Glossary of Recreation Therapy and Occupational Therapy

Glossary of Recreation Therapy andOccupational Therapy ✍ David R. Austin

Glossary of Recreation Therapy and Occupational TherapyVenture Publishing, Inc.

Copyright © 2001Venture Publishing, Inc. 1999 Cato Avenue State College, PA 16801 (814) 234-4561; Fax (814) 234-1651No part of the material protected by this copyright notice may be reproduced or utilized in any form or byany means, electronic or mechanical, including photocopying, recording, or by any information storageand retrieval system, without written permission from the copyright owner.Trademarks: All brand names and product names used in this book are trademarks, registered trademarks,or trade names of their respective holders.Production Manager: Richard YocumManuscript Editing: Valerie Paukovits, Richard Yocum, and Julie F. KleinCover Design: Venture Publishing, Inc.Library of Congress Catalogue Card Number 00-111038ISBN 1-892132-19-2

PrefaceThis glossary of recreation therapy and occupational therapy terms is meant to serve as a study guidefor students and a reference book for practitioners. It may also be a valuable aid to those preparing forcomprehensive examinations, such as national certification exams or graduate school comprehensiveexams. Recreation therapy and occupational therapy encompass a wide scope of activity. Therefore, I haveattempted to be eclectic in developing the glossary in order to reflect a full range of approaches to theseprofessions. I would like to thank my colleagues, Professors Youngkhill Lee, Ph.D., CTRS, and BryanMcCormick, Ph.D., CTRS, for their thoughtful reviews of the glossary. I would also like to thank KarenScott, M.S., OTR, of Bloomington Hospital, for her thorough review of the glossary and ProfessorCelestine Hamant, M.S., OTR, SAOTA , of Indiana University, for identifying historical figures inoccupational therapy. While using this glossary, should you have suggestions to improve it please let mehear from you. David R. Austin, Ph.D., CTRS, FALS Indiana University Bloomington Phone: 812/855-3086 Email: daustin@indiana.edu

Glossary ofRecreation Therapyand Occupational Therapy AA — accessibility AAA abscess Alcoholics Anonymous Localized collection of pusAAHPERD absence American Alliance for Health, Physi- Petit mal epilepsy cal Education, Recreation, and Dance; in 1950s had a Recreation Therapy Section abstinence Refraining voluntarily from some activ-AARP ity, such as sexual intercourse; or from a American Association of Retired Persons substance, such as food or drugsabasement abulia Degradation of oneself; excessive compla- Inability to make decisions cence or accepting punishment abuseabasia To misuse, attack or injure physically or Inability to walk because of a lack of motor psychologically. The most common form coordination, usually due to psychological is child abuse. Child abuse refers to a child disturbance who has suffered repeated injuries (including bone fractures, neurologic and psy-abate chologic damage, and sexual abuse) at the To decrease or reduce in severity or degree hands of a parent or adultabduction Academy of Leisure Sciences (ALS) Movement of a body part away from the Prestigious society composed of scholars midline of the body who have made outstanding contributions to knowledge about recreation and leisureaberration Deviation from what is typical or normal acathexis Lack of feeling associated with an ordinar-abnormal ily emotionally charged subject Diverging from the normal. The problem with the term is that it can only be defined accessibility in relation to what is normal, about which Elements in the built environment (site or there is often much disagreement building) that allow approach, entrance, and use of facilities by those with sensoryabrasion or mobility impairments; having programs Scraping or rubbing off skin or mucous open to persons with disabilities membrane

Glossary of A accommodation — activity therapy Recreation Therapy and Occupational Therapyaccommodation acrophobia Responding to the environment through Abnormal fear (phobia) of heights new activity or thinking; contrast to Piag- et’s assimilation acting out Expression of emotional tension or intra-accreditation psychic conflict in overt behavior rather Voluntary process by which standards are than words; usually used to describe applied to an institution in order to deter- impulsive, aggressive behavior in which mine if they are met. For example, hospi- the person is not consciously aware of the tals and health facilities may be accredited meaning of such act by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). action therapies College and university curricula may be Term to describe action-orientated thera- accredited by an accrediting body pies such as recreation therapy or therapeutic recreation, occupational therapy andacculturation music therapy; in contrast to “talk therapies” The processes by which children are social- ized to learn the behavior patterns of their activities of daily living (ADL) social group or culture Activities usually performed in the course of a normal day in a person’s life, such asacid eating, dressing, bathing, grooming, and Slang term for lysergic acid diethylamide homemaking (LSD) activity analysisacme Process of systematically appraising what The highest point; critical stage or crisis behaviors and skills are required for par- point of a disease ticipation in a given activityacoustics activity group The science of sound; characteristics of a Activity in which several individuals par- room that affect the distinctness with which ticipate sounds can be heard activity therapyacquired immune deficiency syndrome (AIDS) Umbrella term used to describe activity or Infectious disease that disables the immune action-oriented services including recre- system. It is caused by the human immuno- ation therapy or therapeutic recreation, deficiency virus (HIV). When HIV causes occupational therapy and music therapy; the immune system to fail, a person may usually applied in psychiatric facilities develop a variety of life-threatening illnesses

Glossary ofRecreation Therapyand Occupational Therapy actualization — ADHD Aactualization adapted physical education Realization of one’s full potential Modified physical activity in educational settings for students with disabilitiesacuity Sharpness; used in relation to the senses adapted recreation such as visual acuity Term often applied to community-based recreation programs designed for personsacupuncture with disabilities Pain control technique in which fine metal needles are inserted under the skin at cer- adaptive equipment tain locations Term related to equipment that enables a person with a disability to function inde-acute pendently; the term is being replaced by Of sudden onset; not chronic the term, assistive devicesADA addiction Americans with Disabilities Act Compulsive craving for something; over dependence on the intake of certain sub-ADAAG stances; older term for physiological de- Americans with Disabilities Act Accessibil- pendence on a chemical substance ity Guidelines for Buildings and Facilities adductionadaptation Movement of a body part toward the mid- Response or adjustment to a stressor; fitting line of the body one’s behavior to meet the needs of one’s environment which may involve a modi- adherence fication of one’s impulses, emotions or Degree to which clients follow recommen- attitudes dations of practitioners; also called compli- anceadapted activities Altered activities which fit the needs, ADHD interests and capabilities of individuals; Attention-Deficit Hyperactivity Disorder changes may be made in rules or equipment to accommodate the persons participatingAdapted Child A transactional analysis ego-state that has two functions, either conforming or rebel- ling to what another person wants

Glossary of A adhesion — adventitiously blind Recreation Therapy and Occupational Therapyadhesion individual psychology, inferiority complex, Scar tissue that connects two surfaces that and overcompensation normally are separate from each other; adhesions are sometimes a complication of Administration on Aging (AoA) surgery Principle U.S. agency to carry out the pro- visions of the Older Americans Actadipose Fatty adolescence Period from puberty to sexual maturityadjunct Additional treatment or procedure used for adrenal increasing the efficacy of the primary treat- Flattened body above each kidney that ment or procedure secretes steroid hormones, epinephrine, and norepinephrineadjunctive therapy Somewhat dated term referring to supple- adrenalin mental treatment; used in hospitals to Hormone secreted by the adrenal glands categorize disciplines such as recreation (lying over the kidneys) in times of emer- therapy or therapeutic recreation, occupa- gency or excitement; also called epinephrine tional therapy, and physical therapy Adultadjustment Transactional analysis ego state that is Individual’s functional alteration or adap- analytical, rational, and nonjudgmental. It tion to the immediate environment or one’s is the objective part of personality inner self adult day careadjustment disorder Supervised recreation, social, and health DSM-IV-TR category for maladaptive re- services for older clients with cognitive, actions to identifiable life events or circum- emotional, or physical impairments; pro- stances vides respite for regular caregiversADL adventitious deafness Activities of daily living Due to injury of the ear; in contrast to congenital deafness due to a defect in develop-Adler, Alfred ment (1870-1937) The first of Freud’s major followers to break away, after disagreeing adventitiously blind with Freud’s emphasis on the importance Condition of blindness that occurs to of sexuality. Adler stressed concepts of people who have lost vision at some time 10

Glossary ofRecreation Therapyand Occupational Therapy adventure/challenge therapy — AIDS-Related Complex (ARC) A after the first five years of life—the person age appropriateness usually has some visual memory Activities that correspond with the individual’s chronological ageadventure/challenge therapy Treatment technique in which outdoor ageism recreation activities with elements of actual Word coined by Butler to describe the stig- or perceived risk are performed by clients matizing effect of society’s past attitudes who process on their experiences with a toward persons who are elderly therapist aggressionadvocacy Behavioral act with the goal of doing injury Working in support of the rights and needs or harm to a person or object of others; usually used to refer to working in support of persons who have been agitated handicapped Condition characterized by purposeless, restless activity such as pacing. May serveaerobic to release nervous tension associated with With oxygen present stress, anxiety, or fearaerobic exercise agnosia Exercise that promotes cardiovascular fit- Inability to understand the significance ness by increasing blood flow, heart rate, of sensory stimuli; inability to recognize and metabolic demand for oxygen familiar objects or make sense of sensory informationaffect A person’s feelings, tone or mood; one’s agoraphobia emotional response Abnormal fear (phobia) of open spacesafferent agraphia Moving toward a specific site or reference Loss of the ability to write, resulting from injury to the language center of the cerebralaftercare cortex Posthospitalization program of rehabilitation designed to reinforce the effects of AIDS therapy and to help clients adjust to their Acquired immune deficiency syndrome environment; may be provided in ambulatory care, home healthcare, or community AIDS-Related Complex (ARC) health setting Stage in the development of AIDS in which the immune system begins to falter and 11

Glossary of A Al-Anon — American Association of Retired Persons (AARP) Recreation Therapy and Occupational Therapy some symptoms appear allied health professionals Specially trained health workers other thanAl-Anon physicians, dentists, podiatrists, and nurses, Organization of relatives of alcoholics such as recreation therapists, physical patterned after the structure of Alcoholics therapists, and occupational therapists Anonymous to facilitate discussion and resolution of common problems Alzheimer’s disease Type of dementia in which discrete patchesalcohol dependence (alcoholism) of brain tissue degenerate; causes gradual Dependence on alcohol characterized by and progressive decline in cognitive func- either tolerance to the agent or develop- tioning. Named for German neurologist, ment of withdrawal phenomena on ces- Alois Alzheimer sation of, or reduction in, intake. Other aspects involve psychological dependence AMA and impairment in social or vocational Against medical advice; American Medical functioning. Associationalcoholics amblyopia Persons who drink alcohol heavily and are Reduced vision in an eye that does not addicted to it have an obvious cause. Sometimes termed “lazy eye”Alcoholics Anonymous (AA) Self-help organization of alcoholics that ambulation uses inspirational/supportive group meth- Walking with or without aids, such as ods to aid in the rehabilitation of members braces or crutchesalexia ambulatory care Inability to comprehend written words All types of health services that are provided on an outpatient basis, in contrast toalgophobia services provided in the home or to persons Abnormal fear (phobia) of pain who are inpatientsalienation American Association of Retired Persons Feelings of detachment from self or soci- (AARP) ety; feeling estranged, separated and pow- National organization for people over age erless in relation to oneself or others 50. Offers information, education, advo- cacy, and services 12

Glossary ofRecreation Therapyand Occupational Therapy American Hospital Association (AHA) — androgen AAmerican Hospital Association (AHA) American Psychological Association (APA) Trade association of hospitals, healthcare Largest organization of American psychol- facilities, and medical administrators ogistsAmerican Medical Association (AMA) American Speech—Language—Hearing— National organization of medical doctors of Association (ASHA) all specialties National professional organization for speech and language pathologists and audi-American Music Therapy Association (AMTA) ologists National professional organization for music therapists American Therapeutic Recreation Association (ATRA)American National Standards Institute (ANSI) National professional society for recreation National nongovernmental organization therapists who have particular concern for that publishes a variety of voluntary stan- the use of recreation as a clinical interven- dards tionAmerican Occupational Therapy Association Americans with Disabilities Act (ADA)(AOTA) Federal law, passed in 1990, to allow full National professional organization for and equal access to services and facilities occupational therapists and occupational by persons with disabilities therapy assistants amputationAmerican Occupational Therapy Certification Surgical removal of a limb or other part ofBoard (AOTCB) the body Credentialing board for occupational therapists and occupational therapy assistants anal stage Freud’s second stage of psychosexualAmerican Physical Therapy Association development extending from 18 months to(APTA) 3 years in which most pleasure is derived National professional organization for from stimulation of the anal zone by retain- physical therapists and physical therapy ing and expelling feces assistants androgenAmerican Psychiatric Association (APA) Sex hormone present in both sexes but in Professional organization of physicians greater quantity in males which influences who specialize in the practice of psychiatry characteristics associated with males 13

Glossary of A androgynous — APA Recreation Therapy and Occupational Therapyandrogynous anorexia nervosa Having both male and female characteristics Disorder characterized by a prolonged refusal to eatangina pectoris Condition marked by chest pain that gen- ANOVA erally results from a brief or incomplete Analysis of variance statistical test to com- blockage of the blood supply to heart tissue pare group meansanhedonia ANSI Inability to experience pleasure from ac- American National Standards Institute tivities that usually produce pleasure antagonistanimal assisted therapy Muscle acting in opposition to another Treatment approach in which interactions with pets and other animals are used to antecedent bring about therapeutic benefits Something occurring prior to a behavior which influences the occurrence of thatankylosis behavior Fixation of a joint, as in rheumatoid arthritis anterioranniversary reaction Toward the front of the body; situated in Behavioral reactions, symptoms or dreams front or in the front part of an organism that occur at the same time of the year as a significant past event antibiotic Medication that destroys microorganismsAnnual in Therapeutic Recreation Refereed publication of the American Ther- anticonvulsants apeutic Recreation Association (ATRA) Drugs used to control epileptic seizuresanomaly anxiety Malfunction or abnormality Unpleasant state of apprehension, tension or uneasiness from a vague or largelyanomia unknown or unrecognized source; charac- Inability to name objects terized by increased heart rate, trembling, sweating, and disrupted breathinganorexia Lack or loss of appetite for food APA American Psychiatric Association; Ameri- can Psychological Association 14

