Effective Management in Therapeutic Recreation Service, MJ Carter, GS O'Morrow

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Content: Effective Management in Therapeutic Recreation Service THIRD EDITION Marcia Jean Carter, Christen G. Smith, and Gerald S. O'Morrow http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
EFFECTIVE MANAGEMENT IN THERAPEUTIC RECREATION SERVICE THIRD EDITION http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
EFFECTIVE MANAGEMENT IN THERAPEUTIC RECREATION SERVICE THIRD EDITION BY MARCIA JEAN CARTER, RE.D., CPRP, CTRS CHRISTEN G. SMITH, PH.D., CPRP GERALD S. O'MORROW, PH.D., CTRS Venture Publishing, Inc. State College, Pennsylvania http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Copyright © 2014 Venture Publishing, Inc. /'FEFSBM%S 6SCBOB *- No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. Trademarks: All brand names and product names used in this book are trademarks, registered trademarks, or trade names of their respective holders. Cover by StepUp Communications, Inc. Library of Congress Catalogue Card Number 2014947454 ISBN-10: 1-939476-05-4 ISBN-13: 978-1-939476-05-0 *4#/FCPPLhttp://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Table of Contents Preface .....................................................................................................................................................xvii Acknowledgments ..................................................................................................................................... xix SECTION 1: MANAGEMENT CONCEPTS .......................................................................................1 Chapter 1: Introducing First-Line Management: Trends Impacting Your Future .........................................3 Keywords/Learning Outcomes/Overview ..................................................................................................... 3 Health and Human Service in the 21st Century........................................................................................... 4 First-Line Managers...................................................................................................................................... 5 Settings and Populations......................................................................................................................... 5 Managerial Qualities, Responsibilities, Professional Expectations............................................................ 6 References .................................................................................................................................................... 8 Chapter 2: Becoming a First-Line Manager .................................................................................................9 Keywords/Learning Outcomes/Overview ..................................................................................................... 9 Management ................................................................................................................................................ 9 Three Levels of Management ................................................................................................................ 10 Therapeutic Recreation First-Line Manager .......................................................................................... 10 Management Functions.................................................................................................................. 11 Planning ................................................................................................................................... 11 Organizing ............................................................................................................................... 11 Leading..................................................................................................................................... 11 Controlling............................................................................................................................... 12 Resources to be Managed ............................................................................................................... 12 First-Line Manager as a Supervisor ................................................................................................. 12 First-Line Manager as a Leader....................................................................................................... 12 Making the Transition: Practitioner to First-Line Manager ................................................................... 14 Organizational Stress Management................................................................................................. 15 Consequences of Organizational Stress ..................................................................................... 16 Managing Organizational Stress and Burnout................................................................................. 16 Managing Time.............................................................................................................................. 18 Time Analysis ........................................................................................................................... 18 Setting Objectives..................................................................................................................... 18 Controlling Interruptions ......................................................................................................... 18 Summary.................................................................................................................................................... 19 Critical Thinking Activities......................................................................................................................... 20 References .................................................................................................................................................. 20 Chapter 3: Managing and Leading.............................................................................................................23 Keywords/Learning Outcomes/Overview ................................................................................................... 23 Management .............................................................................................................................................. 23 Management Theory............................................................................................................................. 23 Classical Management Theory ........................................................................................................ 24 Behavioral Management Theory ..................................................................................................... 25 human relations Management Theory.......................................................................................... 26 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
vi Effective Management in Therapeutic Recreation Service, Third Edition Modern Management Theory......................................................................................................... 27 General Systems Theory............................................................................................................ 27 Contingency Theory................................................................................................................. 28 Management Theory and Therapeutic Recreation ................................................................................. 28 Leadership.................................................................................................................................................. 28 Leadership Theory ................................................................................................................................ 28 Trait Theories ................................................................................................................................. 29 Behavioral Theories ........................................................................................................................ 29 Contingency Theories..................................................................................................................... 30 Fiedler's Contingency Model .................................................................................................... 30 Life-Cycle Model...................................................................................................................... 31 Path-Goal Model ...................................................................................................................... 31 Contemporary Theories ........................................................................................................................ 32 Transactional Leadership ................................................................................................................ 32 Transformational Leadership .......................................................................................................... 32 Charismatic Leadership .................................................................................................................. 32 Leadership and Power................................................................................................................................. 33 Base of Power ....................................................................................................................................... 33 Power Strategies.................................................................................................................................... 34 Leadership and Supervision .................................................................................................................. 34 Professional Clinical Supervision .......................................................................................................... 36 Vision, Mission, Goals, and Objectives ...................................................................................................... 37 Vision Statement .................................................................................................................................. 37 mission statement ................................................................................................................................ 38 Goals and Objectives ............................................................................................................................ 38 Implications for Therapeutic Recreation ............................................................................................... 39 Summary.................................................................................................................................................... 40 Critical Thinking Activities......................................................................................................................... 40 References .................................................................................................................................................. 41 Chapter 4: Managing Organizational Behavior .........................................................................................43 Keywords/Learning Outcomes/Overview ................................................................................................... 43 Organizational Culture and Climate .......................................................................................................... 43 Organizational Change............................................................................................................................... 44 Factors Affecting Individual Performance ................................................................................................... 46 Attitude ................................................................................................................................................ 46 Personality ............................................................................................................................................ 47 Motivation ........................................................................................................................................... 47 Perception ............................................................................................................................................ 48 Learning Styles ..................................................................................................................................... 48 Diversity............................................................................................................................................... 49 Group Dynamics .................................................................................................................................. 49 Groups ....................................................................................................................................................... 49 Formal Groups ..................................................................................................................................... 50 Informal Groups................................................................................................................................... 50 Group Development .................................................................................................................................. 50 Forming................................................................................................................................................ 51 Storming .............................................................................................................................................. 51 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Table of Contents vii Norming............................................................................................................................................... 51 Performing ........................................................................................................................................... 51 Re-forming/Adjourning........................................................................................................................ 51 Group Dynamics........................................................................................................................................ 51 Group Rank ......................................................................................................................................... 51 Group Status ........................................................................................................................................ 52 Group Role........................................................................................................................................... 52 Group Size ........................................................................................................................................... 53 Group Norms....................................................................................................................................... 53 Group Cohesiveness ............................................................................................................................. 54 Manager's Roles in Group Performance ...................................................................................................... 54 Teams......................................................................................................................................................... 54 Manager's Roles in Team Performance........................................................................................................ 56 Summary.................................................................................................................................................... 57 Critical Thinking Activities......................................................................................................................... 57 References .................................................................................................................................................. 58 Chapter 5: Decision Making, Problem Solving, and Managing Conflict ...................................................59 Keywords/Learning Outcomes/Overview ................................................................................................... 