Program For Adolescent Females

Semi-System Design

Hannah Jardine & Holly Larsen

02/22/17
 Table of Context

Program..2
Implementation Description..2
Objectives and Performance Measures....4
Objectives and Performance Measures....5
Content and Process Description...6
Content and Process Description...7
Content and Process Description...8
Sequence Sheet.11
Performance Sheet...12
References..14
Program: Problem Solving Therapy
Purpose: To increase clients ability to use effective problem solving skills in order to increase confidence, self-esteem, and overall
well-being.

The problem solving program will follow the three levels of problem solving to enhance the client's ability to create and implement
solutions. The first level is the thoughts or general orientation one has to solve a problem, second is related to the specific problem
solving skills, and third is the larger set of skills that are called into use when needed. (Stumbo & Wardlaw, 2011)

Program Objectives

TPO1: Enhance the adoption of a positive problem orientation

EO 1. Demonstrate problem recognition.
EO 2. Increased perceptive on ones own ability to solve problems.

TPO2: Improve ability to create options and implement solutions.

EO 1. Increased ability to generate alternatives
EO 2. Increased ability to implement a solution and evaluate

Implementation Description
Population:
This program is designed for female adolescents between the age of 13-18 whom have been diagnosed with eating disorders, and
may also have co-occurring mental health disorders such as: anxiety and depression. Clients must be able to express themselves
verbally and participate in group discussions.

Program Length and Duration:

This program is designed with 12 sessions, each lasting 50 minutes. The sessions are scheduled twice a week for six weeks.

Program Context:
This program is designed for an inpatient or residential setting; however, with minor adaptations, can also be implemented into many
agencies serving described population.

Staff:
The ratio determined by the facility should be maintained throughout program. The facilities recommended ratio for recreational
therapy is 1-2 recreational therapist and other staff constructing a ratio of 1 staff for every 4 clients. All facilitated by a Utah licensed
TRS/MTRS and is nationally certified as a CTRS. Staff should have the ability to monitor physical and emotional environments. Staff
should also model positive problem solving skills.

Facility:
Outdoor or indoor space to perform interventions. Space should be quiet and free of distractions. Outdoor space should have level
ground and free of any obstacles.

Equipment:
Session 3:
10 PVC pipes cut transversely (1 for every client in group)
2 golf ball
Treasure Chest
Soft ball

Additional Implementation Information:

Session Content and Sequence

Information on the sequence of content to be presented is found on the Sequence Sheet within the text of the materials. The
Sequence Sheet provides direction for the sequence within each session as well as the sequence of the total program.

Program Content and Process

The objectives, and the exact content and process related to each objective, are described in the Context and Process sheets found
within the text of the materials.

A Note on the Discussions

Much of the learning in this program is based on discussion. Leaders must, therefore, be capable of guiding discussions according to
the needs and experiences of the group members. Stimulating discussion may require that the leaders contribute information and
personal experiences; however, they should not dominate the session. Instead, they should build as much as possible on the
responses of the clients.

Evaluation of the Performance Measures

Evaluation of client performance should be conducted on an ongoing basis. Participants will be meeting most of the criteria stated in
the performance measures during discussions. It is therefore necessary that leaders record progress made during or directly after
conducting a session. Notes made during the session should be taken as unobtrusively as possible. Before each session, it is
advisable for leaders to review the performance measures relevant to the content being covered.

A Note on Instructions
Instructions on the Content and Process Sheets are presented in a narrative style. This is to facilitate an understanding of how the
material may be presented. Leaders are to note this style, but should not memorize or read the instructions while conducting group
sessions (unless specified to do so). Instead, an attempt should be made to reproduce the relaxed, conversational tone when giving
instructions to the group.
 Objectives and Performance Measures
Program: Problem Solving
Terminal Program Objective: 1. Enhance the adoption of a positive problem orientation

ENABLING OBJECTIVE PERFORMANCE MEASURE

1 D
emonstrate problem recognition 1. Upon request, the client will (verbally or in writing) recognise the problem
presented.

2. Upon request, the client will (verbally or in writing) use their own words to
define the problem presented.

2 Increased perceptive on ones own

ability to solve problems 1.Upon request, client will (verbally) rank their confidence on solving the
problem themselves.

2. Upon request, client will (verbally or in writing) identify the time and or effort
needed to solve the problem.
 Objectives and Performance Measures
Program: Problem Solving
Terminal Program Objective: 2. Improve ability to create options and implement solutions.

ENABLING OBJECTIVE PERFORMANCE MEASURE

1. Increased ability to generate 1.Upon request, client will (verbally or in writing) list alternatives to a problem.
alternatives
2. Upon request client will (verbally or in writing) identify anticipated
consequences for the listed alternatives.

