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Christie Vander Meer

Olivia Juhas
Comprehensive Program Plan
Our project was based off the Spectrum Health Organization. Spectrum Health has eleven
hospitals in its organization and we narrowed our project down to working with Helen DeVos
Childrens Hospital. We created a recreational program for Helen DeVos Childrens Hospital.
Table of Contents:
Community ----- -----------------Pages 1-2
Agency----------------------------Pages 2-7
Clients-----------------------------Pages 7-8
TR Department-------------------Page 8
TR Profession -------------------Pages 8-12
Statement of Purpose -----------Page 12
Goals------------------------------Pages 12-13
Program Titles-------------------Pages 13-14
Investigation---------------------Pages 14-17
Community: Within the community there is a at least three gyms/recreational center. The
recreational centers host a number of facilities that include but are not limited to treadmills,
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workout machines and fitness classes as well as a pool and tennis court. The fitness classes, pool
and tennis court offer classes that work with all kinds of levels of fitness from intermediate to
novice. These classes are open to our clients at a discounted rate and often times the group
therapy will meet in one of these locations to train together or work toward a center goal that our
center doesnt provide. In addition the local businesses provide another kind of therapy such as
work programs and real world experiences for our clients. In our program the community is an
integral part it allows our clients to connect with other people and bring their therapy into a real
world application. Examples of these programs are with other agencies such as the Hope network
that will pick up clients with cognitive impairments such as down syndrome, autism and
aspergers and take them to places such as the bonefish grill to do tasks such a sweep or fold
napkins for a small wage. In addition the salvation army gives jobs to workers with disabilities
and pays them as well to work as cashiers and restock. Within the community there is also
competitors to our program: Hope Network which has a certified recreational therapist on board
and as previously stated works within the wider community to allow clients to have an more
independent living lifestyle.
Spectrum Health Agency:
Purpose/Mission: Spectrum Health's 20,800 employees and 960 advanced practice
providers and employed physicians share a common mission: to improve the health of the
communities we serve.
Goals:
1. Ensure community members' basic needs of are met
2. Support community members in achieving a healthy weight
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3. Intervene with Youth
4. Ensure community members are aware of available resources
5. Improve access to care & reduce disparities in chronic disease rates by race
6. Improve quality of care for all community members
7. Ensure mental health, substance abuse, and social service needs of community members
are met
8. Ensure healthy beginnings of children born in Kent County
History: Spectrum Health is a not-for-profit health care system which is based in West
Michigan. Spectrum Health is not just one hospital but is a health care system comprised of
eleven hospitals, 173 ambulatory and service sites,960 advanced practice providers and
employed physicians. It also employees 20,800 employees, taking the title as the West
Michigans largest employer. It has influenced the community immensely, and has helped in
more ways than one. Not only by the services they provide, but also the number of jobs it has
provided for the community. Spectrum Health was founded in September, 1997, when it took
many hospitals under its wing. One of these hospitals is Helen DeVos Childrens Hospital which
is the largest childrens hospital in West Michigan. Spectrum Health also holds the title as the
largest adult open heart program in the state. They are the largest regional provider of cancer
care and have one of the top joint replacement programs in the nation. Spectrum Health's
Mission is to improve the health of the communities they serve. There vision is by 2020,
Spectrum Health will be the national leader for health. With the milestones they have already
made this vision is a possibility. Spectrum Health has many programs where they use
recreational therapists specialties. They have many program and services that they provide which
include therapy for balance, brain injuries and concussions, cochlear implants, hand therapy,
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lymphedema, nervous system disorder, pelvic disorders, pulmonary problems, spine and pain
rehab, stroke rehabilitation and water therapy. These programs have helped Spectrum Health to
assist Grand Rapids in maintaining a progressive research culture and is fundamental to their role
as the regions largest medical center. Spectrum Health has eleven hospitals throughout West
Michigan expanding from Zeeland to Reed City, Ludington, Big Rapids and Grand Rapids. It
has clearly expanded to assist many in the West Michigan Area. As mentioned before Helen
DeVos Childrens hospital is the largest childrens hospital in West Michigan. This is why we
have chosen to create a program for Helen DeVos childrens hospital. Helen DeVos Childrens
Hospital opened 1-11-11. This hospital is dedicated exclusively to the health care needs of
children. This hospital became a reality with the help of local philanthropists and the community,
after 1993 when the DeVos Children's Hospital was opened at Butterworth Hospital. After
seeing an increasing need they create a hospital specifically for children. This is where Helen
DeVos Childrens Hospital came from and became part of Spectrum Health.
