Therapeutic Recreation Talk Show Episode 6

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we're going on the air hello and welcome to the TR talk show I'm your host Hawk
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Robinson and joining us remotely over jitsi live we have Kyle down in San
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Diego right now right Sacramento sorry other end northern state sorry it was an essay part of the
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state I was a born in San Diego grew up in Santa Rosa and got friends in
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Sacramento so I'm originally from California actually but I'm here in Spokane Washington and you're over there
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and Kyle tell us a little bit about how you're related to therapeutic recreation
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how far into it are you just start that it's my second semester two semesters to
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go okay and last semester basically so
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you're doing the jumbled kind of generals and tr together kind of mixed
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right right yeah other schools what they do is you have to take all of your others your first two years you have to
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take everything except the TR stuff and then the last two years is all TR so it
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depends on the school I did so aw that's their standard policy is you did two years of your generals trying to figure
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out what you want to do etc even if it's your major you're trying all these things out getting all whatever it is you need to do and then the last two
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years is all TR but I came in knowing exactly what I wanted and I had a custom degree interdisciplinary so I also had
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research psychology neuroscience the little bit of neuroscience that they had back in 2004 and in other areas all
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worked into it so it's very custom degree so is all jumbled so I got to do TR per and we are a quarter system so we
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have to do Tia I had TR every quarter interspersed with all the other and such which was nice because it kept
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me doing the work right away from the beginning and they have a very hands-on program in addition the classrooms you
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do you work a lot with actual populations both at the University and through all the other work that you do
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so it was great to be able to hit the ground running with that experience and they won an award I think in oh 9 or
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somewhere around there Oh 2011 something that has best TR program in the country so that was that was pretty neat
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yeah and that was under John Cogley and now professor Emily Messina is running the program she's she's helped take a
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lot of cod Lee's great ideas and refine them and improve them and had a little more professionalism to them Cogley was
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was a wonderful creator of the program and later became a Dean and such but he's the first person to say he's very
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ADHD and kind of all over the place and emily has really brought in a whole
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other level to it and she's actually now over at RPG research he's actually on our board now on our board of directors
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and she's been a wonderful help so when we were doing our board meeting yesterday she was able to attend and
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that was great to have her feedback and guidance and we've seen I read her contact it's great talking to her she's very supportive of our programs so today
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we're gonna have a little bit of a review we covered BCI's brain computer interfaces in last week's episode and so
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we'll kind of review that because Kyle didn't get to catch that and I always want to try to cater to those who are
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actually interacting on the show whether you're joining us through jitsi or you're commenting in the youtube channel
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a Kyle can you mute your mic when you're not speaking please because a lot of background noise and so I want to be as
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responsive as possible to actually interacting audience members co-host and guests so if we need to rehash a topic
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that I covered earlier that's perfectly okay to your benefit usually there'll be different questions last time I didn't
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have anybody on the show so I was just going through my thing having somebody here to actually ask questions will help
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probably help shape it in different ways so we're gonna re re review brain
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computer interfaces a little bit then we'll talk about the BCI Game Jam and course how that ties in with RT and TR
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and then we're going to talk about the issues with therapeutic recreation recreation therapy being recognized as a
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profession and I mean literally just being listed as a profession so for example the Better Business Bureau RPG
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therapeutics LLC was nominated selected and and accredited as an A+ Better
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Business Bureau business however there was no recreational therapy category in
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the Better Business Bureau database there was no way for me to list recreation therapy therapeutic recreation or any even close
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they have occupational therapy they have rekey therapy they have all kinds of
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others you know interesting therapies but not recreational therapy and so that
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was a little frustrating and so I did talked to the the client advisor person
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who handles my accounts and said I really need you guys to talk to take it up the chain and get your developers to
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add to the database recreational therapy or therapeutic recreation it this is ridiculous that's not listed
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what I really can't believe is it's 2019 and nobody had addressed this there must
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be other or maybe not it is RPG therapeutics the only BBB accredited
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recreation therapy business I haven't looked yet because it's a new category and take some searching but I don't know
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but nobody ever did anything about it and this keeps coming up yes so I've been involved with Rick therapy since 2004 and really passionate about what
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what the research shows the benefits are of recreation therapy and therapeutic recreation and I mean spreading the word
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but but but frustrated at how bad the marketing has been yet by us as a TR
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industry and occupational therapy is eating our lunch to be honest they really are they are out lobbying us as
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witnessed so here in Washington State nobody knew about it it got through nobody in the rec therapy side caught it
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till it's too late occupational therapy added recreation as part of their licensure and description
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here in Washington State which technically should have been stepping on the toes of the RET of the Washington
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state registration for rec therapy but since nobody protested it because we didn't have anybody watching for it now
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occupational therapy covers recreation and such and so we're seeing more facilities using OTS and said of our
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teas because of that and that's our fault for not being on top of I mean it's it's unfortunate the OT folks have
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decided they've been growing that sphere all along and the problem is they're not trained quite the same way in recreation
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as we are and and so I would argue that their efficacy on the recreation side
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both for individuals and groups at least at this point probably isn't as
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effective just because of the the energy and focus that we put in and the OTS they're kind of they're spreading
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themselves a little thinner and a little wider they're you know I want all of us working together as teams right it used
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to be especially prior to the ACA some pretty good cooperation between physical
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therapists recreational therapists occupational therapists and others there
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was a little bit of rivalry here and there sometimes but generally the idea was the good of the client let's work
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together as a team for the good of the client and the way the bill aiming was set up that wasn't a problem but then
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with the ACA the Affordable Care Act aka Obamacare that created a double-edged
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sword on the one hand they recognized recreational therapy for better coverage
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so that it became part of the list of alternative therapies that inpatient and
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Rehab patients are supposed to receive about three hours a day and recreation
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therapy is in that pool the downside is it then became a Scrabble to get that
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those billable hours is what I've seen happen at these facilities unfortunately it breaks my heart and this this