Glossary ofRecreation Therapyand Occupational Therapy apathy — assertiveness training Aapathy apraxia “Don’t care” feeling or affect reflected in a Cerebral dysfunction; inability to initiate a lack of interest or emotional involvement purposeful motor act by thinking about it in one’s surroundings and carrying it outAPE aquatic therapy Adapted physical education; programs of Use of pools for treatment and rehabilitation modified physical activity in educational settings to meet the needs of students with Arc disabilities Association of Retarded Citizensaphasia architectural barriers Impaired ability to use or understand oral Structures such as buildings, walkways, language and stairs that are usable by nondisabled persons but present obstacles for peopleAPIE with disabilities to move about freely Abbreviation for assessment, planning, implementation, and evaluation, which are aromatherapy the elements in the RT process. Pronounced Use of essential oils from plants for health “a–pie” purposesapproach-approach conflict art therapy Caused by having to choose between two Use of art as a therapeutic medium to pro- desirable objects or goals that are com- mote self-awareness, nonverbal expression, pletely or partially incompatible and human interactionapproach-avoidance conflict arteriosclerosis Situation in which both positive and nega- Condition in which fatty patches have active outcomes are inherent in the same cumulated and hardened on artery walls, object or goal such as delicious Tex-Mex thereby reducing their elasticity food that gives heartburn arthritisappropriateness of service Inflammation of a joint Services that are medically necessary for assertiveness training the treatment of a particular condition; may Behavioral therapy approach to assist also refer to aspects of the normalization people to become more assertive in sexual principle (e.g., age appropriate) expression or social relationships through frank and direct interpersonal expression of 15

Glossary of A assessment — attribution theories Recreation Therapy and Occupational Therapy feelings and thoughts atherosclerosis Arterial disorder in which the vessel wallsassessment harden (becoming thick, fibrotic, and calci- Collection and analysis of information to fied), resulting in reduced blood flow to determine the status of the client organs normally supplied by the arteryassimilation atonic Subjective learning process by which new Weak or lacking normal tone or vigor material is modified by established mental structures and made a part of existing ATRA knowledge; contrasts with Piaget’s accom- American Therapeutic Recreation Associa- modation tionassistive device atrophy Any technology that enables a person with Wasting away of an organ or part of the a disability to improve his or her functional body level attending behaviorAssociation of Retarded Citizens (Arc) Responses to relevant stimuli primarily Organization to promote better understand- through the use of eye contact, posture, ing of mental retardation. The organization gestures, and verbal behavior now uses the expression “The Arc” to avoid stigma associated with mental retardation Attention-Deficit Hyperactivity Disorder (ADHD) DSM-IV diagnostic category with threeasthma subcategories: (1) Attention-Deficit Hyper- Disorder of the respiratory system charac- activity Disorder, Predominately Inatten- terized by bronchial spasms and difficulty tive Type; (2) Attention-Deficit Hyperactiv- in breathing ity Disorder, Predominately Hyperactivity Type; (3) Attention-Deficit Hyperactivityasymptomatic Disorder, Combined Type Without symptoms attention spanataxia Length of time an individual can concen- Inability to coordinate muscular move- trate on one thing or participate in one ments characterized by lack of balance or activity before losing interest unsteadiness. In psychiatry the term may be used to refer to a lack of coordination attribution theories between feelings and thoughts Social psychology theories dealing with attributing stable characteristics to other 16

Glossary ofRecreation Therapy ABand Occupational Therapy atypical — bedsore people based on our inferences from ob- autonomic nervous system served behaviors, as well as making self-at- Division of the peripheral nervous system tributions based on events that occur in our that carries messages between the central own lives nervous system and the internal organs. It has two parts: the sympathetic and para-atypical sympathetic nervous systems Unusual or uncharacteristic variations of a disorder autonomy Ability to function independentlyauditory Pertaining to hearing aversion therapy Behavioral therapy technique that uses theaura repeated pairing of unpleasant or painful Visual sensation experienced before a stimulus with an undesirable behavior in seizure order to eliminate the behaviorautism avoidance-avoidance conflict Developmental disability characterized by Having to choose between two negative an inability to relate to others, delay in de- objects or goals velopment of communication skills, abnormal responses to sensations and ritualistic Ball, Edith L. behavior (1906-1997) Author in therapeutic recreation known for her continuum of serviceautogenic training model; she served on the faculty of New Relaxation technique in which a series of York University mental exercises involving sensations of heaviness and warmth are used to exert barrier-free design control over physiological processes Design of buildings and other built environments that allows persons with disabili-autonomic dysreflexia ties to make use of the facilities Potentially dangerous complication in SCI above the T-6 vertebra that involves high baseline information blood pressure, sweating, chills, and head- Data or observations obtained before the ache, frequently due to an overfull bladder application of any intervention or impacted bowel. Also known as hyper- reflexia bedsore Sore caused by a lack of circulation to the involved area; synonym for decubitus ulcer 1

Glossary of B behaviorism — biopsychosocial approach Recreation Therapy and Occupational Therapybehaviorism member at New York University for many Approach to psychology founded by John years B. Watson that emphasizes the examination of overtly observable behavior bestiality Sexual relations between a person and anbehavior modification animal Approach that applies general learning principles to modify behavior through sys- bibliotherapy tematic manipulation of the environment; Therapeutic intervention in which books, techniques include positive reinforcement, stories, poems, and other types of literature shaping, prompting, and fading, among are used to enhance the expression of feel- others ings and bring about insightsbehavioral objectives bilateral Statements of specific behavioral condi- On both sides; of, pertaining to, or having tions, actions, and criteria directly related two sides to long-term goals biofeedbackbehavioral therapy Means of receiving information (feedback) Psychiatric treatment modality based on on various physiological processes (e.g., behaviorism that does not focus on psycho- brainwave activity, muscle tension, heart dynamic causation but attempts to change rate, blood pressure, galvanic skin response) unadaptive habits by use of techniques by use of electromechanical devices such as assertiveness training and aversive biopsy therapy, among others Removal and examination, usually micro-benign scopic, of tissue from a living body Relatively mild; likely to have a favorable biopsychosocial outcome; not malignant Interrelationship of biological, psychologi-Berne, Eric cal, and social factors (1910-1970) American psychiatrist known biopsychosocial approach as the founder of transactional analysis Holistic approach to treatment; implies theBerryman, Doris L. etiology of a disease has biological, psy- (1926-2000) Educator who developed the chological, and sociological determinants first standards and criteria for recreation services for residential institutions; faculty 1

Glossary ofRecreation Therapy BCand Occupational Therapy biopsychosocial model — Canadian crutchbiopsychosocial model borderline personality disorder View that health and illness involve the Disorder in which there is instability in a interplay of biological, psychological, and variety of areas, including interpersonal social factors in people’s lives relationships, behavior, mood, and self- image. Interpersonal relations are oftenbipolar disorder intense and unstable, with marked shifts Mood disorder in which the patient exhibits in attitude. Impulsive and unpredictable both manic and depressive episodes; once behavior may occur. Inappropriate and in- called manic-depressive illness tense anger may occur. Identity problemsbisexual may occur as may problems of tolerating Sexual orientation involving erotic feelings being alone and of emptiness or boredom for members of both sexes bowel programbizarre behavior Habit or pattern for emptying the bowel at Eccentric behavior that does not conform a specific time to social expectations bruxismblocking Grinding the teeth, especially during sleep Involuntary cessation of thought processes bulimia or speech Episodic eating binges or excessive intakeblood pressure of food or fluid, generally beyond volun- Pressure exerted by the blood upon the tary control walls of the blood vessels, especially the burnout arteries Stress reaction developed in personsboard-certified psychiatrist working in an occupation with unrelenting Psychiatrist who has passed examinations occupational demands; helping professionals, of the American Board of Psychiatry and including recreation therapists and occupa- Neurology tional therapists, are subject to burnoutbody language Canadian crutch Expression of thoughts and emotions by Device with a metal cuff for the person’s body posture and movement lower arms with a handle for the hand to allow weight bearing that helps the per-borderline mentally retarded son with a disability involving the lower Individuals who possess an IQ of 70 to 85; extremities to stand or walk they are not considered legally disabled 1

Glossary of C cancer — catastrophic health insurance Recreation Therapy and Occupational Therapycancer carpal tunnel syndrome Class of malignant diseases in which cells Painful disorder in the hand and wrist. Ac- proliferate in an unrestricted manner, usu- tivities requiring sustained or repetitive use ally forming a tumor of the hands and wrists may lead to nerve compression, causing the syndromecapitation Method of payment in which the health- carryover care provider is paid a fixed amount for Ability to use newly learned skills or infor- each person served, no matter what the ac- mation from one setting to another tual number or nature of services delivered case conferencecardiac Multidisciplinary team meeting to discuss a Pertaining to the heart client’s statuscardiogram case history Tracing produced by the electrical impulses A brief report on the client’s background; of the heart often prepared by a social workercardiovascular case management Pertaining to the heart and blood vessels Problem-solving process through which appropriate healthcare services are providedcare plan to individuals and families Interdisciplinary plan to address the client’s assessed needs; the expression care plan is castration common in long-term care; other settings Removal of the sex organs. Used figura- may employ the term treatment plan, reha- tively to denote state of impotence, power- bilitation plan, or individual education plan lessness, helplessness or defeatCARF cataract Originally stood for Commission on Ac- Abnormal opacity or clouding of the lens creditation of Rehabilitation Facilities. of the eye causing interference with light Now known as CARF: The Rehabilitation reaching the retina Accreditation Commission; an accreditating body designed to improve the quality of catastrophic health insurance life of persons undergoing medical reha- Health insurance that provides protection bilitation, assisted living, etc. against the high cost of treating severe or lengthy illness or disabilities 20

Glossary ofRecreation Therapyand Occupational Therapy catchment area — cervical Ccatchment area brain; also called stroke Geographic area for which a facility has responsibility cerebrum Upper and largest portion of the brain. Itcatharsis has primary control over motor and mental Release of impulses, thoughts, and re- activity pressed materials accompanied by an emotional response and tension release. CERT Often used in connection with the release Comprehensive Evaluation in Recreation of aggression Therapy Scalecatheter certification Slender, flexible tube of metal, rubber or Process by which a nongovernment agency plastic that is inserted into a body channel, or association evaluates and recognizes often the bladder an individual as meeting predetermined standardsCAT Scan (computerized axial tomography) Computerized x-ray that produces high-res- Certified Occupational Therapy Assistant olution images of the brain, blood vessels, (COTA) arteries, and veins Individual who works under the direction of an occupational therapist after complet-central nervous system (CNS) ing an accredited course of study and pass- Brain and spinal cord ing a certification examcerebellum Certified Therapeutic Recreation Specialist Large portion of the brain that coordinates (CTRS) motor activities and maintains body balance Certification by the National Council for Therapeutic Recreation Certificationcerebral palsy (NCTRC) for a healthcare practitioner to Condition characterized by the inability to practice therapeutic recreation at the pro- control muscular movements due to injury, fessional level. Certification requires the infection, or faulty development of the completion of the minimum of a bachelor’s motor controls of the brain. It may involve degree in therapeutic recreation and exami- involuntary movements, rigidity, paralyses, nation by NCTRC facial grimacing, and speech disturbances cervicalcerebrovascular accident (CVA) Pertaining to the neck or to the cervix Restricted blood supply to a part of the 21

Glossary of C cervical spine — clinic Recreation Therapy and Occupational Therapycervical spine chronological age Seven bones or vertebrae of the spine in the Age in years region of the neck circulatory systemchaining Network of channels through which blood Behavior modification technique of identi- circulates through the body fying a series of steps involved in performing a specific task and guiding an individu- cirrhosis al through the steps Degenerative disease in an organ of the body marked by excess formation of con-change agent nective tissue and subsequent contraction Helping professional who serves as a cata- of the organ. Most commonly used in cir- lyst for change in treatment and rehabilita- rhosis of the liver tion classical conditioningchange of life Form of learning in which existing re- Menopause; the cessation of menses sponses are attached to new stimuli by pairing those stimuli with those that naturallycharting elicit the response. Sometimes referred to The act of written documentation (often as respondent conditioning referred to as progress notes) on the clinical record or chart of a particular client client Individual to whom clinical services arechemotherapy being provided; often referred to as a Treatment of disease or disorder by admin- patient in medical settings or resident in istration of chemical substances residential settings such as nursing homesChild client-centered therapy Basic transactional analysis ego state, Old term for person-centered therapy (see which consists of feelings, impulses and person-centered therapy) spontaneous acts. As a function of learning history, this ego state can take the form of climacophobia the Adapted Child or the Natural Child Morbid fear (phobia) of stairschronic clinic Continuing over a long period of time or Outpatient establishment for the diagnosis recurring frequently and treatment of illnesses 22

Glossary ofRecreation Therapyand Occupational Therapy clinical impressions — coitus Cclinical impressions cognitive Informed, objective opinion of client Refers to the mental process of comprehen- behavior or functional level based upon sion, judgment, memory and reasoning, as sound professional training and experience contrasted with emotional and volitional processesclinical pathways “Road maps” for the provision of multidis- cognitive-behavioral therapy ciplinary clinical services. They are plans Therapy developed by Aaron Beck, based that identify interventions and sequence on the idea that irrational ideas or faulty them along a timeline. Their purpose is reasoning underlie individual’s thoughts providing the most effective and efficient and beliefs way to approach a diagnosis. Also known as critical paths, clinical paths, critical cognitive dissonance pathways, care maps, and care tracks Theory of Leon Festinger which proposes a motivational state (dissonance) existsclinical practice guidelines when an individual’s cognitive elements Systematically developed guide to practice, (thoughts, attitudes, perceived behaviors) based on research and best practices, that are inconsistent with each other. The aids in clinical decision making unpleasant feeling of dissonance drives the person towards inconsistency inclinical psychologist thoughts, attitudes and behaviors Individual with a Ph.D. or Psy.D. in clinical psychology who aids in diagnosis, cognitive retraining or rehabilitation treatment and prevention of mental and Management and treatment of such func- emotional disorders tions and skills as arousal, perception, discrimination, orientation, organization,clinical supervision thinking, recall, and memory for persons Cooperative process in which a supervisor with open or closed head injuries helps an individual (supervisee) who has direct responsibility for carrying out the cohort agency’s clinical program to improve his or Individuals who share a common charac- her clinical abilities and to achieve the ends teristic such as being of the same age of the clinical program coitusclonic convulsion Sexual intercourse in which the penis is Type of convulsion characterized by rhyth- inserted into the vagina mic alternate involuntary contractions and relaxation of muscle groups 23

