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(Editor: Bernath E. Phillips from "52-'58)

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Originally published in the January 1958 JHPER, v29, issue 1, page 68...

Early Report on National Conference

One-hundred seventeen persons participated in the National Conference on Recreation for the Mentally Ill conducted in November at the Woodner Hotel, Wash., D. C. Conferees truly constituted a representative group; they came from 25 states, Canada, and the District of Columbia; 18 represented as many cooperating national professional societies and agencies. The group included 10 psychiatrists; 51 persons actively engaged in the conduct of recreation at hospitals (24 from state and 17 from Veterans Administration hospitals); 16 persons currently holding responsible state, regional, and national supervisory and administrative positions in this professional area; and 14 persons engaged in the professional preparation of recreation personnel at colleges and universities.

Conferees participated on invitation and, for the most part, attended at their own expense. (Those contemplating registration with the Council for the Advancement of Hospital Recreation may well note that CAHR's registration list was the first consulted by the Steering Committee in selecting potential participants.) Delegates were invited without reference to professional affiliations.

The conference provided a national form at which recognized leaders in hospital recreation and other concerned professions were able to assemble, analyze, and synthesize their views on four main areas on concentration--Professional Attitudes and Practices, Pre- and In-Service Education, Facilities and Equipment, and Evaluation and Research. All conferees were oriented to these four areas at the opening session. Then, during the ensuing two days, two independent work sections (constituting each of four work groups) explored each area, and assembled their findings for presentation to the total conference for refinement on the final day.

· Group A, exploring the first area focused its discussion on professional attitudes rather than practices because it seemed logical that, once having acquired desirable attitudes, effective practices are forthcoming. Consequently, the group first recognized certain desirable attitudes of any professional person, and next identified those characteristics unique to the person working in recreation for the mentally ill.

· Group B, developed specific concepts to govern the development of undergraduate and graduate curriculums for those preparing to conduct recreation in hospitals, listed the goals and the ways and means of in-service training of such personnel, delved rather deeply into the knotty problem of recruitment, and offered recommendations pertaining to other pertinent needs of our profession.

· Group C, concentrated, for the most part, on facility needs, design, location, and construction. General principles were proposed and, in many instances, specific details were recommended. This, of the four areas of concentration, unearthed certain fundamental differences of opinion between one or two psychiatrists, on the one hand, and recreation personnel, on the other. These differences appeared to have been attributable to the lack of a well defined and uniformly agreed upon prediction of the specific nature and direction of the treatment of the mentally ill in the years ahead.

· Group D, developed, among other things, 23 criteria for the evaluation of hospital recreation programs, identified six methods useful in the evaluation process, listed the major available sources in the professional literature, and suggested nine general areas for study.

The sponsorship, organization, and conduct of this conference will be reported in greater detail in the February Journal. Further, it is hoped that the published proceedings will be available for the AAHPER 60th National Convention at Kansas City, Mo., March 30-April 3.

Considering the high professional status and representativeness of the participants, and the rather extensive plans already made for implementing the conference findings, it can reasonably be anticipated that this National Conference on Recreation for the Mentally Ill will prove to have been a milestone in the development of our chosen profession.

Institute for the Homebound

The National Recreation Association and New York University are co-sponsoring a Recreation Institute for the Ill and Handicapped Who Are Homebound, to be held at the NYU School of Education, Washington Square, New York City, January 20-31. Topics to be discussed include existing programs for the homebound ill and handicapped, techniques for developing recreation outlets and pursuits for the homebound, the role of the government family, and friends, recruiting and directing the services of volunteers, and trends toward the day-hospital treatment of the mentally and physically ill. For further information, write Beatrice H. Hill, Hospital Recreation Consultant, National Recreation Association, 8 W. Eighth St., New York 11.

Originally published in the February 1958 JHPER, v29, issue 2, page 60...