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happened I think it started seeing this around 2013 where you started seeing
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money grabs between the different departments and artis kind of lowest man
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on the totem pole they're not about what's best for the client but about
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getting as many billable hours as much as they could grab so by the time RT is supposed to be at the table the clients
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too tired or there's not enough hours left in the billable etc and the clients not getting the best care
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they should be getting and that's been an ongoing problem since that mandate with the ACA so you know unintended
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consequences the road is paved too you know I'm good from I'm totally conflating it
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the road to do you know where is paved with good intentions and these were some
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unintended consequences I'm sure so unfortunately we've seen increasing
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rivalry between these different departments to get those billable hours
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etc and that's saddening but also worse yet is we haven't done a good job of marketing and getting recognition as a
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business as a profession we're accredited there many you know many many
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thousands of rec therapists there are facilities with them etc but it's not really being recognized as a business
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and that's illustrated by the Better Business Bureau so the good news is they they thought it might take a few months
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but in explaining everything to them and because I also have a tech background and I was able to explain hey all you
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need to do is insert this here in the database within a week the Better Business Bureau added recreational
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therapy as a listing so if you take a look at the TR talk show com website and
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you click on episode 6 you will see a screen shot where now there is listed
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recreational therapy as one of the business primary business categories or secondary but I for us its primary it's
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now listed and that did not exist before so yeah a small victory now I've been
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trying to do this with Google business for over five years and they have not
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gotten anywhere yet and I've been on there for a-- i've tried to get through on the phone systems i tried again last
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week they keep redirecting me to a suggestion box if you will and the way
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that's going to work is if more people do that then maybe they'll start to listen the problem is they claim over
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the last five years i'm the only person who's been asking for recreational therapy to be added as a business
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category so if you have a business and you want to be listed on in web search
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results as a as a legitimate business recognized so let's say you go to Google right now and you type in RPG therapeutics LLC
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three words sort of you will find on the right-hand side of Google if you don't have ad blocking on such a photo of our
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location info about our business etc so I'll demonstrate that here on the screen
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here so go to google usually I don't use Google directly but you get the idea can we go to RPG therapeutics LLC and you'll
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see if I expand this out there's our business so that is because
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I have a Google business listing it lists location hours phone number website book an appointment reviews etc
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this is becoming increasingly important people are you know less and less using yellow pages etc and just relying on
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Google web searches so this helps and
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hurts a business right now we're number one in the search for that obviously you know now if you do for example like RPG
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therapy let's see if we're still RP okay so we have lost our number one slot to
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geek & sundry recently that's unfortunate we've been number one for years and years and years but we haven't
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been updating our website very much things like that so it looks like and sundry just bumped us down a slot now
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we're number two and then RPG research is number three etc but we really need
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to and we're also in the Psychology Today listing we need to keep them our content more up to date on our site that
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helps your listings and such now if we did RPG research of course the the
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nonprofit organization and a founder of that should still be us number one yeah
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RPG research and there's the organization for that it's a non-profit 501 C 3 and we come up in multiple
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places and it's covered but you can see how that that would have an impact so if you're looking for let's say Spokane
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because that's where I'm based recreational therapy oops come on I
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haven't really searched let's see what that is so we have therapeutic recreation city of Spokane is number one
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there's they're listening that's a two person department
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Alice and case are the two folks there then we got glass door listings and deed
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listings Gonzaga wast row which is the the local Washington state therapy
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gregory association natural branch zip recruiter so get all these you know job placement things not seeing much in the
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way businesses we got a government agency and job placements and some
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schools but not businesses and part of the problem is if you are a business and
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you're using google business sites and you want to in google maps there is no category for recreational
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therapy and that profoundly impacts your google results which profoundly impacts
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people finding things so our company is recreational therapy we don't even show
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up we've had to pick a category of like consultant because there's nothing you know or generic therapy there's no way
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to list recreational therapy in google business and that's really really
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unfortunate if we go to psychology today i'm trying to remember what the categories were on that you know that's
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the right place to search for it I think it's under find a therapist actually but let's find out yeah so let's go - here
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we go find a therapist 9 9 to 1 okay so
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we got all these different therapists etc and we've got types of therapy let's
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go to more and so alphabetically it's going down the list we got a whole wide
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range but I don't know that
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yeah recreation therapy is not listed in
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there let me see if it shows up in search results by a broader keyword yeah
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so even recreation see therapeutic recreation all right this is Psychology
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Today and this is a problem now the government
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agencies recognize us as a business or as an as a profession and if you look at
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the Bureau of Labor Statistics and you look at your local State thing you'll find recreational therapy or therapeutic recreation specialist etc but that's not
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where most people go right they go to Google they might go to psychology they I get a lot of referrals from psychology today but they're mostly people looking
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for diagnoses etc and so that you know I end up having to just refer them to
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others unfortunately so this is a real
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problem for our profession especially those who are in private practice but it affects you even if you're not in practice even if you're just working at
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a facility if people can't find your resources how are they going to get the
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wonderful benefits of recreation therapy so there's a lot of different areas that need to deal with this and I'm still
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trying to Duke it out with Google trying to make progress here and I need your help and you need to help yourself in
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doing this so I already posted this to the at relic Lahoma email list but here's what you can do to help you can
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can be directly involved in getting recreational therapy recognized as a profession in a business go to
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google.com so you need to go there and you can do a number of entries but just
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for the sake of simplicity go ahead and type in RPG therapeutics let me see if
