Sean Woodland,Maya Inoue, and Dr. Gary Burlingame, Psychology
The Recreation Therapy Program at the Utah State Hospital (USH) remains one of the least-noticed disciplines that the hospital has to offer. The program has the goal of improving the overall quality of life of the patient, focusing on the areas of community integration, skill development, and lifelong leisure. An important part of being able to accomplish these goals is via off-campus activities, ranging from camping and sporting events to visiting theaters and museums. However, in recent years the program has felt pressure from state legislatures and hospital administration to limit these off-campus interventions, mainly due to budget concerns, which were spurred on by the notion that the activities were recreational, but not therapeutic. Despite these challenges, the USH executive staff has been willing to allocate more funding to the program on the grounds of producing data that suggest the efficacy of off-campus activities.
For our project we set out to find such data. Through a rigorous literature review, we found that there were virtually no existing articles that dealt with recreation therapy for the severely and persistently mentally ill (SPMI) population, which meant that we had no model from which to base our study. We decided, then, to use a variety of measures over a variety of constructs to explore what “therapy” actually looked like for the patients when they embarked on different activities. The patients were ultimately assessed across levels of perceived freedom in leisure, self-efficacy, and proactive coping, and were monitored for psychiatric symptoms. We performed these assessments before and after scheduled treatment; this treatment was a 12-week long program consisting of various off-campus recreational activities. Participants for the study were chosen specifically by the recreation therapists as individuals who might benefit the most from recreational services; as such, we worked with a convenience sample.
In order to better control for any change that might occur during the program, participants were given grades by their therapists. These grades were based on level of engagement and participation, as well as learning and satisfaction within the course of the activity. The therapists reported these grades to the investigators, who then tabulated an average grade, or “GPA.”
Upon data analysis, the respective patients’ GPAs were compared statistically to their change scores on measures of proactive coping and change motivation. Spearman’s Rho was employed, which is a simple rank-order correlation. Simply put, we compared the patients’ ranks on change scores to their ranks in GPA. If the off-campus activities were truly therapeutic, then those who ranked higher in psychological assessments should have been esteemed higher by recreation therapists. In the end, a modest correlation was found.
The study as a whole can be considered an initial step toward creating a culture of research driving practice for USH’s Recreation Therapy Program. This was quite possibly the greater result from the study, as the quantitative results were left wanting. The exploratory research study lacked many of the controls that sophisticated research often enjoys, including a control group, reliable baseline data, and a full battery of assessments that were recently nationally standardized. Moreover, the study did not control for maturation, testing, and history effects, which could have influenced the statistical results in either way. Further study on the matter is warranted, specifically research from students with greater experience, or students who know more about what really is going on therapeutically speaking. This will happen as both recreation therapists and future researchers become clearer on the theoretical framework that holds together recreation therapy as discipline.
Overall, the experience gave both of us a peek at psychology as a career. We saw how professionals in the field interacted, and how they went about exacting treatments. We saw that therapy doesn’t always equate to what one reads in a text book, that reality often steps in the way of pure research and practice. However, we also noted that with the opportunity we received from ORCA, we were able to make a difference with a concerted effort. The ORCA grants received for this project helped everyone around the project get serious about research, and we are confident that with more support from BYU, the Recreation Therapy Program at the Utah State Hospital will shift to a focus on evidence as a driving force.