepts
• Dialectical – A method of examining and discussing opposing ideas in order to find the truth.
• The primary dialect is between the opposite strategies of acceptance and change.
• For example, DBT therapists accept clients as they are, while also acknowledging that they need to change in order to reach their goals.
• The four behavioral skills taught throughout DBT
• Mindfulness – The practice of being fully and non-judgmentally aware with focused attention to inner and outer environments
• Distress Tolerance – Learn to how tolerate pain by building skills for radical acceptance and finding meaning within
• Interpersonal Effectiveness – Learn effective strategies for asking what one needs, saying no, and coping with interpersonal conflict
• Emotion Regulation – Learn how to identify triggers for certain emotions and how to choose more productive outcomes in the future
• Key Principle
• DBT analyzes different levels of disorder severity to effectively guide therapists.
• They are based on severity, risk, disability, pervasiveness and complexity.
• These levels of disorder in turn guide stages of treatment and provide strategies and procedures depending on the needs of the client.
• The treatment targets in order of priority are:
• Life Threatening Behaviors – Behaviors that could lead to the clients death including all suicidal and non-suicidal self injuries.
• Therapy Intervening Behaviors- Behaviors that interfere with the client receiving effective treatment.
• Quality of Life Behaviors – Behaviors that interferes with clients having a reasonable quality of life.
• Skill Acquisition – Learn new skillful behaviors to replace ineffective behaviors to help clients achieve their goals.
• RT Application
• As a CTRS, we can use this theory to encourage and guide someone to leisure and provide the specific health benefits needed.
• The skills included in this theory, more specifically mindfulness and distress tolerance, can be attained through recreational activities such as, dance, music, yoga, meditation, and other positive enjoyable activities.
• Finally, leisure involvement can establish a sense of purpose and strengthen an individuals identity.
• Relevant Diagnosis
• PTSD
• Depression
• Eating disorders
• High risk individuals
• Substance Dependence
• Domestic violence victims
• Borderline Personality Disorder
• Inpatient Settings
• Outpatient Settings

GESTALT

• Key Author: Max Wertheimer, Wilhelm Wundt.
• Summary:
• The central principle of gestalt psychology is that the mind forms a global whole with self-organizing tendencies. This principle maintains that when the human mind (perceptual system) forms a percept or gestalt, the whole has a reality of its own, independent of the parts.
• looks at the human mind and behavior as a whole
• Key Terms/Concepts
• Key Principle

• RT Application

behaviorial problems

For Wednesday's Class Theories: (not covered already)

Behavioral Modification: Learned behavior (Pavlov’s dogs), Clark Hull, John Watson (Little Albert-fear fuzzy animals)

• Tabula Rosa: Blank mind

Reality Therapy:

Self Efficacy Theory: High self efficacy-ability to face their problems and solve them. Low self efficacy-low confidence-problem wins.

• performance
• vicarious experience
• verbal persuasion
• psychological arousal

Person-Centered Therapy:

Emotional Intelligence :

Gestalt: A discipline that helps people stand aside from their usual way of thinking . Think in the now and never think of the past or future.

• Existentialism: Phenomenological method; focus on people’s existence, relationships with other people, happiness and sorrow for example, as directly affected

Learned Optimism: One can cultivate joy by challenging any negative self talk.

6. Read, review, and recognize components of all facilitation completed by all peers (both the educational sessions & the facilitations for functional change or treatment).

7. Be able to recognize a description or example of a Facilitation Modality in the form of a multiple-choice format (art therapy, aromatherapy/sensory stimulation, experiential, drama therapy, adventure therapy (trust, cooperation, teamwork), etc.