Education of Hospital Recreation Personnel

Frequently, your editor receives inquiries pertaining to the educational opportunities for professional preparation in hospital recreation. The following summarizes these opportunities: Approximately 75 colleges and universities currently offer undergraduate degrees in recreation. Five institutions were offering such degrees in 1938. Upward of 35 institutions now offer graduate degrees in this field. Approximately 2,000 students are enrolled as recreation majors, and some 500 degrees in recreation are conferred annually.

Of the above, the University of Minnesota and New York University offer Master's degrees in Hospital Recreation, Springfield College and Columbia University offer Master's degrees in Recreation in Rehabilitation, and the Texas Woman's University and Sacramento State College offer Bachelor's degrees in Recreational Therapy. Several other institutions of higher learning not offering the specialized degree in this area do provide for field experience in hospitals for recreation major students planning to seek employment with the ill and handicapped.

Several schools have conducted hospital recreation institutes of three to five days duration. The University of Minnesota will conduct its fourth such institute in May; the University of North Carolina and New York University (in cooperation with the National Recreation Association) have each conducted three such institutes. Springfield College and Columbia University have conducted several two week seminars in Recreation in Rehabilitation. The University of California at Los Angeles has announced a three-day institute for April of this year, and the University of Wisconsin has tentative plans for a similar institute in the spring of 1959.

To date, only the University of Minnesota has made available correspondence study in this professional area. Two courses are offered, namely, "Orientation to Recreation in Hospitals," and "Methods in Supervision of Recreation."

Inquiries pertaining to any of the above should be directed to the institutions concerned.

Columbia University Seminar

Teachers College, Columbia University, has announced a spring term Seminar in Recreation for the Emotionally Disturbed. This is a one or two credit course, and will meet Thursdays, 5:30-7:10 P.M., beginning February 6. This seminar is being conducted in cooperation with the National Recreation Association, and is designed to meet the needs of those responsible for recreation programs in hospitals, special schools, and institutions for the mentally ill. Registration dates are February 1-4; the non-credit university fee is $30. For further information write Dr. Elizabeth Rosen, Box 70, Department of Health and Physical Education, Teachers College, Columbia University, New York 27, N. Y., seminar coordinator.

Fourth Minnesota Institute

The Fourth Institute in Hospital Recreation will be held at University of Minnesota, May 26-29. A qualified faculty of physicians and specialists in hospital recreation will lead group discussions, demonstrations, and subjects of value to those employed in leading recreation for the handicapped. Similar institutes have been conducted by the University in 1950, 1954, and 1956. Details on the Institute will be announced by the University in the spring. In the meantime, further information may be obtained from Professor Fred M. Chapman, Division of Recreation Leadership, University of Minnesota, Minneapolis 14.

Southern District Meetings

Floyd E. McDowell, director of Cottage Life, Sunland Training Center at Gainesville, Florida, reports a rather ambitious program for the Institutional Recreation Section, at the convention of the Southern District, AAHPER, in Louisville, Kentucky, February 26 and 27. This Section consists of the following sub-sections: 1) Hospitals for the Emotionally and Mentally Ill, 2) Institutions for the Mentally Retarded, 3) General Hospitals and Institutions for the Physically Handicapped, 4) Homes for Senior Citizens and Institutions for the Aged, 5) Youth and Adult Correctional Institutions, and 6) Student. At Louisville, each sub-section Chairman will speak on the role of recreation in the institutional area he represents. Attendance at these meetings should certainly provide one with a rather comprehensive picture of Institutional Recreation in the South. It is encouraging to learn of this professional activity in another AAHPER District.

Originally published in the March 1958 JHPER, v29, issue 3, page 62...

More Recommended Practices

Last November this column pointed up the importance of retaining recognized recreation periodicals in the reading room of the medical library of each hospital with a recreation program. There are at least three more practices which Hospital Recreation Directors would do well to consider, or refine.

First, they should confine their recreation service on prescription, and their written reports on patient behavior, to those relatively few, selected patients for whom specific needs have been identified, and for whom individual attention can be assured within recreation staff and resource limitations. Too often, recreation departments accept these responsibilities for more patients than they are able to instruct and/or carefully observe, thus attenuating their programs.