Glossary of C colitis — congenital blindness Recreation Therapy and Occupational Therapycolitis Comprehensive Evaluation in Recreation Inflammation of the colon (large intestine) Therapy Scale (CERT) often accompanied with weight loss and Original CERT assessment instrument is pain for use in psychiatric settings and contains the three areas of general information,coma individual performance, and group perfor- State of unconsciousness during which mance; a second CERT was developed for most behaviors and reflexes are suspended use with clients with physical disabilities and contains eight clusters of itemscommitment Legally hospitalizing persons for psychiat- compulsion ric treatment Uncontrollable impulse to perform an act repetitivelycommunication Verbal and nonverbal transmission of ideas, computerized axial tomography (CAT Scan) feelings, beliefs and attitudes that permits a Computerized x-ray that produces high-res- common understanding between the sender olution images of the brain, blood vessels, of the message and the receiver arteries, and veinscommunity mental health center (CMHC) conduct disorder Mental health service delivery system Childhood disorder characterized by anti- located in the community typically pro- social behavior viding the following services: inpatient, outpatient, partial hospitalization, emer- confidentiality gency services, consultation and education, Protection of a client’s privacy through specialized services for children and adults careful use of oral and written communica- who are elderly, transitional halfway hous- tions es, alcohol and drug abuse services, assistance to courts and other public agencies, congenital and follow-up care; sometimes referred to Present or existing from the time of birth as centers for behavioral health congenital blindnesscomplete injury Condition of blindness that is present at Total paralysis (loss of movement) and loss birth or during the first five years of life; of sensation (feeling) below the level of the congenitally blind person does not have injury visual memory 24

Glossary ofRecreation Therapyand Occupational Therapy conjoint therapy — criterion level Cconjoint therapy cope Therapy in which both marital partners are To deal or contend with problems success- seen in a joint session fullycontagion coping Spreading of a behavior within a group due Process by which persons deal with prob- to reducing restraints about performing the lems or try to manage the stress they behavior after seeing others doing it experiencecontinuing education unit (CEU) coping mechanisms CEUs are awarded by professional organi- Learned ways of behaving to curb distress zations or universities to individuals who or tension participated in a structured educational program such as a conference or workshop coronary heart disease (CHD) Class of illnesses that result when a nar-continuum rowing or blockage of the coronary arteries A continuous whole whose parts cannot be restricts the blood supply to the heart completely separated, such as the continuum of therapeutic recreation services countertransference Idea from psychoanalysis in which thecontractures therapist unconsciously responds to the Shortening and tightening of tissues around client as though he or she was a significant a joint; decreasing movement other from the therapist’s pastcontrol group “crack” Research group used as a comparison with Purified cocaine alkaloid (also called “free- the experimental group base”)contusion credentialing Bruise without an external break in the skin Recognition of professional or technical competenceconvulsive disorder Epilepsy crisis intervention Brief and instant treatment of acute psychi-co-payment atric emergencies Fee that must be paid by patients, despite being insured, when they use healthcare criterion level Predetermined standard of acceptable performance 25

CD Glossary of Recreation Therapy critical care unit (CCU) — debriefing and Occupational Therapycritical care unit (CCU) cystogram Specially equipped hospital area designed An x-ray of the bladder to see if reflux, the and staffed by personnel skilled in rec- movement of urine backward into the blad- ognizing and immediately responding to der, is present cardiac emergencies cystographyCritical Parent Examination of the bladder with an instru- Transactional analysis ego state which is ment called a cystoscope to detect infection critical and fault finding. Contrasts with and stones and determine how well the the Nurturing Parent bladder is emptyingcunnilingus dance therapy Kissing, sucking, and licking the female Use of dance, movement and rhythmic genitalia activity as a medium for treatment or rehabilitation. It is a nonverbal means ofcustodial care expression employed with both individuals Care provided to meet basic needs which and groups does not offer active treatment datacutaneous Information Pertaining to the skin databaseCVA (Cerebrovascular accident) Information obtained about a client’s past Stoppage of blood circulation to a part of or present level of health during the assess- the brain; also called stroke ment phasecynophobia day hospital Abnormal fear (phobia) of dogs Psychiatric facility that offers therapeutic programs during daytime hourscyst Collection of fluid within any closed cavity debilitation or sac Generalized weakness and lack of strengthcystic fibrosis (CF) debriefing Disorder of the exocrine glands that causes Analysis following an activity which those glands to produce abnormally thick permits clients to think about their partici- secretions of mucus. The glands most af- pation, to examine their feelings, and to fected are the respiratory, pancreatic, and discuss how they may use insights gained sweat glands from the activity 26

Glossary ofRecreation Therapyand Occupational Therapy decubitus ulcer — department Ddecubitus ulcer alcohol but also occurring as a result of Bedsore or pressure sore brain inflammation and senile psychosis.deductible delusion Amount that the client must pay directly to Fixed false belief or conviction without the provider (usually each year) before the foundation; often regarding one’s status insurance plan begins to pay benefits (delusions of grandeur), persecution (delusions of persecution) or oversuspiciousnessdefense mechanisms (paranoid delusions) Strategies that take place unconsciously to protect oneself from a threat to the integ- dementia rity of the ego or to protect oneself against Nonspecific but lasting deterioration of painful negative feelings. Examples include intellectual functioning characterized by denial, sublimation and rationalization failing memory, distractibility, impairment in judgment and abstraction, reduceddehydrate language facility, alterations in mood and To remove water affect, and disturbance of orientation. Ac- companied by changes in personality anddehydration ways of relating to others Excessive loss of water from body tissues denialdeinstitutionalization Defense mechanism by which a person Change in mental health care from tradi- avoids emotional conflicts or anxiety by tional, institutional care to the provision of refusing to acknowledge thoughts, feelings, community based services desires, impulses and other factors that would cause intolerable paindéjà vu Sensation or illusion that one is experienc- department ing what one has experienced before Organizational unit within an agency that may function as an independent unit ordelirium may be an aspect of another unit, division Confused state of consciousness often or service area; an occupational therapy characterized by delusions, hallucinations department is an organizational unit of one and illusions or more staff structured as a work groupdelirium tremens for the purpose of delivering occupational Delirium characterized by intense trem- therapy services ors, anxiety, hallucinations, and delusions suffered by alcoholics after withdrawal of 2

Glossary of D Department of Health and Human Services (DHHS) — Diagnostic and Statistical Manual of Mental Disorders (DSM) Recreation Therapy and Occupational TherapyDepartment of Health and Human Services developmental disability(DHHS) Disability originating before age 18 that Cabinet-level department of the U.S. may be expected to continue for an indefi- government that contains units such as the nite period and that constitutes a substantial Public Health Service, Administration on impairment. Developmental disabilities Aging, Social Security Administration, and include epilepsy, cerebral palsy, mental National Institutes of Health retardation and autismdependency diabetes mellitus Reliance on another (usually a helping pro- Syndrome arising from an absolute or rela- fessional) for psychological support tive lack of body insulin; symptoms stem from excess glucose and include thirst,depersonalization frequent urination and fatigue. In Type I Feelings of unreality or strangeness con- diabetes mellitus (previously known as ju- cerning either the environment, the self, or venile diabetes) there is little, if any, insulin both being made by the body. In Type II there may be sufficient endogenous insulin butdepression the body is unable to use it properly Wide-range feeling running from unhap- piness to extreme dejection. As a clini- diabetic cal syndrome it involves deep sadness or A person with diabetes caused by a de- despair, feelings of worthlessness, morbid ficiency of insulin being secreted by the thinking and greatly reduced psychomotor islands of Langerhans activity diabetic comadepth perception Excessively high level of sugar in the Perception of distance between the stimu- blood resulting from insufficient insulin in lus and the subject the bodydermatitis Diagnostic and Statistical Manual of Mental Inflammation of the skin Disorders (DSM) American Psychiatric Association’s officialdetoxification classification of mental disorders, first pub- Process of the removal of the toxic effects lished in 1952. DSM-IV was published in of a drug from the body 1994. A revised version, DSM-IV-TR, with new statistical information, was publisheddevelopment in 2000. Progressive increase in skill and capacity 2

Glossary ofRecreation Therapyand Occupational Therapy diagnostic related groups (DRGs) — diversional program Ddiagnostic related groups (DRGs) discharge plan Classification representing 23 major diag- Plan that summarizes the treatment or nostic categories that aggregates patients rehabilitation provided, the client’s re- into case types based on diagnosis, age, sex, sponse, current level of functioning, and treatment procedures, and discharge status, recommendations for continued services or predicting use of hospital resources and aftercare as necessary; used when client is length of stay. It has been used as a basis discharged or services are discontinued for system of prospective payment under Medicare disease Literally, the lack of ease; a pathologicaldialysis condition in which physiologic or psycho- Process of separating or removing certain logic functions of the body deviate from substances from the blood when the kid- what is considered to be normal neys fail to perform their normal function disorienteddiplegia Confused as to time, place, and person Paralysis of corresponding parts on both (the position of the self in relation to other sides of the body (i.e., both arms or both persons); characteristic of organic mental legs) disordersdiplopia displacement Double vision Defense mechanism in which emotions are transferred from the original person ordirectionality object to a less formidable, or safer, target. Awareness of and distinction between and It is the “kick the cat” defense among left, right, up, down, front, back, etc., in the world around one. Awareness distal of directional relationship in space Farthest from the center, from the medial line, or from the trunk; opposed to proxi-disability mal; far or distant from the origin or point Physical or mental impairment that sub- of attachment stantially limits one or more of an individual’s life activities diversional program Program of activities designed to divertdischarge goal attention from the client’s problems or Outcome to be exhibited by the client upon concerns. Term may refer to activities to discharge from the service or agency alleviate the boredom of the institutional routine, or to alleviate fear of hospitaliza- 2

Glossary of D Dix, Dorothea — dysphagia Recreation Therapy and Occupational Therapy tion and illness, and to stimulate interest in drug addiction getting well Condition characterized by an over-whelm- ing desire to continue taking a drug toDix, Dorothea which one has become habituated through (1802-1887) Social reformer known for her repeated use work in improving prison conditions and care of persons with mental illness drug dependence Psychological or physiological reliance ondocumentation a chemical agent Act of recording client assessments and interventions in the client’s chart. The chart DTs is a permanent record that is considered a Delirium tremens legal document and is audited to evaluate changes and quality of care dual diagnosis To indicate a client or patient has moredorsal than one major diagnosis; the most com- Pertaining to the back or posterior; directed mon dual diagnosis is mental illness and toward or situated on the back surface substance abuseDown’s syndrome duration Common type of mental retardation Length of treatment or rehabilitation brought on by a congenital condition services, e.g., services will be provided resulting from a chromosomal abnormal- for three weeks or until client goals are ity. At one time referred to as mongol- reached ism. Children with Down’s syndrome are characterized by widely spaced and slanted dyad eyes, a flat face, small ears and congenital Two-person relationship anomalies of the heart dysfunctionalDRGs Unable to function normally Diagnostic related groups dyslexiadrug abuse Impairment in the ability to read Use of a drug to obtain effects for which it dysphagia is not prescribed Difficulity in swallowing 30

Glossary ofRecreation Therapy DEand Occupational Therapy dysphasia — egogramdysphasia edema Difficulty in comprehending oral language Abnormal accumulation of fluid in intercel- or in trying to express verbal language; the lular spaces in the tissues older term for aphasia EEGdyssocial behavior Electroencephalogram Behavior of persons who are not classifi- able as antisocial personalities, but who effective listening are predatory and follow criminal pursuits. Active process that can be used in any Formally termed sociopathic personalities interpersonal transaction. It involves four major skills: attending, paraphrasing, clari-eating disorders fying, and perception checking Marked disturbances in eating behavior including anorexia nervosa and bulimia efferent Conveying away from a centerECG or EKG Electrocardiogram or electrocardiograph efficacy Having the desired influence or outcomeecholalia Automatic repetition of another person’s ego words or phrases Part of the psychoanalytic personality (along with the id and superego). It is theeclectic approach rational part that mediates between the id Utilization of therapeutic approaches and and superego techniques selected from various sources or theoretical orientations egocentric Self-centeredecology Study of the mutual relationship between egogram people and their environment Concept from transactional analysis. The egogram is a visual representation of one’sECT personality using a bar graph to display Electroconvulsive therapy the amount of energy emanating from the five functional ego states (Critical Parent,eczema Nurturing Parent, Adult, Free Child, and Skin condition in which fluid is excreted Adapted Child) through the skin 31

Glossary of E egoist — encounter group Recreation Therapy and Occupational Therapyegoist emaciation Selfish person who seeks to satisfy his or State of being extremely thin her own interests at the expense of others embolismego states Obstruction in a blood vessel caused by the Concept of transactional analysis that states presence of an embolus too large to pass there are three structural ego states that through it (e.g., blood clot) represent distinct and independent levels of psychological functioning (the Parent, embolus Adult, and Child) Any foreign matter, such as a blood clot or air bubble, carried in the blood streamEKG or ECG Electrocardiogram or electrocardiograph emesis Vomitingelectrocardiogram (EKG or ECG) Tracing showing changes in electric poten- empathy tial produced by contractions of the heart Ability to perceive the world from the and used to diagnose heart disease client’s frame of reference or to put oneself in another’s place and understand his or herelectroconvulsive therapy (ECT) feelings and behaviors Treatment used to combat depression and schizophrenia in psychiatric patients. An empirical electric current is applied to the brain Based on facts and experience rather than through electrodes on the scalp, causing theory or philosophical principles; system- convulsions. Sometimes termed electro- atic observation and experiment shock treatment (EST) encephalitiselectro-ejaculation Inflammation of the brain Means of producing sperm by electrical encopresis stimulation from men with ejaculatory Involuntary passage of feces, usually dur- dysfunction ing sleep at nightelectroencephalogram (EEG) encounter group Graphic record of the electrical activity of Group whose major goals are awareness the brain and genuineness. Concern is not so muchelopement with the transfer of learning but with the “Running” (unauthorized departure) from a encounters among members. Sessions tend psychiatric treatment facility to be emotionally charged, dealing with 32

