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Is There a Role For Recreational Therapists in Obesity Management?



At a recent talk, I happened to meet a recreational therapist, who expressed an interest in perhaps getting involved in obesity management. I must admit that I had not seriously considered the potential contribution that recreational therapists may bring to the field of bariatric care.

For readers, who are not be familiar with this profession, it may be important to point out that the field of therapeutic recreation recognizes leisure, recreation and play as an integral component of quality of life. Recreational therapists specialize in helping individuals, who have physical, mental, social, or emotional limitations which impact their ability to engage in meaningful leisure experiences.

This is something that would certainly be of relevance to many patients that I see in our bariatric program – many express loss of interest and ability to engage in leisure activity due to the very real barriers posed by their excess weight.

It turns out that recreational therapists are the professional experts in helping clients to rediscover and maximise independence in leisure, optimal health and quality of life.

Recreational therapy has been shown to reduce depression, stress, anxiety, as well as recover or maintain motor functioning, reasoning abilities and build confidence that allows clients to enjoy greater independence and quality of life.

Although, many readers may think that this is a new profession, recreational therapists have been around for a while. For e.g. the Alberta Therapeutic Recreation Association was founded in 1985, i.e. over 25 years ago and has over 400 members.

Established benefits of therapeutic recreation include maintenance of physical and pscyhosocial health, cognitive functioning, personal and life satisfaction, and prevention of complications of physical disabilities and improved self-care and adherence to treatment plans.

These services would most certainly be relevant to many of the severely obese patients that we see in our clinic, who have experienced social isolation due to their excess weight and have certainly lost much of their social network and interactions.

I am not aware of ‘bariatric’ recreational therapists, who have specialized in managing clients with severe obesity or ‘recovering’ from severe obesity following bariatric surgery.

If my reader have, I’d certainly be most interested in hearing about their experiences with recreation therapists and whether or not they found these services helpful.

I most certainly would love to hear from recreational therapists working in this field or who happen to have ideas on what they would bring to obesity management.

AMS
Edmonton, Alberta

14 Comments

  1. My experience is that I haven’t found that Psychologists, Physiotherapists and/or Recreational Therapists add anything to the process.

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  2. it sounds like an excellent idea, though, for specialists — someone who understands the difficulties encountered by the overweight, and knows how to help the obese PLAY, even if they aren’t able to “work out”. it should be a quality-of-life gain.

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  3. What a great idea. Many of us who are morbidly obese don’t go out into the world, so to speak, because we’re afraid. I’m afraid that people won’t accept me. I’m afraid that my destination will be too far to walk to or that there won’t be chairs sturdy or wide enough to sit in (a frequent problem). My fear is greater than my desire to go out and have some fun. If there was someone who could pave the way and figuratively speaking hold my hand, I would regain enough confidence that later on I would go by myself.

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  4. I am a Certified Kinesiologist and I work out of the Bariatric Care Centre in Thunder Bay, Ontario. It is my direct responsibility to have our patients that are in the program become more physically active and through that, help them find activities that make them feel better in all aspects of their lives. Usually we start by investing time into making their activities of daily living easier and more manageable. From there, I integrate my patients into the community by finding environments and activities that are of interest to them. I provide ideas, they make the decision. This has shown to be a very integral part of our program an really helps to invest our patients in taking control of their health plan and become much more invested in the program all together. Having spent time with a rec therapist who works with neuro patients integrating them into the community, we share many of the same values and achieve very similar results. In my personal opinion, I think this should be part of every bariatric program and I am currently working towards achieving this. Please direct any questions you have my way. jay.tysoski@me.com. Thank you!! Great topic!!

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  5. I spent four years living in a nursing home that had a bariatric program with about thirty participants at any given time. Part of the program included recreational therapy in the morning and afternoon. The morning session was a 90 minute exercise class for those of us who didn’t have prescribed physical therapy. Most of us were in wheelchairs, BTW. The afternoon session was mandatory for everyone in the program and lasted an hour. This was basically a socializing session, with games and crafts being done.

    I felt that the morning session was more beneficial to me since it forced me to move and get some exercise. It would have been nice if we could have had a larger meeting space since it could get quite crowded with all the wheelchairs. The afternoon session I could have done without. While I understand the program director’s intention was to keep us occupied and encourage us to socialize with other program members (and keep us away from food), the activities we were given to work on during the afternoon session were more suited for the institution’s residents who had limited mental faculties.

    I have nothing but good things to say about the rec therapist who was assigned to our group. She did make every effort to try to find engaging activities for us but had to work within the constraints of the recreation budget and administration dictates.

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  6. The concept of exerize being a social outing look at the Special Olypmic Program. For socialization with others who have a simular diagnosis look to the Clubhouse for Mental Health Consumers. A recreational theropist be it for physical or social activities is important and the special needs of the obese like suitable chairs ablitiy to get to the program easily are just the tip of the obesity issue. Socializing without being over food is a very hard issue–not all exersizes or crafts are ideal for everyone–from my point of view physical is hard because flexing my one ankle hurts my foot moving my hand in some directions hurts (I can no longer cut out a pattern to sew, I can not twist my wrist well enough to crochet, the other cheap little crafts do not interest me.) But helping others who have become isolated because of obesity would be beneficial for many others.