8. Identify the 2 components of the Leisure Ability Model that are experienced/facilitated in this class.  

• 1 Functional Intervention : treatment

• 2  Leisure education/ psycho education: skill building and knowledge info  

9. Particularly, know WELL the details from the following facilitations:

A. Cognitive Distortions/Cognitive Behavioral Therapy

1. Make sure that learn and understand each cognitive distortion.

• All-or-Nothing Thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure. You think in absolutes such as “always”, “never,” or “every”.
• Overgeneralizing: You see a single negative even as a never-ending pattern of defeat and you make broad interpretations.
• Mental Filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened. like a drop of ink that colors the entire beaker of water.
• Disqualifying the positive: You reject positive experiences by insisting they “don’t count” for some reason or other. In this way, you can maintain a negative belief that is contradicted by your everyday experiences.
• Jumping to Conclusions: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
• a. Mind Reading: You arbitrarily conclude that someone is reacting negatively to you, and convincingly support your conclusion.
• B. The Fortune Teller Error: You anticipate that things will turn out badly, and you feel convinced that your prediction is already-established fact.
• Magnification or Minimization: You exaggerate the importance of things (such as your goof-up or someone else’s achievement) or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick”.
• Emotional reasoning: You assume that your negative emotions necessarily reflect the way things are: “I feel it, therefore it must be true”
• “Should Statements”: You try to motivate yourself with shoulds and shouldn’ts as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “outghts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.
• Labeling/ Mislabeling: This is an extreme form of exaggeration. Instead of describing your error, you attach a negative label to yourself: “I’m a loser” When someone else’s behavior rubs you the wrong way. You attach a negative label to them: “They are really mean jerks.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
• Personalization and Blame: You see yourself as the cause of some negative external event which in fact you were not primarily responsible for.

2. Make sure you understand the basic steps of a triple/five column of how to challenge and change your cognitive distortions.

Summary of Steps

According to Burns, the keys steps to use the Triple Column Technique are as follows:

• Step 1 – Create the Triple Column Technique table.
• Step 2 – List your self-criticism.
• Step 3 – Identify cognitive distortions.
• Step 4 – Identify rational thoughts.

Step 1 – Create the Triple Column Technique table

According to Burns, to create the table for the Triple Column Technique:

1. Draw two lines down the center of a piece of paper to divide it into thirds.
2. Label the left-hand column “Automatic Thoughts (Self-cricitism)
3. Label the middle column “Cognitive Distortion”
4. Label the right-hand column “ Rational Response (Self-defense)”

Step 2. List your self-criticism.

According to Burns, in the left-hand column, write down all the hurtful self-criticisms you make when you are feeling worthless and down on yourself.

Step 3 – Identify cognitive distortions.

According to Burns, in the middle column, write down the cognitive distortions. Using the list of 10 Distorted Thinking Patterns , see if you can identify the thinking errors in each of your automatic negative thoughts. The 10 Distorted Thinking Patterns are:

• All-or-nothing thinking
• Overgeneralization
• Mental filter
• Disqualifying the positive
• Jumping to conclusions (Mind reading, fortune teller error)
• Magnification or Minimization
• Emotional reasoning
• Should statements,
• Labeling and Mislabeling,
• Personalization.

Step 4 – Identify rational thoughts.

According to Burns, substitute a more rational, less upsetting thought in the right-hand column. Don’t try to cheer yourself up by rationalizing or saying things you don’t objectively believe are valid. Instead, try to find a more objective fact. Your response can take into account what was illogical or erroneous about your self-critical automatic thought.

10.  Be able to name and identify various “detailed facilitation techniques” learned in class through your peers and the mini-teachings occurring throughout the semester (ex., ensuring there are no chairs missing and the circle is perfect).

• tone
• safety
• fix the circle
• lighting is comfortable
• during closure; everyone has to share/ is encouraged to share final thoughts, one word they can take from the session

• if someone steps outside, after a few minutes check up on them
• inform the group about the materials they will need for the session ex. pen/pencil
• Identify any themes that form during facilitation (‘I noticed many people mention the colors in their masks, maybe there is a significance in the colors you chose, maybe we can discuss colors during the sharing as well.’)
• Instead of just thanking every speaker and moving on, ask questions about what they contributed.
• Return to anyone who was not ready to answer after the group is all finished, they may have thought of a good answer. Or simply say ‘What do you think the answer could be?’
• Facilitators should be at the same level as everyone else to show equality.
• open language (during closure start off with a broad question so everyone can feel free to talk about anything they took from the facilitation
• if they don’t have an answer, ask them to guess! they most likely know it but don’t want to share

11.  Be able to write out the purpose of the Personal Growth Paper, part 1 and part 2.  What was a professional preparation purpose of this assignment? What are some academic purpose of this assignment? What did it require the writer to do/feel/ synthesize?

• Purpose: To apply theory and concepts to your life and to gain greater Self- Awareness.
• It was to conduct a personal reflection about the most difficult and most positive experiences and to apply academic learning
• Apply psychoanalytic theory
• Attachment theory
•  Enneagram
• Irrational Beliefs
• Coping and defense mechanism
• Core beliefs

12.  Be able to recognize or write about 2 core academic purposes of the “Silent Telling a Story without Words” (intervention Suzy facilitated where we sat on the floor and told our story without words).

• to listen to others from your heart, (when you were the observer), we must learn to feel our feelings through listening to clients and with our hearts bc when we listen with our hearts we receive more information. mind = analyzing. that is not helpful in this situation.
• to create a bond with another person, maybe potential client, a non judgemental bond, because sometimes therapy is just about someone witnessing your emotions, and the goal is not to provide advice sometimes just telling the story is therapeutic enough.