59 Critical Thinking........................................................................................................................................ 60 Decision Making........................................................................................................................................ 60 Types of Decisions ................................................................................................................................ 61 Decision-Making Conditions ............................................................................................................... 61 Policies, Procedures, Rules .................................................................................................................... 61 Policies ........................................................................................................................................... 62 Procedures...................................................................................................................................... 63 Rules .............................................................................................................................................. 64 Decision-Making Process...................................................................................................................... 64 Issue Identification ......................................................................................................................... 64 Exploring Alternatives through Creative Thinking.......................................................................... 64 Evaluating Alternatives ................................................................................................................... 68 Selecting an Alternative .................................................................................................................. 68 Implementing the Decision ............................................................................................................ 69 Evaluating the Decision.................................................................................................................. 69 Group Decision-Making Techniques .................................................................................................... 69 Interaction Group .......................................................................................................................... 70 Brainstorming ................................................................................................................................ 70 Nominal Group Technique............................................................................................................. 70 Delphi Group Method ................................................................................................................... 70 Electronic Meetings........................................................................................................................ 71 Analytical Decision-Making Tools ........................................................................................................ 71 Decision Grids, Gantt Charts, Consequence Tables........................................................................ 71 Decision Trees ................................................................................................................................ 72 Program Evaluation and Review Technique (PERT)/Critical Path Method (CPM) ........................ 72 Problem Solving ......................................................................................................................................... 72 Problem-Solving Process ....................................................................................................................... 73 Define the Problem ........................................................................................................................ 73 Gather Information........................................................................................................................ 73 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
viii Effective Management in Therapeutic Recreation Service, Third Edition Analyze Information....................................................................................................................... 73 Develop Solutions .......................................................................................................................... 74 Make Decision ............................................................................................................................... 74 Implement ..................................................................................................................................... 74 Evaluate.......................................................................................................................................... 74 Personal Elements of Making Decisions and Solving Problems................................................................... 75 Managing Conflict ..................................................................................................................................... 75 Sources of Conflict ............................................................................................................................... 75 Conflict Prevention and Resolution ...................................................................................................... 76 Resolution Strategies............................................................................................................................. 77 Resolution Outcomes ........................................................................................................................... 77 Summary.................................................................................................................................................... 79 Critical Thinking Activities......................................................................................................................... 80 References .................................................................................................................................................. 80 SECTION 2: MANAGING OPERATIONS .......................................................................................81 Chapter 6: Applying Technology and Implementing Research...................................................................83 Keywords/Learning Outcomes/Overview ................................................................................................... 83 Technology................................................................................................................................................. 83 Technology Supporting Management Decisions ................................................................................... 84 Dashboard Reports......................................................................................................................... 85 Handheld Electronic Devices and Wireless Access .......................................................................... 85 Internet Resources.......................................................................................................................... 87 electronic health records .......................................................................................................................... 87 Technology Opportunities and Barriers ...................................................................................................... 89 Applying Technology to Research............................................................................................................... 90 Evidence-Based Practice in Therapeutic Recreation............................................................................... 90 Evidence-Based Practice Model for Implementation ............................................................................. 91 Challenges to Implementation of Evidence-Based Practice.................................................................... 92 Enhancing Research ................................................................................................................................... 92 Summary.................................................................................................................................................... 94 Critical Thinking Activities......................................................................................................................... 94 References .................................................................................................................................................. 95 Chapter 7: Marketing and Advocating .......................................................................................................97 Keywords/Learning Outcomes/Overview ................................................................................................... 97 Trends ........................................................................................................................................................ 98 Marketing Concepts................................................................................................................................... 99 The Marketing Process: A Marketing Plan................................................................................................ 100 Step 1: Assessment.............................................................................................................................. 100 Step 2: Planning ................................................................................................................................. 101 Step 3: Implementation ...................................................................................................................... 103 Branding ...................................................................................................................................... 103 Logo............................................................................................................................................. 104 Tagline ......................................................................................................................................... 104 Bundling ...................................................................................................................................... 104 Digital Networking ...................................................................................................................... 105 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Table of Contents ix Marketing Benefits ....................................................................................................................... 105 Step 4: Evaluation and Control........................................................................................................... 106 Managerial Roles...................................................................................................................................... 106 Ethics in Marketing.................................................................................................................................. 107 Summary.................................................................................................................................................. 108 Critical Thinking Activities....................................................................................................................... 108 References ................................................................................................................................................ 108 Chapter 8: Financial Management ...........................................................................................................111 Keywords/Learning Outcomes/Overview ................................................................................................. 111 Health-Care Financing: Milestones and Concepts .................................................................................... 112 Milestones: United States and Canada ................................................................................................ 112 United States................................................................................................................................ 112 Canada......................................................................................................................................... 113 Concepts: Regulations and Financial Practices in North America ....................................................... 114 Revenue Sources and Coverage................................................................................................................. 117 Revenue Sources ................................................................................................................................. 117 Coverage............................................................................................................................................. 118 United States................................................................................................................................ 118 The Budgeting Process.............................................................................................................................. 119 Types of Budgets................................................................................................................................. 120 Budget Formats .................................................................................................................................. 121 Budget Monitoring............................................................................................................................. 122 Trends and Challenges in Health-Care Financing..................................................................................... 123 Summary.................................................................................................................................................. 124 Critical Thinking Activities....................................................................................................................... 125 References ................................................................................................................................................ 126 SECTION 3: MANAGING HUMAN RESOURCES ..........................................................................127 Chapter 9: Staffing Services .....................................................................................................................129 Keywords/Learning Outcomes/Overview ................................................................................................. 129 Human Resource Planning....................................................................................................................... 131 Position Opens ................................................................................................................................... 131 Budget Review.................................................................................................................................... 131 Job Description Review and Job Analysis............................................................................................ 131 Candidate-Selection Criteria............................................................................................................... 133 Recruitment Plan................................................................................................................................ 134 Job Announcement ...................................................................................................................... 135 Selection Process................................................................................................................................. 135 Application Form ......................................................................................................................... 136 Interview...................................................................................................................................... 137 Background Checks...................................................................................................................... 137 Selection Decision........................................................................................................................ 138 Job Offer ............................................................................................................................................ 140 Probationary Period ............................................................................................................................ 140 Professional Standards ........................................................................................................................ 141 Staff Training and Development............................................................................................................... 141 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