Glossary ofRecreation Therapyand Occupational Therapy endemic — existentialism E feelings of love and aggression erotic Conscious or unconscious sexual feelings;endemic sensually related Belonging, native, restricted or peculiar to a particular people, country, locality or ESP region Extrasensory perceptionendotracheal tube EST Tube inserted into the mouth or nose that Electroshock therapy serves as an artificial airway. It passes through the vocal cords, and therefore etiology speech is not possible with this tube in Cause of a disease or disorder place. It is the tube that connects a respira- euphoria tor to the patient Altered state of consciousness character-enuresis ized by an exaggerated feeling of well-be- Involuntary passage of urine; bed wetting ing, with or without foundationepidemiology euthanasia Statistical study of incidence, prevalence, “Mercy killing,” or putting to death pain- and distribution of diseases in a population lesslyepilepsy exacerbate Disorder characterized by recurrent sei- To increase the severity; to make worse; to zures caused by disturbances of the electri- aggravate cal activity of the brain exhibitionismeremophobia Exposure of one’s genitals to a person of Abnormal fear (phobia) of being by oneself the opposite sex in socially unacceptable situationsErikson, Erik (1902-1990) Psychoanalyst noted for his existentialism theory of psychosocial development Philosophical theory that stresses the way in which a person experiences the pheno-erogenous zone menologic world and takes responsibility Area of the body particularly susceptible to for existence. It is holistic and self-deter- erotic arousal when stimulated, especially ministic in contrast to deterministic points the oral, anal and genital areas of view 33

E F Glossary of Recreation Therapy extended care facility — fetishism and Occupational Therapyextended care facility fading Institution providing medical, nursing or Gradually removing assistance when help- custodial care for clients over a prolonged ing a client perform a task or learn a skill period; includes intermediate or skilled nursing home care failure to thrive (FTT) Physical and developmental retardation ofextension infants or children resulting from physical To straighten a joint; opposed to flexion or emotional neglectextensor FALS Any muscle that extends a joint Fellow in the Academy of Leisure Sciencesextinction family therapy Weakening of a reinforced operant re- Treatment of more than one member of a sponse as a result of ceasing reinforcement. family in the same session. The assump- Also, the elimination of a conditioned tion is that a mental disorder in one mem- response by repeated presentations of a ber of a family may be manifestation of conditioned stimulus without the uncondi- disorder in other members and may affect tioned stimulus interrelationships and functioningextrasensory perception (ESP) fee-for-service Experiencing of an external event by Type of reimbursement in which a health means other than the five senses, as by provider charges a client (or third-party telepathy or clairvoyance payer) a specific price for a specific serviceextrinsic fellatio Coming from the outside; doing something Kissing, sucking, and licking the male for reasons of reward or punishment ex- genitalia ternal to the activity itself; contrasted with intrinsic motivation fetal alcohol syndrome (FAS) Fetal abnormalities associated with heavyfacilitation alcohol consumption by the pregnant Enhancement of any action or function womanFACTR fetishism Functional Assessment of Characteristics Practice of arousing sexual desires with for Therapeutic Recreation inanimate objects 34

Glossary ofRecreation Therapyand Occupational Therapy Fidler, Gail — Free Child FFidler, Gail Talking in an incoherent and unrelated (1916- ) Advocate for the role of occu- stream pational therapy with persons with mental illness, she wrote the first comprehensive flow experiences textbook on psychiatric occupational therapy Episodes that provide intensely absorbing experiences in which participants lose trackfine motor skills of time and awareness of themselves while Skills involving precise or well-controlled engaged in challenges that match their movements in writing, tracing, cutting, and skills. The term flow was made popular by similar activities Csikszentmihalyifixation Foley catheter The arresting of personality development Tube inserted into the bladder to drain the prior to full maturity due to either exces- urine into a plastic bag either attached to sive frustration or gratification. In Freud- the leg or the bed ian theory the individual may become fixated at any of the psychosexual stages folie à deux Emotional illness shared by two closelyflaccid related persons that involves sharing of the Soft, limp, relaxed, without muscle tone same delusionsflagellation forensic psychiatry Masochistic or sadistic act in which one or Branch of psychiatry dealing with legal is- both participants derive erotic stimulation sues related to mental disorders from whipping or being whipped fornicationflat affect Sexual intercourse between two persons Absence or near absence of any signs of who are not married to each other affective expression “freebase”flexibility Purified cocaine alkaloid (also termed Ability to use a muscle through its entire “crack”) range of motion Free Childflexion That part of personality (according to trans- State of being bent; opposed to extension actional analysis) which is spontaneous, eager and playfulflight of ideas 35

Glossary of F frequency — fusion Recreation Therapy and Occupational Therapyfrequency normal or accepted manner Number of times the service will be provided within a given time frame; e.g., ser- Functional Assessment of Characteristics for vices will be provided twice daily for three Therapeutic Recreation (FACTR) weeks or until treatment goals are reached Assessment instrument used to identify client needs related to basic functional skillsFreud, Sigmund and behaviors used in leisure participation (1895-1939) Austrian psychiatrist and founder of psychoanalysis functional disorder Disorder in which the performance orFRG operation of an organ or organ system is Function Related Group abnormal, but not as a result of known changes in structurefrontal Pertaining to the forehead; a plane that functional electrical stimulation (FES) divides the body into anterior and posterior Application of low-level, computer- portions controlled electric current to the muscles, including paralyzed muscles, to enhance orFrye, Mary Virginia produce function (1918- ) Red Cross hospital recreation worker during World War II. Held faculty Functional Independence Measure (FIM) posts at the University of Illinois and Iowa 18-item, 7-level scale that assesses severity State University. Leader in the advance- of disability in performing basic life activi- ment of the national registration program ties and coauthor of major TR textbook functional psychosisFTT Major emotional disorder characterized by Failure to thrive derangement of the personality and loss of the ability to function in reality; not direct-Function Related Group (FRG) ly related to physical processes System in which clients are grouped according to functional ability. It is currently fusion the grouping system for the Health Care Joining together; as in joining two or more Finance Administration’s prospective pay- vertebrae to make solid and prevent motion ment system (PPS) in rehabilitation settingsfunctional ability Level of skill to perform activities in a 36

Glossary ofRecreation Therapyand Occupational Therapy GAF Scale — gross motor skills GGAF Scale gerontology Global Assessment of Functioning Scale Study of aginggait gestalt therapy Manner or style of walking, includes Type of psychotherapy developed by Fred- rhythm, cadence and speed of walking eric Perls that focuses on sensory awareness and here-and-now experiencesgalvanic skin response (GSR) A means to measure change in the electri- glaucoma cal resistance of the skin using a galvanom- Disease of the eye caused by increased in- eter to gain an index of emotional arousal ternal fluid pressure, leading to progressive visual impairment and finally blindnessgames Transactional analysis concept. Stereo- Global Assessment of Functioning Scale (GAF typed and predictable patterns of behavior Scale) based on transactions which are partially Scale used to describe the highest social, ulterior and which result in negative out- occupational, or educational level of func- comes (e.g., “Kick Me,” “Rapo”) tioning of a person in the 12 months pre- ceding the current evaluationgay Popular term for homosexuals, particularly glucose males Blood sugargender goal Specific sex of a person or the classification Aim or an end; expected outcome or gen- of a person as male, female, or ambivalent eral objectivegeneralized anxiety disorder grief DSM-IV term for anxiety neurosis Form of sorrow involving the person’s thoughts, feelings and behaviors, occurringgenital organs as a response to an actual or perceived loss Male and female sex organs gross motor skillsgeriatrics Skills involving coordination of large mus- Branch of medicine dealing with the aging cle groups in activities such as walking, process and medical problems of aging running, jumping, throwing, and maintain- ing balance 3

GH Glossary of Recreation Therapy group — health and Occupational Therapygroup hallucination Collection of individuals who coordinate False sensory perception involving any of their activities toward a common goal or the senses, without corresponding stimuli. cooperate to fulfill some purpose. Group Hearing voices that do not exist, for exam- members relate to one another and are ple, would be an auditory hallucination interdependent halo orthosisgroup dynamics Metal ring and supporting frame, placed Group process; phenomena that occur in around the head with pins inserted into groups the cranium and attached to a body jacket or vest, to immobilize the upper body andgroup home cervical spine Supervised living situation that helps persons to learn skills to prepare them for handicap semi-independent or independent living Term originally used to denote disadvan- tage in sports that is open to change and togrowth psychology interpretation. In popular usage sometimes Humanistic psychology that perceives used interchangeably with the term disabil- people as being self-aware, able to accept ity. May be used to signify what society or reject environmental influences, and can do to persons with disabilities by refus- generally capable of being in conscious ing them opportunities or what individuals control of their own destiny. It emphasizes with disabilities may do to themselves by the development of unique potentials believing that they cannot do something when, in fact, they could function given theGSR right conditions Galvanic skin response hardinessgustatory Array of personality characteristics that Involving taste enables individuals to withstand stress and not succumb to its negative health effectshabilitation Encouragement and stimulation of the HCFA development and acquisition of skills and Health Care Financing Administration functions not previously attained healthhabituation Individual’s ability to function optimally in Acquired tolerance from repeated exposure his or her environment; involves the physi- to a stimulus cal, mental, and social well-being of the 3

Glossary ofRecreation Therapyand Occupational Therapy Health Care Financing Administration (HCFA) — high-level wellness H individual; encompasses coping adaptively, helplessness as well as growing and becoming Feeling that results when events and behaviors are perceived to be uncontrollable.Health Care Financing Administration (HCFA) Helplessness is learned through environ- Unit of the U.S. Department of Health and mental interactions and therefore may be Human Services that administers Medicare altered and Medicaid hemiplegiahealth maintenance organization (HMO) Paralysis of one side of the body Group healthcare agency that provides basic and supplemental health maintenance hemophilia and treatment services to voluntary enroll- Hereditary condition in which the blood ees who prepay a fixed periodic fee without fails to clot quickly enough causing pro- regard to the amount or kind of services longed, uncontrollable bleeding; it occurs received almost exclusively in males and is transmitted by femalesHealth Protection/Health Promotion Model Model of practice for therapeutic recreation hemorrhage developed by David R. Austin. Its goals Bleeding include the treatment of illnesses and disorders (health protection) and the achieve- heredity ment of optimal health (health promotion) Transmission of genetic characteristics from parent to childhedonic Seeking pleasure and avoiding pain hernia Protrusion of an organ, or part of it, throughhelping relationship the wall of the cavity that houses it Interpersonal relationship between a person(s) with special problems or needs heterosexuality and a person skilled in techniques to help Sexual attraction or contact between op- meet these problems or needs. The goal of posite-sex individuals the relationship is to facilitate clients in as- high-level wellness suming responsibility for themselves; it is Approach that centers around the whole- not to solve their problems for them. The ness of the individual, calling for wellness relationship is directed toward maximizing or health enhancement in contrast to the ill- the clients’ growth potential and preventing ness orientation often found in the medical or relieving problems community 3

Glossary of H Hill, Beatrice H. — Hutchinson, Ira J. Recreation Therapy and Occupational TherapyHill, Beatrice H. hopelessness (1914-1993) Prominent citizen leader who Feeling that often accompanies helpless- helped shape therapeutic recreation, and ness in which the individual feels doomed founder of Comeback, Inc., which gave to live with a condition with no opportunity grants to universities for graduate students to change in therapeutic recreation horticulture therapyHIV Working with plants to bring about thera- Human immunodeficiency virus peutic outcomes in clientsHMO hospice Health maintenance organization Program that provides supportive care for terminally ill patients and their familiesholism Concept that views a person as more than humanistic perspective the total sum of parts and shows concern View that perceives the delivery of human and interest in all aspects of the person services as a human enterprise in which the dignity and rights of clients are fully recog-holistic healthcare nized. People are seen as striving to realize Healthcare that takes into account the whole their individual potentials, yet capable of person interacting with the environment growing beyond themselves in order to care about othershomemaking Refers to skill and performance in home Humphrey, Fred management tasks, such as meal planning, (1922-1994) Educator active during the meal preparation and clean-up, laundry, evolutionary days of therapeutic recreation. cleaning, minor household repairs, shop- Initiated TR curricula at the University of ping, and use of household safety principles Iowa, Pennsylvania State University, and Temple University. Past president of NTRShomeostasis State of equilibrium Huntington’s chorea Hereditary progressive central nervoushomophobia system disease characterized by jerking Fear of or prejudice against persons who motions and progressive mental deteriora- are homosexuals tion; onset in adult lifehomosexuality Hutchinson, Ira J. Sexual attraction or contact between same (1926- ) First president and first execu- sex individuals tive secretary of NTRS 40

Glossary ofRecreation Therapy HIand Occupational Therapy hydrotherapy — imageryhydrotherapy Low blood sugar Use of water in the treatment of disease hypomaniahyperactivity Psychopathologic state with restlessness Overreaction to stimuli leading to greatly and over activity, disinhibited behavior, increased muscular movement. In DSM- racing thoughts, and elated mood IV called attention deficit disorder (ADD) hypotensivehyperemia Abnormally low blood pressure Congestion of blood in any part of the body hypotonichyperextension Abnormally low tension or tone, especially Extreme or abnormal straightening beyond in the muscles a position of extension idhyperopia Part of the psychoanalytic personality Farsightedness (along with the ego and superego). It contains the primitive biological urgeshypertension that demand immediate gratification and is Consistent elevation of blood pressure ruled by the pleasure principle above normal ideas of referencehyperthermia Symptom in which a person (who usually Highly increased body temperature is paranoid) ascribes special importance to irrelevant events and believe that they arehypertonic related to himself or herself Abnormally high tension or tone, especially of the muscles idiopathic Without a known causehypertrophy Increase in the size of a tissue or organ IEP independent of the general growth of the Individualized educational program body illusionhypochondriasis Misperception of an actual sensory stimulus Psychological disorder characterized by anxiety and a preoccupation with somatic imagery concerns and symptoms that do not exist Use of positive suggestions to create mental representations of things we know orhypoglycemia 41

