Glossary of Recreation Therapy and Occupational Therapy


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Glossary of Recreation Therapy and Occupational Therapy

  1. 1. Glossary of Recreation Therapy andOccupational Therapy ✍ David R. Austin
  2. 2. Glossary of Recreation Therapy and Occupational TherapyVenture Publishing, Inc.
  3. 3. 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
  4. 4. 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:
  5. 5. 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 (includ- ing 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
  6. 6. 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 thera- peutic 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
  7. 7. 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
  8. 8. 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 con- genital 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
  9. 9. 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 individ- ual’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 work- ing 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 rehabilita- tion designed to reinforce the effects of AIDS therapy and to help clients adjust to their Acquired immune deficiency syndrome environment; may be provided in ambula- tory 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
  10. 10. 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 pro- vided 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
  11. 11. 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 mu- sic 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 thera- pists 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
  12. 12. 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, ten- sion 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
  13. 13. 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 ac- tive 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
  14. 14. 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 men- tal 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
  15. 15. 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, abnor- mal responses to sensations and ritualistic Ball, Edith L. behavior (1906-1997) Author in therapeutic recre- ation 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 envi- ronments 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
  16. 16. 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
  17. 17. 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
  18. 18. 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 ap- propriate 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
  19. 19. 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
  20. 20. 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 perform- ing 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 pair- ing 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 clini- cal 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
  21. 21. 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 clini- cal 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
  22. 22. 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, assis- tance 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
  23. 23. 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 continu- um 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 per- formance 25
  24. 24. 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
  25. 25. 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 (delu- sions 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, impair- ment 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
  26. 26. 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
  27. 27. 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 individu- al’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
  28. 28. 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 in- terventions 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
  29. 29. 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
  30. 30. 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
  31. 31. 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
  32. 32. 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