Second, They should budget time within the normal work-week for such essential functions staff conferences, individual conferences with patients' physicians and other hospital personnel, in-service education, necessary paperwork, and other indispensables of a "quality" and a "quantity" program; between the "long-term" and the "short term" view.

Third, they must provide for the intelligent selection of pertinent information for reference to their subordinates. Simply routing all publications to members of one's staff is rarely very productive. Someone must take the time to sort out the significant matter from the vast amount of literature now available, and to plan for its consumption by those best able to use it, i.e., those working directly with patients.

UCLA Institute--Recreation in Rehabilitation

A resident Institute will be conducted April 17-19 on the Presbyterian Conference Grounds, six miles west of the UCLA campus. It is being conducted by the UCLA Recreation Education Unit in cooperation with the Medical Center and School of Social Science; the Calif. Recreation Comm., Dept. of Mental Hygiene; and Recreation Society; the VA and American Red Cross. It will emphasize professional preparation, attitudes, and practices for recreation leaders in hospitals, nursing homes, schools, and institutions for the physically and mentally handicapped. Alexander Reid Martin, M.D., American Psychiatric Association, will deliver the keynote address.

Registration fee is $24, which includes meals, lodging, a copy of the proceedings, and certificate. The 15-hour course carries one University credit. Information may be obtained from Norman Miller, UCLA, 305 Hilgard Ave., Los Angeles 24.

U. of Iowa Hospital Recreation Curriculum

Betty van der Smissen, major adviser in recreation leadership, Department of Physical Education for Women, University of Iowa reports that her department is developing specializations in Hospital Recreation at the undergraduate and graduate levels. With several medical opportunities in Iowa City, Miss van der Smissen feels her department can offer excellent field experience and research opportunities.

At the undergraduate level, the student selects for program emphasis two of seven available activity areas. He also may elect to specialize in Recreation for the Ill and Handicapped (including Hospital Recreation) which is one of five service areas from which he may choose. At the graduate level, provision is also made for specialization in Hospital Recreation, including a theses and field work. Information may be obtained from Miss van der Smissen.

Improving Communications

The need for improving communications within the hospital setting and the adjacent community has been accented at several recent professional meetings. Nick J. Catamas, chief of recreation, Veterans Administration Hospital, San Fernando, Calif., has reported his approach to the solution of this problem. In an inter-office memorandum to all Service and Division Chiefs, his Manager announced two lecture programs in Hospital Recreation. These programs were held on consecutive Wednesday afternoons, for approximately 45 minutes each. Mr. Catamas conducted the first, using a series of color slides depicting his station's recreation program, and demonstrating the station's closed circuit television facilities. A renowned author-lecturer conducted the second.

These programs were so well received that Mr. Catamas was asked to schedule repeat performances. These were also announced more than a week in advance through the same medium. Further, training coordinators at the hospital were so favorable impressed with this approach to better communication that they have recommended it to other Divisions within the hospital.

Other suggestions on improving communications in the hospital setting are invited for reporting in this column.

Originally published in the April 1958 JHPER, v29, issue 4, page 62...

Suggested Duties of the Hospital Recreation Leader

A major problem confronting the Hospital Recreation Director is defining the duties of the Hospital Recreation Leaders on his staff. One good approach is to assign to each such Leader the full responsibility for coordinating a medically prescribed or cleared, diversified and comprehensive recreation program for an identifiable segment (type of patient, building, group of wards) of the hospital's patient population. In this capacity, and under the direct supervision of the Director, each Leader:

· Works directly with patients' physicians to determine treatment objectives, capabilities and limitations of patients, and plans for meeting these objectives within indicated restrictions.

· Works directly with other concerned professional management personnel to learn of patient interests, assay material and personnel resources, and identify the restrictions in scheduling imposed by established hospital routines.

· With this medical guidance, and having assayed the interests of patients and recreation resources, plans recreation activities for patients on a daily, weekly, monthly, and/or seasonal basis.

· Arranges for an coordinates the assistance of other staff recreation specialists and generalists in the conduct of these planned recreation activities.