Glossary of I impaction — insight Recreation Therapy and Occupational Therapy can fantasize individualized treatment plan (ITP) Program designed to meet a client’s treat-impaction ment needs based on treatment goals and Blockage of the bowel with stool that re- considering the client’s unique background, sults in severe constipation psychological makeup, personal needs, and expectationsincest Sexual activity between close blood rela- individualized educational program (IEP) tives, such as father-daughter, mother-son, Program specially designed to meet the or between siblings educational needs of a specific child with a disability or disabilitiesinclusive recreation Full inclusion of persons with disabili- indwelling catheter ties into the recreation mainstream; joint Catheter designed to be left in place for participation of persons with and without a prolonged time; often used to refer to a disabilities flexible tube, retained in the bladder, and used for continuous urinary drainage to aincomplete injury leg bag or other device Some movement and/or feeling remains below the level of injury; movement and infarct feeling may improve over time Area of tissue that dies from loss of blood supplyincontinence Inability of any of the organs to restrain informed consent discharges of their contents so that the dis- Permission given by a client to be involved charges are involuntary in a treatment procedure or research studyincontinent inpatient Unable to restrain a natural discharge, as in Patient who has been admitted to a hospital urine, from the body or other healthcare facility for at least an overnight stayIndex Medicus Index published monthly by the National insight Library of Medicine listing articles from the Awareness of the origin, nature, and mech- medical, nursing, and allied health litera- anisms of attitudes and behaviors; self-un- ture derstanding 42

Glossary ofRecreation Therapy I Jand Occupational Therapy instinct — Johari’s windowinstinct intrinsic Unlearned, biologically determined drive Coming from within; an inherent qualityinsulin reaction intubation Low blood sugar resulting from too much Insertion of a tube through the nose or insulin, increased physical exercise, or mouth into the windpipe to keep the air- insufficient intake of food ways openintensity IQ (intelligence quotient) Level or complexity of care provided Numerical expression of intelligence encompassing setting and resources used derived by dividing mental age by chrono- (e.g., acute inpatient care is generally con- logical age and multiplying by 100 sidered to require more intensity than home healthcare) isometric exercise Muscle contractions without major bodyintensive care unit (ICU) movement, including tensing and relaxing Hospital unit where patients receive critical opposing groups of muscles, or pulling or care and close monitoring pushing against stationary objectsinterdisciplinary team isotonic Group of professionals with varied and Equal tension specialized training who function together to provide clinical services for a cli- isotonic exercise ent. Recreation therapists (or therapeutic Muscle contraction, involving a constant recreation specialists) and occupational amount of muscle tension, such as in therapists are usually members of teams gradually lifting a weight and, depending on type of setting, serve ITP with professionals such as medical doc- Individualized treatment plan tors, nurses, social workers, psychologists, speech therapists, and physical therapists JCAHO Joint Commission on Accreditation ofintern Healthcare Organizations Student completing a major field experience Johari’s windowintervention Diagram of the interpersonal behavior of Carrying out a plan of action derived dur- individuals that reveals the degree of opening the planning stage of the RT process to ness with which they meet other people bring about changes in the client and their level of awareness of themselves 43

J L Glossary of Joint Commission on Accreditation of Healthcare Recreation Therapy Organizations (JCAHO) — legal blindness and Occupational TherapyJoint Commission on Accreditation of lateralHealthcare Organizations (JCAHO) Pertaining to or toward the sides of the Group of agencies that establish standards body; denoting a position farther from the for hospitals and health organizations median plane or midline of the structure which they apply during inspections that lead to accreditation laterality Awareness of the right and left sides of theKahmann, Winifred body (1895-1982) Started OT services at Indiana University Hospitals in the 1920s; Chair- leadership man of War Services Committee during Ability to influence the activities of others WWII; first occupational therapist to serve toward accomplishing sought outcomes as president of AOTA (1947-1952) learned helplessnessKardex Condition of apathy or inactivity that Trade name for a care plan documentation results from repeatedly experiencing a lack system of control over adversive life experienceskinesiotherapy learning disability Treatment of disease by movement or exercise Condition affecting persons of normal or above normal intellect characterized bykinesthesis specific difficulties in learning. Examples Muscle sense; the feel that accompanies a include dyslexia (difficulty in reading) and movement dysgraphia (difficulty in writing)labeling least restrictive environment Act of assigning a categorical term to an Best possible environment for an individu- individual, often causing stigmatization al with disabilities in which the individual is not unnecessarily controlled, preferablylabile an environment shared with persons who Unstable; rapidly shifting are nondisabledlaparocolostomy legal blindness Forming a permanent opening into the colon Visual acuity for a distance of 20/200 or by incision in the wall of the abdomen less in the better eye with correcting lenses or a visual field of less than an angle of 20latent degrees. Thus, the legally blind person can Something that is dormant; existing as a see no more at a distance of 20 feet than a potential 44

Glossary ofRecreation Therapyand Occupational Therapy leisure — license L person with normal vision can see at 200 Leisure Diagnostic Battery (LDB) feet, or the person has an extremely narrow Collection of instruments to assess leisure field of vision functioning of persons with disabilities and persons without disabilitiesleisure Intrinsically motivated, self-determined lesbianism experience allowing for a chosen level Female homosexuality of mastery and competence that leads to feelings of self-efficacy, empowerment, lesion excitement or enjoyment; having freedom An injury or wound; any visible abnormal- to become ity of skin tissues, such as a wound, sore, rash, or boilLeisure Ability Model Practice model for therapeutic recreation lethargy originally developed by Carol Peterson and Mental dullness or drowsiness Scout Gunn that has as its goal developing leukemia the client’s leisure abilities Form of cancer that involves the blood-Leisure Competence Measure (LCM) forming tissues of the bone marrow, spleen, 8-leisure domain, 7-level point scale de- and lymph nodes signed to document leisure functioning and Lewin, Kurt to measure recreation therapy outcomes (1890-1947) German psychologist wholeisure counseling emigrated to the United States where he Helping process in which the counselor studied leadership and group dynamics and attempts to assist the client to discover and developed field theory; known as the father change leisure attitudes or behaviors. Vari- of modern social psychology ous verbal and nonverbal techniques are libido utilized in a counseling setting to help the Psychic drive or energy associated with the client cope effectively with leisure prob- sexual instinct lems and concerns, make decisions and develop plans for future leisure participa- license tion, become self-aware regarding percep- Permission granted to an individual or tions toward leisure, and explore options organization by a governmental agency to for leisure engage in a practice, occupation, or activity otherwise unlawful 45

LM Glossary of Recreation Therapy lipid — Maslow, Abraham and Occupational Therapylipid maladaptive behavior A fat Activity that is dysfunctional or counter- productive in coping effectively with stresslocus of control Generalized belief people have about malignant whether the causes of events in their lives Very dangerous; likely to cause death (e.g., are within or outside their control cancer is a malignant tumorLSD malingering Lysergic acid diethylamide. A potent hallu- Simulation or exaggeration of an illness to cinogen commonly called acid avoid an unpleasant situation or duty or to obtain some type of personal gainlumbar Pertaining to the lower back; part of the managed care body between the thorax and pelvis General term for any system of healthcare delivery organized to enhance cost-ef-lumbar spine fectiveness. Managed care networks are Five vertebrae of the spine in the region of providers that agree to provide services to the lower back, the strongest part of the spine those covered under a plan, usually organized by insurance carriers but may also bemagical thinking organized by hospitals or employers Conviction that thinking equates with doing. Occurs in dreams with children, in mania primitive peoples, and in clients under a Abnormally euphoric emotional state char- variety of conditions. Characterized by a acterized by extreme excitement, excessive lack of realistic relationship between cause elation, hyperactivity, agitation, and accel- and effect erated thinking and speakingmagnetic resonance imaging (MRI) marathon group Special technique for neurologic diagnosis; Uninterrupted meetings of twenty hours or form of imaging that provides images of more with a goal of breaking down de- thin slices of the brain in any plane using fenses nonionizing energy Maslow, Abrahammainstreaming (1908-1970) Leading exponent of human- Helping people with disabilities to be inte- istic psychology closely associated with grated into typical settings so that they can the concept of self-actualization and one’s function at their optimal level of indepen- needs hierarchy dence 46

Glossary ofRecreation Therapyand Occupational Therapy mastery — minimal brain damage Mmastery and heartbeat rate Demonstrated ability to perform a given task meningitis Inflammation of the meninges covering themasturbation brain and spinal cord Achievement of sexual gratification by manual stimulation menorrhea Menstruation; very profuse menstruationmedial Near the midline of the body menses Menstruation, the normal flow of bloodMedicaid from the female genital tract Joint federal and state health insurance program for a population of low-income mental retardation persons, families with dependent children, Significantly subnormal general intellectual and clients who are aged, blind, or disabled functioning existing concurrently with defi- cits in adaptive behavior, evident at birthmedical clearance or manifested during childhood. Degrees Approval from a medical doctor for a pa- of mental retardation are commonly mea- tient or client to take part in an activity sured in terms of IQ: mild (50-55 to 70); moderate (35-40 to 50-55); severe (20-25 toMedicare 35-40); profound (below 20-25) Federal program to provide hospital and medical care for persons 65 years of age midbrain and older Portion of the brainstem that plays an important part in vision, hearing, and musclemeditation movement Technique that involves sitting comfortably in a quiet place for a few minutes one or milieu therapy two times each day while passively dwell- Psychiatric treatment approach that empha- ing on a single word or sound (mantra) sizes socioenvironmental manipulations or the effect of the total environment onMEDLARS the client. It has usually been employed in Medical Literature Analysis and Retrieval psychiatric hospitals System, a computerized literature retrieval system minimal brain damage Minimal or mild neurological abnormalitymedulla that may lead to learning difficulties Part of the brainstem that contains control centers for such vital functions as breathing 4

Glossary of M Minimum Data Set (MDS) — muscular dystrophy Recreation Therapy and Occupational TherapyMinimum Data Set (MDS) mortality Basic assessment tracking form for nursing Death, usually with reference to large home resident assessment and care screen- populations ing MRIMinnesota Multiphasic Personality Inventory Magnetic resonance imaging(MMPI) Psychological instrument often adminis- multimodal therapy tered to psychiatric patients; it provides a Psychotherapy approach developed by profile reflecting nine dimensions of per- Arnold A. Lazarus that uses a diverse range sonality of treatment methods drawn from various sourcesmobility Ability to move from one location to an- multiple personality other Rare and dramatic dissociative reaction in which a person has two or more distinc-modality tive personalities such as Dr. Jekyll and Mr. Activity used as an intervention for treat- Hyde or The Three Faces of Eve ment or rehabilitation purposes multiple sclerosis (MS)modeling Chronic, slowly progressive disease of the Learning by watching the behavior of other central nervous system that usually occurs persons; demonstration of a task, skill, or between the ages of 20 and 35. It is unpre- desirable behavior in order to teach another dictable, often punctuated by remissions person and exacerbations. Weakness of the extremities is the most common symptom ofmoral therapy the disease; other symptoms include partial Philosophy and technique of treating men- or complete paralysis of the body, a prick- tal patients that prevailed in the first half of ing sensation in parts of the body, numb- the 19th Century and emphasized removal ness, defective vision, noticeable dragging of restraints, humane and kindly care, of the feet, loss of control of bowels and attention to religion, and performance of bladder, poor balance, speech difficulties, purposeful activities; known as a forerun- weakness and fatigue, loss of coordination, ner of recreation therapy and tremors of the handsmorbidity muscular dystrophy Condition of illness, injury, or disability Chronic, inherited disease of the muscles characterized by gradual weakening and 4

Glossary ofRecreation Therapy MNand Occupational Therapy music therapy (MT) — NCTRC degeneration of the voluntary muscles National Association of Recreation Therapists (NART)music therapy (MT) Begun in 1952, NART championed the Professional discipline that uses music use of recreation as a tool of treatment. In listening, participation and interpretation as 1965, NART merged with other organiza- a treatment modality tions to form the National Therapeutic Recreation Societymyelitis Inflammation of the spinal cord National Board for Certification in Occupational Therapy (NBCOT)myocardial infarction Authority that administers entry-level Damage to the heart muscle (myocardium) certification programs for occupational that results from severe or prolonged therapists blockage of blood supply to the tissue. Commonly termed a heart attack National Council for Therapeutic Recreation Certification (NCTRC)myopathy National body that tests and certifies thera- Abnormal condition of skeletal muscle peutic recreation specialists in the United characterized by muscle weakness and States wasting National Institutes of Health (NIH)myopia U.S. Public Health Service agency that Nearsightedness includes a number of divisions such as the National Institute of Mental Health (NIMH)narcissism Self-love; preoccupation with self National Therapeutic Recreation Society (NTRS) National professional society for therapeu-narcotics tic recreation specialists; a branch of the Drugs that relieve pain, act as sedatives, National Recreation and Park Association and may produce euphoria. These substances are also called opiates and usually Natural Child lead to addiction with continued use Transactional analysis ego state which is impulsive, spontaneous and creative. Con-National Alliance for the Mentally Ill (NAMI) trasts with the Adapted Child National organization for family members of persons with mental illness NCTRC National Council on Therapeutic Recre- ation Certification 4

NO Glossary of negative reinforcement — Recreation Therapy Occupational Therapy Uniform Evaluation Checklist and Occupational Therapynegative reinforcement as possible; direct involvement of individu- Any behavior which increases the probabil- als with disabilities with nondisabled peers ity of a response by terminating or with- by including activities of everyday life that drawing an unpleasant stimulus are consistent with the norms and patterns of mainstream societynervous breakdown Nonspecific euphemism for a mental disor- Nurturing Parent der Transactional analysis ego state that is warm, supportive and caring. In contrastneurogenic bladder with the Critical Parent Dysfunctional bladder due to an injury of the nervous system obese Excessively overweight; 20% above idealneurology weight Diagnostic study and treatment of organic diseases of the nervous system observational learning Behavior learned by an individual by imi-neurosis tating the behavior of a model In common usage, emotional disturbances of all kinds other than psychosis; it implies obsession anxiety and maladaptive ways of dealing Persistent, fixed idea or impulse that cannot with it; dated term be eliminated by logic or reasonnoctiphobia occupational therapy (OT) Irrational fear of the night Purposeful mental and physical activities prescribed by medical doctors to enhancenocturnal individuals’ abilities to perform daily occu- Occurring at night pational roles. Clients include those with physical injuries or illnesses, developmen-nonverbal communication tal disorders, problems caused by aging, or Messages passing between the sender and social or emotional problems receiver that do not use the spoken word Occupational Therapy Uniform Evaluationnormalization Checklist Refers to the provision of relatively normal American Occupational Therapy Associa- experiences so that individuals with dis- tion guidelines for occupational therapy abilities can maintain or develop traits and assessment behaviors that are as culturally normative 50