2. Increased ability to implement a 1.Upon request client will (verbally or in writing) identify steps taken to
solution and evaluate implement the solution.

2. Upon request client will (verbally or in writing) identify effects of the

implemented solution
 Content and Process Description
Equipment:
Treasure Chest
TPO No. 1 Enhance the adoption of a positive problem orientation
EO No. 2 Increased perceptive on ones own ability to solve problems

Content Process

Gather Clients in a seated circle on the (Opening)

floor, in the classroom, and go over Welcome back to Recreational Therapy
group values. Before we get started, will someone read to us our group values?
How are we doing on these values?
Group values: Can someone tell me the steps to problem solving?
Open mindedness
Safe environment Can someone tell me what we talked about in session 1?
Respect Can someone tell me what problem solving orientation means?
No rescuing

Steps to Problem Solving

Rational problem-solving style has four Please take 1 item from the circle that relates to how you feel when
skills: presented with a medium sized problem. Whatever medium sized means to
1.Problem definition and formulation you.
2.Generation of alternatives
3.Decision making Remember that a positive orientation is being optimistic about your ability to
4. Solution implementation and solve the problem, viewing the problem as a challenge, and understanding
verification that successful problem solving takes time and effort, with that said, what are
the benefits of having a positive orientation?

As clients are seated on the floor in the Remember that a negative orientation is a negative affect to solving the
classroom and place treasure chest in problem and/or avoidance. With that said, what happens when we have a
the middle of the circle, and ask clients negative orientation?
to pick a processing item that relates to
how they feel when they are faced with a While we move on throughout the day, reflect on the importance of having a
problem. positive orientation.

Positive Orientation Abilities

A). Appraise problems as challenges
B). Be optimistic in believing that
problems are solvable
C). Perceive ones own ability to solve
problems is strong
D). Believe that successful problem
solving involves time and effort.

Negative Orientation
A negative orientation may result in
negative affect and avoidance, which
can lead to negative thinking about one's
ability to solve problems in the future.
 Content and Process Description
Equipment:
1 soft ball
10 PVC pipes cut transversely
2 Golf Balls

TPO No.2 Improve ability to create options and implement solutions

EO No.1 Increased ability to generate alternatives

Content Process

Gather the students in a seated circle on (Opening)

the floor to explain the first initiative. Today we are going to be focusing on generating alternatives to problems.
We are going to start with an initiative.
Minute to Win It description. Everybody stand up, while remaining in the circle.
Ask the group to stand up in a circle. _______ (choose someone in the circle) is going to start with the ball, the ball
Explain that the ball cannot be passed cannot be passed directly to your left or to your right, and has to end with the
directly to the left or to the right and has same person. While you are passing the ball call the person's name, and
to end with the same person who started remember the pattern.
with the ball. Remember this order. Alright, now we have to move this ball in the same order, touching
Explain that the ball has to go in the everybodys hand in less than one minute.
same order, touching everybodys hand,
in less than one minute. I am going to pause you every time there is a different alternative idea to
solving the solution.

Invite the clients to stand up and begin.

How many solutions did we come up with?
Pause the clients every time they come Why is it necessary to come up with different ideas to solve the problem?
up with a different alternative to solve the
solution. Excellent work on coming up with different ideas!
We are going outside for our next initiative, you are all high levels and we
Invite the clients to go outside expect you to act like it. This means no running, and no pretending to run, if
there are incidents we will have to drop your level, and it may affect you
 coming to group next week.

(BODY)
Therapist will need to have 12 pre cut Alright we have another initiative that we would like to present today.
PVC pipes, (1 foot long, and cut We need to get the marble from one location to another, using PVC pipes.
transversely) prepared before group. The Rules are as follows:
Every client will get 1 PVC pipe, and as Everyone gets 1 PVC pipe.
a group will have to move the marble The golf ball has to touch everyones pipe.
from one place to another. The marble The golf ball has to be moving at all times.
needs to touch everybodys PVC pipe, Once the golf ball is in your PVC pipe, your feet cannot move.
and while the marble is in your pipe, your If the golf ball drops, we start again from the beginning.
feet cannot move. Does anyone have any question before we begin?
Alright everybody grab their PVC pipe and begin.