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the LLC is necessary that's all you need okay RPG therapeutics you should see our listing on the right if you know of
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another business that has is specifically recreational therapy then feel free to type in that business as
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long as they have a business listing they need to have a business listing though so you use ours as an example now
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scroll to the bottom of your results and down there is a link for send feedback
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if you see that link down there at the bottom click that send feedback link now
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it says describe your issue or share ideas it optionally will include a screenshot of the business and such and
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you want to list something like need to list recreational therapy as a
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business last profession null category
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for example and once that's there and
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screenshots loaded whatever it loads then you go ahead and click send feedback and I don't know how well they
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actually listened to these things but we need a lot of people doing it and then
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hopefully it will rise up enough to catch their attention and the only way that's gonna work is if you every single
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one of you go ahead and do this coming from many different accounts for many different geographic locations at many
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different times go in and make this request so that businesses can actually
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list whether they're a facility a private practice a hospital would have you can actually list recreational
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therapy as a valid profession and business there's no way to do it right now you can add your own little keywords
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and things like that later in the process but the strongest benefit when people are doing keyword searches will
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be that business listing so do that right now take a moment go to Google type in RPG
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therapeutics or whatever business you want make sure a business comes up you have to have a business and come up or it won't work scroll down go to send feedback and and
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you know keep it straightforward if you want to add some links to the size of the profession things like that feel
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free let's get their attention and let's get recreational therapy recognized by Google as a legitimate category for
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business and profession so that's what you can actually do now as far as lobbying Congress and all these other
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things that's much harder much more expensive and time-consuming this will take you all of potentially a minute
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maybe two so really do that now and you'll be doing your part to try to help with the people knowing even that this
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profession even exists Kyle do you have any comments or questions so far
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I just filled out the feedback form excellent thank you sent that off to
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Google good good good spread the word to your fellow students
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and your teacher yeah I don't think they
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noticed but I've definitely typed in like gerontologist before and then the
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first thing that pops up on Google's like this big ol thing that explains what a gerontologist is which is the job Jian fine how many people are treated by
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it but yeah if you I think if you type in recreation therapy nothing really pops up like that it just gives you a
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bunch of random things the earlier
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mentioned I just thought it was interesting you mentioned the Obamacare thing that it kind of caused this kind
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of money grab between all the different departments and like you're saying yeah that's kind of unfortunate yeah it's a
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real bummer it breaks my heart that people are losing sight of our number-one priority is the patient the
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client and you know people are fighting over scraps but it's a consequence of
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policy and part of that policy is the lack of recognition of legitimacy in TR
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which goes back to I think you know we keep hammering on wanting more evidence-based and proof of the efficacy
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of record of recreation therapy and we have improving research but we have some
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fundamental flaws in the profession so for example I've talked about it some of the early episodes I'll keep bringing it
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up until we get it fixed the activity analysis forms that are used in the
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profession now you haven't been through any of that yet have you activity analysis like program planning and
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program creating program plans you're not that far along yet right okay so the
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high level so in a pie assessment planning implementation evaluation and
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then you get DNR which are implied which is documentation and and re-evaluation etc assessment the first step is
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assessment the first part of what we do the foundation of what we do is
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assessment and what do we do in the assessment phase do you recall some of
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the basics of that what was actually just talking to one of the CTRs is a
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Sacramento State University I was actually trying to get some help from for my dad mm-hmm I think mm-hmm
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so base to talk to her when she showed me this big old red book called the red
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book yeah the red book yep it's the one
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from idle Arbor by John Burlingame and Thomas black oh this is fourth edition
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it's the latest edition right looks like that big ol red plain book with gold
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lettering yep that's it that's the red book correct kay so she showed you that just went
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over right and she was also saying to if
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family is always the hardest to work with and when you are a CTRs mm-hmm well
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talking people into it etc yeah yeah
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well right so we we love this red book
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this is a wonderful book its assessment tools for recreational therapy and related fields and it is a wonderful
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book you'll see I have tons and tons of post-it bookmarks and notes and all
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kinds of stuff in it it is a well-loved and used book it's it's one of the key 3
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4 books if you could only have three or four books it would be this one probably the cookbook one of the blue books with
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all the ICF codes and maybe one the facility techniques books if you were you know if
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it's all you could care it bring with you as a TR but there's a key thing
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missing from here so so what's lovely about this book is it has all these
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wonderful excessive assessment tools it gives you example the full examples you know because a lot of them are licensed
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so it's wonderful than able to get these sample versions that you can actually go
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through and learn to use you can't use them in practice you have to buy them and they're like a buck a copy or
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something it's very reasonable pricing you can compare that to like the whisk or whey is and such and there are hundreds and hundreds of or even
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thousands of dollars for for one client you know that you have to pay licensing
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fees and all the special training etc and so what's really great though is it
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doesn't just list the assessment tools it then lists the validity and reliability if it's been tested for that
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and then gives you the scoring on the validity and reliability which is
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awesome and some of them in here score horribly so you have you been through
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statistical analysis yet in your training okay well in high school did
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you did you at least learn about basics of coefficients and such okay then then
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you would remember hopefully that if when you're doing this is for research
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and you're looking for a correlation of effects so a a positive one point zero
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or a negative one point zero is a perfect correlation or inverse correlation does that sound familiar yes
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yes you would so and no correlation would be a zero that's completely random
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chance and so a lot of research you hear
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in the media coming out they're so excited because they'll see like a point for coral correlation between this new