Glossary ofRecreation Therapyand Occupational Therapy occupations — outcome criteria Ooccupations organic mental syndrome (OMS) Meaningful and purposeful activities in Abnormality associated with transient which people engage during their everyday or permanent dysfunction of the brain of lives such as work, leisure, social interac- unknown or unspecified etiology, char- tions, and self-care acterized by disorientation and signs of psychosis such as hallucinations, delusions,ocular impaired judgment, and poor impulse control Pertaining to the eye orientOedipus complex To acquaint someone with new surround- Freud’s notion of an erotic attraction of ings the male child for his mother; extended to relate to sexual impulses toward the op- orientation posite-sex parent and aggressive or envious Awareness of oneself in terms of time, feelings toward the same-sex parent place, and personolfactory orthopedics Involving smell or odors Correction or prevention of disorders involving muscles, bones, or tissuesO’Morrow, Gerald S. (1929- ) Past president of NTRS, major orthosis therapeutic recreation textbook author, Device (e.g., special braces) applied to the noted educator, and early advocate for outside of the body to support, aid, and leisure counseling align the body and the limbs or to assist motion by controlling, correcting, or com-operant conditioning pensating for bone deformity Type of learning in which responses are modified by their consequences. Rein- osteoarthropathy forcement increases the likelihood of future Any disease of the bones and joints occurrences of the reinforced response. Sometimes termed instrumental condition- osteoporosis ing or reinforcement theory Disorder characterized by abnormal loss of bone densityorganic disease Disease characterized by demonstrable OT structural or biochemical abnormality in an Occupational therapy organ or tissue outcome criteria Criteria that describe, usually in client 51

OP Glossary of Recreation Therapy outcome goals — Parkinsonism and Occupational Therapy behaviors, the end result of treatment and pain care provided Sensory and emotional discomfort, usually related to actual or threatened tissue damageoutcome goals General objectives that describe client pain clinics behavioral outcomes of treatment or reha- Centers that specialize in the treatment of bilitation; contrast with process goals that chronic pain describe what staff will do to help the client achieve outcome goals palsy Paralysisoutcome measure Instrument designed to gather information para on the efficacy of a program; a means to Prefix meaning “alongside”; sometimes determine if outcome goals and objectives used as a shortened version of paraplegic have been reached paranoidoutcome objectives Lay term commonly used to describe an Specific objectives are written at a level to overly suspicious person. The technical designate explicit client behaviors and may use of the term refers to people with para- stipulate conditions and/or criteria. Gen- noid ideation, a type of schizophrenia, or a eral objectives (sometimes termed outcome class of disorders goals) are written at the level of specificity paraparesis needed to direct action but are not overly Partial paralysis, usually affecting extremi- restricting. A general objective provides ties below the cervical section of the spinal direction toward a general type or class of cord behavior and should be definable by stating specific objectives relevant to it paraplegia Paralysis of the lower extremitiesoutpatient Patient receiving medical care who does paraprofessional not require hospitalization Trained aide who assists a professionalOutward Bound Parkinsonism Adventure/challenge program begun in Once called Parkinson’s disease, it is cur- England in the 1940s for youth to develop rently perceived to be a clinical syndrome inner resources through physical and men- and not a specific disease. It usually begins tal challenges with a tremor in one of the upper limbs 52

Glossary ofRecreation Therapyand Occupational Therapy partial hospitalization — person-centered therapy P accompanied by “pill-rolling” movements peds of the thumb and fingers, a masklike ap- Informal abbreviation of pediatrics pearance to the face, and slowed speech. Balance and ambulation may be affected, perception as well as cognitive processes. It usually Process of becoming aware of, attend- affects older persons and is slowly progres- ing to, or interpreting stimuli, usually by sive visual, auditory, or kinesthetic sensespartial hospitalization performance test Type of psychiatric/mental health service Test that measures client performance in a for clients who require hospitalization only specific area (e.g., cardiovascular endur- during the day, overnight, or on weekends ance, range of motion)pathological peripheral nervous system Abnormal; caused by disease Network of nerve fibers that transmit messages between the central nervous systempathology and the skin, skeletal muscles, and internal Branch of medicine that deals with causes organs. It has two parts: the somatic and and symptoms of diseases, especially the autonomic nervous systems structural and functional changes caused by a disease personality disorders Deeply ingrained, inflexible, maladaptivepatient patterns of relating, perceiving and think- Person receiving healthcare services in a ing of sufficient severity to cause other im- hospital or other medical setting pairment in functioning or distress. Some personality disorders include antisocial,Pavlov, Ivan Petrovich borderline, compulsive, dependent, para- (1849-1936) Famous Russian neurophysi- noid, passive-aggressive, and schizoid ologist noted for his research on classical conditioning person-centered therapy Growth-oriented therapeutic approachpediatrician developed by Carl Rogers. The role of Medical doctor who specializes in the the helper in person-centered therapy is to development and care of children and the display unconditional positive regard for treatment of children’s diseases clients who are seen to have a basic tendency to actualize their potentials and seekpediatrics positive self-regard Healthcare of children and the study of childhood diseases 53

Glossary of P Peterson, Carol Ann — positive reinforcer Recreation Therapy and Occupational TherapyPeterson, Carol Ann Piaget, Jean (1941- ) With Gunn, developed Leisure (1996-1980) Swiss psychologist noted for Ability Model. Past president of NTRS his theory of cognitive development and major textbook author PKUphantom pain Phenylketonuria Perceptions of pain in a body part that has been surgically or accidentally removed placebo from the body Material prepared to resemble an active drug but that has no pharmacologic activ-phenomenological ity; an inactive substance or procedure Subjective experiences and feelings of an given to the control group as if it were an individual effective treatmentphenylketonuria (PKU) play therapy Genetic disorder resulting in the buildup of Type of psychotherapy for children that concentrations of chemicals that interfere utilizes play activities and toys with brain development, leading to severe mental retardation; detectable by a simple pleasure principle test administered shortly after birth and According to psychoanalytic theory, the treatable by diet when detected early basic human tendency to avoid pain and seek pleasurephobia Obsessive, persistent, unrealistic, intense poliomyelitis (polio) fear of an object or situation Acute communicable systemic viral disease affecting the central nervous system withphysical disability variable severity ranging from subclinical Physical degeneration or loss to an individ- infection to paralytic disease, to possible ual caused by either congenital or adventi- death tious factors ponsphysical therapy (PT) Portion of the brainstem involved in the Physical therapists (PT’s) are concerned control of eye movements and facial ex- with restoration of physical function and pressions prevention of disability following disease, injury, or loss of body part. PT’s apply positive reinforcer therapeutic exercise and functional training Any stimulus which follows a behavior and procedures increases the likelihood of the occurrence of the behavior which it follows 54

Glossary ofRecreation Therapyand Occupational Therapy positron emission tomography (PET scan) — professional helping Ppositron emission tomography (PET scan) take action to restore their health Brain-imaging technique that permits evaluation of regional metabolic differences pressure sore by looking at radioisotope distribution Breakdown in the skin due to pressure that results in tissue death and sometimes infec-posterior tion; also known as skin sore or decubitus Situated behind; the back part of something ulcerposttraumatic stress disorder (PTSD) problem-oriented record (POR) Disorder characterized by reexperiencing Simple conceptual framework to expedite a psychologically disturbing event (such and improve medical records. It contains as war or rape) and by overresponsiveness four logically sequenced sections: database, to stimuli that recall the event producing problem list, plans, and follow-up unrealistic or excessive anxiety process criteriapostural drainage Criteria that describe sequence of activities Positioning the head lower than the chest or events used in the delivery of care so that gravity can be used to help drain secretions from the bronchi and the lungs process goals General objectives that describe what staffprecipitating factor will do to help the client to reach outcome Element that causes or contributes to the goals occurrence of a symptom processing (an activity)Premack principle Procedures used before, during, and after Type of reinforcement in which a more pre- an activity to enhance the therapeutic quali- ferred behavior by the individual is contin- ties found in the experience; sometimes gent on the successful completion of a less used to describe the procedure of debrief- preferred behavior ing groups following participation in an activitypresbyopia Farsightedness with inability to focus on professional helping near objects, resulting from loss of elastic- Process where assistance is given by a pro- ity of the lens; occurs with age fessional person, working from a knowledge base, in which client needs are para-prescriptive activity mount and the ultimate aim is to facilitate Intervention directed and structured by a the highest possible level of independence recreation therapist to encourage clients to in the client 55

Glossary of P Professional Standard Review Organization (PSRO) — psychologist Recreation Therapy and Occupational TherapyProfessional Standard Review Organization proxemics(PSRO) Study of the use of space by humans Founded by Congress to assure the quality of services under Medicare, Medicaid, and psoriasis Maternal and Child Health programs Chronic skin disease characterized by scaly, itchy patchesprognosis Forecast of the probable course and out- psyche come of a disorder The mindprogress notes psychiatrist Charting done by members of the interdis- Physician who specializes in the diagnosis, ciplinary team that indicates the progress, treatment, and prevention of mental and or lack thereof, being made by the client, emotional disorders patient, or resident psychoanalysisprogressive relaxation Therapy based on Freudian constructs Guided exercise in which people systemati- which attempts to explore the unconscious cally tense and release their muscles while by bringing it to the surface of consciousness attending to the resulting sensations of ten- psychoanalytic theory sion and relaxation Psychological theory developed by Freud.projection A conflict model involving three systems of Attributing to others unacceptable personal personality (id, ego, and superego) and two thoughts, feelings, and behaviors instinctual drives (sex and aggression)prompt psychodrama Cue or stimulus, usually in the form of Psychotherapy approach originated by J. physical guidance, which produces the L. Moreno that utilizes a dramatized acting response of a proper behavior out of the client’s problemsprostate psychogenic Gland that surrounds the neck of the blad- Having emotional or psychological origin der and urethra in the male in contrast to organic basisprosthesis psychologist Replacement of a missing part of the body, Individual who holds a degree (usually such as a limb, by an artificial substitute Ph.D. or Psy.D.) in psychology and who engages in psychological testing, diagnosis, counseling, and other therapies 56

Glossary ofRecreation Therapy PQand Occupational Therapy psychomotor — quality improvement (QI)psychomotor psychotherapy Manipulative or motor acts requiring vol- Process of personal contact between a untary human movement (neuromuscular therapist and client involving verbal and coordination); in contrast to involuntary nonverbal communication that provides reflex movement treatment to alleviate maladaptive behaviors or produce personal growthpsychopath Person who has an antisocial personality psychotropic drugs Pharmaceutical agents that have an effectpsychopharmacology on the psyche Study of drugs that affect the mind pulmonarypsychosexual development Concerning or involving the lungs Series of stages proposed by Freud, from infancy to adulthood, relatively fixed in purposeful activity time, determined by the interaction be- Activity that is goal directed tween a person’s biologic drives and the environment QA Quality assurancepsychosis Major mental disorder that seriously dis- QI rupts a person’s ability to recognize reality, Quality improvement think rationally, remember, communicate, quadriplegia and relate to others. It involves all forms Paralysis of all four limbs of adaptive behavior and interferes with the capacity to meet the everyday demands quality assurance (QA) of life. It is often characterized by bizarre Process whereby the quality of healthcare behavior, inappropriate mood, regressive is evaluated in terms of predefined stan- behavior, delusions, and hallucinations dards; more recently referred to as quality improvementpsychosomatic Pertaining to the interaction of the mind quality improvement (QI) and body. Commonly used to refer to Process whereby the quality of healthcare bodily symptoms having at least a partial is evaluated in terms of predefined stan- emotional cause dards; formally termed quality assurance; sometimes termed continued improvement or performance improvement 5

QR Glossary of Recreation Therapy quality of life — recreation therapist and Occupational Therapyquality of life readiness skills Individual’s perception of overall satisfac- Skills needed to prepare a person to acquire tion with his or her life; perceptions include higher-level skills physical status and abilities, psychological well-being, social interactions, and eco- reality orientation (RO) nomic conditions Technique used with confused elderly people involving regular repetition of basic facts andrange of motion (ROM) constant orientation to time, place, names, Movement of joints through the full extent events, and things in the environment to which they can be moved reality therapyrapport Therapeutic approach developed by Wil- Feeling of a close and harmonious rela- liam Glasser that emphasizes present tionship between two persons. Often used behavior, facing reality, and taking respon- to describe the client’s confidence in the sibility for one’s needs helper and a willingness to work coop- eratively with the helper. Having “good recreation rapport” indicates a level of trust and ease Enjoyable, restorative activity in which in- in communicating with the helper dividuals exercise choice and control; often associated with leisure timerational-emotive therapy (RET) Cognitively oriented therapeutic approach recreation therapy (RT) developed by Albert Ellis to change irratio- Provision of purposeful intervention us- nal ideas for rational ones ing prescriptive activities, recreation, and leisure experiences. RT employs therationalization recreation therapy process of assessment, Defense mechanism which gives question- planning, implementation and evaluation able behavior a logical or socially accept- (APIE) in order to assist clients to achieve able explanation health protection and health promotionreactance recreation therapist Response to restrictions on freedom of Person who applies appropriate strategies choice or action to facilitate growth and help prevent and relieve problems of clients through thereaction formation provision of the recreation therapy process; Giving a reason for behavior that is the op- sometimes referred to as a therapeutic rec- posite from the true cause reation specialist or Certified Therapeutic Recreation Specialist (CTRS) 5