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  7. Recreation Therapists are all concerned with promoting community integartion, inclusion and enhancing positive experiences in the envirnments of choice. They enlist the support of family and clients friends to assist in the re-integration process or develop opportunities for those lacking supports to develop new helpful long term supportive relationships through the course of their work. Quality of life is always at the forefront as an outcome as is enrichment and empowerment. Togehter with collaboration with other disciplines, clients can acheive great long lasting outcomes and benefits. One example is of how a nurse and a Recreation Therapist worked collaboratively with a dialysis unit to improve patient follow through with treatments. It worked so well, the patients looked forward to coming each session and found that the sessions passed by quickly and effortlessly, thus improving/maintaining their health until a transplant was available. There are many such examples and testimonies so I strongly feel they should be a part of bariatric care.

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  8. Having a recreatin therapist as part of the bariatric treatment team would be a wonderful asset for the clients. Addressing the entire clients needs and lifestyle will only be a benefit in the process developing a healthy lifestyle. One’s quality of life will be increased by exposure to a supportive community, which provides an opportunity to engage in positive cognitive, social and physical activities. As a recreation therapist working in community mental health, I have had the opportunity to observe the changes in clients’ recovery and independence by their involvement in leisure activities.

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  9. I am a new graduate of Dalhousie in NS and a Certified Therapeutic Recreation Specialist. I wrote my 4th year final term paper on this topic!

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  10. I am also a Certified Therapeutic Recreation Specialist and have worked as a Recreation Therapist in Ontario for 15 years with adults living with chronic disease and disability. Many of my patients have struggled with obesity and mismanaged diabetes for years leading to several additional chronic conditions. Many people see a Recreation Therapist doing activities with patients, residents, etc. and think “oh that’s nice that they can have something to do…pass the time while they are in the hospital” but what they are unaware of is that although there may be 5 or 10 people participating in a group they may or may not be there for the same reasons as they have goals based on their individual needs. Many patients have a lack of awareness, are unable to identify their strengths and abilities, feel they will never have the necessary skills or confidence to participate in their chosen leisure activities and may not have leisure partners because of self isolation. A skilled Recreation Therapist will help the patient reflect on past positive leisure experiences regardless of when they occurred to examine how it made them feel and why. Why did they stop participating (barriers) and what activities could elicit similar feelings/benefits now. Many people associate weight loss with diet and exercise Rx and although essential to long term success it is just as important to recognize the need to support patients to achieve their own aspirations, while increasing the value placed on leisure as it relates to overall well-being (physical, cognitive, social and emotional). Weight lost on the scale, decreased inches and carefully measured portions are quantifiable outcome measures. Although TR interventions are measurable there are mounds of qualitative examples often overlooked in health care. Our profession must continue to advocate as an essential service for so many area’s we are not included in.
    Thank you to the RECT you spoke with and to you for seeing the potential influence our profession is striving to be recognized for. I would like to see more positions created for RECT’s in prevention and management of chronic disease in Canada. For more information on Therapeutic Recreation in Canada visit http://www.canadian-tr.org or in Ontario http://www.trontario.org. National Therapeutic Recreation Awareness Week is Feb 5-11th, 2012.

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  11. Health care professionals are beginning to recognize that quality of life may be one of the most important health outcomes to consider in managing a disease, such as obesity (Kolotkin, Meter & Williams, 2001).

    An important factor that contributes to quality of life is a person’s ability to participate in recreation and leisure that is personally meaningful and satisfying. When people are involved in something meaningful, it increases their self-efficacy as well as their overall health. People with disabilities and chronic conditions have very limited opportunities for involvement and real barriers exist for this group, as compared to those whom are able-bodied. A positive leisure experience empowers individuals to achieve their full potential in all aspects of life.

    The South Zone, Allied Health, community recreation therapists are successfully building capacity by creating leisure and recreational opportunities for people with disabilities and illness. They provide clients with valuable education on community and personal leisure awareness and also help to develop healthy activity patterns. Examples of programs include, community aquatic therapy, walking for wellness, community keep fit, home support exercise program, WHOGA, etc.

    The South Zone, Allied Health, Therapeutic Recreation program recently submitted a proposal outlining the benefits that a Recreation Therapist could bring to an Obesity Management team.

    We would have loved to have been part of the Obesity conference held in Lethbridge last week but were not aware it was happening.

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  12. To Claire In NS:
    I am a Certified TR specialist, working with developmentally disabled and elderly for 30 years! I raised a son with obesity challenges and wished I could make more impact as a therapist. I’d like to read anything about “our” work in this field. May I start with your 4th year paper?

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  13. To Claire in NS or Jan, I too would love to read that paper, I am currently studying Dietetics.

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