Therapeutic Recreation Research Articles

A Logotherapy Meaning-Centered Approach to Therapeutic Recreation Rooted in Centripetal Leisure

This paper describes a logotherapy meaning-centered therapeutic recreation model based on Viktor Frankl’s will to meaning theory and his centrifugal and centrip-etal leisure dichotomy.This manuscript introduces a therapeutic recreation meaning-centered intervention grounded in existentialism and logotherapy, with its focus on human suffering-meaning potentials and self-transcendence. Therapeutic recreation application begins with an assessment focused on understanding the client’s values and meaning potentials then links leisure as a way to discover or experience meaning. Primary intervention strategies are search for meaning and Socratic and ma-ieutic dialog linked to leisure interest finders to help cli-ents experience centripetal leisure. The paper presents an intervention applying these strategies. A concluding sec-tion offers recommendations for education and research.

A Need for Increased Awareness of Disability Models in Recreational Therapy Practice

Inherently embedded within the descriptions, models, and practices of the field of therapeutic recreation, dis-ability models conceptualize disability, guide therapeu-tic processes and service delivery, and influence client experiences and outcomes. Despite their significance, disability models have received limited attention by the field resulting in inconsistencies within the philosophi-cal underpinnings of the recreational therapy profession. The purpose of this article is to increase awareness of disability models and their implications for recreational therapy practice. A brief conceptual overview of three disability models, including the medical, social, and In-ternational Classification of Functioning, Disability, and Health (ICF) models, is provided, and the models’ cur-rent applications in the field of therapeutic recreation are explored. Utilizing a disability studies lens, a critique of the relationships between each disability model and the core concepts of recreational therapy practice is pre-sented. Commentary is provided to stimulate discussion regarding the need for philosophical consistency of dis-ability values across the profession.

The Role of Extraversion in the Effectiveness of Leisure Coping on Depressive Symptoms

Research suggests that leisure is as an effective coping strategy for depression. The foundational theory of lei-sure coping assumes that leisure coping can be benefi-cial in three ways: mood enhancement, diversion, and companionship. While theorists asserted that the above three strategies are universal, research suggests that the personality trait of extraversion is associated with leisure behavior and may affect the effectiveness of leisure cop-ing strategies. The current study aimed to examine the role of extraversion in the relationship between leisure coping and depressive symptoms. A total of 155 adults with depression (59 males and 96 females) were recruit-ed from four different depression-related venues and responded to an online survey. The results of multiple regression analyses found that extraversion did not affect the relationship of leisure palliative coping and mood en-hancement; however, it significantly moderated the rela-tionship between leisure companionship and depressive symptoms. While a significant negative association be-tween leisure companionship and depressive symptoms was found among extroverts, no significant relationship was observed among introverts. The results suggest that the personality trait of extraversion matters to leisure coping and should be considered to better facilitate rec-reational therapy interventions.

Community reinforcement approach (CRA) supported with structured recreation therapy: Experiences of people living with HIV in a pilot substance use treatment program at a specialty hospital