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drug and a reduction in let's say depression or something
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so they'll have a control group that got a placebo and there is the placebo effect so you'll get like a point to
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correlation or something of some people getting better because of the placebo effect from this from a placebo drug
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you'll actually see some people get better because they believe it whatever the reasons the power of the placebo effect power the mind but then the
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people who took the actual drug maybe got a point for maybe point point six correlation of them getting better for
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example as you add up all the numbers I'm I'm hugely simplifying here but the key is that number and those are
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actually pretty low correlations you really want something that's point eight
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or higher for a strong correlation it's kind of the gold standard is point eight or higher you really want to see 0.9 you
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you pretty much never see 1.0 if you see 1.0 something's wrong with your research probably so so certainly our gold
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standard at RPG therapeutics / RP research is anything that's a point eight or higher on validity reliability
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inter-rater reliability etc and this
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book tells you if they have done an assessment on the validity reliability
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etc of each tool and often in each section of each tool and that can help
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you decide whether this is a valid and reliable tool for what you're wanting to learn so is it valid is it actually
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testing what you want it to test is it reliable is it going to consistently
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give you the right results for a certain level of ability functioning result whatever and interrater reliability is
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if I hand this to you - and you're equally well trained you know in the in how to use this tool will you come up
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will will your participant end up with the same scoring as you do the scoring and such so that it's the same so high
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inter-rater reliability means that many different people ran the test and got roughly the same results with the same
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clients right if it doesn't have a high interracial eye ability that means the
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clients cannot count on consistent care right
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so for example let's say you go to your general practitioner and he runs a test
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on you for diabetes and the tool he's using has an integrator reliability of
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only point two and you want a second opinion you're not sure you know and he
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says you came up yes you've got diabetes we need to get you on insulin etc but you want a second opinion before you go
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down that road so you go go to another doctor he runs the exact same test but he says
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no you don't have diabetes because of the way he interpreted the results of
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the test or administer the test whatever the whole phase of the process so now
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you've got two conflicting views so now you go to a third person and she runs the test and she's like well you're kind
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of borderline so you know maybe we just do a slight diet adjustment but you don't need insulin now you have three
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different views on whether you have diabetes or not what are you supposed to
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do because the first one says you need to get an insulin right away or you're
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gonna go blind and body parts will start falling off and you know your heart's gonna degrade very rapidly it's it's
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severe diabetes you need to treat this right away with insulin injections etc the other person says no you don't have diabetes
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well I don't know what he's talking about the third one says well you're kind of borderline let's just do some diet stuff you've gotten three different
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opinions from three different doctors but they all administer the same tests because of a low interrater reliability
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of that test does that make sense right
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well then what do you do well and it it could be life or death if the first doctor was the one who was
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right because maybe they've just got more experience or whatever they know how to interpret the results of the test better whatever the reason their gut
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instinct whatever it is you know you could be in the hospital very soon and and blind but if the second person is
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wrong or sorry if the if the first
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person is wrong though let's say the second person is right you don't have diabetes at all and the first persons making you start
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doing insulin injections bad things will happen to you from that too you do not
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want to you can die you can at least have seizures right that's how they induce seizures for fighting depression
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now they do that often more than electro convulsive therapy to induce seizures for profound depression that's not
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responsive to other treatments so you could end up having a seizure from your insulin injection right now this is not
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the greatest example because we have great tools that you can prick your finger fee wait see what your levels are and they have we have good valid and
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reliable tools now but it wasn't always that way it used to be you go back 1800s
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you know you had all kinds of wacky ideas about how to deal with symptoms related diabetes many of them much worse
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oh you need to eat more sugar filled drink you need to keep your energy up by
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consuming more sugar you're eating too much meat and fat and not enough sugar okay what does that do to a diabetic
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exactly yeah let out the blood oh that's great you know so this is the problem with inter-rater reliability is the tool
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might work really well in a certain practice with just that practitioner but let's say that practitioners out that
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day and somebody else taking over uses the same tool and the inner a reliability is low they interpret the
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results completely differently and the client gets completely different treatment than what they're supposed to get this really matters well
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unfortunately while we have lots of great tools here in the red book for
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evaluating the client right there's lots and lots of leisure satisfaction measure
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measure of social empowerment and Trust leisure interest measure several of which I use because they've got point
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eight point nine or better coefficients and they're interrater reliability strong their their validity strong their
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their alpha of R'lyeh all these different things are all strong they've been thoroughly tested and they work well to evaluate what the client needs
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so that's what this book is full of and it also helps you if you so if you do as a baseline and then you do an exit or
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periodic testing being careful about the testing effect negative consequences exit testing effect
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you have a way to measure progress right because when you go back and do your revaluation they came in at a low number
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you want him at a higher number at the end they have a higher number they don't have a higher number something's wrong with your program or you need more time
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or whatever it is but you've got a measurable effect this is evidence-based practice yeah everybody's happy
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we've got can you know we can tell if we're making a difference or not and we know that the tool is a good tool for
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evaluating this however on the other
39:12
side is what is the right activity because we're all about in recreation therapy finding the right activity to
39:19
achieve the goals so so we've done an evaluation a client and we've determined they need more cooperative social
39:27
activities they're withdrawn alone all the time they don't know how to communicate and get along with people
39:32
they struggle with turn-taking and interruption and impulse control they struggle maybe a little bit with anger
39:38
management we need to come up with an activity that is going to help them develop skills remember part of it our
39:45
job is recreation and leisure education right we are teachers as well as therapists so when we do an evaluation
39:54
of their leisure interest or their leisure education levels to find out what they like to do in their free time
40:01
and we see that all they list is you know watch watch streaming shows play
40:09
video games party on Friday Saturday nights and get drunk and you know maybe
40:15
get high during the week you know when they're off work or something that's not a well-balanced recreation and lever
40:22
leisure lifestyle is it's not a very diverse lifestyle and we want to help
40:28