After the group completes this challenge, Great! Will everybody grab their water bottle and sit down in a circle?
invite the group to sit down in a circle to
process.
Remembering-
Additional Information on Problem o What was the problem in this intervention?
Solving o How did we define the problem/ why was that a problem?
There are two types of problem solving Applying-
styles: adaptive (rational) or maladaptive o How would you describe your orientation on this problem?
(impulsive/careless or avoidance). o What were some alternatives solutions discussed?
- How did you come up with these alternatives?
Rational problem-solving style has four o How did you decide which one worked best?
skills: o What happened when you implemented the solution?
1.Problem definition and formulation Analyzing-
2.Generation of alternatives o How does that relate to eating disorders?
3.Decision making o How much time/effort is needed to work on eating disorders?
4. Solution implementation and o Research states that eating disorders develop when someone feels out of
verification control of their life. How would understanding your ability to come up with
 alternatives to solving problems help with your eating disorder?
There are two maladaptive problem Evaluating-
solving skills: o What are some examples of a problem that has played into the
1. Impulsive/careless- using a quick development of your eating disorder?
solution, and therefore does not consider Creating-
all option and chooses a solution O What are some alternatives to manage that problem?
unwisely. Instead of solving the problem
this often creates new ones. (Closing)
2. Avoidance- procrastination, being I invite you to journal about this problem. First define the problem, and then
passive, or pushing the problem to come up with three alternatives to solve this problem? I will read these entries
someone else. next tuesday.

(Stumbo & Wardlaw, 2011) Now I invite you to create a team cheer that relates to problem solving and
what you learned in group today.
Assign group or individual assignments.

Invite the group to create a cheer that Huddle around in a circle, place one hand in, and on the count of three, and
relates to the focus of the group today. yell the cheer, while raising the hands.
Invite them to place one hand in the
circle and on the count of three shout the
cheer while raising their hands.
 Sequence Sheet

TPO EO Description Session no. Time (min.)

2 1 Opening of Group 3 5

2 1 Warm Up 3 5

2 1 Introduction & Instruction for PVC Pipe Intervention 3 5

2 1 PVC Pipe Intervention 3 20

2 1 Processing Questions 3 10

2 1 Closing of Group and Final Cheer 3 5

Total Time: 50 min

Performance Sheet Staff: Hannah Fenton & Holly Larsen
Date: 02/22/17
PROGRAM: PVC Pipe Activity

Program Performance Personal Performance

Client Name TPO 1: EO 1: EO2: TPO 2: EO 1: EO 2: Sasha connected her

Enhance the Demonstrate Increased Improve Increased ability Increased ability to interests of hiking and
adoption of a problem perceptive on ability to to generate implement a biking as being an
positive recognition ones own create alternatives solution and alternative to feeling
Sasha problem ability to options and evaluate sad about her eating
orientation solve implement disorder and where it
problems. solutions essentially came from.
She showed
excitement when
completing tasks and
interest throughout
session.

Enhance the Demonstrate Increased Improve Increased ability Increased ability to Haley seems to still be
adoption of a problem perceptive on ability to to generate implement a having a hard time
Haley positive recognition ones own create alternatives solution and coping with her fathers
problem ability to options and evaluate loss. She was able to
orientation solve implement identify having her
problems. solutions cousin as her friend as
a strength and
alternative but seemed
to be timid during
initiatives.

Enhance the Demonstrate Increased Improve Increased ability Increased ability to Brooke was
adoption of a problem perceptive on ability to to generate implement a suggesting alternatives
Brooke positive recognition ones own create alternatives solution and during processing and
 problem ability to options and evaluate initiatives. She showed
orientation solve implement interest in the
problems. solutions initiatives and learning
about generation of
alternatives.

Enhance the Demonstrate Increased Improve Increased ability Increased ability to

adoption of a problem perceptive on ability to to generate implement a
Ellie positive recognition ones own create alternatives solution and
problem ability to options and evaluate
orientation solve implement
problems. solutions

Enhance the Demonstrate Increased Improve Increased ability Increased ability to

adoption of a problem perceptive on ability to to generate implement a
Beka positive recognition ones own create alternatives solution and
problem ability to options and evaluate
orientation solve implement
problems. solutions

Enhance the Demonstrate Increased Improve Increased ability Increased ability to

adoption of a problem perceptive on ability to to generate implement a
Becca positive recognition ones own create alternatives solution and
problem ability to options and evaluate
orientation solve implement
problems. solutions

5- Objective X
Exceeded

4- Objective Met X X X

3- Objective X X
Somewhat Met
2- Objective Not Met

Reference
Stumbo, N., & Wardlaw, B. (2011) Facilitation of Therapeutic Recreation Services: An evidence-Based and Best Practice Approach
to Techniques and Processes, 155-169

Stumbo, N., & Peterson, C. (2009) Therapeutic Recreation Program Design: Principles & Procedures, 339-409

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