IntroductionCommunity reinforcement approach (CRA) is a behavioral intervention that has demonstrated favorable treatment outcomes for individuals with substance use disorders across studies. CRA focuses on abstinence; however, abstinence is not a desired goal among all people who use substances. Previous research has called for harm reduction–oriented treatment programs, especially within hospital settings. We examined the feasibility of a pilot CRA program, “Exploring My Substance Use” (EMSU), that integrates a harm-reduction perspective with structured recreation therapy at a specialty HIV hospital in Toronto, Canada. MethodsThe 12-week EMSU program was delivered alongside a feasibility study that ran for 24 weeks (including an additional 12 weeks after program completion). We recruited hospital in/outpatients with moderate to severe substance use disorder to participate in the program and study. The EMSU program combined weekly substance use groups with weekly recreation therapy sessions. We collected data at five timepoints throughout the study; this article focuses on qualitative data from the final (24-week) interviews, which examine participants' experiences of the program—an under-researched element in CRA literature. We conducted thematic analysis in NVivo12 and descriptive statistics in SPSSv28. ResultsOf the n = 12 participants enrolled in the EMSU program, six completed the 12-week intervention. All participants completed the 24-week study interview. The average age of participants was 41.5 years; eight identified as cis-male; most identified as white, experienced food insecurity, and were unstably housed. All participants valued the program, including opportunities to learn new skills and examine function(s) of their substance use, and would enroll if it were offered again. Participants discussed the benefits of leisure activities introduced through recreation therapy, which fostered social connections and provided inspiration/confidence to try new activities. Participants cited a lack of support for those experiencing health/personal challenges and overly strict program attendance rules. To improve the program, participants suggested more tactile activities and incorporating incentives. ConclusionsOur findings support the feasibility of a CRA-based program with an integrated harm reduction and a recreation therapy component within an outpatient setting. Future programs should consider building in more flexibility and increased supports for clients dealing with complexities as well as consider COVID-19 related contingencies.

Supporting resident engagement via web-based assessment system: experience of activity professionals from long-term care settings

ABSTRACT Loneliness, depression, and social isolation are observed among residents in long-term care settings. Activity professionals can help prevent this by encouraging residents and providing them with opportunities to be more active during daily life. Questionnaires measuring the extent to which activity professionals design and implement activities among residents are lacking. In addition, there are no measurement instruments to gain insight into activity professionals work performance. A web-based assessment system, ‘Elder Engagement Performance Improvement (EEPI),’ has the potential to help activity professionals support resident engagement. This study explored long-term care activity professionals’ experiences in using the EEPI assessment.Semi-structured interviews with 23 long-term care activity professionals (e.g. certified activities directors, therapeutic recreation specialists, life enrichment directors, and life engagement directors) were conducted and analyzed using qualitative content analysis.Activity professionals` experiences showed the EEPI was a means of improving the performance of activity professionals by increasing residents’ engagement both in quality and quantity. Four main themes emerged from this explorative investigation: (a) Lack of assessment tools, (b) Acceptance of the web-based assessment system, (c) Barriers to using the EEPI (time, staffing issues, and lack of management support), and (d) Areas for job improvement (person-centered activities and engagement).The EEPI may serve as a valuable tool in long-term care settings for activity professionals. The web-based assessment system, EEPI, facilitated activity professionals’ daily work and involved the residents’ interests in their activities, which may enhance resident engagement and reduce the risk of social isolation in long-term care facilities.

DEVELOPMENT AND TESTING AN INTERPROFESSIONAL PLIÉ TRAINING PROGRAM FOR VA NURSING HOME STAFF

Abstract In this study, we collected formative data from key stakeholders (nursing home staff and leadership, dementia care experts), developed, pilot tested, and refined a 10-week remote training program at 2 VA nursing homes with 15 interprofessional staff (e.g., recreation therapists, social workers, registered nurses). Training components included weekly livestreaming didactic sessions for staff that demonstrated PLIÉ guiding principles and themes. Weekly experiential sessions, facilitated by the lead PLIÉ instructor, included staff and residents with dementia participating together online. All training sessions were video recorded and available for review along with a training manual. Staff completed weekly surveys, post-training focus groups, and expressed high confidence using 6 of 8 PLIÉ principles; 100% rated their overall training satisfaction as “very good” or “excellent.” The remote PLIÉ training was an efficient model for staff training that leveraged interprofessional knowledge and skills. This presentation includes an experiential demonstration of PLIÉ in action.