x Effective Management in Therapeutic Recreation Service, Third Edition Training Cycle .................................................................................................................................... 142 Needs Assessment......................................................................................................................... 142 Objectives .................................................................................................................................... 143 Implementation............................................................................................................................ 143 Evaluation .................................................................................................................................... 144 Training and Development Trends...................................................................................................... 145 Performance Appraisals ............................................................................................................................ 146 Performance Appraisal Systems........................................................................................................... 147 Results-Oriented Evaluations (Objectives).................................................................................... 147 Critical Incident Reports .............................................................................................................. 148 Rubrics (Behaviorally Anchored Rating Scale).............................................................................. 148 Ranking ....................................................................................................................................... 148 Narrative ...................................................................................................................................... 149 Performance Appraisal Interview ........................................................................................................ 149 Performance-Improvement Action Plan .............................................................................................. 149 Progressive Discipline ......................................................................................................................... 150 Grievance Procedure ........................................................................................................................... 151 Retaining Staff.................................................................................................................................... 151 Legal Environment................................................................................................................................... 152 Equal Employment Opportunity........................................................................................................ 152 U.S. Legislation .................................................................................................................................. 152 Summary.................................................................................................................................................. 156 Critical Thinking Activities....................................................................................................................... 157 References ................................................................................................................................................ 157 Chapter 10: Volunteer and Intern Management.......................................................................................159 Keywords/Learning Outcomes/Overview ................................................................................................. 159 Planning................................................................................................................................................... 160 Assessment ......................................................................................................................................... 160 Policies and Procedures....................................................................................................................... 161 Job Descriptions ................................................................................................................................. 161 Staff and Training Resources ............................................................................................................... 162 Screening............................................................................................................................................ 162 Marketing Plan................................................................................................................................... 163 Selection and Orientation ........................................................................................................................ 164 Selection and Interview....................................................................................................................... 164 Placement and Orientation................................................................................................................. 165 Training, Supervision/Evaluation, Contracts....................................................................................... 166 Training and Supervision.......................................................................................................................... 168 Training.............................................................................................................................................. 168 Supervision......................................................................................................................................... 169 Evaluation, Termination, and Recognition ............................................................................................... 170 Formative Evaluation.......................................................................................................................... 170 Summative Evaluation and Termination ............................................................................................. 170 Recognition ........................................................................................................................................ 172 Trends and Issues...................................................................................................................................... 172 Summary.................................................................................................................................................. 173 Critical Thinking Activities....................................................................................................................... 174 References ...h.t.t.p.:././w..w..w....s.a..g.a..m..o.r.e..p.u..b...c.o..m../.p.r.o..d.u..c.t.s./.e.f.f.e.c.t.i.v.e..-m...a.n..a.g..e.m..e..n.t.-.t.h.e..r.a.p..e.u.t.i.c.-.r.e.c..r.e.a..ti.o.n..-.s.e..rv..ic..e.-.3..rd..-.e.d..?.s..r.c.=.l.i.p.d..f............ 174
Table of Contents xi Chapter 11: Communicating Effectively in the Workplace ......................................................................177 Keywords/Learning Outcomes/Overview ................................................................................................. 177 interpersonal communication in the Workplace...................................................................................... 178 Formal Communication Modes.......................................................................................................... 179 Verbal Communication ................................................................................................................ 179 nonverbal communication.......................................................................................................... 179 Appearance................................................................................................................................... 179 Written Communication.............................................................................................................. 179 Informal Communication Mode ........................................................................................................ 180 Technology's Impact on Workplace Communication .......................................................................... 180 Workplace Variables Impacting Communication ................................................................................ 180 Physical ........................................................................................................................................ 181 Emotional .................................................................................................................................... 181 Semantics ..................................................................................................................................... 181 Role ............................................................................................................................................. 181 Gender ......................................................................................................................................... 181 Generational ................................................................................................................................ 181 Culture......................................................................................................................................... 181 Organizational Culture................................................................................................................. 182 Information Overload .................................................................................................................. 182 Principles of Effective Communication............................................................................................... 182 Feedback ...................................................................................................................................... 183 Active Listening............................................................................................................................ 183 The Manager and Organizational Communication................................................................................... 183 Variables Affecting Organizational Communication ........................................................................... 184 Organizational Communication Strategies.......................................................................................... 184 Effective Meeting Strategies ................................................................................................................ 185 Delegation ......................................................................................................................................... 185 Negotiation ........................................................................................................................................ 187 Collaboration ..................................................................................................................................... 187 Criticism, Complaints, and Confrontation ......................................................................................... 188 The Manager--A Professional Advocate ................................................................................................... 189 Summary.................................................................................................................................................. 190 Critical Thinking Activities....................................................................................................................... 190 References ................................................................................................................................................ 190 Chapter 12: Creating a Motivating Work Environment ...........................................................................191 Keywords/Learning Outcomes/Overview ................................................................................................. 191 Motivational Theories............................................................................................................................... 192 Maslow's Hierarchy of Needs .............................................................................................................. 192 Clayton Alderfer's Modified Need Hierarchy (ERG)........................................................................... 192 Herzberg's Two-Factor Theory ............................................................................................................ 193 Skinner's Positive Reinforcement Theory ............................................................................................ 193 Argyris's Maturity-Immaturity Continuum......................................................................................... 193 McClelland's Three Needs Theory....................................................................................................... 193 McGregor's Theory X and Theory Y.................................................................................................... 194 Vroom's Expectancy Theory ................................................................................................................ 194 Equity Theory..................................................................................................................................... 195 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xii Effective Management in Therapeutic Recreation Service, Third Edition Goal-Setting Theory ........................................................................................................................... 195 Theory Z ............................................................................................................................................ 195 Need Fulfillment and a Motivating Work Environment ........................................................................... 196 Need Fulfillment through Intrinsic and Extrinsic Motivators.............................................................. 196 Manager's Role in Creating a Motivating Work Environment............................................................. 197 Trends and Issues Challenging Motivational Work Environments ............................................................ 200 Summary.................................................................................................................................................. 201 Critical Thinking Activities....................................................................................................................... 201 References ................................................................................................................................................ 202 SECTION 4: MANAGING SERVICE DELIVERY.............................................................................203 Chapter 13: Managing for Service Accountability ...................................................................................205 Keywords/Learning Outcomes/Overview ................................................................................................. 205 Staffing and Scheduling Options .............................................................................................................. 206 Staffing Variables ................................................................................................................................ 206 Scheduling Options and Challenges ................................................................................................... 