broaden their horizons so that they can have a healthier life balanced right
40:34
yeah actually what's interesting we're
40:45
talking about depression yes mm-hmm and
40:52
one of the things we talked about was how playing can help with depression social
41:00
anxieties or generalized anxiety disorder now your you talking about psychological role-playing or
41:06
role-playing games mm-hmm right helps with empathy and such
41:13
what's that and maybe think of RPG research right there's a bunch of people
41:20
that can be helped through role-playing games Tabletalk because not only do you
41:27
get the social interaction but you're also kind of pressing your own
41:32
boundaries and like exploring different and because of the statistics that come
41:37
with role-playing games so games add some sort of rules and boundaries clearly defined parameters whereas
41:43
straight role play is more freeform and like some people on autism spectrum and such are responsive to drama therapy and
41:50
roleplay therapy others are completely overwhelmed by the open endedness of that they need more structure and role playing games can be
41:56
really helpful for those individuals plus when with the dice rolling and at doing the math and the reading you can
42:04
end up building literacy skills math comprehension skills a lot of other ancillary benefits happen in addition to
42:11
the roleplay benefits yes exactly so but let's back up a second here excuse me so
42:19
we want to find activity that addresses their their their social skills issues
42:24
their depression etc and we want to know what is the best one for this person
42:31
we've put them through a bunch of an of analysis of them we know that they like
42:36
so for example we've been working on a few assessment tools to figure out people's genre interests so they read
42:42
different books they consume different media they watch streams they listen to podcasts what have you and we've
42:47
determined that they like science fiction fantasy comic book and superhero content they are not interested in
42:53
religious spiritual self-help science or Western you know I called West or
43:00
biblical genres so now we've got an area of interest we know they like
43:07
that helps us start narrowing down our tools okay so we want something that they're intrinsically motivated because
43:12
they're going to have to do some hard work and the intrinsic motivation helps them push through the boring or unpleasant or painful periods because of
43:19
the the the overall intrinsic motivation now we need to find an activity that
43:25
will match that well how do we do that as recreation therapists you probably haven't had this part yet but what we do is we have something called the activity
43:31
analysis and let me go grab the cookbook which is the there's several books that
43:50
include sample activity analysis forms
43:56
the classic one this is what most wreck therapists have learned from for the CTR
44:02
centering is therapeutic recreation program design by Norma J stumbled Carol
44:07
and Peterson this is by Pearson Benjamin Cummins publishing etc it's called the
44:12
cookbook because it looks like the Betty Crocker cookbook but also it is a
44:18
cookbook if you want to make a program plan and there's another one that is heavily bookmarked and used if you want
44:25
to put together a program plan this walks you through step by step just like a cookbook if you follow these steps and
44:32
fill in all the details and don't skip the steps you will put together an effective program plan but there is one
44:39
glaring flaw in here that is really problematic and that is the activity
44:44
analysis step which is one of the early steps so the activity analysis step
44:53
tries to determine which activities will have what impact so let's say we need to
45:01
figure out what I so what I've done in the past before I before I started realize this was flawed years ago I had
45:06
I have these spreadsheets and I would go through and do this activity analysis based on this and some other forms that
45:13
are out there that are industry standards that a lot of people have sent me their versions from their facilities and they're all roughly the same
45:20
so let me let me let me go over before I go through the rest of it so principles of activity analysis
45:26
overview first when an individual engages in an activity action is required in for behavioral areas
45:33
regardless of the type activity physicals aka psycho motor cognitive aka
45:38
intellectual social and affective aka emotional behaviors for example when
45:44
playing ping-pong the physical actions are easily observed the player must be able to grasp and hold a paddle and have
45:50
sufficient elbow shoulder and wrist movement to hit the ball enough mobility to move quickly and hand-eye
45:56
coordination cognitive skills are also required there are rules to remember there is continuous scoring and there
46:03
are strategies to plan these cognitive or mental requirements add to the totality of the involvement social
46:09
skills are required in the form of taking turns playing fair and the like effective requirements for controlling
46:15
and expressing emotions also are part of the action and activity analysis a ping-pong or any activity for that
46:21
matter examines each behavioural area in a systematic way jumping ahead activity
46:27
analysis should not be confused with task analysis that comes later another term and procedure often used in
46:33
the therapeutic recreation that will be discussed later in the chapter task analysis is the breaking down of a skill
46:39
into it's sequential parts for the purpose of instruction so you do a than
46:46
you do B then you do C then you do D to do the activity right you break down each task to do the activity you reach
46:53
for the door knob you grasp the door knob you turn the doorknob you pull on
46:58
the doorknob step aside as the door opens you walk through the door you turn around you reach back you grab the other
47:06
doorknob grab it and close the door release the doorknob and then walk away that would be a task analysis right this
47:13
is a very engineering type approach activity analysis which looks at the
47:18
participation resuming participation requirements in the various behavioral domains physical social cognitive
47:26
affective will contribute to a quality task analysis in that each sequential
47:31
part that needs to be taught will be better under stood the activity analysis rating form
47:37
discussed in this book is one of many that can be used to evaluate activities in arm a number out there I cannot find
47:42
one that has gone through there any any of the validity and reliability testing
47:48
that's in the red book for the other analysis forms so there none out there that I can I've been I've been talking to the atra folks at the conference I
47:54
was talking to Thomas Blasco who does the books I've talked posted on multiple
48:00
lists and fora people have emailed me all of theirs from their facilities and none that I can find and I would love
48:07
for somebody to show me otherwise has ever been through any kind of validity
48:12
reliability testing and they all pretty much follow the roughly the same format as what's in this book and the other
48:18
books so so principles of activity
48:24
analysis whether the specialist chooses to use this generic form in this chapter or create his or her own right right
48:31
there we're not setting any real standards we've just got a guideline there are a few general principles that
48:36
apply to activity analysis these must be considered before performing an activity analysis one analyze the activity is
48:43
normally engaged that's key thing about activity analysis this is before we do any adaptation so you might be planning
48:49
to do drum circles with people in wheelchairs and you're gonna have to do some adaptation because of that but
48:57
whether or not drum circles are the right activity for this group or not is irrelevant to your activity analysis the
49:05
matching of the client needs to the activity comes later in the process
49:10
right now you're just trying to put like forget I put together a spreadsheet of different activities their strengths and
49:15
weaknesses and requirements and then that helps me with I do a cross-reference spreadsheet I enter in the clients requirements and their
49:21
scores and I can cross-reference and it pulls up the different activities that are our best matches for this client's
49:28
needs so the one we were talking about with social skills cooperation impulse control and depression I might come up
49:34
with tabletop role-playing game for example right as the best fit as the activity based on what I put on the
49:39
activity analysis side I'm cross-referencing two sets of data but I
49:45
did it as a non adapted adaptive is a whole other separate step
49:51
separate from activity analysis what number two when completing the activity analysis rating form rate the activity
49:57
is compared to all other activities so now you've got to have understanding you have to have experience well the wide
50:02
range of activities how do you rate drum circle volume compared to reading a book
50:09
in a library now most people are gonna score drum circle is on a scale one to five five being the highest one being
50:15
the quietest you're gonna be reading a book as a one and drum circles as a five right because it's pretty loud that would be a pretty
50:21
typical response but what about if your experience is in a rock band drum circle
50:27
is not really quite as loud as like a heavy metal band so you might put drum circle at a three or four yeah it's loud
50:33
but it's not as loud as if we do a cooperative electric electric music jam right so you can have a little bit
50:39
difference based on your own personal experience we don't have any objective rating of what is loud with that type of
50:47
approach so that's number two but it's one where one of the problems sneaks in number three analyze the activity
50:53
without regard for any specific disability group per se so again just the way it normally is don't worry about
50:59
adaptation don't worry about special populations go with what the most common population is and just go with that
51:04
number four analyze the activity with regard to the minimal level of skills required for basic successful
51:11
participation and I thought that was pretty straightforward but as I have done peer review analysis of these tools
51:18
it's really subjective I thought everybody would agree that a drum circle
51:25
like to play a drum doesn't require much coordination a lot of people scored it
51:31
on so scale one to five like one is very little coordination five is extremely complex coordination I figured it was a
51:38
one or two I put one because as long as you can move you can hit a drum that's
51:44
enough to play a drum and I'm a pretty experienced drum circle facilitator as well as musician and such and for my
51:52
experience of all these instruments and all these activities we have two year olds who can play in drum circles no
51:57
problem I have lots of experience with that most other people who didn't have much experience drum circles maybe they just had the
52:03
basics rated drums as a two three or four in complexity because they all kept
52:09
looking at dum diddy dum dum - right though the advanced kind of drumming but
52:14
we're talking the minimum required and all that is is that I need to be able to hit a drum on a certain rhythm and it
52:22