IMPLEMENTATION BARRIERS AND FACILITATORS OF COGNITIVE STIMULATION THERAPY ACROSS CARE SETTINGS

Abstract Cognitive Stimulation Therapy (CST) is an evidence-based treatment for people living with dementia that is not in widespread use in the United States. To better understand barriers and facilitators to implementation of CST, we conducted virtual focus groups of newly trained facilitators of Cognitive Stimulation Therapy (CST). Of 12 facilitators trained, representing two settings of care (The Program for All-inclusive Care of the Elderly and a Continuing Care Retirement Community), 4 facilitators, representing Social Work n = 2, Speech Therapy n = 1, and Recreation Therapy n = 1, participated. We analyzed interview transcriptions using framework analysis guided by constructs from the Consolidated Framework for Implementation Research (CFIR). Themes that emerged across constructs were 1) balancing competing personal, stakeholder, and organizational needs; 2) lack of mastery experiences and the need for opportunities for more practice, reflection, and feedback from trainers; 3) building a community of facilitators to provide peer support; 4) logistical concerns; and 5) identifying appropriate participants who would most benefit from CST. The barriers to implementation imposed by the ongoing COVID-19 pandemic were also a cross-cutting theme. Many of these barriers are readily managed, and professionals who implement CST in their sites should be aware of and take into consideration these barriers and facilitators.

SUPPORTING RESIDENT ENGAGEMENT VIA WEB-BASED ASSESSMENT: EXPERIENCE OF ACTIVITY PROFESSIONALS IN LONG-TERM CARE

Abstract Background Resident engagement and activities have positive relationships with emotional wellbeing and physical health. However, regularly offered activities may not be suitable for all individuals and may be unsustainable when there are changes in residents’ health. Loneliness, depression, and social isolation are observed among residents in long-term care facilities. A web-based assessment system, “Elder Engagement Performance Improvement (EEPI),” has the potential to support resident engagement. Activity professionals are crucial in utilizing EEPI and engaging residents in meaningful activities, especially regarding their role in helping enhance resident engagement and wellbeing. This study aims explores activity professionals’ experiences in implementing the EEPI assessment. Method: Semi-structured interviews with 23 long-term care activity professionals (e.g., certified activities professionals, therapeutic recreation specialists, and activity assistants) were conducted and analyzed using qualitative content analysis. Results Activity professionals` experiences showed the EEPI was a means in improving residents’ engagement quality and making engagement a more targeted outcome. Four main themes emerged: (a) Lack of assessment tools, (b) Acceptance of a web-based assessment system, (c) Barriers to using the EEPI (time arrangements, staffing issues, and being on the same page), and (d) Areas for job improvement (person-center care and measurable practices). Conclusions The EEPI may serve as a valuable tool in long-term care facilities. The web-based assessment system facilitated activity professionals' daily work and involved the residents' input in their care, which may enhance resident engagement and reduce the risk of social isolation in long-term care facilities.

Effects of recreational therapy on emotional adjustment of students with intellectual disabilities

Emotional adjustment behaviours of individuals with mild intellectual disabilities were not adequately measured after a therapeutic recreation intervention. This qualitative experimental research aimed to determine the effect of a recreational therapy programme on the emotional adjustment of individuals with intellectual disabilities at Meram Melike Hatun Special Education Vocational School in Konya, Turkey between March 2019 and May 2019. Thirty-four parents of students with intellectual disabilities were recruited. The participating parents were allocated to an experimental group (n=17) or a control group (n=17). Demographic characteristics of the participants were collected with a personal information form developed based on relevant literature. The Hacettepe Emotional Adjustment Scale (HEAS) was used to collect emotional adjustment data. A pretest–post-test experimental design was used. Therapeutic recreation was applied in 16 sessions as 2 sessions per week, presented by the researchers and each lasting about 1 hour. No significant difference was found between the post-test HEAS total and sub-dimension mean scores in the experimental and control groups (p>0.05). HEAS measurements in the experimental and control groups revealed no significant difference in total and sub-dimension scores (p>0.05). Our study suggests that implementing therapeutic recreation activities in 16 sessions is insufficient, with longer-term programmes required to solve problems of emotional adjustment.