Glossary ofRecreation Therapyand Occupational Therapy recreation therapy process — repression Rrecreation therapy process Reinforcement always increases the future Systematic method of problem solving em- probability of the reinforced response ployed in recreation therapy. The process contains four phases: assessment, planning, relaxation training implementation, and evaluation; sometimes Means to help clients experiencing stress referred to as the therapeutic recreation and tension to develop feelings of deep re- process laxation through a series of guided exercises involving muscle tensing and relaxing.Red Book Also termed progressive relaxation training Common name for Assessment Tools for Recreational Therapy by burlingame and reliability Blaschko Degree to which test results are consistent on different occasions; internal consistencyreferral of a test Occurs when a client is directed to another helping professional reminiscing Technique used with elders that involvesregeneration recalling past events and experiences Regrowth, repair, or replacement of lost or injured cells, nerve fiber tissues, or organs remission Significant improvement or recovery fromregression a disease or disorder which may or may Returning to an earlier method of behav- not be permanent; partial or complete ing; a relapse or exacerbation of symptoms disappearance of symptoms of a chronic or malignant diseaserehabilitation To restore or return the person to maximum remotivation functioning and optimal adjustment Originated by Dorothy Haskins Smith, this technique involves a group interactionReilly, Mary process for moderately confused elderly (1916- ) Occupational therapist (OT) residents who promoted the importance of work and play; foremost OT futurist; guiding light of repression graduate study in occupational therapy Exclusion of an anxiety-producing event from the conscious awarenessreinforcement Presentation of a reward or removal of an aversive stimulus following a response. 5

Glossary of R resident — Rolfing Recreation Therapy and Occupational Therapyresident reticular system Client in a residential setting (e.g., nursing Portion of the brainstem containing control home); physician completing postmedical centers for sleep, arousal, and attention school training beyond the internship rheumatic feverresidual urine Infection of the upper respiratory tract. Urine that remains in the bladder after Rheumatic heart disease is a potential com- voiding plicationresocialization risk management Techniques used to increase the social Process of identifying, analyzing and treat- functioning of residents in geriatric settings ing risks, thus avoiding risks that could which aim to increase the awareness of self lead to injury of clients, staff, or visitors; and others by helping clients form relation- risk management should improve client ships, establish friendships, and develop care and reduce malpractice claims new interests risky shiftResource Utilization Group (RUG) Phenomenon studied by social psycholo- Patient classification system in which gists that people in groups behave with clients are grouped according to their an- greater risk than those not in a group ticipated use of healthcare resources. This grouping system is the basis for the Health RO Care Financing Administration’s prospec- Reality orientation tive payment system (PPS) in skilled nurs- Robinson, Ruth ing facilities (SNF) (1913-1992) Occupational therapist whorespiratory system was Chief of Army Medical Specialist Network of organs that supply oxygen for Corps; approved education program for metabolism and expel carbon dioxide COTA’s while AOTA president (1955-1958)respite care Rogers, Carl R. Care in which someone comes into the (1902-1987) Psychologist who helped home for a few hours to relieve the care- found humanistic psychology and devel- giver or when the client is sent to an agen- oped person-centered therapy cy (e.g., day care) or facility (e.g., nursing Rolfing home) for a short period of time (e.g., Technique involving deep massage of the weekend or week) to give the caregiver a connective tissues which bind and connect rest muscles and bones 60

Glossary ofRecreation Therapy RSand Occupational Therapy ROM — seizures, generalizedROM ing disturbance is marked by distortion of Range of motion reality, often with accompanying delusions, hallucinations, and incoherent speech. TheRorschach test mood disturbance is marked by inappropri- Projective psychological test sometimes ate affective responses. Behavior may be referred to as the inkblot test withdrawn, regressive, and bizarreRT scoliosis Recreation therapy; respiratory therapy Lateral curvature of the spineRUG scripts Resource Utilization Group Basic existential decisions about one’s life plan made at an early age regarding one’srumination self and others. Script positions relate Obsessive repeating of a thought or idea; to “I’m OK, You’re OK,” “I’m not OK, used with infants to mean regurgitation and You’re not OK,” and so on. Term from reswallowing of food transactional analysisRush, Benjamin secondary disease (or disorder) (1745-1813) Father of American psychiatry Disease or disorder that results from an earlier injury or medical problemsacrum Lowest part of the spine; the bones or ver- secondary reinforcement tebrae in this section of the spine end with Conditioned reinforcer; one that is learned the “tailbone” and join the pelvis (hip) seizures, generalizedsadism Seizures in which there is a loss of con- Pleasure derived from inflicting physical or sciousness. If brief (lasting a few seconds), psychological pain or abuse on others it is called an absence seizure (once termed petit mal) which consists of staring or rollingscapula back the eyes. To an observer, the seizure Flat, triangular bone in the back of the may be seen as a brief lapse in activity. shoulder—often called the shoulder blade The other type of generalized seizure isschizophrenia the tonic/clonic (once called grand mal) Term used to designate a large group of in which the person loses consciousness, severe mental disorders of a psychotic level stiffens all over, has jerking movements of characterized by disturbances of thinking, the arms and legs, and has a loss of urine emotionality, and behavior. The think- 61

Glossary of S self-actualization — significant other Recreation Therapy and Occupational Therapyself-actualization sensory stimulation Basic human drive toward growth, com- Programming to reactivate senses (e.g., pleteness, and fulfillment taste, smell) that have not received ad- equate stimulation; often used in long-termself-concept care facilities How individuals see themselves and how they feel about themselves. Made up of sensory training both self-awareness and affective elements Group technique directed toward main- taining and improving the functioning ofself-efficacy regressed patients through a program of People’s belief that they can succeed at stimulus bombardment something they want to do service dogsself-esteem Dogs trained to assist people with disabili- Self-regard or the value placed on oneself. ties by performing tasks such as opening or Equates roughly to terms such as “self-re- closing doors, picking up items, or pulling spect” and “personal worth” a wheelchairself-fulfilling prophecy shaping Distorted belief or expectation that leads Behavior modification technique involv- the individual to behave as he or she is ing the development of a new behavior by expected to behave by others reinforcing a series of behaviors that are progressively similar to the desired newsenile dementia behavior Dementia found in old people, whose symptoms are often referred to as “senil- sheltered workshop ity.” Onset is insidious, progression is Supportive employment environment in slow and gradual, and no specific therapy is which persons with disabilities produce a known product or provide a servicesensory side effect Pertaining to sensation Drug’s undesired action on the bodysensory integration significant other Organization of sensations, from the seven Parent, teacher, coach, recreation leader or sensory systems, for use. It is a primary other person whose relationship is regarded function of the central nervous system to be especially important. Significant others influence feelings and behavior 62

Glossary ofRecreation Therapyand Occupational Therapy skilled nursing facility (SNF) — sodomy Sskilled nursing facility (SNF) socialization Nursing home, or unit in nursing home, Means by which people acquire the behav- that meets criteria for accreditation in order iors, competencies, and attributes they need to receive Medicaid and Medicare reim- in order to fit adequately into the society bursement; skilled nursing facilities include to which they belong. A second meaning, the provision of rehabilitation, nursing, and often found in therapeutic recreation, is the medical services process in which clients interact socially (i.e., socialize) with others, often with theSkinner, B. F. intent of improving social skills. (1904-1990) Noted behaviorist psychologist known for his work on operant condi- social learning theory tioning or reinforcement theory Developed by Albert Bandura, it is a theoretical system of learning that combinesSlagle, Eleanor Clarke operant and classical conditioning with (1871-1942) Third president of the Ameri- cognitive mediational processes (e.g., vi- can Occupational Therapy Association carious learning) to account for the forma- (1919-1920); started first occupational ther- tion of behaviors apy school (The Henry P. Faville School of Occupations) in Chicago; Founding Mem- social reinforcement ber of National Society for Promotion of Behavioral term indicating attention (e.g., Occupational Therapy (NSPOT) smile, affection, approval) from a significant otherSNF Skilled Nursing Facility social skills Interpersonal and interactive competenciesSOAP employed in relating effectively with others Method of charting, which designates the four parts of each entry in a problem-ori- social support ented record: subjective data, objective Perceived comfort, caring, esteem, or help data, assessment, and plan an individual receives from other peoplesocial facilitation theory sodomy Social psychology theory centered on the Anal intercourse; legally, the term may effect of the presence of others on behav- include other sexual deviations such as ior, particularly performance and learning. sexual intercourse between a human and an Robert B. Zajonc has been responsible for animal (bestiality) much of the research on this theory 63

Glossary of S somatic — standard of practice Recreation Therapy and Occupational Therapysomatic special recreation Pertaining to the body Programs directed toward the provision of recreation services for person who havesomatic nervous system special needs due to their disabilities Division of the peripheral nervous system that transmits sensory and motor impulses speech therapists Professionals who provide assessment,somatic therapy education, interventions, and services for Treatment of psychiatric clients by physi- individuals with communication disorders ological means sphincterSpackman, Clare Muscle fibers that constrict or block a pas- (1910-1992) Occupational therapy (OT) sageway, such as the urethra or the rectum educator who, with Helen Willard, wrote the first comprehensive OT textbook; pio- spina bifida neer in work hardening and work condi- Congenital closure defect that generally tioning occurs in the lower lumbar region of the spine. In mild forms there may be no obvi-spasm ous deformity, but in severe forms, parts Abnormal, involuntary, sudden movement of the spinal canal balloon out through the or convulsive muscular contraction defect, although the defect remains covered with skinspasticity Tendency to spasm or violent involuntary spinal shock contractions Body’s initial response to injury to the spinal cord, which may last three to fourSpecial Olympics weeks and cause immediate flaccid paraly- Athletic programs designed to meet the sis, in which the muscles are soft or weak needs of persons with mental retardation. Begun in 1968 by the Kennedy Founda- sprain tion, Special Olympics programs are now Tear in a muscle, ligament, or tendon held throughout the world standard of practicespecial populations Norm or criterion that expresses the agreed Groups of people who are not normally in- upon level of practice that has been devel- cluded in the mainstream of society; dated oped to measure excellence; the basic or term minimum level of practice deemed acceptable 64

Glossary ofRecreation Therapyand Occupational Therapy standardized test — suctioning Sstandardized test with the behavioristic concept of social Test that has established norms reinforcementstatistically significant structure criteria Research result in which there is an associ- Criteria in standards of practice that de- ation between variables that is greater than scribe service delivery in terms of environ- would occur by chance ment, resources, organizational purpose and mission, legal authority, facilities,stereotypes qualifications of providers, and standards Assumptions and beliefs about a group of of licensing, regulatory, or accreditation people that have been assigned to every agencies member of that group structured activitiesstrain Activities that have rules and can be broken Pull in a muscle, ligament, or tendon down into manageable steps; term is often caused by excessive stretch used in psych/mental health programming for clients who need a structured environ-stress ment Condition that results when one perceives a discrepancy between the demands of a situ- subacute care ation and his or her resources Level of treatment between chronic care and acute carestress management General term used to indicate interventions sublimation to reduce stress, such as progressive relax- Defense mechanism in which energy as- ation training, meditation, and yoga sociated with unacceptable impulses is diverted into acceptable channels (e.g.,stressors dancing to sublimate sexual desires) Events or circumstances an individual perceives as threatening or potentially harmful substance abuse Prolonged overuse of a chemical substance,stroke involving a clear pattern of pathological Cerebrovascular accident; a condition use and heightened social and occupational involving a brain damage that results from problems a disruption of the blood supply to that region. Also a transactional analysis term suctioning meaning a unit of recognition one person Removal of mucus and secretions from the receives from another. Equates roughly lungs used in individuals who lack the ability to cough 65

S T Glossary of Recreation Therapy superego — theory and Occupational Therapysuperego that enables the body to mobilize and ex- Part of the psychoanalytic personality pend energy during physical and emotional (along with id and ego). It contains inter- arousal nalized parental and societal controls and acts as the conscience symptom Indication of a disease or change in asupine client’s condition Lying horizontally on the back, or turn- ing the hands so the palms face upward or syndrome forward; opposite of prone Complete picture of a disease, including all symptomsSupplemental Security Income (SSI) Income for persons in financial need; eli- tactile gibility determined by income, resources, Related to the sense of touch disability, and age (under 65); those who target heart rate receive SSI are eligible for Medicaid Safe range of the pulse or heart rate persupportive employment minute during exercise. This is the range Approach to assist persons with develop- that will lead, over time, to improved ef- mental disabilities or mental illness with ficiency of the heart, lungs, and muscles employment through programs such as job terminal illness placement, work adjustment, job coaching, Disease that results in death career development, and training T-group (training group)supportive psychotherapy The T-group allows “normal” people to gain Psychotherapy that deals predominantly increased awareness and increased skills with conscious material and centers chiefly in interpersonal relations. Groups of 10-15 on support of the individual’s strength and work together for 20-30 hours in an unstruc- assets tured environment. Members are urged tosymbolic interaction try new behaviors and share emotional reac- Theoretical view that focuses upon the tions to behaviors interactive aspects of human behavior (e.g., theory communication, language, symbolic ges- General statement that relies on a set of tures) interrelated concepts to form a systematicsympathetic nervous system view of a phenomenon in order to under- Division of the autonomic nervous system stand and explain that phenomenon 66

Glossary ofRecreation Therapyand Occupational Therapy therapeutic — transactions Ttherapeutic thrombosis Pertaining to a treatment or beneficial acts Coagulation of the blood in some part of the circulatory system which forms a clottherapeutic agent that obstructs circulation in that part Anything (people or drugs) that brings about therapeutic outcomes time-out Behavior modification technique of exclud-therapeutic community ing or removing a child from an activity for Way of operating a relatively small unit a specific period of time within a hospital or institution in which the entire social milieu is used as an intervention tinnitus Perception of sound in the absence of antherapeutic recreation (TR) acoustic stimulus, most commonly de- Term sometimes used to encompass both scribed as a ringing in the ears recreation therapy and special recreation; see recreation therapy (RT) token economy reinforcement Reward system that gives tokens, checktherapeutic recreation process marks, points, or chips for meeting a pre- See recreation therapy process determined criterion of behavior; tokens can later be exchanged for items which aretherapeutic recreation specialist reinforcing and/or valuable to an individual See recreation therapist total blindnessthird party payer No light perception in either eye. Only Any organization (public or private) that twelve percent of legally blind persons fall pays or insures health or medical expenses into this category on behalf of beneficiaries or recipients (first party) to the caregiver (second party); e.g., toxic Blue Cross and Blue Shield and Medicare Poisonous and Medicaid transactional analysis (TA)thoracic vertebrae Theory of personality and social interaction Twelve bones or vertebrae of the spine in developed by Eric Berne. It is commonly the area of the upper back used as a basis for group therapythought disorder transactions Disturbance of speech, communications, or Transactional analysis term for the ba- content of thought, such as delusions, ideas sic unit in human communications; any of reference, and flight of ideas exchange between the various ego states of 6