doesn't have to be complex it could just be 1 2 3 4 1 2 3 4 or even 1 2 3 4 5 6 7
52:30
a 1 2 so we've got people with profound disabilities they as long as they can
52:35
move a limb in a somewhat controlled way they can still have spasticity and other
52:41
things they can play a drum so I put it as a pretty low coordination requirement to participate in a drum circle at the
52:48
most basic level are they going to be master percussionists no that's that
52:54
would require high complexity but this says the basic successful participation
52:59
at the minimal level of skill and yet experience CTR s's and inexperienced
53:05
ones I got scores all over the place and experienced CTS's with no drum
53:10
experience rate it is huh needing a high coordination and it doesn't so you see
53:16
where those problems are creeping in early on and that's what I use to do that's I've been using to test these
53:22
different activity analyses as far as inter-rater reliability its way to open it and then there's the actual phrasing
53:28
of the questions of the activity analysis so the ones that are binary are
53:34
generally I found a interrater reliability of about point 9 or better so that's good so for example physical
53:41
aspects what is the primary body position required so let's use drum circle as the example is it lying down
53:48
kneeling sitting standing or other what do you think of those you can put a checkmark in all that apply so what do
53:54
you think would apply there Kyle lying down do you think that's typical of a
54:01
drum circle participation I mean if you want to so you know kneeling is a
54:12
possibility sitting is very common standing is not uncommon there
54:18
isn't really an other that I can think of off top of my head I'm sure you could get creative about it but kneeling city
54:23
understanding are all possibilities however in the most typical version the
54:30
most common is sitting so primary would
54:35
be a checkmark in sitting and we saw good inter-rater reliability most people
54:41
figured it out you said sitting most people into it that pretty easily what are the body Riccar parts required
54:47
arms hands legs feet neck head upper torso lower torso so what do you think
54:54
some of those would be there's multiples in this what do you think would apply would arms apply yeah yes would hands
55:02
apply typically yeah would legs apply typically it's optional but it's not
55:13
typical so we locally we put leg shakers on things like that you can do it as an
55:19
adaptive thing but when you're looking at typical drum circles do you see people using their legs because you're
55:26
in the sitting position are they using their legs to participate in the drum circle activity well when I think about
55:34
legs I think someone using their legs to hold the drum in place okay that that's
55:39
sometimes so you could put that that that is a possibility okay okay right
55:49
feet well we let's say we're focusing on the sitting position okay so feet and
55:54
it's not that they're not involved in some way but this is required are you
55:59
required to wrap your legs around the drum for to edit because we've also yeah
56:04
exactly so yeah I remember the the language is very specific are your feet required to play it do the drum circle
56:11
no okay what about your neck other than
56:16
that you need to move your head and stuff but is your neck involved in the drum circle itself the only Trump circle
56:24
I've ever been no necks involved how about your head I
56:32
want to see a drum circle yes indeed
56:37
upper torso that one would be a yes
56:45
because your arms are attached to your torso and you're doing all that movement
56:50
and everything so it has significant effect on your upper torso but what
56:57
about the lower torso right not now yeah so what you want to consider is if
57:04
somebody was paralyzed from the waist down could they participate yeah if
57:10
they're now this is getting outside of it but it's just keeping this if you're having trouble figuring out what's required or not if somebody's paralyzed from the neck
57:16
down could they participate generally know that without adaptation correct
57:27
that's what you got to look at the required aspect without adaptation so
57:32
generally when people understand that you know you're new to this so you don't have that quite down yet but those who
57:38
have been through this and understand those criteria 0.9 or better inter-rater reliability what types of movement does
57:44
the activity require bending stretching standing walking punching catching throwing hitting reaching grasping
57:50
skipping hopping running etc we're not gonna go through all those is gonna take too long but you get the idea what are
57:56
the primary sense is required for the activity touch taste sight hearing smell I like to add things like gustatory and
58:02
and others but anyway so those generally those binary responses of a checklist as
58:09
long as people interpret the question correctly about require required right
58:16
people sometimes forget that but as long as people have enough training that they correctly interpret the question good
58:22
inter-rater reliability here's where it starts to break down catastrophic ly what is the amount of
58:30
coordination and movement between body parts required by the activity on the
58:35
and also here's a wacky thing these these do which rail against much is a 1 and little is a
58:43
5 how confusing is that oh gosh that
58:48
reminds me the leisure ability where yes yes it's backwards and they do this it's
58:58
it's a weird it's a weird ISM and and all my professors are complained about
59:04
it and we've seen it and I understand there are mathematical scoring reasons for it but it is really counterintuitive
59:11
and it leads to a high error rate so I've done multiple tests where I have
59:17
given the exact same activity analysis of different people and these are trained CTR s's or CTRs as in training
59:25
and laypersons and people outside of TR in other professions like psychology etc
59:30
and I've given them the exact same it's different it may be in the activity
59:36
analysis it may be another form but I did it the way the book said which is with the low number means more and high
59:43
number means less type and then I've rewritten all of those tests the other
59:49
way where it intuitively makes more sense where the low number means less and the high number means more and the
59:56
error rate for the normal way is extremely high because I'll go back through it and say so you said that you
1:00:04
picked a 1 for drumming that meaning it requires much coordination they're like
1:00:10
oh no no no I meant that it doesn't require much coordination they don't even realize they're answering it wrong
1:00:16
from what their intent is so when you invert this you kind of get a Stroop effect type thing you familiar with the
1:00:22
Stroop effect did you get that near abnormal psych thing yep ok the Stroop
1:00:27
effect is where you see a bunch of words printed and they'll say things like red green yellow and the red text is in red
1:00:36
the green text is in green and the yellow text is in yellow and you're able to and it's a much longer list but you
1:00:42
hurry and you read aloud red green yellow as fast as you can and then they flash another one and it'll be different
1:00:49
you know and they'll be like then then they'll give you a list where the the red is is green the green is red
1:00:56
and the yellow is green where no I get
1:01:01
screwed that up the red is yellow the green is red and the yellow is green
1:01:07
anyway they're all the colors are different than the letters and you're just supposed to read the letters and you can generally say red green yellow
1:01:14
no problem then they say now tell us the color of each word rather than what the
1:01:21
word is written so if the red one is green color you need to say green instead of red
1:01:27
if the anyway what happens is you will be much slower in trying to say the
1:01:33
color that is different than the letters if you're if you're literate it's it's
1:01:40
it's an interesting effect in it and it creates it kind of we had a cognitive dissonance and we have to do more
1:01:45
processing etc and so when we have to sit here and invert these scales counter
1:01:51
to what we're used to encountered or to intuition our chance a we slow down on
1:01:56
the processing and B our error rate is more likely to be higher we're more
1:02:02
likely to write down the wrong answer from what we intended we actually understand the question but we write it
1:02:08
down wrong because of this cognitive struggle and so that's a huge flaw
1:02:15
throughout many of these tests as when they invert it so when I give it the test to clients I have rewritten the
1:02:21
tests the other way and had a much lower error rate and I probably should have
1:02:28
said that on the air but so anyway this
1:02:36
activity now says so right there there's a problem with that with that issue so that's an issue and there's an error right so so when I flip it around and
1:02:43
get the lower error rate then I see the difference between so if you were you know now I've already I've already
1:02:49
primed and contaminated your response to this question what is the amount of coordination and movement between body
1:02:55
parts required by the activity ignoring how it is in the book let's just say one
1:03:00
is very little coordination and five is a lot of coordination where would you rate using
1:03:05
just the bare minimum to participate where would you rate that requirement to be on that scale somewhere between a one
1:03:16
and two right but I already contaminated that response didn't I because I
1:03:21
discussed it earlier yeah exactly and
1:03:26
that would have been a typical inexperienced response because people keep seeing the more advanced to the
1:03:32
kilt the culmination of people all drumming together and advanced drummers and think that that's required that's
1:03:38
not what's required for participation these two year-olds who join our groups with with everybody else do not have
1:03:44
very good coordination and they are totally able to participate that's part of the beauty of cooperative music and
1:03:51
drum circles is it you can go as young as two years old and have full participation and they have a blast and
1:03:57
and they are they're not they're not deterring from the benefit of the activity so so that's a problem there is
1:04:05
that getting the interpretation so what's the degree of energy needed for
1:04:10
the activity endurance etc so that area we had basically close to a zero
1:04:18
you know rate or reliability coefficient meaning people responded anywhere from
1:04:24
one through five on those questions now when I've rewritten them to be very specific if I gave examples of this is
1:04:32
complicated and this is simple and rather rephrase some of them I've been
1:04:37
able to get better inter-rater reliability but I've had to completely rewrite the questions to do so and I've
1:04:46
had to keep and this was the main feedback we got from everybody we tested this with they needed examples because
1:04:52
everybody has a different tool set of experience so you need to establish a
1:04:58
more objective range rather than this highly subjective because remember back here it says when completing the
1:05:06
activity analysis rating form rate the activity is compared to all other activities it's humanly impossible to be
1:05:13