207 Therapeutic Recreation Process................................................................................................................. 208 Accountability in the Therapeutic Recreation Process ......................................................................... 208 Assessing ...................................................................................................................................... 209 Planning....................................................................................................................................... 209 Implementation............................................................................................................................ 209 Evaluation .................................................................................................................................... 209 Accountability Tools, Protocols and Critical Pathways ........................................................................ 210 Protocol........................................................................................................................................ 210 Critical Pathway ........................................................................................................................... 210 Documenting APIE............................................................................................................................ 211 Monitoring and Consulting Practitioner Performance .............................................................................. 213 Monitoring/Coaching and Practitioner Performance .......................................................................... 213 Consultant and Practitioner Performance ........................................................................................... 214 Summary.................................................................................................................................................. 215 Critical Thinking Activities....................................................................................................................... 216 References ................................................................................................................................................ 216 Chapter 14: Managing Risk, Safety, Security, and Legal Aspects..............................................................219 Keywords/Learning Outcomes/Overview ................................................................................................. 219 Risk Management .................................................................................................................................... 220 Components of a Risk Management Program..................................................................................... 221 Step 1: Risk Identification ............................................................................................................ 223 Step 2: Risk Evaluation................................................................................................................. 224 Step 3: Risk Management Strategies ............................................................................................. 225 Step 4: Risk Management Implementation and Reporting ........................................................... 226 Security and Personal Safety ..................................................................................................................... 227 Legislation and Laws, United States and Canada ................................................................................ 228 Organizations in United States and Canada........................................................................................ 229 Legal Issues and Concerns ........................................................................................................................ 230 Legal Responsibilities of the Manager ................................................................................................. 232 Summary.................................................................................................................................................. 233 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Table of Contents xiii Critical Thinking Activities....................................................................................................................... 234 References ................................................................................................................................................ 234 Chapter 15: Managing Service Quality in Health Care ............................................................................237 Keywords/Learning Outcomes/Overview ................................................................................................. 237 Brief Evolution of Quality Concerns in Health Care ................................................................................ 238 How is Quality Defined in Health Care?.................................................................................................. 239 Client Perceptions of Quality in Health Care ........................................................................................... 241 Quality Initiatives Applied to Health Care ............................................................................................... 241 TQM as a Broad Philosophy of Quality Improvement........................................................................ 242 CQI as a Process of Quality Improvement .......................................................................................... 243 The Deming cycle ........................................................................................................................ 244 Quality Assurance............................................................................................................................... 245 Structure ...................................................................................................................................... 245 Process ......................................................................................................................................... 245 Outcome...................................................................................................................................... 246 Indicators ..................................................................................................................................... 247 Quality Improvement ......................................................................................................................... 248 Quality Improvement through Evidence-Based Practice ........................................................................... 248 Summary.................................................................................................................................................. 250 Critical Thinking Activities....................................................................................................................... 251 References ................................................................................................................................................ 251 Chapter 16: Managing Your Future: Professional Qualities and career planning ....................................255 Keywords/Learning Outcomes/Overview ................................................................................................. 255 A Professional Career................................................................................................................................ 255 Ethical Practices and Principles........................................................................................................... 256 Values and Rights ............................................................................................................................... 257 Values........................................................................................................................................... 257 Rights........................................................................................................................................... 258 The Manager and Professional Ethics.................................................................................................. 259 Ethical Decision-Making and Moral-Reasoning Model....................................................................... 260 Managing and Advancing Your Career ..................................................................................................... 261 Career Planning.................................................................................................................................. 261 Assessment ................................................................................................................................... 261 Planning....................................................................................................................................... 261 Implementation............................................................................................................................ 262 Evaluation .................................................................................................................................... 263 Advancing Your Professional Future.................................................................................................... 263 Summary.................................................................................................................................................. 263 Critical Thinking Activities....................................................................................................................... 265 References ................................................................................................................................................ 266 Index ........................................................................................................................................................269 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
xiv Effective Management in Therapeutic Recreation Service, Third Edition List of Tables and Figures Table 1.1 Trends, Issues, and Challenges in Recreation Therapy/Therapeutic Recreation ................................... 5 Table 1.2 Managerial Responsibilities by NCTRC Professional Knowledge Domains ........................................ 7 Figure 2.1 Three Levels of Management .......................................................................................................... 10 Figure 2.2 Managerial Responsibilities by NCTRC Professional Knowledge Domains .................................... 13 Figure 2.3 Expectations of First-Line Managers ............................................................................................... 14 Figure 2.4 Variables Affecting the Therapeutic Recreation Manager ................................................................. 15 Figure 2.5 Prolonged Stress: Physical, Psychological, and Behavioral Symptoms of Stress ................................ 17 Figure 2.6 The Differences Between Stress and Burnout .................................................................................. 17 Figure 2.7 Managing for Effective Meetings .................................................................................................... 20 Figure 3.1 Functions of Management and Leadership ..................................................................................... 24 Figure 3.2 Functions of Management and Leadership ..................................................................................... 26 Figure 3.3 Theory X and Theory Y Assumptions ............................................................................................. 26 Figure 3.4 Open System .................................................................................................................................. 27 Figure 3.5 Examples of Common Leadership Traits ......................................................................................... 29 Figure 3.6 Behavior Styles of Leadership .......................................................................................................... 29 Figure 3.7 Continuum of Leadership Behavior ................................................................................................ 30 Figure 3.8 Fiedler's Contingency Theory Model .............................................................................................. 31 Figure 3.9 The Life-Cycle Model ..................................................................................................................... 32 Figure 3.10 Path-Goal Theory ......................................................................................................................... 32 Figure 3.11 Rules of Using Power .................................................................................................................... 35 Figure 3.12 Planning Statements: Vision, Mission, Goals, and Objectives ....................................................... 37 Figure 3.13 Mission Statements for Therapeutic Recreation ............................................................................ 39 Table 4.1 Work Rules and Climate and Culture .............................................................................................. 44 Table 4.2 Manager Change Agent Abilities ...................................................................................................... 45 Figure 4.1 Phases of Planned Change .............................................................................................................. 45 Table 4.3 Manager's Strategies to Build Employee Consensus .......................................................................... 46 Table 4.4 Managerial Processes to Manage Perceptions .................................................................................... 48 Table 4.5 Personal Differences Contributing to Diversity ................................................................................ 49 Table 4.6 Positive Group Task Roles ................................................................................................................ 53 Table 4.7 Positive Group Maintenance Roles ................................................................................................... 53 Table 4.8 Roles That Inhibit Group Functioning ............................................................................................. 53 Table 4.9 Managerial Actions Contribute to Positive Group Norms ................................................................ 54 Table 4.10 Comparative Features of Effective and Ineffective Groups .............................................................. 55 Table 4.11 Variations between Groups and Teams ........................................................................................... 56 Table 4.12 Qualities of effective teams ........................................................................................................... 56 Table 5.1 Critical Analysis Questions .............................................................................................................. 60 Table 5.2 Decision Making Conditions ........................................................................................................... 62 Table 5.3 Policy Statement Guidelines ............................................................................................................. 63 Figure 5.1 Organizational Policy ..................................................................................................................... 65 Figure 5.2 Departmental Policy Aligned with Organizational Policy ................................................................ 66 Figure 5.3 Procedures within Department Policy ............................................................................................. 67 Table 5.4 Creative Thinking Steps ................................................................................................................... 67 Figure 5.4 A Decision Grid ............................................................................................................................. 71 Figure 5.5 A Decision Tree .............................................................................................................................. 72 Table 5.5 Comparison of the Problem-Solving and Therapeutic Recreation Processes ...................................... 