1) Minimum 6 pages  (No word count per page)-   Follow the 3 x 3 rule: minimum of three paragraphs per page ( minimum 300 words per page)

You must strictly comply with the number of paragraphs requested per page.  

The number of words in each paragraph should be similar

Part 1: minimum 3 pages

Part 2: minimum 3 pages

2)¨******APA norms

        The number of words in each paragraph should be similar

        Must be written in the third person

         All paragraphs must be narrative and cited in the text- each paragraph

         The writing must be coherent, using connectors or conjunctive to extend, add information, or contrast information. 

         Bulleted responses are not accepted

         Don’t write in the first person 

  Do not use subtitles or titles      

         Don’t copy and paste the questions.

         Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by the AI writing Detector (Identify the percentage of AI writing) *****Under no circumstances will AI writing be tolerated*****

4) Minimum 4 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed 

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

 Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

Q3. Research is…………………………………………………. (a) The relationship between……… (b) EBI has to

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

_______________________________________________________________________________  

 

Part 1: Evaluation and Evidence-Based Practice in Recreational Therapy

 France  is  a  47-year-old  woman  who  lives  with  her  husband,  three  sons,  and one daughter. Denise holds a bachelor’s degree and is a freelance writer. She first experienced some slurring and difficulty enunciating while reading to her children at bedtime.  Symptoms progressed impacting her vocal chords and facial muscles. She was originally diagnosed with myasthenia gravis. Upon having increased difficulty in motor tasks was revaluated and diagnosed with Bulbar-onset Amyotrophic Lateral Sclerosis.She lives in a two-story home with her husband and children. She is alone for up to eight hours a day.  Her family serves as primary care givers supporting her independence. She  utilizes  a  walker  in  the  home  and  a  wheelchair  when  in  the  community.  Prior  to  diagnosis,  patient  was  physically  active,  enjoying  running,  swimming,  biking,  roller  blading,  playing  volleyball,  playing  whiffle  ball  with  her  children,  going  to  the  park.  Travel was a large part of the family’s leisure. Denise saw her doctor to discuss her medications and changing medical condition. The  doctor  has  responded  by  increasing  her  antidepressant  dosage  and  prescribing  a  consult with a recreation therapist and leisure education. He has referred Denise to you, a CTRS in the day program at the hospital where she was originally diagnosed, to help her in reaching her goals. Denise’s provider shares the following information from her most recent visit:

Significant   past   medical   history:   Three   normal   pregnancies   and   deliveries.   Hospitalized  (ICU)  with  H1N1.  Family  history  of  stroke  and  myasthenia  gravis.  Father had severe reaction to prednisone, resulting in death. Mother has dementia. 

Medications:  Gabapentin,  Baclofen,  Rilutek  (riluzole),  Sertraline  (25mg)  before  bed. Baclofen PRN for muscle stiffness 

Cognition/perception:   Patient   struggles   with   depression   and   accepting   the   diagnosis  and  limitations  of  her  physical  body  have  proven  difficult.  She  enjoys  being active and is adjusting to changes. Patient voices frustrations with inaccessible environments as they limit her ability to travel. She has adequate social supports and uses her writing to process as well as help others.  She wants to remain connected to her close family through activities that don’t center around her medical condition.

Physical examination: 

a.Sensation: Moderately impaired for light touch, pain, and temperature right and left distal LE (below the knee to the sole of the foot) with the ability to accurately identify five of 10 stimuli. 

b.ROM: Limited both upper and lower extremities

c.Strength: Difficulty with gripping and fine motor tasks

d.Balance: WNL in sitting; however, patient requires a standard walker to maintain balance  once  independently  attained  from  sitting.  Patient  uses  wheelchair  in  community settings and is a fall risk.

e.Pain: Patient reports severe back pain at rest and after long periods of immobility such as sleeping. Muscles stiffen quickly.

Mobility:

a.Bed mobility: Needs assistance rising from bed in morning

b.Transfers:  Transfers  are  independent  with  a  walker  for  home-level  function.  Supervised transfers for car and uneven surfaces. 

c.Gait: Patient is able to ambulate with a standard walker for short distances.”