· Determines the need for volunteers and orients them in the recreation program; schedules their services to insure the most efficient operation of the program; supervises and evaluates their work; and makes recommendations regarding their recruitment, selection, utilization, retention, recognition, and termination of services.

· Personally serves as leader and instructor in selected recreation activities.

· Evaluates recreation activities, including patients' reactions thereto, and makes or directs indicated changes in both program content and methods, best designed to meet treatment and management objectives.

· As requested, reports to physicians on patient behavior and progress.

· Directs and/or assists in the performance of various administrative-type functions essential to the smooth operation of the recreation program for which he is responsible, among these being:

a. Planning, interpreting, and implementing local policies and procedures, recommending same when and as indicated;

b. Training leadership personnel and assistants;

c. Safeguarding employed and volunteer personnel, participants, property, and supplies;

d. Maintaining contacts with public and private individuals and organizations through personal contact and correspondence;

e. Gathering recreation statistics, maintaining records, and rendering reports as required;

f. Preparing and justifying necessary budget estimates;

g. Recommending capital expenditures for recreation facilities;

h. Purchasing, issuing, and accounting for necessary recreation supplies;

i. Developing publicity materials;

j. Advising on technical aspects of recreation matters.

Suggested Qualifications of the Hospital Recreation Leader

The knowledge, abilities, and other qualities typically required of the Leader performing the above duties include:

· Basic background of applicable biological, social, and physical sciences, and ability to apply such knowledge in the day-to-day implementation of recreation activities.

· Demonstrated personal qualities of leadership and good working knowledge of the principles, plans, tools, and techniques of recreation involved in local program planning and implementation.

· General working knowledge of, and skills in, several fields of recreation, and demonstrated ability to apply such knowledge and skill in the conduct of recreation for the segment of the patient population for which he is responsible.

· Ability as necessary to plan, assign, supervise, and evaluate the work of assistants in positions of lower grade; or ability to obtain the services of and to direct volunteers who perform work equal in variety and scope to that of such assistants.

· Demonstrated ability to adapt and to adjust recreation plans, procedures, tools, and techniques to the specific operational situations and conditions encountered in the performance of his functions.

· A good working knowledge of medical terminology; physical, mental, and emotional limitations of patients that are caused by a variety of diseases and disabilities; and the adaptation of recreation activities to satisfy patients' needs.

· Ability to write observation reports on patients, progress reports on program, and, potentially, to contribute to the professional literature.

Originally published in the May-June 1958 JHPER, v29, issue 5, page 68...

INDEX OF SELECTED ITEMS FROM THIS COLUMN, 1952-58

IN ORDER to facilitate reference, there are listed below, chronologically, and by general interest category, selected items which have appeared in this Recreational Therapy column during the past six years.

Philosophy

Management

Program

Professional Preparation

Research

Bibliographical References

Employment

Originally published in the September 1958 JHPER, v29, issue 6, page 67...

REGULAR READERS of the recreational therapy column will miss the familiar by-line "by B. E. Phillips" which has been over the column for the past five years. Dr. Phillips' writings on recreational therapy, research, professional preparation, philosophy, and hospital programs have been a source of inspiration to those of us who work with the mentally ill. We will try to continue in his footsteps, a trifle behind his brisk pace, to bring to your attention the new developments, the sources of material, and the progress of recreational therapy.

No one person can be aware of all the important developments that are going on in the field. What you are now doing at your hospital, your desk, or your college or university may be of real interest and help to others in another part of the country. Use this column to bring your work, your meetings and conferences, your thoughts on recreational therapy and research to their attention.

Send your comments, suggestions, and criticisms to the address above. We will acknowledge each letter and include here all material suitable for the column. We will attempt to make the column a medium of exchange for recreational therapists at all hospitals, private and state as well as federal.

Recreation for the Mentally Ill

The report of the AAHPER conference held in Washington, D. C., last November is now available. Entitled Recreation for the Mentally Ill, the report covers a wide field of inquiry into professional attitudes and practices, pre- and in-service education, facilities and equipment, evaluation, and research.