Existing Programs:
Spectrum Health has a vast list of existing programs. The list is as follows.
1. Aquatic Therapy
2. Balance Center
3. Breast Care Therapy
4. Burn Center
5. Cardiac Rehabilitation
6. Core Health Program
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7. Healthy Start Program
8. Lymphedema therapy
9. Mild Brain Injury Program
10. Neuro Rehabilitation
11. Occupational Therapy
12. Pelvic Rehabilitation
13. Physical Therapy
14. Pool Therapy
15. Pulmonary Rehabilitation
16. Speech Language Therapy
17. Traumatic Brain Injury Program
18. Water Therapy
19. Music Therapy
Relevant Legislation:
ADA: The ADA stands for Americans with Disabilities Act. This act affects Spectrum Health
because it works with people with disabilities every day. They are a hospital and are continently
working with people with disabilities. We need to be aware of this act for our Recreational
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Therapy program as well. A lot of our patients will be coming to us to learn how to live with
their disabilities. We need to know how this act affects our work.
IDEA: The IDEA stands for Individuals with Disabilities Education Act. Through this act
children are required to be given the opportunity to receive a public education. This will affect
our practice because we will be working with children with autism. We need to be able to work
with children with autism appropriately which is why we want to know how this act affects our
work.
Membership:
Commission for Accreditation of Rehabilitation Facilities (CARF): CARF is an accreditation
program used in order to make sure recreation therapies provide the best therapy possible. They
make sure all the rules are being followed and that the program is being run properly. CARF
provides accreditation services worldwide at the request of health and human service providers.
NCTRC: National Council for Therapeutic Recreation Certification (NCTRC) supports quality
human service and health care standards and maintains recognition
by the Joint Commission and the Commission for Accreditation of Rehabilitation Facilities
(CARF). NCTRC provides credential verification services to employers and health care
agencies. These services are strongly encouraged by NCTRC to monitor personnel adherence to
the standards of the Certified Therapeutic Recreation Specialist.
The Joint Commission (JCOH): The joint commission evaluates and certifies organizations in the
U.S., making sure they are following the standards and are providing good, quality health care.
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Disability Attitudes: There attitude toward a disability is very welcoming and accepting.
Spectrum Health works with patients with disabilities constantly. They are a hospital and work
with disabilities in order to improve the patients way of life. They are very accepting and
positive about disabilities.
Therapeutic Recreation would appear in the chart under rehabilitation. Spectrum Health
offers many opportunities for rehabilitation and Therapeutic Recreation would be joined with
Occupational Therapy, Speech Language Therapy, and Physical Therapy.
Clients: Our client basis is a youth program that focuses on children age 4-18 that is open to all
genders, ethnicities and religious backgrounds. They must be at least four years of age so that
they are able to partially comprehend the program and able to complete the program with the
assistance of a parent and cognitively the brain has more plasticity at a younger age. The number
of clients should be both groups and individual sessions. The client should be evaluated for the
best program fit and then placed in an individual setting and then after the client can opt out of
the program or join a group setting to continue to improve with the support of the community.
The group sessions would consist of 10 clients with an individual and group outcome that will
allow the client to succeed both by themselves and then within a larger setting.