73 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Table of Contents xv Table 5.6 Criteria to Review Collected Information ........................................................................................ 74 Table 5.7 Selected Resolution Strategies .......................................................................................................... 78 Table 6.1 The Technology Plan ........................................................................................................................ 85 Figure 6.1 Dashboard Report .......................................................................................................................... 86 Table 6.2 Data Security for Electronic Health Records .................................................................................... 89 Table 6.3 Categories of Evidence ..................................................................................................................... 91 Table 7.1 Marketing Plan Outline ................................................................................................................. 101 Figure 7.1 Target audiences for Therapeutic Recreation Marketing ............................................................... 101 Figure 7.2 Marketing Goals and Objectives ................................................................................................... 101 Figure 7.3 Action Plan ................................................................................................................................... 102 Figure 7.4 Marketing Timetable .................................................................................................................... 103 Table 7.2 Steps to Developing a Tagline ........................................................................................................ 105 Table 8.1 USA Payment Shifts and Legislation .............................................................................................. 113 Table 8.2 Canadian Health-Care Legislation ................................................................................................. 114 Table 8.3 U.S. Payment-Related Programs .................................................................................................... 116 Table 8.4 Fiscal Terms ................................................................................................................................... 117 Table 9.1 Human Resource Department Responsibilities .............................................................................. 130 Figure 9.1 Entry-Level Job Description ................................................................................................. 132­133 Figure 9.2 Selection Criteria Form ................................................................................................................ 134 Figure 9.3 Common Media for Distribution of Job Announcements ............................................................. 135 Figure 9.4 Advantages and Disadvantages of Recruitment Software ............................................................... 136 Figure 9.5 Position Announcement ............................................................................................................... 136 Table 9.2 Preparing for the Interview ............................................................................................................ 138 Table 9.3 Pre-Employment Questions: What is Legal .................................................................................... 139 Table 9.4 Common Selection Decision Mistakes ........................................................................................... 140 Table 9.5 Purposes of New Employee Orientation ......................................................................................... 142 Table 9.6 Types of Staff Training and Development Programs ....................................................................... 143 Table 9.7 Advantages and Disadvantages of E-Learning Training ................................................................... 144 Table 9.8 Training Methods Summary ........................................................................................................... 145 Table 9.9 Performance Appraisal Methods ..................................................................................................... 147 Table 9.10 Potential Performance-Appraisal Rating Errors ............................................................................. 148 Table 9.11 Major United States Federal Laws and Regulations Related to Human Resource Management .... 153 Table 9.12 Summary of Canadian Employment Law ..................................................................................... 154 Table 10.1 Management of Agency Volunteers and Interns ........................................................................... 160 Table 10.2 Volunteer and Intern Job Description Information ...................................................................... 162 Table 10.3 Contract/Affiliation Agreement Content ...................................................................................... 162 Table 10.4 Volunteer and Intern Screening Criteria ....................................................................................... 163 Table 10.5 Marketing Plan to Recruit Volunteers and Interns ........................................................................ 164 Table 10.6 Preliminary Interview Content ..................................................................................................... 165 Table 10.7 Volunteer/Intern Interview Questions .......................................................................................... 165 Table 10.8 Volunteer/Intern Behavioral Questions ........................................................................................ 165 Table 10.9 Agency and Unit Orientation Topics ............................................................................................ 166 Table 10.10 Work Assignment Orientation Topics ........................................................................................ 166 Table 10.11 Weekly Assignment Checklist .................................................................................................... 167 Table 10.12 Volunteer Assignment ................................................................................................................ 168 Table 11.1 Choosing Communication Modes ............................................................................................... 178 Table 11.2 Effective communication principles ............................................................................................ 182 Table 11.3 Effective Feedback Techniques 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xvi Effective Management in Therapeutic Recreation Service, Third Edition Table 11.4 Active Listening Skills .................................................................................................................. 183 Table 11.5 Organizational Communication Variables .................................................................................... 184 Table 11.6 Organizational Communication Strategies ................................................................................... 184 Table 11.7 Effective Meeting Strategies ......................................................................................................... 186 Table 11.8 Delegation Process ....................................................................................................................... 187 Table 11.9 negotiation process ...................................................................................................................... 187 Table 11.10 Managing Criticism, Complaints, Confrontation ...................................................................... 188 Table 12.1 Job Dimensions ........................................................................................................................... 198 Table 12.2 Managerial Guidelines to Promote Satisfaction and Quality ......................................................... 199 Table 13.1 Staffing Goals ............................................................................................................................... 206 Table 13.2 Manager's Evaluation Tasks .......................................................................................................... 210 Table 13.3 Documentation Best Practices ...................................................................................................... 212 Table 13.4 Coaching Objectives .................................................................................................................... 213 Table 13.5 Manager's Coaching Practices ...................................................................................................... 214 Figure 14.1 Risk Management Decision-Making Process in Therapeutic Recreation ...................................... 221 Table 14.1 Risk Management Responsibilities of Manager ............................................................................ 222 Table 14.2 Risk Management Policy Statement ..................................................................................... 222­223 Table 14.3 Risk Management Concerns in Health-Care Agencies ................................................................. 224 Table 14.4 Illustrations of Potential Errors in Recreation Therapy ................................................................. 224 Table 14.5 Hazards in Recreation Therapy Services ....................................................................................... 224 Table 14.6 Content of Incident Reports ........................................................................................................ 225 Table 14.7 Risk Management Plan Documents and Practices ........................................................................ 226 Table 14.8 Security Devices ........................................................................................................................... 227 Table 14.9 Safety and Quality related Organizations in US and Canada ........................................................ 229 Table 14.10 Criteria for Tort ......................................................................................................................... 231 Table 14.11 Legal Considerations for Professional Liability ........................................................................... 231 Table 14.12 Professional Behavior Important to Minimizing Litigation ........................................................ 231 Table 14.13 HIPAA and PIPEDA Regulations .............................................................................................. 233 Figure 15.1 Triad of Health Care Concerns ................................................................................................... 238 Figure 15.2 Quality Initiatives ....................................................................................................................... 242 Figure 15.3 Elements of TQM as a Philosophy of Management .................................................................... 243 Figure 15.4 The Deming Cycle ...................................................................................................................... 244 Figure 15.5 Five Steps to Improving Health-Care Quality ............................................................................. 248 Table 16.1 Ethical Principles that Guide Practice Behaviors ........................................................................... 257 Table 16.2 ATRA and CTRA Ethical Principles ............................................................................................ 260 Table 16.3 Ethical Decision-Making/Moral-Reasoning Model ...................................................................... 261 Table 16.4 Career Planning Model ................................................................................................................ 262 Table 16.5 SWOT Analysis to Manage and Advance Your Career ................................................................. 264 http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Preface
are acknowledged: Students and practicing managers may engage in professional preparation, live, and practice
Effective Management in Therapeutic Recreation Services, in completely different geographic areas, so culture and
Third Edition provides theoretical and practical diversity are integrated into topics throughout the text.
knowledge about the management of therapeutic rec- reation services* in health and human service organi- Text Organization
zations in North America. The text was written for This third edition reflects a management perspective,
upper-level undergraduate and graduate students as well as opposed to a program perspective. Therefore, in the
as practitioners. The text was also prepared for a ther- sequence of chapters, program and consumer informa-
apeutic recreation specialist who has responsibility for tion follow management as quality consumer program-
managing direct therapeutic recreation service and the ming relies on successful execution of management
assignment and direction of staff, volunteers, and interns functions. The third edition is organized into four parts.
who deliver the service.
Section 1 considers management and leadership
While we realize all the information useful to a concepts. In Chapter 1, new to this edition, the trends
potential manager or practicing manager is not in this and issues creating challenges to managing services are
one volume, the intent is to present the most important summarized and precede a brief description of the
portions of management information relevant to the settings, populations, and responsibilities of the first-line
professional who is a first-line manager. Changes are taking manager. Chapter 2 outlines management functions of
place on a daily basis in health and human service orga- the first-line manager and the transitions from a prac-
nizations, which in turn affect therapeutic recreation titioner to first-line manager. New to the text is con-
service and its management. Management of therapeutic sideration of organizational stress and techniques that
recreation service, regardless of setting, will change dra- first-line managers use to adjust to the demands of their
matically in the future. Hence, we foresee that some work environment. In Chapter 3, management and
statements may not be as appropriate as they were at the leadership theories are summarized and applied to
time the manuscript was prepared.
therapeutic recreation. The chapter concludes with
Instructor and Student learning tools
discussion of the manager-leader's role in preparing planning statements to guide the department or agency.
New features of this third edition introduced to support Organizational behavior, Chapter 4, focuses on the
instructors and learners are an instructor's manual and nature of human behavior in the department. In-depth
text format with interactive pedagogical tools. The in- consideration is given to change, teams, and individual
structor's manual includes PowerPoints, test questions, factors affecting performance--topics expanded from
and review questions. Each text chapter is introduced the previous edition. Chapter 5, on decision making,
with learner outcomes that are then embedded in the problem-solving, and conflict, addresses fundamental
text narrative in close proximity to the relevant learner tasks found in all management functions and in situations
content. Within the chapters, significant content is where people work together in a constantly changing
presented in Figures and Tables and enumerated in the environment. Expanded in this edition are examples of
chapter summary. Lastly, the text has been reduced in agency policies, procedures, and rules, as well as sources
length so instructors may organize units according to of conflict such as bullying.
the average number of weeks in an academic term.
Section 2 reviews operational aspects of manage-
New Content
ment, including technology and research (Chapter 6), marketing and advocacy (Chapter 7), and financing
Another new feature of this edition is the introduction (Chapter 8). Technology, in addition to contributing
of information relevant to therapeutic recreation man- to the increasingly rapid rate of change and access to
agement in Canada. Since publication of the second information, is also affecting how services are delivered
edition, academic programs in Canada are increasing; and how professionals carry out their responsibilities.