able to compare it to all other activities you cannot in a lifetime have participated in
1:05:19
every activity on the planet that could be recreation music what-have-you it's not possible it is always going to
1:05:26
be a highly subjective experience so what you need to do for your analysis form is create something that people can
1:05:33
more objectively relate to and say on a scale of one to ten or one to five what have you with breathing being a one and
1:05:42
running a marathon being a five what is the level of exertion of this activity
1:05:48
right you give them that range and then they're gonna give an example and it won't be perfect right you may only get
1:05:54
a point six or point eight inter-rater reliability but you will get a lot better than a zero or point two which is
1:06:00
what I'm getting with all these forms you see how that helps narrow the parameters and give some definition
1:06:05
isn't that much easier to understand so
1:06:10
and your experience of Marathon money running might be zero so it's going to be perceived but you're gonna have a
1:06:17
pretty good idea of what we're asking for so then they go into some more check marks about what kind of Avedon
1:06:23
interaction patterns required have you been 300 action patterns yet okay that's
1:06:30
like extra individual intra-group intergroup etc we cover that in RPG research training as well we've got a
1:06:36
simple cheat sheet for that here's another one that I was surprised this
1:06:42
one did better but I was surprised at the variability in it what's the minimum fewest number or maximum greatest number
1:06:49
of people required for the activity so you put the minimum number on the maximum number so for a drum circle what
1:06:55
do you think the minimum would be three
1:07:01
okay and I would agree with you because that's a me it's really a triangle but it's the closest otherwise you've got a
1:07:07
circle exactly exactly now technically you could do a drum facilitation
1:07:15
activity with two or a person can play by themselves and practice by themselves
1:07:22
but if we're being specific about the activity saying this is a group
1:07:27
cooperative social activity in some way so have you been
1:07:32
Tuchman training yet at RPG research I don't think you'll get it through TR forming storming norming performing have
1:07:38
you been through that yet oh good good
1:07:45
sometimes they cover it sometimes they don't so what is according to Tuckman's theory of small group formation and
1:07:51
communication and dynamics what's the minimum number what's the minimum maximum number of people for a small group for a team he had a very specific
1:08:01
numbers and by the way you get you get whole classes on just Tuchman from us
1:08:07
through RPG research I think he was three or four okay what was the maximum
1:08:20
Tuchman said specifically the minimum required for a team for a small group
1:08:26
he's very specific about this is three because you have to be able to have factions you can't have a faction with
1:08:34
two people the faction means two against one or something like that you got be able to break up into groups two means
1:08:41
you have two different reviews but that's not a faction so you it's a minimum of three to have a small group
1:08:46
or it and a team is a specialized type of small group he then argues that the
1:08:51
maximum number is nine that one is a debated topic there are people go as high as 20 but he argues that that's
1:08:58
multiple groups breaking up into smaller groups right you've got they're working together cooperatively but you end up
1:09:04
having small groups within those larger groups so he argues three to nine is a
1:09:09
small group when you get larger than that then it becomes other things he goes all the way up to mass and all
1:09:14
these other things just start breaking
1:09:24
off and start talking yep and in role-playing gaming we found the sweet
1:09:29
spot is about four to five players when you start adding the the six player the game really starts to slow down for is
1:09:36
like just right fifth fifth can add a little extra flexibility when you hit six it really is noticeably slower and
1:09:43
I've run groups with six seven eight I've run groups of players for several months weekly we
1:09:49
required strict enforcement and facilitation techniques to make that work and everybody had to really pay
1:09:55
attention be ready because it couldn't have the UM where I was I what was I doing everybody has to be ready for their turn
1:10:01
they only get 15 seconds and that still means with 20 people that it's still several minutes before your turn comes
1:10:07
around again but I made it so that it was the same amount of time as is typically experienced in a group of four
1:10:12
to five players right so if you figure the average time for you to have your
1:10:17
turn is typically one to three minutes each time you just do the math on the
1:10:23
number of participants and that's how much time each person gets so that your experience of you how frequently you get
1:10:29
a turn is exactly the same duration as a small group or with a large group it
1:10:35
hinders how much free form real role playing you can do but in tactical situations it works beautifully but it
1:10:42
requires a lot of discipline and focus and it's challenging and I use these little egg timers that help with that
1:10:48
process and with the Talking Stick and such but three to nine is what Tuchman says for the forming storming norming
1:10:53
performing and adjoining reforming etc so with the drum circle and it's a group
1:11:00
we're talking about the minimum is going to be three based on all of those things the maximum for drum circle is there a
1:11:07
maximum assuming you have only one facilitator yep I've done groups that
1:11:29
size no problem with drum circles it's more the merrier
1:11:36
mmm Evelyn Glennie from Scotland she's one of the world's few or maybe only
1:11:43
master solo orchestral percussionist who is also deaf by the way she plays
1:11:49
barefoot she plays with entire symphonies as a percussionist weathers the marimba or other percussion
1:11:55
instruments but she has put together entire stadiums full of drummers
1:12:00
that she facilitates the entire stadium of drummers now these weren't like gem
1:12:08
Bay's and stuff but still the principle applies I'm not aware of an upper limit of a drum circle other than facilitation
1:12:14
facility limits right noise codes things
1:12:20
like that you know if you do it in a quiet neighborhood out in the middle of the street you're gonna probably get the cops called but there's I'm not aware of
1:12:29
an upper limit however just managing it realistically I you know generally if
1:12:37
you're a rec therapist just trying to figure out would be appropriate without it being overwhelming to set up if you don't have any helpers you could say
1:12:43
three to twenty comfortably managing a twenty player drum circle is not difficult for a single facilitator to do
1:12:50
when you start getting above 20 be difficult but see that upper number is gonna be very fluid and based on your
1:12:55
own ability and confidence so there isn't really an easy answer to the upper number on that which creates inter-rater
1:13:03
reliability inconsistencies so that question could be phrased a little more specifically to say you know given your
1:13:10
specific facility what would be the upper maximum number that would then say oh well that room can only handle 50
1:13:16
people so I'm gonna put maximum numbers 50 because I know I could handle that whatever what clothing is needed to be
1:13:23
socially appropriate that's a really open-ended question isn't it that's the
1:13:30
question there's no answer other than just your response and most of these these forms have blanks they just say
1:13:36
what is this what's required and there's a blank line and you're supposed to give an answer how are you supposed to have
1:13:41
inter-rater reliability with those kinds of open-ended questions right a lot of
1:13:53
the questions yeah a lot of questions the activity analysis are open-ended questions they'll say so for this one
1:13:59
here what clothing is needed to be socially appropriate and that's it there's no scale there's no examples it
1:14:06
just as an open-ended question for you to answer do you think that inter-rater reliability is going to be very strong
1:14:14
because that's highly culturally variable right let's be careful but yeah
1:14:26
yeah it's gonna be highly culturally variable so there's an awful lot of the
1:14:32
assessment tools that are open-ended that way and you get the idea so I have
1:14:40
found that and I've been given all these different activity analysis forms and I've done the evaluations and most of
1:14:48
them are only point two two in the aggregate there are at best a point two
1:14:53
two point four on the inner rater reliability on every single one I'd be able to find so far and these are
1:15:00
actively being used in facilities across the country and different parts of the world that's really bad
1:15:08
and it's the foundation on which recreation therapy as part of now that
1:15:16
being said that's inter-rater reliability we have other people to hand it off to I by myself before I
1:15:22
discovered this problem did just fine with the spreadsheet I created and my intuition of my experience of oh for
1:15:28
this client who needs it has these needs through my evaluation of the client this activity from my experience tells me
1:15:33
this will be a good match we generally Intuit it as recreation therapists based on the tool set that we
1:15:38
have and it works okay but let's say you're sick that day and somebody needs to cover for you they're not going to
1:15:46
get the same level of care if it hasn't been thought out or the evaluation I'm gonna get a completely different
1:15:51
activity because the other person's tool sets so different and that may or may not be a good or bad thing for the
1:15:57
client but it certainly isn't consistent so anyway we went on longer about that than I intended a lot longer I really
1:16:04
wanted us to so we come to the part the other ones I just want to quickly ream ention if you wanted to learn more about the BCI stuff you have to watch last
1:16:11
week's episode because unfortunately we're way over on time the BCI game jam
1:16:16
so let me pull this up for everybody again as they did last week so I have to
1:16:22
do is go to google and type BCI Jam or game jam and you'll find the website
1:16:27
this is the brain computer interface Game Jam this is out of Canada we have them on our RPG talk show just a couple
1:16:34
of weeks ago talked about it at length I have equipment here so I've been
1:16:40
experimenting with neuron by Oh feedback for decades in both in music therapy
1:16:46
before now also with recreation there's an open source kit you can buy if you go
1:16:53
to open I think it's open to EEG let's see open yeah open EEG dots
1:17:00
sourceforge.net which redirects to okay
1:17:07
that's it open EEG dot sourceforge.net and you can scroll down and find the hardware go to olam X and that's what
1:17:15
this looks like here and they have these kits that are either the rough versions
1:17:22
or the completed set go to open EEG so
1:17:27
I'm gonna so you got these boards that you can get from them for a few euros or
1:17:32
the assembled basic set of five inputs so that's what I have here and one of
1:17:38
them can be turned to active there by default all passive receivers with a USB port and then one active you can get
1:17:45
