KNR 273
Newer and Older TR Models
Health & Human Services Models
Newer TR Models
(Sylvester, Voelkl, & Ellis, 2001)
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Health Protection/Health Promotion Model
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Therapeutic Recreation Service Delivery &
Outcome Models
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Van Andel, 1998
Self-Determination & Enjoyment Enhancement
Model
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Austin, 1991
Dattilo, Kleiber & Williams, 1998
Optimizing Lifelong Health Through Therapeutic
Recreation Model
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Wilhite, Keller, & Caldwell, 1999
Health & Human Services Models
(Carter, Van Andel, & Robb, 2003)
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TR is provided in the context of several
different health & human services systems or
models
Each of these contexts are based on a
philosophy of services that impact therapeutic
recreation
Some of these have been noted as older TR
models
Health & Human Services
Models (Older)

Medical or clinical
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Doctor is primary therapist
Doctor determines what role others play
Assumes client has a disease or illness that
needs to be treated, cured, or healed
Treat illness without regard for broader needs of
client
Recreation is guided by doctor’s diagnosis and
prescription
Settings: Physical med. & rehab; general
med/surgical hospitals
Health & Human Services
Models (Older)

Custodial
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Focus is not rehab, but on providing for basic
needs
Strong effort to maintain order & keep institutional
routines
Activity programs keep residents occupied
Settings: Correctional facilities, nursing homes,
state institutions, group homes
Being replaced by Long Term Care Model

Maintain highest level of functioning and QofL
Health & Human Services
Models (Older)

Milieu therapy (environmental therapy or
therapeutic milieu)
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Emotional problems are often the product of
unhealthy interactions with one’s environment
Staff are organized as a caring community that
help client learn to readjust to environment
Primary therapist is whoever has the most
effective relationship with the client
Settings: Mental health facilities
Health & Human Services
Models (Older)

Educational/Training Model
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Focus on acquisition of knowledge & skills that
are required to become contributing member of
society
Heavy emphasis on classroom-like framework
Focus on leisure skills & social skills
Settings: Sheltered workshops, voc rehab
centers, day-care centers, schools
Health & Human Services
Models (Older)

Community or special recreation
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Critical aspect of recreation service is the
provision of a wide range of leisure opportunities
in the community
Provide opportunities to select experiences &
acquire skills to participate in inclusive
community-based programs
Settings: City recreation departments, SRAs,
Easter Seals
Health & Human Services
Models (Newer)

Psychosocial Rehabilitation Model
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MI is continuous and the medical model is not
appropriate for people with severe, persistent MI
Foster optimal level of functioning in the
community including participating in activities
Equip people with skills in vocation, education,
personal adaptation, housing, recreation, and
social
Looks at strengths and abilities
Stay in here and now vs. past
Health & Human Services
Models (Newer)

Recovery Model
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Hope and restoration of a meaningful life are
possible despite serious mental illnesses
Holistic view that focuses on the person and not
the symptoms
Recovery is possible and achievable even though
symptoms may reoccur
Person has primary control over decisions about
outcomes
Health & Human Services
Models
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Recovery Model
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Hope: Belief in self & willingness to preserver
Secure base: Housing, income, healthcare
Supportive relationships: Professionals, friends, family, support groups, and
community
Empowerment & inclusion: Importance of social inclusion, recovery of social
skills and increased involvement in the community, has power over life &
illness
Coping strategies
Coping with loss: Past
Meaning
Medication & treatment: Take least amount possible
Education: Knowledge about illness
Spirituality
Employment or meaningful activity