Added to the report of the conference are sections on personnel standards of the Council for the Advancement of Hospital Recreation, duties of hospital recreation personnel, standards of the Veterans Administration student affiliate recreation trainee program, recreation in hospitals with psychiatric services, and a medical viewpoint of hospital recreation. Under the stimulus of a group of leaders in the profession, the conferees have prepared a document which should be a valuable guide to all hospital recreation workers. Copies of the report can be ordered from AAHPER.

Volunteer Workers

Much valuable assistance in carrying out recreation programs in hospitals for the mentally ill is provided by the large and still growing number of volunteers who work with paid staff at these hospitals. Usually these volunteers are recruited for specific jobs through national or local organizations and throughout their service at the hospital maintain their identity as members of the organization.

From time to time articles on the recruiting, screening, on-the-job training, supervision, and recognition of volunteers have appeared in this journal. Although the pattern for the use and training of these unpaid recreation workers is fairly uniform in most hospitals, occasionally we come across a unique or more efficient way of obtaining, employing, or recognizing the services of these people.

Keeping a record of the hours of service of volunteers is a fairly universal practice at most hospitals. This yardstick of their contribution to the medical team of the hospital is a treasured form of recognition for the volunteers. The award ceremonies, at which certificates are presented to those who have reached certain totals in their hours of service, are an important part of the recognition program at some hospitals. At others, formal or informal in service training programs are the core of a program designed not only to improve the quality of volunteer service but to maintain the volunteers' interest at a high level.

If the methods you use to recruit, screen, train, assign, evaluate, or accord recognition to your volunteers have produced for you, perhaps they would be helpful to others. Share it with others through this column.

Originally published in the October 1958 JHPER, v29, issue 7, page 51...

BENEDICT F. FIORE Veteran's Administration Hospital, Northampton, Mass.

Statistics on Privileges

The June 1958 issue of the American Journal of Psychiatry reports a survey of public mental hospitals by Lucy D. Ozarin, M.D., and A. H. Tuma, Ph.D., on patient "privileges" in these hospitals. The study is based on information gathered from 292 hospitals in the U. S., Canada, Hawaii, and Puerto Rico totaling 629,916 beds. Of the patients, 12.8 percent are classified as "open" ward patients, in wards with doors unlocked all or most of the day; 22.3 percent are privileged, can leave the ward unaccompanied (included here were the "open" ward patients); 45.8 percent are semi-privileged, can leave the ward accompanied by the staff, visitors, or volunteers; 31.9 percent are in the non-privileged group.

The statistics for Veterans Administration hospitals show 39.6 percent in the first, or privileged, group; 53.8 percent in the semi privileged group; and only 6.6 percent in the non privileged category. Statistics from the newer hospitals show larger percentages in the privileged or semi-privileged classes. The authors conclude that the "trend of present day psychiatric thinking and practice is toward the open hospital."

Patients' Interests and Skills

How many hospital recreation workers are looking into the patients' background for leads to their interests and skills in areas of recreation? How can we learn what their hobby interests are or if they have a liking for music, an interest in sports, an appreciation for play reading, or any of the many specialized activities that make up a well-rounded recreation program?

It is possible to review the patients' complete folder, and several of the other hospital services use this method to assist them in prescribing craft activity for patients. Some hospitals make use of interest sheets, on which the patient himself lists the things he has done or presently likes to do for his recreation.

Another method of obtaining information of this kind is to include interest sheets or hobby interest forms in the papers that are completed by the family of the patient. When such a program is established for all new admissions, a file is gradually built up which will be of immense value to the recreation leader.

Many a fly-tyer, cartoonist, radio disc-jockey, stamp club member, or barber-shopper has been discovered and re-introduced to his old leisure time activity through the use of interest questionnaires of one kind or another.

Hospital Communications

Communications play an important part in any worthwhile hospital program. We need good communications to encourage those who work with us to express their ideas and opinions, as well as to pass on to others the product of our own thinking.