13.  Know the concept of debriefing (processing) and recognize its importance and KNOW possible excellent and poor example questions.

• debriefing is expressing feelings and getting things out.,
• clinical assessment
• bc all wounds are relational > talking to one another > building a relationship > healing/having ‘AH HA!’ moment. HEALING IS IN PROCESSING.
• for however long you have treatment = however long you process for

good questions

they need to be general.. asking a specific question right off the bat shocks everyone and they are less inclined to share. for example) so how did you feel about that experience? is a good processing question

14.  Be able to define and recognize examples of open (probe) and closed questions and to create your own during the exam.

open questions = open responses

closed questions = closed / short responses

Probing questions are, in essence, follow up questions that ask for additional information, request the person expand on what she has said, or ask the person to go deeper. Using probing questions can be helpful in increasing understanding, since most people need to be encouraged to go beyond what they have said to help someone understand their deeper feelings, and opinions.

They indicate interest and a desire to understand.

Probing questions can be non-directive (eg. "Go on", or "Could you clarify that?", or they can be more directive and specific as below:

Person A: I live in New York

Person B: Ah. Do you live in Brooklyn, or The Bronx?

I got this definition from (http://work911.com/communication/skillsprobing.htm)

15. Describe the purpose of the “frame” when facilitating treatment.

To provide the clients with an understanding of what the purpose of the facilitation is and get a sense of what is going to be done.

Having a specific intro helps direct us towards a specific outcome

16. Describe the purpose of “setting the tone.”

Setting the Tone:”orienting” the clients or intended purpose of session.

• o   Ask relevant question that involves them thinking about a personal way that the topic related to their lives.
• Ex: “who had a frustrating situation In the past week?”
• Group discussion/sharing
• Edu information
•  1:1 sharing
•  Mini experience

Setting tone provides an opportunity to have the client become present for the session, and allows them to recognize that this is a safe place, with no judgement.

it helps direct them towards a specific outcome

This includes: facilitator’s tone of voice, lighting, and grabbing the group’s attention.

17. Explain how closure is facilitated and why it is facilitated this way. JN

At the end in a circle, EVERYONE SHARES a thought, word, or sentence of what they took from the facilitation.

After diving deep into someone's heart and thoughts it is important to have everyone speak so that they are not left vulnerable and they are able to  have a concrete ending.

18. Recognize the purpose, definition, concept, and major components of a protocol.

Protocol (course reader and lecture).

1 logistics: to ensure that you have taken care of the “business” in order to move on

• Learning objectives
• Safety/ rules
• Review agenda and intended outcomes

2 Setting the Tone:”orienting” the clients or intended purpose of session and challenge by choice.

• o   Ask relevant question that involves them thinking about a personal way that the topic related to their lives.
• Ex: “who had a frustrating situation In the past week?”
• Group discussion/sharing
• Edu information
•  1:1 sharing
•  Mini experience

3 Directed Education: teach the concept of the learning objectives/ treatment goals

•  Activities

4 De-Briefing/ Processing: processing and intermixed with learning

•  What did you learn?

5 Closure: Review major lessons

•  Re-cap
•  Lesson?
•  Thank them
•  Next session we will…..

19. Be able to discuss how you grew as a professional facilitator during the course of having to facilitate 3 times, in 3 very different ways.  Be prepared with specific learning points.  Be able to share how do you want to improve?  Be able to share how you grew as a person/healed.

20. What does your favorite treatment type and favorite type of client?

21.Read the posted reading “Behavioral Health Chapter” and be able to:

• Recognize various mental health disorders.

Schizophrenia and Spectrum Disorders-

Schizophrenia: Delusions, hallucinations, disorganized thoughts, speech, disorganized or abnormal motor behavior (atypical).

Delusions: Beliefs that are relatively fixed and unchanging even in the face of evidence to contrary that they are incorrect.

Examples:

Persecution-belief you are being surveyed

Reference-A specific song or book has reference to you

Grandiosity-belief you have special abilities.

Somatic-belief you are missing internal organs

Religious-belief you are Jesus

Hallucinations: Perceptual experiences that occur in absence of external stimuli.

Many exist in any sensory form: Auditory most common.

Hallucinations/ Delusions together: Hearing voices outside your home that people are plotting to kidnap you.

Mood & Affective Disorders:

Major Depressive Disorder: Symptoms of depressed mood, diminished interest in previously satisfying activities, significant change in weight, sleep disturbance, change in activity level, fatigue, feeling of worthlessness, diminished ability to concentrate, and recurrent thoughts of suicide.