Transdisciplinary Implementation of Heart Rate Monitors During Inpatient Rehabilitation

<h3>Research Objectives</h3> Clinical practice guidelines demonstrate clear benefits of cardiovascular intensity on movement recovery after a neurologic injury, particularly walking recovery. However, research shows a lack of sufficient intensity during inpatient rehabilitation for both physical and occupational therapy sessions. Knowledge translation efforts and implementation of wearable heart rate monitors have been shown to support increased intensity during physical therapy directed interventions. Through a year-long effort, we have investigated the feasibility of implementing transdisciplinary heart rate monitoring informed by the knowledge to action cycle. <h3>Design</h3> 1 year transdisciplinary feasibility study. <h3>Setting</h3> 114 bed inpatient rehabilitation hospital. <h3>Participants</h3> 16 clinicians (9 physical therapists, 6 occupational therapists, 1 recreational therapist). <h3>Interventions</h3> 1 year, 4 phase Multicomponent Knowledge Translation initiative using the Knowledge to Action Cycle Framework. <h3>Main Outcome Measures</h3> -Clinician Participation (session count). Clinician Satisfaction, Clinician Perceived Relevance (summative feedback questionnaire). <h3>Results</h3> This four phase study will end August 2022. The first 13-week phase included 6 therapists (4 PTs, 2 OTs) that engaged in 70 sessions with an average of 5.38 sessions/week. The second phase included 10 therapists (6 PTs, 4 OTs), engaging in 152 sessions, averaging 11.69 sessions/week. The third phase included 13 therapists (8 PTs, 5 OTs), engaging in 436 sessions, averaging 33 sessions/week. The final phase included 16 therapists (9 PTs, 6 OTs, 1 RT), engaging in 503 sessions, averaging 38 sessions/week. In the one year follow up survey responses, 81% of pilot group users reported high satisfaction with heart rate monitor use. Clinician perceived relevance of heart monitor use differed for persons with non-neurological and neurological diagnoses. <h3>Conclusions</h3> Current data suggests that implementation of wearable heart rate monitoring devices for a transdisciplinary inpatient rehab team is feasible and supported by a multicomponent knowledge to action framework. Majority of pilot group participants were very satisfied with participation in heart rate monitoring interventions and highest perceived clinical relevance was for patients with neurological injuries, consistent with clinical practice guideline recommendations. Future studies will expand implementation among onsite clinicians, further investigate barriers of use, and determine optimal interventions for promoting high intensity and specificity within each discipline. <h3>Author(s) Disclosures</h3> None.

Identification and Treatment of Agitation in Nursing Home Settings: Applying the IPA Algorithm

AbstractBackgroundWith an estimated prevalence of 55%, agitation is particularly common among nursing home residents. The recent International Psychogeriatric Association (IPA) agitation treatment algorithm describes steps for the identification and treatment of agitation across multiple care settings.MethodThis abstract describes the application of the IPA algorithm to the long‐term care (LTC) setting.ResultIn the IPA algorithm, nonpharmacologic care is considered first and continued for both treatment and prevention. In LTC residents, nonpharmacologic interventions are a key first step. For agitation in nursing home residents with dementia, the current evidence suggests that group activity based interventions (e.g., recreation therapy), resident interventions (e.g., massage and touch therapy, and music therapy) and multidisciplinary training and care (e.g., person‐centred care) are the most consistently effective nonpharmacologic treatments. There are several caveats that may impact efficacy of interventions. Feasibility and scalability considerations may impact implementation of nonpharmacologic interventions in long‐term care settings. Most interventions require training, implementation, or supervision by external specialized staff. Feasibility of interventions may also be limited by the capabilities of individuals with dementia; sensory impairments and physical disabilities may preclude some residents from participating in interventions such as music therapy or exercise. As such, interventions must be personalized. Data also show that nonpharmacologic interventions that modify the environment or stimulate the senses may be effective for different aspects of agitation in LTC residents with dementia. Pharmacologic care is personalized and guided by the major features of the agitation including when it occurs, severity and whether it represents a danger to self or others. Importantly, recent efforts have evaluated multi‐modal interventions in LTC. Taken in toto, literature to date provides evidence for use of the above mentioned nonpharmacological interventions for mild agitation in long‐term care facilities. Implementing these interventions requires assessment of medical and environmental causes for agitation, ongoing nonpharmacologic intervention and then pharmacologic interventions as necessary.ConclusionFuture studies should continue to investigate the long‐term effects of multi‐modal nonpharmacological interventions, alone and in combination with pharmacologic interventions in participants with severe agitation.