more complex setups if you want so these have the electrodes that you plug into those ports and you get the electrodes
1:17:53
here and then I take like a motorcycle sock so it's that little you put it on before you put your helmet on and you've
1:17:59
just got either here or the face exposed and I've used I've taped or glued these
1:18:05
on the inside and just use the part of that to put the electrodes on etc they've got more much nicer fancier ones
1:18:12
the bcig em site has some good examples of that tube and there's a bunch of open-source software that you can use to
1:18:18
do all the EEG electroencephalogram stuff so last episode has a lot more info and also the RPG talk show episode
1:18:27
from two weeks ago which should be available to the public in about two more weeks if your patreon supporters feel to get to it right away
1:18:32
has even more detail because of the interview of the BCI Jam folks but this is coming up
1:18:39
and this is relevant to recreation therapy you know integrating modern technology it's coming up they're taking
1:18:44
submissions open from November eighth through November tenth and so check that
1:18:51
out it's at itch i tch dot IO forward slash Jam ford slash bc i - game - jam
1:19:01
and again you just find it by just typing bc i game jam and google and it's number one result so in ten days this is
1:19:08
starting and you can contribute you can they're going to be streaming they're gonna be talking about it and this is
1:19:14
really great some of its accessibility a lot of its for all ages it helps with
1:19:21
the neurofeedback thing it helps for accessibility there's all sorts of benefits to this and so what is a
1:19:28
brain-computer interface it is our new and growing technology aids it's not
1:19:34
it's actually not that new if the implementation of it's new but it's been used for decades and decades but that
1:19:40
allows users to interact with their environments such as a computer through directly processing their brain patterns
1:19:45
by processing intent and activity from the brain directly we can bypass neuromuscular limitations and allow
1:19:53
people with physical impairments to control and interact with the world around them this opens up a huge
1:19:58
opportunity for new possibilities for people with physical impairments with BCI research looking to help in a
1:20:04
variety of ways from gaining independent movements to playing video games for the first time not the first time but what
1:20:10
what they're doing so I've written multiple papers on this topic over the last 15 years because of my tech
1:20:15
background it's really awesome and enabling and recreation therapists should be aware of this technology as a
1:20:22
key thing to help enable your participants and there's more than that so that's the accessibility side you can
1:20:29
also use the neurofeedback thing to help with self control calming energizing focus so that's the
1:20:37
neurofeedback side where the games give feedback when you are focused and calm
1:20:44
then the videogame cooperates with you more then when you're agitated and distracted then the game goes off the
1:20:49
rails your car crashes into a wall things like that there are some primitive versions of this principle you
1:20:57
can buy on the market for example the mind flex game and this is where you
1:21:03
move a ping-pong ball with jets of air using just your mind it's mind control
1:21:13
and you create these obstacles etc there's even a two-player version where
1:21:18
you can play against each other literally a battle of the minds it's
1:21:26
very cool the very simple version you'll see out there there's a Star Wars one where it's just a tube with a ball and
1:21:31
you're using the force through focus and so you put on a headset you turn the game on it takes patience to get the
1:21:38
hang of it because if you're not focused enough it won't do anything you'll just sit there as you get your brainwaves and
1:21:44
the right parameters that's calibrated for the fan will kick on and the ball will float up and then you get a little
1:21:50
knob that you move the ball along carefully and put it through all these different obstacles and such it you
1:21:55
actually feel I've used this on and off over the years you feel fatigued you
1:22:01
feel your brain working out it's quite the experience I think this is about a
1:22:06
140 for this set I think the two-player one's about 250 I don't know the prices may have changed there's some simpler
1:22:14
ones that are just more biofeedback so while Devine has a lot of their
1:22:19
meditation related they're kind of very froofy new-agey stuff but it's it doesn't completely discount the efficacy
1:22:26
of the biofeedback this one you clip on your ear it monitors your heart rate and and does a mathematical calculation of
1:22:35
your breathing rate based on that and then it's got some activities like blowing out the candles with your mind things like that or lighting the candles
1:22:41
with your mind some software to play games like that to help you focus make the butterfly flit around etc they have
1:22:47
more advanced versions that have finger cuffs wrist cuffs galvanic skin response etc so these are all related to bio
1:22:55
neurofeedback and now the brain computer interface and so these things have been around for decades but they're really
1:23:02
gaining in awareness and popularity the thing is it also gives you insight
1:23:07
into the brain whereas like MRI scans and stuff are very expensive and difficult to do this doesn't let you see
1:23:14
the physical inside your brain but it does get let you see some functional aspects that can be helpful right like
1:23:20
with ADHD and such and helping work on executive function and attention span and such so just a little reminder about
1:23:27
that before we wrap up Kevin questions comments me sorry Kyle
1:23:39
sorry my bad I'm at a little cognitive fatigue myself so sorry that's pretty
1:23:51
cool yeah reading online yep do um and I
1:23:59
did a paper if you look on our PG research I did a paper on a combination of BCI and VR for people who are like
1:24:05
completely paralyzed and a fellow who was previously a software developer who was no longer able to support himself
1:24:11
but then through VR and BCI back then it was through EEG equipment but same thing
1:24:17
was able to slowly start be able to type you know in a computer using his mind and slowly start to write code again now
1:24:25
I I would love to find out where he's at all these years later if he was able to get back to making a living as a
1:24:30
software developer if the technology progressed enough I don't know I mailed I've tried a few times to find updates
1:24:36
no mail to finding but you can see how this could bring lives back I talked
1:24:41
about before when I was a nurse's aide and LPN trainee at doc C hatch we had a 19 20 year old
1:24:51
there who I think it was a ski accident was completely paralyzed couldn't even move his eyes but was fully aware full
1:24:58
brain activity he was on a gelatinous bed that was you know moving all the time and we had to move him around
1:25:03
periodically etc and and he'd been there over a year and people had stopped visiting etc
1:25:10
mm-hmm which is really sad but he was fully aware he could hear you know had
1:25:16
to moisten his eyes etc but he could see apparently as far as they could tell from the the brain responses trapped in
1:25:24
a body that he could not move in any way right couldn't even move his eyes so that he could like use an eye control
1:25:31
thing just horrific and you know he
1:25:37
trapped in his own body this kind of BCI technology could potentially set somebody trapped in
1:25:43
their own body free right I mean there's all kinds of applications you could literally move a wheelchair or rolling
1:25:49
bed around using your brain once you learned enough control you could use robotic arms to get you things I mean
1:25:56
the possibilities are limited only by imagination and current technical implementation but and then through VR
1:26:02
and the Internet the social interaction completely opens up right now you can chat with people and do all kinds of
1:26:09
incredible things as this technology advances and I think records therapists should stay aware of these advancements
1:26:17
in these tech be two blades of the games and recreation so that's why we bring
1:26:22
that up repeatedly totally you bet
1:26:31
assuming assuming they're able to have enough you know a cognitive control to do it it isn't easy and it's very fuzzy
1:26:40
it is not hard you have to calibrate things to each individual person and each individual's Iggy's vary from time
1:26:48
day to day and moment to moment so it requires a lot of calibration and it's
1:26:54
not easy but it's getting better and better to the technology's getting better we're still at the early stages
1:27:00
of this but it's really coming along in amazing ways and this Jam is to try to help raise that awareness and start
1:27:07
pushing the development right and coming up with creative ideas and solutions so definitely check that out when they're
1:27:15
there and check out the site etc any other questions or comments before we wrap up here Kyle cool it was cool to go
1:27:29
over some of the stuff it's nice to to kind of get a head start above some my other classmate yes Danielle was
1:27:37
still going through her CTRs courses when when we when she joined us and she
1:27:42
had a huge advantage with our training helped her ace her school tests way
1:27:48
ahead of her peers and it was actually my her professor who used to be my professor who would refer to us and such
1:27:54
and so for example flow state right you're familiar with flow state immersion and flow state alright have
1:28:02
you watched my video on it yet the ten minutes uh because it's part of your baseline training I only did the first
1:28:12
okay yeah keep going through the checklist but she found that incredibly helpful and her fellow students checked
1:28:19
it out and it helped them before they were failing that the the questions about immersion and flow state and that
1:28:24
video helped them reduce their confusion it made it much much clearer for them to understand or if you just go to youtube
1:28:32
it's really easy to find if you just want a short cut to it it's not very long but if you just go to youtube and
1:28:39
in the search box there you just type I think flow state RPGs that it yes
1:28:46
number one it's it's my little thing from from a couple of years ago for a class a psych class and such and it'll
1:28:56
give you it's ten minutes and nine seconds it's not the best production quality but it does the job
1:29:06
alright well we're gonna we're this was a long episode but there's a lot to cover look forward everybody else
1:29:12
commenting giving feedback requesting topics for future episodes I'll start
1:29:18
working on what we're gonna cover for next week there's so much as you can see there's a lot to cover each week so this
1:29:23
was episode number six October 29 2009 teen tiara talk show calm is the website
1:29:30
and on YouTube you can search for RPG therapeutics and you'll find our channel
1:29:36
there but if you go tiara talk show calm you'll get a link to all the archived episodes that you can watch or listen to that's all on a playlist on YouTube
1:29:43
anyway and so join us next week Tuesday from 1 to 2 p.m. Pacific time for episode 7 of
1:29:51
TR talk-show wherever maybe we'll be well and happy recreational therapy
1:29:57
Tuesday