History of Assessment in Recreational Therapy

History of Assessment in RT

• Assessment in recreational therapy (RT) has evolved significantly over time
• Early approaches (pre-1950s) were limited, focusing on games therapy and psychological coping, and lacked standardized assessment
• Clients were often grouped based on perceived psychological impact of hospitalization
• No standardized assessment tools existed in the early era of RT

Assessments in the 1950s

• Assessments became more clinical-based, with clinical applications of recreational therapy emphasized
• Recreational activities were used to assess function
• The recreational skill set itself was used as an assessment tool

Assessment Examples in the 1950's

• Outcome areas were assessed pre- and post-operatively
• Examples include calisthenics, balloon games, ball skills, ring toss, table tennis, and sports
• Crude and simple observational assessment techniques were typical

Dr. John Eisele Davis

• A key figure in the field, developing principles and practice of recreational therapy for the mentally ill
• Published "Principles and Practice of Recreational Therapy for the Mentally III" (1936) and "Clinical Applications of Recreational Therapy" (1952)
• Served as a recreational therapist at Perry Point Mental Hospital

New Discoveries

• Recreational therapists are ideally positioned to identify significant diagnostic information via observations and participation in the client's play
• Therapeutic effectiveness is enhanced by motivation, interest, incentive, and effort within the context of play
• The natural context of play and recreation is important

Dr. "Bernie" Phillips

• Hospital recreation director at Walter Reed General Hospital, emphasizing the objectives to assist doctors in patient recovery and provide satisfying lives during medical stay
• This era saw more care & consideration for patients who were unable to return to their normal lives

Recreation for the Mentally III Conference (1957)

• A conference focused on recreation for the mentally ill was held
• The location for this conference was near the Hotel Woodner in November

RT Assessments (1960s)

• The National Recreation Accreditation Project emphasized setting standards for RT programs within hospitals
• Recreation in Hospitals was a significant report of organized programs
• Limited assessment tools were available; more assessment tools began to be developed

RT Assessment Instruments (1960s)

• The Mundy Inventory was developed for trainable mentally retarded adults in 1966

• This was the first standardized test in RT

• First functional assessments were developed to evaluate the abilities of mentally-impaired individuals

• The intent was to create homogeneous groupings in program

• The Leisure Interest Inventory was devised in 1969 and evaluated leisure domains and use of activity

• However, the instrument was not commercially distributed

RT Assessments (1970s)

• Professionals' competency in assessment became crucial
• New assessments were developed
• Include tools such as the Milwaukee Avocation Satisfaction Questionnaire, the Leisure Satisfaction Questionnaire, and the Leisure Activity Survey
• Other key assessments include the Leisure Activity Blank, the Oves' Picture Card Survey, and the Walshe Temperament Survey

RT Assessments (1970s)

• The Fox Activity Therapy Social Skills test was key in the development of functional prerequisites for successful community integration
• The Community Integration Program (CIP) was identified as key in implementing community integration

RT Assessment (1980s)

• The 1980s saw a push for more standardized assessments
• Professionals used/developed multi-faceted techniques
• Standardized and non-standardized tests became widely implemented
• The conceptual organization of RT processes became key in assessment

RT Assessment (1990s)

• The first complete collection of RT assessments appeared in textbooks
• Surveys and assessments became more common as RT was evaluated for its effectiveness
• More focus was placed on outcome assessments to evaluate functional abilities

RT Assessment (2000-Present)

• Screening, specialized interdisciplinary assessments, and the "funnel approach" were employed
• VALID (Valid Activities, Leisure, and Daily Living Activities) tests were popular in the era
• FUNCTIONAL versus ONLY leisure was important at this time
• Client-centered care became common
• Emphasis on cost efficiency and reimbursement purposes increased
• Computerized health records, and EMR systems were incorporated
• Tools like the FIM (Functional Independence Measure) and subsequently, alternative metrics, were developed.

Protocols

• Protocols established standard procedures for RT assessments.
• Includes materials, credentials, facilitation techniques, and norms for interpretation and analysis

Issues Remaining

• Research needs to explore the functional meanings of assessment scores
• Valid instruments and appropriate use were important
• Instruments consistently lacking reliability for effective use needed evaluation and modification
• Standardizing the number of agencies and approaches to assessment development was encouraged