Action For Cultural Transformation (ACT)

<h3>Research Objectives</h3> To create a cultural of diversity and inclusion within our organization, through addressing racism, biases, inequalities, and social injustices. To identify and eliminate health disparities amongst the patients we serve throughout our organization. <h3>Design</h3> Focus Group Sessions held over three months. <h3>Setting</h3> Single, urban, adult-inpatient post-acute rehabilitation center located in Philadelphia, PA. <h3>Participants</h3> 205 employees participated in the focus groups (Registered Nurses, Certified Nursing Assistants, Occupational, Physical, Recreational, and Respiratory Therapy). There were two sessions with the leadership group as well. <h3>Interventions</h3> The interventions included work to create a culture of diversity, inclusion, and address inequalities. The themes from the ACT focus groups guided the development of 3 taskforce: General Taskforce that initiated the "Just-Do-Its" Health Equity Taskforce Safe Workplace Taskforce. <h3>Main Outcome Measures</h3> 29 ACT Focus Group Sessions were completed. 205 employees shared their experiences with racism Additionally, employees have given us feedback on what our organization does well and our opportunities for improvement. <h3>Results</h3> 29 ACT Focus Group Sessions were completed 205 employees sharing their experiences with racism Additionally, employees have given us feedback on what our organization does well and our opportunities for improvement. <h3>Conclusions</h3> The ACT focus groups served as a listening platform for employees to share their stories and express their feelings and concerns related to racism, biases, inequalities, and social injustices. Employees were also able to help our organization identify areas of opportunity and give ideas to ensure diversity, inclusion, and health equity for staff and the patients we serve. <h3>Author(s) Disclosures</h3> None.

Clinician perspectives on the implementation of inpatient cycling-based exergames for children with cerebral palsy: A qualitative study

ABSTRACT Objective To understand the perspectives of key stakeholder clinicians in implementing inpatient cycling-based exergames for children with cerebral palsy (CP) into pediatric rehabilitation. Methods Sixteen clinicians (nurses, physiotherapists, recreational therapists) that participated in a study exploring the feasibility of implementing cycling-based exergames for inpatient children with CP were interviewed. Clinicians’ responses were coded using the Theoretical Domains Framework (TDF). Beliefs were generated from each response and relevant domains were identified. Results Ten domains from the TDF were identified as relevant. Key enablers to clinician participation in future implementation included revision of clinician roles and responsibilities, the belief that children with CP will benefit from exergames, and the belief in potential applicability to other pediatric populations. Barriers included clinician limited time and exergame responsibilities not aligning with perceived clinician roles. Conclusions This study identifies key barriers and enablers that future inpatient pediatric rehabilitation settings should consider when incorporating exergames into rehabilitation practice.

Use of person-centered goals to direct interdisciplinary care for military service members and Veterans with chronic mTBI and co-occurring psychological conditions.

