Magazine article Parks & Recreation

Therapeutic Recreation and Relapse Prevention Intervention

Magazine article Parks & Recreation

Therapeutic Recreation and Relapse Prevention Intervention

Article excerpt

The substance-abuse problem in our society remains a predominant concern as it affects a greater number of young individuals. Often left with little or no adult supervision (because of current lifestyle demands), more and more young people turn to alcohol and drugs as a means of relieving boredom, peer acceptance, and recreation alternatives. Moreover, many of those who are substance abusers as teens or children remain dependent throughout their twenties and thirties, some for the rest of their lives.

It is the "chronic" substance-abuse population, which is often underserved, that poses a major challenge to adjunctive health care systems. The potential contribution for therapeutic recreation is considerable and often underutilized (Kunstler, 1992). Therapeutic recreation programs endeavor to structure healthy, beneficial leisure and recreation activities while educating the individual who is substance dependent about alternatives to drugs and alcohol consumption during his or her leisure time. Through appropriate interventions, the therapeutic recreation specialist may help retrain negative thoughts and determined behaviors. Leisure education programs may assist clients in learning new coping strategies as well as gratifying, non-substance-related methods of engaging in leisure activities.

Historically, the greatest potential for substance abuse among young people and adults is during their leisure time -- either after school or during non-working hours. More importantly, and often disregarded, is the fact that certain leisure activities may present "high-risk" situations that can trigger a relapse in those persons actively abstaining from substances. High-risk leisure situations include leisure-based situations that pose a threat to an individual's sense of control in maintaining sobriety. For example, if an alcohol-dependent individual went bowling in a facility where alcohol beverages were served, the bowling facility could then be considered a high-risk leisure situation. If the person is able to implement an effective coping response to high-risk leisure situations, the chance of relapse decreases considerably.

Intervention and the Relapse Process

Because of the high prevalence of relapse among substance-dependent people, it is important that therapeutic recreation specialists understand the relapse process. Relapse is characterized by setbacks and the substance abuser's failure to maintain sobriety (Beck, Wright, Newman & Liese, 1993). Figure 1 represents a relapse process model that depicts how high-risk leisure situations can increase an individual's probability of relapse. Theory-based therapeutic recreation programs, specifically designed to address leisure-related social and psychological needs, can play a pivotal role in helping substance-dependent individuals maintain sobriety and ameliorate the relapse syndrome. Unfortunately, there remains a dearth of such programs in the therapeutic recreation arena today, despite the potential benefits.

[Figure 1 ILLUSTRATION OMITTED]

Attribution Retraining

"Retraining" the thinking process of the person who is substance dependent, referred to as attribution retraining, is a possible therapeutic recreation intervention that can help clients learn new coping skills regarding high-risk leisure situations. The attribution Retraining Leisure Education Model (ARLEM) is a recently developed therapeutic recreation intervention based on Marlatt's (1985) Relapse Process Model (Figure 1) for use with chronic substance abusers. Based upon cognitive therapy procedures (Beck et al., 1993; Marlatt, 1985; Seligman et al., 1995) the ARLEM is a nine-session leisure education program that uses techniques such as recreation and leisure activity, experiential education, group discussion, and role playing to help clients "retrain" their thought processes to be more optimistic.

A typical substance-dependent individual attributes successful leisure outcomes to external forces such as fate or luck (external pessimistic attributions) instead of personally taking the credit. …

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