where appropriate, discussion presents information Chapter 6 introduces expanded content on health-care
unique to Canadian learners. Likewise, throughout the technology, including dashboards, electronic health
text, the global interactions of health and human services http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
xviii Effective Management in Therapeutic Recreation Service, Third Edition
records, informatics, a technology plan, and the significance of research in evidence-based practice. Health care is a business, which is most evident with the new business concepts introduced in the marketing and advocacy chapter (7). Trends like social marketing are influencing the manager's advocacy roles and concerns for assuring ethical relationships among stakeholders and the larger community that benefits from therapeutic recreation outcomes. Financing health care in the United States and Canada is the focus of Chapter 8. New to the chapter are consideration of the global fiscal challenges affecting health care, review of health-care payment shifts and legislation in Canada and the United States, coverage, and financial trends. Human resources are the focus of Section 3 of the text. Chapters consider staffing (Chapter 9), volunteers and interns (Chapter 10), workplace communication (Chapter 11), and motivating work environments (Chapter 12). Chapter 9 covers staff planning and selection, training and development, and performance appraisal. New content includes recruitment software, e-learning, results-oriented assessments and evaluation in addition to expanded information on interviewing, orientation, staff retention, and employment regulations. Chapter 10 introduces a Canadian perspective to managing volunteers and interns. Also introduced are the changing natures of volunteer commitments and student internship needs that impact the manager's responsibility to create capacity-building experiences. Chapter 11 emphasizes that because a manager is in a high-profile position, everything a manager does communicates. An expanded emphasis is given to workplace variables, influencing communication and the manager's role as a professional advocate. The closing chapter in this section, Chapter 12, expands information on motivational theories--the manager's role in relating to the unique needs of staff in order to create a motivating environment that satisfies staff goals and department or agency goals--and shares research on intrinsic and extrinsic forms of motivation in therapeutic recreation. Also, trends like the global and generational workforce are challenging managers to introduce new intangible and tangible motivational features to the work environment. Four chapters comprise Section 4 and focus on service delivery: They include service accountability (Chapter 13); risk, safety, security, and legal aspects
(Chapter 14); quality (Chapter 15); and managing a professional future (Chapter 16). Chapter 13 introduces evidence-based staffing and enhances discussion of the manager's roles in assessment, planning, implementation, and evaluation by adding information on critical pathways. A contemporary social issue is security and personal safety in the workplace. The content of Chapter 14 expands beyond risk to address safety and security of professionals and stakeholders in health care. A number of laws, organizations, and regulations govern and provide resources in Canada and the United States to help the manager ensure safety, quality, and privacy; websites are presented, relevant terms defined, elements of safety and security plans described, and management of the therapeutic recreation process to reduce malpractice concerns is outlined. Chapter 15 presents the manager's responsibility to sustain quality in service delivery. New to this edition are reviews of quality initiatives applied to health care, evolution of quality concerns in health care, expanded definitions of quality by the Institute Of Medicine and World Health Organization, and an introduction to the American Hospital Association quality-improvement model. Closing the text (Chapter 16) is a new chapter on managing a professional future. This chapter reiterates the trends and issues shared in the introduction and throughout the text. Also, the chapter summarizes the critical nature of ethics and ethical decision making as professional qualities and behaviors. To manage a future that advances the emerging professional's career requires continued acquisition of relevant knowledge, skills, and abilities and the flexibility to change. To accomplish these goals, a career-planning model grounded on the process of assessment, planning, implementation, and evaluation and a strategic-planning-analysis template are presented. These tools help professionals identify their assets and plan strategies to remain abreast of global and professional challenges while advancing the profession. *The term "therapeutic recreation service" is used for ease of readership and is intended to be inclusive of the terms "recreational therapy" and "recreation therapy."
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Acknowledgments Professionals who contributed to chapters in this edition include: M. Jean Keller, CTRS, University of North Texas, Denton, Texas (Chapter 6) Shane Pegg, Ph.D., University of Queensland, St. Lucia Campus, Australia (Chapter 15) Norma J. Stumbo, Ph.D., CTRS, President, Education Associates, Normal, Illinois (Chapter 15) Health and human service professionals and organizations that generously offered materials that have contributed to this third edition include the following: Craig Hospital, Englewood, Colorado, Kenneth R. Hosack, M.A., Director of Marketing and public relations Fox Valley Special Recreation Association, Aurora, Illinois, Carolyn Nagle, MPA, CTRS, CPRP, Executive Director Genesis Health System, Davenport, Iowa, Kelly Sigler, M.S., CTRS, Lean Specialist Howard County, Maryland, Susan L. Potts, M.S., CTRS, Recreation Manager National Council for Therapeutic Recreation Certification, New City, New York, Bob Riley, Ph.D., CTRS, Executive Director Dr. Gerald S. O'Morrow conceived and was the primary author of the first edition of Effective Management in Therapeutic Recreation Service. With acknowledgment of continued support from his family, we are honored to have the opportunity to show our appreciation and respect for his dedication to the profession through this third edition. Marcia Jean Carter Christen G. Smith http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
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Chapter 1 INTRODUCING FIRST-LINE MANAGEMENT: TRENDS IMPACTING YOUR FUTURE
Keywords
organization or with others in the community who deliver similar services. There may be times, however,
that the manager is responsible for providing direct
· Care continuum
service (e.g., staff on vacations or during special
· Change
programs). In some large health and human-service
· Demographics
organizations (e.g., hospitals, public or private freestanding
· Education
community-based centers for persons with disabilities)
· Evidence-based practice
and depending on the organizational structure, therapeutic
· Globalization
recreation managers may occupy a middle-management
· Health-care business
position. In such instances, they would be responsible
· Holistic care
for implementing basic policies and plans developed by
· Patient-centered care
top management and for supervising and coordinating
· Research
the activities of lower-level managers. The director of a
· Technology
rehabilitation department with a corporation like Genesis
Healthcare who is responsible for several disciplines (e.g.,
Learning Outcomes
occupational, speech-hearing, and recreation therapy) would be a middle manager, as would the manager of
After reading this introduction, students will be able to: therapeutic recreation services in a community organi-
zation like Pathways Health Centre for Children in
1. Outline trends, issues, and challenges influenc- Ontario, Canada.
ing management in our profession.
A first-line-manager position is often the first
2. Identify settings and populations where first-line position held by a practitioner who enters management
managers are employed.
from direct services; however, there are some settings in
3. Outline qualities, responsibilities, and profes- which the first-line manager is also the sole practitioner
sional expectations of first-line managers.
(e.g., long-term care settings, small community-based
4. Describe topics and outcomes students may organizations). Thus, most first-line managers have had
expect with use of this text.
little or no formal academic preparation in therapeutic
recreation management. Their advancement is the result
Overview
of competency in direct service, program knowledge, and job experience. A management position continues
What is a first-line manager? And why are management to be one of the options open to a practitioner to offer
skills critical to a new professional in recreation therapy/ salary increases.
therapeutic recreation?
The intent of this introduction is to introduce trends,
Today all practitioners are managers. While there issues, and challenges impacting management in our
are various levels of management (e.g., top, middle, profession; survey employment settings, responsibilities,
first-line), first-line managers are responsible for delivery and professional expectations of first-line managers; and
of therapeutic recreation service, assignment and outline the management topics and outcomes students
direction of professional practitioners and volunteers, may expect as a result of using this text.
and interaction with other managers in the same http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
4 Effective Management in Therapeutic Recreation Service, Third Edition
Health and Human Service
like aging, income levels, and violence are adding demands to an overburdened system. The World Health Organ-
in the 21st Century
ization's International Classification of Functioning, Disability, and Health (ICF) provides a universal language
"Today's health-care system is continuing to undergo and framework to describe health and disability (2002).
significant changes" (Sullivan & Decker, 2009, p. 3). This bio-psycho-social model integrates the medical,
Change is the norm. Change is constant and affects the social, and human aspects of health. Disability is a
organization and delivery of health and human services. universal human experience. As therapists, embracing
As a change agent, the manager is a role model and this model suggests we capitalize on client strengths and
advocate for positive outcomes that improve client include the interrelationships of our environments and
programs. A climate of change presents new opportunities human functioning as we assess and deliver interventions
for professionals and our profession. Change is necessary (Sylvester, 2011).
for growth and viability of clients, organizations, and
As the care continuum moves beyond the doctor's
professions. A number of forces are changing health and office and hospital to primary care in community centers,
human services. These trends and issues are briefly a broader array of health-care professionals are providing
summarized in Table 1.1.