To explore the use of person-centered goals (PCGs) to direct interdisciplinary care to support PCG attainment in military service members and Veterans (SM/Vs) with chronic mild traumatic brain injury (mTBI) and co-occurring psychological conditions. A retrospective chart review was completed for 146 United States military SM/Vs reporting chronic symptoms following mTBI and co-occurring psychological conditions who received care in the SHARE Military Initiative intensive outpatient program, a donor-funded program administered by a not-for-profit hospital, between April 1, 2015 and March 31, 2019. PCGs were used to direct care consisting of individual and group-based interventions and therapies delivered by an interdisciplinary, co-located team including behavioral health, case management, neurology or physiatry, nursing, occupational therapy, physical therapy, recreation therapy, speech-language pathology, and transition support. The primary outcome measure was PCG attainment measured via goal attainment scaling. Increased PCG attainment was demonstrated at program discharge and throughout the first year following program discharge. Predictors of goal attainment at discharge included longer participation in treatment, greater reduction in depressive symptoms and greater improvement in adjustment at discharge, male gender, and higher cognitive and physical abilities on admission. This sample of military SM/Vs with mTBI and co-occurring psychological conditions who received intensive, interdisciplinary, PCG directed care demonstrated increased PCG attainment at program discharge which further increased with transition support over the year post-discharge. Results suggest PGC goal directed care is a feasible, promising methodology of individualizing treatment in this population. This exploratory study lays a foundation for future prospective, controlled, comparative effectiveness research that will further understanding of the effectiveness of intensive, interdisciplinary, PCG directed care.

The impact of therapeutic recreation camps in the United Kingdom on the wellbeing of youth with serious illness and disability: A qualitative investigation

PurposeTherapeutic recreation (TR) summer camps can provide psychosocial benefits for children and young people (CYP) with chronic illness. At present however, there is a lack of recent research in the UK investigating the impacts of such camps. This study aimed to investigate experiences of a TR summer camp in the UK for CYP with chronic illnesses or disabilities. Specifically, it aimed to assess both children's and parents' perceptions of camp, to understand the impact on CYP's psychological wellbeing, social functioning and self-esteem; and the experiences of attending a camp specifically for CYP with health challenges. Design and methodsSemi-structured interviews were conducted (N = 21; 11 parents, 10 children). Data were analysed thematically. ResultsAnalysis produced themes in three broad domains: experiences of social marginalisation and emotional problems outside camp; experiences of camp; and impacts of camp. Impacts included improved self-confidence; gain in self-worth and positive self-identity; changing attitude towards their health condition; and development of social skills and independence. One of the most commonly reported themes was the value of friendships formed and maintained at camp. Parents and CYP reported predominantly positive experiences of camps, feelings of happiness, inclusivity and enablement, and a strong sense of empowerment in contrast to their usual feelings of being marginalised or different. ConclusionsThis study provides rich insights into the experiences and impact of TR camps for CYP with chronic illness. Practice implicationsFindings can help practitioners and commissioners make informed recommendations to families regarding the potential benefits of camp.

Recreational Therapy Modalities for Treating Survivors of Intimate Partner Violence: A Scoping Review

The purpose of this scoping review was to examine the extant research on modalities that fall within the recreational therapy scope of practice. A systematic search of the literature was conducted following the PRISMA-ScR guidelines for scoping reviews. The original database search yielded 706 studies (with duplicates removed) and 22 studies were included in the final review. The scoping review included peer-reviewed intervention studies for survivors of intimate partner violence (IPV), with the purpose of addressing the following research questions: RQ1: What recreational therapy modalities have been used and researched for treating survivors of IPV? RQ2: What are the primary health outcomes measured for of recreational therapy modalities for survivors of IPV? RQ3: What are the biggest gaps within the research? Types of modalities used included mind-body interventions, creative expression, and physically active leisure. Outcomes measured were primarily depression, anxiety, and post-traumatic stress disorder symptoms. Future research directions include the need for interventions to be evaluated when run specifically in the recreational therapy context, the need for evaluation of current practices with intimate partner violence and trauma-informed care, and the need for more diverse sampling to establish culturally affirming interventions for people who identify as LGBTQIA+ or racial/ethnic minorities.

