Recreation Therapy and Mental Health: Helping people help themselves

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Recreation and leisure may seem to describe time spent doing nothing of importance, but an allied health-care professional will quickly tell you that recreation and leisure are essential to good health – not just physical but mental health as well. Shirley Tremblay, Manager of the Psychiatric Inpatient Unit at Joseph Brant Memorial Hospital, agrees with that and has worked to expand the involvement of recreation therapy in the mental health program at the hospital.

The integration of recreation therapists to the multi-disciplinary team which includes a psychiatrist, social workers, and nurses reflects emerging best practice recognizing evidence-based reporting on the benefits of exercise and stress reduction techniques to patients’ overall health and well-being.

“I want to ensure that patients realize that achieving and maintaining good mental health is about more than medication and electroconvulsive therapy (ECT),” Shirley says. ECT is a form of therapy that may be used in the treatment of depression. She emphasizes that while these therapies are critically important, clinical components in patient care, sustained recovery and wellness also require a commitment by patients to be active partners in their own wellness after they are released from hospital. But to do that they need help and that’s the role of the recreation therapist. Simply put, they help patients help themselves.

What is Therapeutic Recreation?

Derek Pickett, one of two full-time recreation therapists in the program, describes therapeutic recreation as “helping people with potentially limiting conditions to make the most of their lives – physically, mentally, and socially.”

Derek came to Joseph Brant from the Centre for Addiction and Mental Health in Toronto. “When I saw an opportunity to work in my home area and interact with a multi-disciplinary team, I jumped at it,” Derek says. He talks about the great advantages to having two full-time recreation therapists working separate shifts from 7:30 am to 9:30 pm. “This allows for evening programs and provides greater accessibility for family members which fits well with the hospital’s emphasis on patient and family-centred care,” he says.

Derek points out that many of the people he sees have time management problems. “They don’t know what to do with their time and consequently can make negative choices. We help them to explore healthier choices, improve their social skills, have positive experiences and regain confidence,” he says.

What’s involved in the program at Joseph Brant?

Each program is “custom designed” to meet individual needs. The therapeutic recreation specialist works with a team of professionals to: assess a patient’s abilities, interests, needs and desires; set both short-term and long-term goals based on assessment findings; design a plan; and evaluate progress through various evaluation tools.

Recreation programs implemented by the team include exercise groups such as yoga, and other physical activities such as active games, creative arts, woodworking and crafts. One very popular activity is a weekly trip to the Community Garden. This project was initiated to help patients develop new skills or reconnect to an old pastime. Many of the patients enjoy and benefit from spending a morning a week tending growing things while enjoying the fresh air and sunshine. This experience often evokes pleasant memories and peaceful feelings. Produce from this garden is sold and funds go into a “kitty” for patient recreation supplies. These activities help the patients learn to manage stress by engaging in activities that relax both the mind and body. These activities also help patients recognize the importance of physical activity and to experience its benefits.

What are some other goals of the program?

Feelings of loss – a loss of control over their lives and their actions – are common to people battling their way back from mental illness. Their mental illness may have distanced them from friends and family. They feel a loss of self-esteem and confidence.

Assisting patients to regain their emotional footing and to integrate into supportive networks is a very important component of the program. “We help people make connections,” said Christine Sherk. “Many people don’t know what supports are available to them in the community and we help them explore their options,” she says.

Christine is the other recreation therapist on this team. She transferred from therapy services where she worked mostly with a geriatric population. She welcomed the opportunity to expand her professional scope and experience. “I’ve learned so much from working in this program,” she said. Her enthusiasm and concern for those in her care shows. “I really enjoy my job. It gives me the opportunity to help people realize their full potential.”

What happens after patients are discharged?

Natalie Snyder, Manager of Mental Health Ambulatory/Outpatient Services, notes that recovery spans both the inpatient and outpatient experience. She praises the recreation therapy program for the foundation it lays. “The outpatient program also strives to strengthen patients’ social skills and help them develop recreation and vocational skills. We are supported and assisted in our efforts when this process begins with the inpatient program,” she says. She stresses that the emphasis on reconnecting with social skills and hobbies helps patients deal with some of the stress they experience. Natalie notes that activities in the recreation therapy program are informal in their structure, offering “natural” social scenarios, which can be experienced as much less threatening than more clinically oriented group therapy programs.

The therapeutic recreation program offered within the mental health program at Joseph Brant Memorial Hospital is an important component of quality patient care. Its comprehensive scope recognizes the individuality of patients – empowering them to become actively involved in their recovery by introducing them to many tools that can help them help themselves.