Bipolar Disorder: Depression/Mania

Mania: Energy/activity enhanced feeling of well being followed by rapid speech, racing thoughts, motor agitation, engagement in activities with potentially negative outcomes like buying sprees, risky sexual behavior, and/or risky financial resources.

May have to be hospitalized, effects verbal, episodic, working memory, executive function but not as bad as schizophrenia.

Anxiety, Stress, and Trauma Disorders: Characterized by : Fear and anxiety associated with a situation that is not currently dangerous.

• Fear: Emotional response to real/imagined present threat.
• Anxiety: Real/imagined threat to future.

-Obsession compulsion

-Anxiety/panic disorders

-Disorders with obsessive thoughts and compulsive acts

Behavior Disorders:

• Eating disorders (RT’s see eating disorders most)
• Sleeping disorders
• Sexual dysfunction

Binge eating: body shape/weight

Less common: anorexia nervosa

Personality Disorders: Patterns of experience and behavior that are markedly different from one’s culture or situation.

-Disruptive to social relationships

6 Domains:

1. Anti-social: egocentric/callous disregard to others
2. Avoidant: Anxiety/inferiority
3. Borderline: Impulsive, risky, self destructive
4. Narcissistic: grandiose attention/approval seeking
5. Obsessive Compulsive: Rigid/ perfectionist
6. Schizotypal: Withdrawn from, diminishing capacity

• Where are the majority of mental health services provided?

I believe the answer to this one is outpatient care because in the article is says 48% of clients get their treatment in these settings which was the largest percentage listed.

• Write your own RT intervention idea for the patient in the case study found on page 79.

MS

old woman

obese

bipolar

thinks she has a close relationship with her daughter

RT:

get more physically active and do things for longer. (did activity for 5 mins and got bored)

volunteers at group home that gives her a lot of joy.

yoga.

• Identify the importance of the Affordable Care Act.

‘Obamacare’- Provides provisions, improves, and expands health care for people with mental illnesses and behavioral issues.

-Expands medicaid coverage

-Subsidies and mandates health care coverage

-Prohibits denial of coverage due to pre-existing conditions

Affordable healthcare is the primary coverage for people with mental disabilities. It also reduces fragmented services and could change behavioral health and support services.

Which means more Recreational Therapists and evidence based practices.

EXTRA CREDIT:

1. Identify the most commonly used facilitation techniques (top 3) in the nation according to the ATRA Annual publication article found in the course reader (Kinney et al., 1999).

(Tentative -- not sure as of yet)

Community reintegration

Problem solving

Self-esteem exercises

2. Identify 2 learning outcomes you learned from the BATRA/SJSU Spring Practicum Fling.

BATRA = Suzy’s book: Transformation toward wholeness; Norma Stumbo: Evidence based practice; Licensure

17.   Be able to discuss how you grew as a professional facilitator during the course of having to facilitate 3 times, in 3 very different ways.  Be prepared with specific learning points.  Be able to share how do you want to improve?  Be able to share how you grew as a person/healed.

18.   What does your ideal facilitation group and clientele experience look like?

• Skilled Facilitators are conference and frame the experience for the clients.
• Facilitators also allow maximum participation by clients
• All clients get a chance to talk and share their feelings and interpretation of their experience

19.  Be able to discuss the significance and importance of setting the tone (an integral component to your written requirements and the facilitation.

setting tone provides an opportunity to have the client become present for the session, and allows them to recognize that this is a safe place, with no judgement.

it helps direct them towards a specific outcome.

(Suzy told us to study these notes for the exam)

Continuation------------------------------------->Empathy

Disconnected: Ex: Sociopath diagnosis

• Person could be mass murderer
• Complete disconnection from everyone and everything
• No longer human

Apathy: Starting to care but subversive anger, disconnected from self and others.

• Just don’t care
• Way down inside anger

EX: Giving up on politics

Disdain/Hatred: Anger emerges and triggered.  Disconnected from self.

• Has not given up: anger is coming up

Pity: Feeling sorry for the others which is a sign you are starting to open your heart when in reality you are dehumanizing and objectifying others.

• This avoidance helps you stay on your own.  Terror at bay by pitying other-you keep in actuality completely terrified that ‘this could be me’ and thus you pity them. Still disconnected from yourself and the other.

Caring: Feeling the plight of the other, but disregard the self to the degree that you are giving your heart away!

• The shadow of caring is that you have attachment to overcome.

• You are invested in how things turn out.
• You find yourself complaining about something you actually care about that circumstance because you are investing your life force energy into that circumstance.

` -Ask yourself ‘why do I care about this?’ The answer is always on some level, because you invested in the outcome…….