Exploring the Effects of Swimming on Sleep Behaviors of Children with Autism Spectrum Disorder Using Single-Subject Design

Evidence suggests physical activity (PA) improves sleep of typical children but benefits for children with autism spectrum disorders (ASD) are not established. We examined the effects of PA, particularly swimming, on the sleep behaviors of three children with ASD using objective and parent-report measures. Children participated in eight weeks of a specialized swim program. Parents completed sleep and behavior measures at the beginning and end of the eight-week program. Parents also completed a sleep log for one week while their child slept on a sleep sensor. Results showed variable response to the Sensory Enhanced Aquatics intervention. One child’s sleep and behavior were stable and/or improved, one child’s outcomes were variable, and one child’s sleep worsened. The sleep sensor revealed children fell asleep more quickly after swimming, but increased times out of bed for one child. Recreational therapists should use caution when recommending physical activity to improve sleep with this population and carefully monitor outcomes.

Factors Affecting CTRSs' Motivation to Join Professional Organizations in Recreational Therapy

A strong professional organization has been associated with credibility and vitality of a profession. The field of recreational therapy (RT), however, has historically demonstrated poor membership on both national and state/regional levels. The purpose of this study was to examine what CTRSs identify as benefits as well as real/perceived barriers to membership in professional RT organizations and examine the relationship between membership status and professional commitment. A 43-item Qualtrics electronic questionnaire addressing benefits and barriers of membership, professional commitment, and demographics was sent to active CTRSs. Statistical analysis found that just over half of the 2003 respondents were members of either national and/or state/regional organizations. Differences existed regarding benefits of membership where members perceived more professional benefits and non-members perceived more personal benefits. Barriers were primarily financial and “cost-benefit” concerns. In addition, professional commitment was higher among members. Many recommendations exist for practice, education, and research.

Using Multisensory Interventions to Address Anxiety, Agitation, and Pain in Adults Receiving Treatment for a Substance Use Disorder

This study examined the impact of activity-based multisensory-interventions (MSI) provided in a multisensory environment (MSE) on anxiety, agitation, and pain in adults receiving residential treatment for substance use disorder (SUD). Participants (N = 35) were randomly assigned to two groups and all received four, 30- to 45-minute individualized recreational therapy (RT) sessions over the course of two weeks during their residential stay. The experimental group participated in MSI in a MSE. A comparison group participated in RT sessions using table games (TG). Targeted outcomes were assessed using standardized, self-report measures and physiological data. Pre-and post- session assessments revealed significant reduction in anxiety, agitation, and pain, for individuals in both groups. Between groups comparisons documented a significant main effect for treatment (MSI, TG) on anxiety (p &lt;.001), agitation (p = .03), and pain (p = .05) measures with significantly greater symptom reduction for the MSI group. Individuals receiving MSI also presented with significantly reduced respiration rate following the intervention (p &lt;.01). Heart rate changes were non-significant for both groups. A participant survey at the conclusion of sessions yielded feedback that all individuals who received the MSI (n = 18) reported these sessions were a valuable addition to their SUD treatment.

The Potential Use of HeartMath®’s emWave Technology to Establish Evidence-Based Therapeutic Recreation Practice to Produce Physiological and Psychological Outcomes: A Systematic Literature Review

With the capability of evidence-based therapeutic recreation interventions to produce meaningful emotional/behavioral and cognitive health outcomes, it would be valuable to establish use of HeartMath®’s emWave device as an evidence-based practice to potentially benefit individuals with various disabilities and/or diagnoses. This systematic literature review explores evidence-based practices in various fields that involve use of HeartMath®’s emWave device with individuals with and without disabilities or diagnosed health-related issues to produce and measure psychological and/or physiological change. Twenty-one databases were searched in October 2020, and 13 articles were selected for final review. Specific topics were revealed: use of HeartMath®’s emWave device, suitability and accessibility, need for standardized treatment approach, and need for formal evaluation of participant experiences. Results revealed a variety of implications and future recommendations that support future research to test the use of HeartMath®’s emWave device with individuals with various disabilities and/or diagnoses and establish evidence-based therapeutic recreation practice.