Client Goals

1.Group activities to encourage family connectedness

2.Learn techniques to cope with evolving illness

3.Physical activity to assist with my muscle stiffness

1. Create a treatment plan for Denise France, using evidence-based practice to guide your  decision  on  appropriate  interventions  following  the  DENT  problem-solving  method.

 

a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)

b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)

c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)

d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)

2. What assessment would be most appropriate for you to give to Denise? (1 paragraph: Question 2 and Question 3) 

3.What factors must be considered when planning Denise’s intervention?

4.What is your PICO question?  (1 paragraph: Question 4 and Question 5) 

5.What outcomes do you anticipate from your treatment plan?

6.How will you evaluate the outcomes of your treatment plan?  (1 paragraph: Question 6 and Question 7) 

7.What contraindications should you consider in Denise’s treatment?

8.What  recreational  activities  would  be  appropriate  considering  Denise’s interests,  goals, and current functioning level?   (1 paragraph)

9.How would you communicate your recommendations to Denise?”  (1 paragraph)

Part 2: Evaluation and Evidence-Based Practice in Recreational Therapy

“Adam  Smith  is  an  8-year-old  boy  in  the  second  grade  with  ADHD.  He  recently  moved to New Hampshire, and this is the fourth move he has experienced in four years and the fourth school he has attended in the same amount of time. Because of this, his peers in class are slow to accept the newcomer. Making friends is nearly impossible for him, so he has relied on his mother for companionship. Adam’s  parents  divorced  due  to  domestic  violence  when  he  was  three  years  old.  Although his father now lives in Idaho, Adam maintains a reasonably good relationship with his father and sees him during the summer and during breaks in the school year. Adam’s  mother,  who  also  has  ADHD,  works  full  time  in  management  for  a  national  corporation.  Her  job  requires  that  Adam  attend  before-  and  after-school  care  at  the  school. After work, his mother is often too tired to enforce the rules she has established for homework and behavior, so Adam experiences inconsistent expectations.Adam’s  mother  is  receiving  notes  from  his  teacher  about  his  disruptive  behavior  in the classroom and lack of attention to instruction. This is not unusual; she received similar information from Adam’s teachers in the schools he previously attended. This time,  however,  she  reaches  out  to  the  school  psychologist,  who  suggests  professional  counseling for both of them.One  of  the  suggestions  made  by  the  mother’s  psychologist  is  that  she  look  into  requesting  therapeutic  recreation  services  through  the  school  district  for  Adam.  You  are the CTRS for the school district. In addition to working with teachers to promote inclusive practices, you often meet with students and their families to create treatment plans to address their concerns in and out of the classroom. In your meeting with Adam and his mother, you note the following information.

Significant past medical history: Adam witnessed an incident of domestic violence between his mother and father

Medications:   Recent medication change to Strattera; used to take Adderall XR but was losing too much weight”

Behavioral complaint (Per mother): inconsistent in follow-through with chores

Behavioral   complaint   (Per   teacher):   difficulty   sitting   still;   impulsive;   highly   distractible, inattentive, disorganized, unpredictably irritable

Client  Goals

1.Make friends

2.Deal with ADHD symptoms

1. Using  the  DENT  problem-solving  model  and  evidence-based  practice,  create  a  treatment plan for Adam based on his interests, goals, and current diagnosis.

a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)

b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)

c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)

d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)

2. What assessment would be most appropriate for you to give to Adam? (1 paragraph: Question 2 and Question 3) 

3.What factors must be considered when planning Adam’s treatment plan?

4.What is your PICO question?(1 paragraph: Question 4 and Question 5) 

5.What outcomes do you anticipate from your treatment plan?

6.How will you evaluate the outcomes of your treatment plan? (1 paragraph: Question 6 and Question 7) 

7.What contraindications should you consider in Adam’s treatment plan?

8.What  recreational  activities  would  be  appropriate  considering  Adam’s  interests,  goals, and current level of functioning? (1 paragraph)

9.How can this treatment plan be communicated to his teacher at school?” (1 paragraph)