holistic patient-centered care (Hoss, Powell, & Sable, 2006;
Change and the rapid pace of constant change is a Sullivan & Decker, 2009). Informed citizens are partic-
leading force in the evolving nature of health and human ipating in health-care decisions. Integrated-care networks
service organizations and services. Technologyis a primary rely on technology to share and organize client plans
contributor to the rapid pace of change. Health infor- among professionals through community models like
mation technology, electronic medical records, and Medical Homes. This encourages fiscal prudence by
robotics, for example, are changing administrative re- focusing on the performance of an interdisciplinary team
sponsibilities, facility operations, and client care to produce outcomes in a timely manner (value-based
approaches (Hoss, Powell, & Sable, 2006).
performance). Concern for accessible and accommodat-
Health care is a business (Stumbo & Hoss, 2009; ing experiences is shifting to universal design and
Sullivan & Decker, 2009). Given this, managers focus on collaborative interventions. Similarly, while there remains
containing costs even with increasingly limited resources a concern for management of chronic diseases like
in order to sustain services in a competitive environment. cardiovascular issues, there is an increasing acknowl-
The growth rate of health-care spending continues to edgment of lifestyle behaviors that contribute to issues
advance in developed countries, and paying for services like obesity. This shift is prompting a focus on
is challenging for North American governments and in- health-related quality of life and well-being or preven-
dividual clients. Accountability demands, benchmarking, tative and participation measures.
and need to reduce medical errors continue to force the
Evidence-based practice grew out of a desire to use
manager to improve quality and outcomes and focus on scientific evidence to make clinical decisions (Sullivan &
safety in the workplace. A third issue worldwide is access Decker, 2009). This effort complements challenges to
to care among various cultures, generations, and economic improve safety, reduce costs, and validate the appropri-
groups. Native Canadians, the elderly, and the financially ateness of specific interventions to produce consistent
poor experience health disparities. The recent release of client outcomes. Managers guide professionals as research
Healthy People 2020 identifies one of four foundational is conducted to validate various practice models and
health measures as disparities; the intent is to monitor theories in order to develop clinical guidelines and
progress in attaining the highest level of health in all people protocols. While efficacy research may be a challenge in
in the USA (U.S. Department of Health and Human day-to-day practice, program evaluation helps justify the
Services, 2010).
effectiveness and viability of recreation therapy in holistic
Health care is a global public concern. Globalization health. Along with education, research supports change
yields common threats like natural disasters, terrorism, and contributes to professionals' continued growth and
and pandemics, and it yields solutions like tele-a-medicine advancement, which are essential to our careers and the
and alternative delivery models to manage escalating vitality of our profession.
health spending and financing. Demographics worldwide http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Chapter 1: Introducing First-Line Management 5
Table 1.1 Trends, Issues, and Challenges in Recreation Therapy/Therapeutic Recreation
· old-old (85 and older) to those not yet born; · from those with temporary dysfunction (e.g.,
Trend/Issue
Challenge
recovering from orthopedic surgery) to those with permanent dysfunction (e.g., spinal cord
Change Technology Health-care business
Rapid, constant rate creates stressful environment and need to be flexible Advancements change job functions and create information overload Accountability measures, productivity levels, creative budgeting are used
injuries); · from those with chronic lifelong disorders (e.g., autism spectrum disorder) to those with acute incidents (e.g., cardiac conditions); and · from those with syndromes with clearly defined
Globalization
Cultural and demographic disparities
characteristics (e.g., intellectual disabilities) to
are evident worldwide
those with non-specific definitions (e.g.,
Demographics Care continuum
Income levels and aging societies overburden system and escalate costs Practice integration, transparency,
persons with social and mental health needs, the abused, those with PTSD).
and continuous relationships are critical
According to the National Council for Therapeutic
Holistic care
Interdisciplinary cooperation and
Recreation Certification (NCTRC), there are 12,000
access to complementary care essential
Patient-centered care
Client and advocates guide intervention with professional facilitation
Evidence-based practice Documentation and sharing of outcomes are crucial to profession
CTRSs (Certified Therapeutic Recreation Specialists) in the United States and Canada, and 70% are employed full-time with the title of therapist or therapist supervisor while 6% have administrator titles. The majority of the CTRSs practice in hospitals and skilled nursing facilities,
Research
Contributes to viability of profession
while others are found in residential/transitional,
and program effectiveness
community parks and recreation, outpatient/day
Education
Professional advancement and growth aid in adapting to change
treatment, and human services settings (NCTRC, 2009). Populations with whom employment is primarily
found are behavioral/mental health and geriatrics
LEARNING OUTCOME Outline trends, issues, and challenges influencing management in our profession.
(NCTRC, 2009). "Students entering the field of therapeutic recreation need to be cognizant that there is no single definition for the delivery of therapeutic recreation services for persons
with disabilities in a global society" (Genoe & Singleton,
First-Line Managers
2009, p. 39). Differing terms describe therapeutic recreation like "Diversional Therapy" in Australia and New
Settings and Populations
Zealand and "Therapeutic Recreation" in Canada with "Recreation Therapy" and "Therapeutic Recreation" used
The scope of recreation therapy/therapeutic recreation in the United States. The titles used in various cultures to
reveals a wide range of services to individuals with an describe service delivery to persons with disabilities reflect
equally diverse set of health and functional issues. social and professional constructs--government policies,
Services are provided to individuals in residential facil- social beliefs about individual abilities, and professional
ities, community-based health and human service standards and regulations.
agencies and centers, rehab and outpatient services,
Research also suggests that practicing professionals
home health agencies, hospices, and day-treatment and differ in their perceptions of their jobs and that the scope
social programs (e.g., summer day camp, adult social of their responsibilities is also changing. A study of
clubs, and inclusion buddy aquatic programs). Popu- practicing professionals in North Carolina found that
lations benefiting from services vary from persons who those persons who have been in the field and their current
are considered:
positions longer were more satisfied with the nature of
their jobs and relationships with supervisors and coworkers
(Stone, Kline, & Hammond, 2009). Professionals in http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
6 Effective Management in Therapeutic Recreation Service, Third Edition
another state (Pennsylvania) identified that they are in- understanding of the interdependency of the process and
creasingly performing duties beyond the traditional scope events occurring in the organization, such as
of therapeutic responsibilities as departments transition
to unit-based programming and satisfy cost-containment
· the exchange relationships and social marketing
needs (Witman & Rakos, 2008). Several tasks mentioned
that must occur between the organization and
most frequently included ADLs (activities of daily living),
its task environments;
safety, special events, education, and assuming various
· the effects of organization, structure, and climate
administrative responsibilities like budgeting, customer
on communication, practitioner motivation,
service, quality improvement, and HR (human resource)
and performance;
issues. Thus not only are settings and populations diverse,
· the importance of occupational commitments
practicing professionals differ in their Job Satisfaction and
and professional vested interests as determinants
are experiencing expanding job responsibilities.
of individual and group behavior; and
· the dynamics underlying various problems like
LEARNING OUTCOME Identify settings and populations where first-line
balancing cost with quality and inter-professional conflict.
managers are employed.