T U Glossary of Recreation Therapy transdisciplinary team — unilateral and Occupational Therapy two or more individuals treatment Techniques or actions customarily appliedtransdisciplinary team in a specified situation to restore health Treatment or rehabilitation team of professionals from various disciplines who share treatment plan their skills with one another to provide Interdisciplinary plan to address the client’s client care assessed needs; the expression care plan is common in long-term care; other settingstransfer may employ the term rehabilitation plan or Movement of a person from one surface to individualized education plan another, such as from a wheelchair to a bed type A personalitytransference Personality type characterized by excessive Idea from psychoanalysis in which the drive, competitiveness, and overscheduling. therapist is unconsciously perceived as a significant figure from the client’s past, type B personality usually a parent. The therapist is attributed Personality type characterized by a relaxed, the attitudes and feelings the client holds easygoing manner toward the significant other. Transference may be hostile or affectionate ulcers Psychophysiological disorder involvingtransverse wounds to the stomach or upper section of Extending from side to side; at right angles the small intestine to the long axis; divides the body into upper and lower portions unconditional positive regard Nonjudgmental caring and acceptance oftransvestism, transvestitism the client as a human being Strong desire to dress in the clothing of the opposite sex (cross-dressing); sensation of unconscious sexual arousal when wearing clothing of That part of the psyche rarely subject to the opposite sex; usually seen in men awarenesstrauma unified sport Injury Athletic program that integrates equal numbers of persons with and without dis-trauma (emotional) abilities Emotional shock having long-lasting effects unilateral Affecting or occurring on one side only 6

Glossary ofRecreation Therapy UVand Occupational Therapy urgency — vital capacityurgency their values and to make decisions consis- Sensation of the need to void soon tent with their valuesusability variable Refers to built environments providing the Something that is free to vary. A measur- opportunity of maximum use by those with able characteristic of persons, objects, or sensory or mobility impairments events that may change in quantity or qual- ityutilization management Planning, organizing, directing, and con- ventilator trolling of the healthcare product and its Device used in respiratory therapy to assist delivery to ensure cost-effective, high qual- in the breathing process ity services that contribute to achievement of agency goals. This is accomplished ventricle through the judicious use of resources to Either of the two lower chambers of the control admissions, lengths of stay, and use heart or any of the four small continuous of ancillary services cavities within the brainutilization review vertebrae Process of evaluating the use of profession- Bones that make up the spinal column, al medical care, services, procedures, and including the cervical, thoracic, facilities using predetermined criteria lumbar, sacral, and coccygeal vertebraeVA vertigo Veterans Affairs Sensation of dizzinessValidation Therapy vestibular Developed by Naomi Feil for use in long- Referring to the vestibular apparatus, lo- term care facilities, residents “validate” cated in the ear, which senses the position their feelings and needs underlying their of the head in space and sudden changes perceptions in the direction of movement of the body; vestibular stimulation may be broughtvalidity about by using swings, hassocks, therapy Extent to which a test measures what it balls, or scooter boards claims to measure vital capacityvalues clarification Measurement representing the greatest pos- Technique to help individuals to discover sible breathing capacity 6

VW Glossary of Recreation Therapy vital signs — working through and Occupational Therapyvital signs Willard, Helen Temperature, pulse, blood pressure, and (1894-1980) Occupational therapy educa- breathing rate tor who, with Clare Spackman, wrote first comprehensive textbook in occupationalvoid therapy; American Occupational Therapy To expel urine Association president (1958-1961)voyeurism withdrawal Sexual gratification from secretly watching Physical or psychological removal of one- others naked, undressing, or having sex self from a stressorwalkers withdrawal syndrome Lightweight devices with four legs that Physiological and psychological responses are pushed by individuals to assist them that occur when a person physiologically with ambulation by providing support and dependent on a substance abruptly with- balance; often used by older residents in draws from its use long-term care facilities word saladwarm-up exercise Form of speech in which words and phras- Technique, exercise, or game of short es have no apparent meaning or logical duration used to promote an atmosphere in connection which therapeutic enterprises can occur workWatson, John B. Paid or unpaid (e.g., volunteering) cultur- (1878-1958) American psychologist who ally meaningful activity that contributes to founded behaviorism subsistence or produces a product or serviceWest, Wilma work hardening (1916-1996) Served as American Occu- Multidisciplinary program of a structured pational Therapy Association president environment and supervised activities for (1961-1964); served as Executive Direc- injured workers with the aim of helping the tor of AOTA; instrumental in starting the client to return to work American Occupational Therapy Founda- tion; pioneer in introducing occupational working through therapy into prevention and community Exploration of a problem by client until health a satisfactory solution has been found or until a symptom has been traced to unconscious sources 0

Glossary ofRecreation Therapy WYand Occupational Therapy World Health Organization (WHO) — yogaWorld Health Organization (WHO) United Nation’s unit to promote healthyoga Exercise postures (or poses) which focus on contracting a group of muscles accompanied by stretching or relaxing an opposite muscle group; also involves the compo- nents of breathing and meditation 1

Glossary of Recreation TherapyAbbreviations and Symbols and Occupational Therapy Abbreviations and SymbolsThe following list comprises the more common abbreviations. It is not an inclusive list.Abbreviations–a Beforea a–– Of eachAA Alcoholics AnonymousAAROM Active assisted range of motionAb AntibodyABE Acute bacterial endocarditisa.c. Before mealsACT Acute Crisis TeamACU Acute Care UnitADA Americans with Disabilities ActADD Attention deficit disorderADHD Attention deficit hyperactivity disorderADL Activities of daily livingad lib As much as wanted; as desiredadm AdministrationADR Adverse drug reactionAg AntigenAIDS Acquired Immune Deficiency SyndromeAMA Against Medical Advice; American Medical AssociationAMI Acute myocardial infarctionamt. AmountAOM Acute otitis mediaAOTA American Occupational Therapy AssociationAPA American Psychological Association; American Psychiatric AssociationARD Acute respiratory distressARF Acute renal failureASAP As soon as possibleASCVD Atherosclerotic cardiovascular diseaseASHD Arteriosclerotic heart diseaseATRA American Therapeutic Recreation AssociationA.T. Activity TherapyAV Atrioventricular; arteriovenousBBT Basal body temperatureBCLS Basic cardiac life supportb.i.d. Twice dailyb.i.w. BiweeklyBLS Basic life supportBM Bowel movement; basal metabolism; body massBMR Basal metabolic rate 2

Glossary ofRecreation Therapyand Occupational Therapy Abbreviations and SymbolsBP Blood pressure; bypassBR Bed restBRP Bathroom privilegesBS Bowel sounds; breath soundsBT Bleeding time; body temperatureBTB Breakthrough bleedingBTU British Thermal Unit–c WithCa CancerCA Coronary artery; chronological ageCAD Coronary Artery DiseaseCAT Scan Computerized Axial Tomography ScanCBC Complete blood countCBF Cerebral blood flowCBR Complete bed restCCU Coronary Care UnitCERT Comprehensive Evaluation in Recreation TherapyCF Cystic FibrosisCHD Coronary heart disease; congenital heart diseaseCHF Congestive Heart FailureCIHD Chronic Ischemic Heart DiseaseCNB Cutting Needle BiopsyCNS Central Nervous SystemCO Cardiac Output; Carbon MonoxideC/O Complaints of...COPD Chronic Obstructive Pulmonary DiseaseCP Cerebral Palsy; Chronic Pain; Chemically PureCPR Cardiopulmonary ResuscitationC-section Cesarean sectionCSF Cerebrospinal fluidCTRS Certified Therapeutic Recreation SpecialistCV CerebrovascularCVA Cerebrovascular accident; strokeDBP Diastolic blood pressureD/C Discontinue; discharge the patientD&C Dilation and curettageDD Developmentally disabledDES DiethylstilbestrolDI Diabetes insipidusDKA Diabetic ketoacidosisDM Diatolic murmur; diabetes mellitusDOA Dead on arrivalD.R. Dining roomDRG Diagnostic related group 3

Glossary of Recreation TherapyAbbreviations and Symbols and Occupational TherapyDSM IV Diagnostic and Statistical Manual of Mental Disorders, 4th editionDts Delirium tremensDx Diagnosisea. EachECC Emergency Car CareECF Extracellular fluidECG Electrocardiogram; electrocardiographECM Extracellular materialEEG Electroencephalogram(E)ENT (eye), ear, nose, throate.g., For exampleEKG Electrocardiogram; electrocardiographEMG ElectromyogramER Emergency roomESRD End-stage renal diseaseex ExerciseFACTR Functional Assessment of Characteristics in Therapeutic RecreationFAS Fetal Alcohol SyndromeFBS Fast blood sugarFHx Family historyflex Flexion; flexorft. Foot; feetFTT Failure to thriveFx FractureGAF Global Assessment of Functioninggal Gallon; gallonsGI Gastrointestinalgm Gramgrp. GroupGSR Galvanic skin responseGU GenitourinaryGyn Gynecologyh., hr. HourHb or Hgb HemoglobinHBP High blood pressureHCFA Health Care Financing AdministrationHCT HematocritHEENT Head, ears, eyes, nose, throathemi HemiplegiaH/H Hemoglobin/HematocritHHC Home health careHIV Human immunodeficiency virus 4

Glossary ofRecreation Therapyand Occupational Therapy Abbreviations and SymbolsHMO Health maintenance organizationhosp. HospitalHPI History present illnessHR Heart rateht. HeightHx HistoryICF Intracellular fluidICP Intracranial pressureICU Intensive Care UnitID Identification; Intial dose; intradermalIDEA Individuals with Disabilities Education Acti.e., That isIHD Ischemic heart diseasein. InchIOP Intraocular pressureIQ Intelligence QuotientITP Individual treatment planIUD Intrauterine device (Contraceptive)IV IntravenousIWR Ideal weight rangeJCAHO Joint Commission on Accreditation of Healthcare Organizationskg. KilogramL Leftlab. Laboratorylat. Laterallb. PoundLBW Low birth weightLD Learning disabledLDB Leisure Diagnostic BatteryLDL Low density lipoproteinliq. LiquidLLE Left lower extremityLLQ Left lower quadrantLOC Loss of consciousnessL.P.N. Licensed Practical NurseLS Left septumLUE Left upper extremityM.D. Medical DoctorMDS Minimum Data SetMED Minimal effective dosemeds Medications 5

Glossary of Recreation TherapyAbbreviations and Symbols and Occupational Therapymg., mgm MilligramMI Mental illness; myocardial infarction; mitral insufficiencymin. Minimum; minutemm. MillimeterMMPI Minnesota Multiphasic Personality Inventorymod. ModerateMR Mental retardationMS Multiple sclerosisM.S.W. Master of Social WorkM.T. Music therapyNAAP National Association of Activity ProfessionalsNAMI National Alliance for the Mentally IllNBCOT National Board for Certification in Occupational TherapyNBM Nothing by mouth; No bowel movementNCA National Center on AccessibilityNCTRC National Council for Therapeutic Recreation CertificationNIH National Institutes of HealthNIMH National Institute of Mental Healthn/l Normal limitsno. Numbernoc. NightNOS Not otherwise specifiedNTRS National Therapeutic Recreation SocietyN&T Nose & throatOD Overdose; right eyeOP OutpatientOPD Outpatient DepartmentO.R. Operating RoomOS Left eyeOT Occupational TherapyOTA. Occupational Therapy AssistantOTD Out the door = dischargeOTR Occupational Therapist, RegisteredOU Both eyesoz. Ouncep Afterp.c. After mealsPE Physical exam; physical educationpeds PediatricsPh.D. Doctor of PhilosophyPID Pelvic inflammatory diseasePMH Post medical historyPMS Premenstrual syndrome 6

Glossary ofRecreation Therapyand Occupational Therapy Abbreviations and SymbolsPNS Peripheral nervous systemp.r.n. As requiredPsy.D. Doctor of PsychologyP.T. Physical Therapy; physical therapistpt. Patientq EveryQA Quality assuranceq.am Every morningq.d. Every dayQI Quality improvementq.i.d. 4 times/dayq.o.d. Every other dayq.pm Every eveningQO2 Oxygen consumptionquad QuadriplegicRBC Red blood cell (Count)rehab RehabilitationREM Rapid eye movementRLE Right lower extremityR.N. Registered NurseRO Reality orientationROM Range of motionrt. RightRT Recreation Therapy; Respiratory TherapyRTA Recreation Therapy AssistantRUE Right upper extremityRx. Treatment–s WithoutSCD Sudden cardiac deathSH Social historySIDS Sudden infant-death syndromeSOAP Subjective, Objective, Assessment, PlanSOB Shortness of breathSP Systolic pressureSQ or SubQ Subcutaneousstat. Immediately; at onceSTD Sexually transmitted diseaseSW Social WorkerT Temperature; tensiontab TabletT&A Tonsillectomy and adenoidectomyTB Tuberculosis

Glossary of Recreation TherapyAbbreviations and Symbols and Occupational TherapyTBW Total body weightTIA Transient ischemic attacht.i.d. Three times a dayTLC Tender loving care; Total lung capacityTR Therapeutic recreationTV TelevisionTy TypeUA Unauthorized leaveUG UrogenitalUR Utilization ReviewUTI Urinary tract infectionVA Veterans AffairsVAMC Veterans Affairs Medical CenterVD Venereal diseaseVol. VolumeVol VolunteerVO MAX Maximal oxygen uptake (volume)VW Vessel wallWBC White blood cell (count)W/C WheelchairWHO World Health OrganizationWNL Within normal limitswk Weekwt. WeightX TimesY/O or Y.O. Years oldyrs. YearsSymbols@ At‘, ft. Foot“, in. Inch+ Plus; excess; acid reaction; positive- Minus; deficiency; alkaline reaction; negative“ Plus or minus; either positive or negative; indefiniteX Multiplied by; magnification= Equals> Greater than; from which is derived< Less than; derived from

Glossary ofRecreation Therapyand Occupational Therapy Abbreviations and Symbols: Ratio; “is to”:: Equality between ratios; “as” Male Female

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Glossary of Recreation Therapy and Occupational Therapy

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Glossary of Recreation Therapy and Occupational Therapy Document Transcript