CTRS cheat sheet

The therapeutic recreation process follows APIED: Assessment, Planning, Implementation, Evaluation, and Documentation, as defined in the ATRA Standards of Practice.

The Leisure Ability Model (Peterson & Gunn) organizes service into three areas: functional intervention, leisure education, and recreation participation.

Austin's Health Protection/Health Promotion Model moves clients from prescriptive activities through recreation to leisure, with an emphasis on health promotion.

Maslow's hierarchy ascends from physiological needs to safety, belongingness and love, esteem, and self-actualization.

Six ethical principles guide practice: autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity.

Valid informed consent requires client capacity, voluntary participation, disclosure of relevant information, and comprehension; consent may be withdrawn at any time.

The CTRS credential is awarded and renewed by the National Council for Therapeutic Recreation Certification (NCTRC), with recertification on a five-year cycle.

HIPAA (1996) protects individually identifiable health information and applies the minimum necessary standard to disclosures of protected health information.

The Americans with Disabilities Act (1990) prohibits disability-based discrimination in employment, public services, and places of public accommodation.

Assessment establishes baseline function, identifies strengths and needs, determines eligibility for services, and supplies data used to build the intervention plan.

Reliability refers to consistency of repeated measurement; validity refers to measuring the intended construct. An instrument must be reliable to be valid.

The Functional Independence Measure has 18 items (13 motor, 5 cognitive) scored 1 to 7, where 1 = total assistance and 7 = complete independence.

The MMSE has a maximum score of 30; scores below 24 commonly suggest cognitive impairment and are interpreted alongside education and sensory status.

The Leisure Satisfaction Scale (Beard & Ragheb) yields six subscales: psychological, educational, social, physiological, aesthetic, and relaxation.

Activity analysis identifies the physical, cognitive, social, and emotional demands of an activity so demands can be matched to client ability.

MDS 3.0 Section F records a nursing facility resident's preferences for customary routine and activities.

Assessment data sources include client interview, direct observation, standardized instruments, and review of medical and referral records.

A measurable behavioral objective states a condition, a target behavior, and a criterion (e.g., 'given a visual cue, will initiate two leisure activities in 3 of 4 sessions').

SMART goal criteria: specific, measurable, achievable, relevant, and time-bound.

Grading adjusts task demands up or down along a continuum; adapting changes materials, rules, or environment so the client can participate.

Intervention plans include problems or needs, goals and objectives, specific interventions, frequency and duration, responsible staff, and discharge criteria.

Discharge planning begins at admission and is revised as outcomes and functional status change.

Least restrictive environment means delivering services in the most inclusive, normalized setting consistent with the client's safety and treatment needs.

Contraindications and precautions such as seizure, weight-bearing, or cardiac restrictions are documented in the plan before implementation begins.

Goals are integrated with the interdisciplinary team plan and reflect the client's own priorities and values.

Facilitation techniques include modeling, prompting or cueing, shaping, chaining, and fading of prompts.

Forward chaining teaches the first step first; backward chaining teaches the final step first, with reinforcement following completion of the sequence.

Intermittent reinforcement schedules are ratio-based (responses) or interval-based (time); variable schedules produce the greatest resistance to extinction.

Tuckman's group stages are forming, storming, norming, performing, and adjourning.

Group leadership styles: directive (leader controls structure and decisions), facilitative (shared control), and advisory (members direct activity).

Flow theory (Csikszentmihalyi) holds that engagement peaks when task challenge matches the person's skill and feedback is immediate.

Self-Determination Theory (Deci & Ryan) identifies autonomy, competence, and relatedness as the three needs supporting motivation.

Standard precautions, including hand hygiene and barrier protection, apply to all clients regardless of diagnosis.

SOAP note format = Subjective, Objective, Assessment, Plan; DAR format = Data, Action, Response.

Documentation is objective, behavioral, timely, accurate, complete, and legible; the record is a legal document.

Behavior data collection methods include frequency count, duration, interval recording, latency, and magnitude.

Progress is judged against the criterion stated in the objective, using the same measure and method as the baseline.

Evaluation determines whether the intervention continues unchanged, is modified, or is discontinued.

Formative evaluation occurs during intervention to refine programming; summative evaluation judges overall outcomes at the end of service.

Discharge summaries report presenting problems, services provided, progress toward goals, final outcomes, and recommendations or referrals.

Errors in a record are corrected with a single line, date, and initials so the original entry remains legible; correction fluid and erasures are not used.