Effective managers have a common affinity for
Managerial Qualities, Responsibilities,
understanding the nature of the larger organization within which they work. In other words, a special effort
Professional Expectations
is made to understand the inner workings of the larger
organization of which their unit is a part. They observe,
Even though the first-line manager holds a bottom-rung inquire, and integrate so they feel competent in repre-
managerial position in the organization, that position senting their employees and their organization
is one of the most critical and valuable roles within the (Whitehead, Weiss, & Tappen, 2010).
administration of the organization. The manager's re-
Other characteristics of a successful first-line thera-
sponsibility is to turn a plan of operation into reality. peutic recreation manager would include the following:
The majority of objectives for any therapeutic recreation the ability to negotiate to resolve problems by using creative
service, regardless of setting, relate to the consumer, and solutions, being able to rebound from the frustrations of
the first-line therapeutic recreation manager is the ad- today and recognize that tomorrow is another day with
ministrative channel through which these objectives its own challenges and rewards, and a sense of humor--
ultimately succeed or fail. This professional must ensure without the latter, the environment can rapidly create
that quality services for clients are delivered efficiently management burnout. The changing and challenging
in an ever-changing environment of standards and health and human service system requires the manager to
regulations, consumer activism, and budget limitations. allocate scarce resources appropriately "and to be visionary
Planning for the unit, for example, is in vain if the and proactive in planning for challenges yet to come"
therapeutic recreation manager cannot translate the (Marquis & Huston, 2009, p. 52).
objectives into concrete action. The first-line manager
Managerial responsibilities vary with the nature of
also serves as a linking agent by advocating and repre- the setting, populations served, and influence of gov-
senting the interests of subordinates to the next managerial ernment and professional regulations and standards.
level and communicating, clarifying, and enforcing the Regardless, the focus in this text is on managerial job
directives of his or her supervisor. The first-line manager tasks and knowledge, skills, and abilities (KSAs) defined
networks with those above and below to influence the by our credentialing body and professional organizations.
status of staff and quality of services provided to clients Table 1.2 presents a summary of the professional
(Whitehead, Weiss, & Tappen, 2010).
knowledge domains of the NCTRC job analysis
The new manager needs to have an appreciation of organized by chapter in which the content appears
the organization as a functioning system. While the (CTRA, 2006; NCTRC, 2007; West, Kinney, &
manager will certainly understand the dynamics of the Witman, 2008).
unit as a practitioner, he or she now must develop an http://www.sagamorepub.com/products/effective-management-therapeutic-recreation-service-3rd-ed?src=lipdf
Chapter 1: Introducing First-Line Management 7
Table 1.2 Managerial Responsibilities by NCTRC Professional Knowledge Domains
Managerial Responsibilities
Chapter
Foundational Knowledge Legislation Relevant guidelines/standards Principles of group interaction/leadership Practice of Therapeutic Recreation/Recreation Therapy Standards of practice Codes of ethics Organization of Therapeutic Recreation/Recreation Therapy Service Documentation procedures Evaluating agency/TR/RT service program Quality improvement TR/RT service plan of operation Personnel/intern/volunteer supervision payment system Facility/equipment management Budgeting/fiscal responsibility Advancement of the Profession Accreditation standards/regulations Professionalism TR/RT certification/recertification Advocacy Legislation/regulations Professional standards/Ethical Guidelines Public relations/marketing Maintaining/upgrading professional competencies Professional associations/organizations Partnership for advancement of the TR/RT profession Continuing education/in-service training
8, 9 13­16 2, 4 13­15 16 13 6, 13, 15 15 3 4­5, 9­10, 12 8 14 8 8­10, 13 2, 11, 16 9, 10, 16 7, 11 6, 8, 9, 14, 15 16 7 9, 13, 16 16 7 16
Source: Adapted from: National Council for Therapeutic Recreation Certification (NCTRC). (2007). 2007 NCTRC job analysis report, NCTRC report on the international job analysis of Certified Therapeutic Recreation Specialists. New City, NY: Author.
Within each chapter, student learning outcomes articulate competencies of first-line managers. Each setting is unique with protocols and policies governing performance expectations. To illustrate, we introduce staffing responsibilities, realizing managers craft specific policies related to hiring, supervising, and competency assessment appropriate to their work setting. We provide example statements, documents, and web information
asking you to participate in the learning experience by reviewing key words, responding to review questions, and viewing chapter PowerPoints. Professionals are held to higher expectations due to their specialized education and training. First-line managers, therefore, not only represent their employees and the organization but also our profession to internal and external audiences. This added layer of responsibility
LEARNING OUTCOME Outline qualities, responsibilities, and professional expectations of first-line managers.
LEARNING OUTCOME Describe topics and outcomes students may expect with use of this text.
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8 Effective Management in Therapeutic Recreation Service, Third Edition
requires the first-line manager to model and articulate ethical behaviors and professional practices, monitor staff development, establish mentee-mentor relationships to advance their career and foster staff growth, engage in professional organizations to self-regulate the practice, contribute to the body of evidence and theories justifying our practice, and to advocate for recreation therapy/ therapeutic recreation as a necessary public service and essential care team participant. The text concludes with a summary of professional expectations. Together with the trends, issues, and challenges introduced in this opening section, these professional expectations significantly influence the first-line manager's effectiveness in achieving client outcomes through unit operation. The first-line manager and our profession are judged by not only practice effectiveness but also by how fluid and competently the first-line manager represents the profession as a change agent. References Canadian Therapeutic Recreation Association (CTRA). (2006). Standards of practice for recreation therapists & therapeutic recreation assistants. Calgary, Alberta, Canada: Author. Genoe, R., & Singleton, J. (2009). World demographics and their implications for therapeutic recreation. In N. J. Stumbo (Ed.), Professional issues in therapeutic recreation (pp. 31­42). Champaign, IL: Sagamore. Hoss, M. A. K., Powell, L., & Sable, J. (2006). Healthcare trends: Implications for Therapeutic Recreation. In M. J. Carter & J. E. Folkerth (Eds.). Therapeutic recreation education: Challenges and changes (pp. 107­122). Ashburn, VA: NTRS/NRPA. Marquis B. L., & Huston, C. J. (2009). Leadership roles and management functions in nursing: Theory & application (6th ed.). Philadelphia: Lippincott Williams & Wilkins. National Council for Therapeutic Recreation Certification (NCTRC). (2007). 2007 NCTRC job analysis report, NCTRC report on the international job analysis of Certified Therapeutic Recreation Specialists. New City, NY: Author. National Council for Therapeutic Recreation Certification (NCTRC). (2009). Recreation therapy, CTRS profile, Certified Therapeutic Recreation Specialist. [Brochure]. New City, NY: Author.
Stone, C. F., Kline, S. M., & Hammond, A. (2009). Job satisfaction levels of therapeutic recreation specialists in North Carolina. Annual in Therapeutic Recreation, 17, 46­60. Stumbo, N. J., & Hoss, M. A. K. (2009). Higher education and healthcare: Parallel issues of quality, cost, and access. In N. J. Stumbo (Ed.), Professional issues in therapeutic recreation (pp. 367­387). Champaign, IL: Sagamore. Sullivan, E. J. & Decker, P. J. (2009). Effective leadership and management in nursing (7th ed.). Upper Saddle River, NJ: Prentice-Hall. Sylvester, C. (2011). Therapeutic recreation, the International Classification of Functioning, Disability, and Health, and the capability approach. Therapeutic Recreation Journal, 45(2), 85­104. U.S. Department of Health and Human Services. (2010). Healthy people 2020. Retrieved from http://www. healthypeople.gov/2020/ West, R. E., Kinney, T., & Witman, J. (Eds.). (2008). Guidelines for competency assessment and curriculum planning for recreational therapy practice. Hattiesburg, MS: ATRA. Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and management (5th ed.). Philadelphia: F. A. Davis. Witman, J. P., & Rakos, K. S. (2008). Determining the "other related duties" of therapeutic recreation and activity professionals: A pilot study. American Journal of Recreation Therapy, 7(2), 29­33. World Health Organization. (WHO). (2002). Towards a common language for functioning disability and health, ICF. Geneva, Switzerland. Retrieved from http://www.who.int/classifications/icf/en/
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