Good communications do not travel along a one-way street from the leader to those in subordinate positions. The way must be open in all directions, side-ward, upward, as well as from the top down. There must be many avenues of communications in hospital recreation because we depend on so many other people and services to accomplish our missions. Every hospital service, beginning with accounting through to ward administration, is involved at some time with some phase of the programs we plan for patients.

The dietitian must not only be advised that we want coffee for a picnic for 100 patients, but must also be told that it will be a picnic supper, that the picnic will replace a regular hospital meal, that the patients involved will come from Wards A and D, and that two, twelve, or no special diet patients are involved. Will the coffee be black or with cream and sugar? Finally, to what area will it be delivered? When all this information is included in our original request, cooperation comes more easily. The dietitian knows just what is wanted, for what purpose, and what effect your program will have on her own operation.

How are your communications?

Originally published in the December 1958 JHPER, v29, issue 9, page 47...

MOST of the recreation programs for hospitalized mental patients include bowling activities of one sort or another. Ten pin bowling is enjoyed in most hospitals which are equipped with alleys. Duck pins are favored among parts of the Eastern seaboard, however. A less popular form of bowling, which to our knowledge is little known outside isolated New England communities, is candle pin bowling.

Candle pins, like ten pins, are made of maple and actually resemble wickless candles. They measure 15 5/8" in length and are 2 3/4" in diameter at the middle of the pin, tapering slightly at both ends. The balls are smaller than those used for duck pins, measuring 4 1/2" in diameter. Some manufacturers equip their candle pins with plastic ends for greater durability.

Method of Resocialization

Bowling is a wonderful device for resocialization of withdrawn, depressed patients. At first, the patient who bowls is doing something relaxing by himself. The sound of the ball as it hits the alley and then rolls into the pins has a pleasant, almost rhythmic quality. The interval between the time the ball leaves his hand until the crashing of the pins is a measured period of time, something the patient can depend upon. His first adjustment to this interval is the only one he has to make--it is fairly constant thereafter.

It does not particularly matter how many pins fall into the pit. Interest in the score comes at a later stage. After three balls are rolled, thrown, or even lobbed, the game stops while the pins are reset and the balls returned. The activity is unhurried, and the rest periods are frequent in a ten frame string.

At the beginning, scoring has meaning mostly in terms of pleasing the recreation leader. It is this dedicated person, the recreation leader, who gradually assists in developing an appreciation for the spare and the strike and, finally, an interest in a bowling average. Only when he has reached this point does the patient begin to show an interest in the bowling achievements of his fellow bowler and to view him as a competitor or as a teammate.

An awareness of the other fellow is a long forward step in the resocialization process of the patient. Now he rolls the ball down the alley not only for his own satisfaction but to make his contribution to the efforts of the other men bowling on his team. The number of pins which fall after each roll of the ball and the score that goes up on the board take on a meaning previously nonexistent. If he does well, he becomes accepted by the others, the recreation leader is pleased, and therefore he too derives greater pleasure from the game. He now has a new basis of communication with the others on his team.

In a future column we would like to devote some space to a discussion of bowling programs in mental hospitals. One hospital in New England has developed a bowling program that begins with instruction in the basic skills and, by means of simple devices, leads the patient through a series of plateaus culminating in a place on the "varsity" bowling team which represents the hospital in competition with community teams away from the hospital grounds.

Patient Services Improve

We are grateful to Dr. Martin W. Meyer, coordinator of activity therapy for the state of Indiana, for the annual report of the Interdisciplinary Study Group. The ISC was formed at a meeting in New York City in June 1957 for the purpose of fostering "closer integration of patient services through increased mutual understanding of those disciplines whose primary function is the direct application of activities in the treatment of the mentally ill." In other words, occupational, physical, corrective, manual arts, and educational therapy, hospital library service, and hospital recreation are going to make a determined effort to achieve a better understanding of each other's contribution to the treatment of mental patients.

We hail this action of the hospital treatment services and are happy to report that the Recreation Therapy Section of the AAHPER voted to continue representation on this group through the Council for the Advancement of Hospital Recreation (CAHR).

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