The community should be involved in the treatment of patients both while they are in the client
is in the program and when they leave again they can opt out or continue treatment within the
community setting. The community will provide emotional support such as group meeting in the
church or at the local recreational center in addition financial support will be needed so to help
with auctions and donations may be necessary. This would be made possible by having dinners
to show the donors their appreciation as well as having the donors meet with their clients and
have a one on one. This program would take place in a rural setting considering the fact that we
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need to have the medical supplies, buildings and services available in a larger city compared to
an urban setting in which the population may be more scattered and the socio-economic status
lower. The socio-economic status ideal would average to be from 60,000-150,000+ realistically
middle to upper class. This status is important because the clients family would have to be
afford the program treatment and pay the therapist, yet there would be financial aid available to
those who are unable to find treatment anywhere else. The last aspect of leisure history in the
area consists of other hospitals such as Spectrum Health Butterworth and other physical therapy
centers around the area such as PT 360 in easttown and pain-free in cascade.
TR Department:
Our staff currently includes a vast amount of specialists and different types of workers.
This list includes the following, athletic trainers, home medical equipment provider, music
therapy, nurses, occupational therapists, physical therapists, recreational therapists, rehabilitation
physician, social workers, speech language therapists, spiritual care staff, and wound care
specialist. In the TR department we work alongside many of these specialists, but especially the
physical therapist and occupational therapist. Our program started in January 2011, the same
time all of the other departments started since that is the year Helen Devos Childrens Hospital
was open. We like to utilize our volunteers in the best way that is possible for both the volunteer
and patient. Some volunteers enjoy going around and speaking with our clients while others want
to be a little more hands on and observing work down. We try to accommodate what is best for
the volunteer and patients. Since this is a hospital the number of nurses tends to be larger than
the number of Recreational therapists. We will have both full time and part time workers.
TR Profession:
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Our qualified and caring recreational therapists work with our patients to improve mobility,
comfort, and well-being by using state-of-the-art equipment and proven therapeutic techniques.
Along with the basic physical therapy services, our group of highly skilled therapists is
constantly developing specialized programming. Our multispecialty approach to care means all
our patients will have the comprehensive care needed to restore a health and more active
lifestyle.
This philosophy creates the warm and caring environment that promotes health and leisure
together allowing the client to feel as if we are walking together toward an outcome that is
attainable to them through various support systems and that the therapist has the time, training
and the skills to aid the client in their desired outcome.
Vision of NCTRC
To be publically recognized as the largest international body of Certified Therapeutic Recreation
Specialists to provide recreation therapy services.
To have premier recognition status among consumers, employers, and regulators.
To use research and technology to enhance the certification exam program and the critical
functions of the Council.
To establish a viable and effective organizational marketing program and promote the validity
and value of the credential.
To enhance opportunities for research and serve as a repository of information pertaining to
credentialing opportunities within therapeutic recreation.
To Achieve this Vision we
Establish the Value and Worth of the CTRS Credential
Ensure Practice-based Certification Standards
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Maintain an Effective and Technologically Advanced Exam Program
Promote Legal Recognition of the CTRS Credential
Increase the Number of New Applicants for NCTRC certification
Increase Recertification Retention
Ensure Fiscal Responsibility

Mission of NCTRC
To protect the consumer of therapeutic recreation services by promoting the provision of quality
therapeutic recreation services by NCTRC certificants.
To Achieve this Mission we...
Develop standards for certification.
Establish standards of conduct and apply a disciplinary process.
Conduct entry, recertification, and reentry testing.
Maintain an up-to-date job analysis.
Liaison with professional organizations with regards to standards of practice.
Verify certification for employers.
Conduct research and development.
Provide recertification and reentry.
Liaison with educators to provide information and develop opportunities for student
acquisition of education and experience necessary for certification.
Provide information to the public regarding standards, disciplinary processes, and
certification.
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This organization is important to the program as well because its the legalistic and educational
side of the program that focuses less on community and more on the rules and regulations of the
program and how to run the program in accordance with the laws enforced by the state.
Goals of NCTRC
Current Strategic Goals
Promote the Value of the Credential
Create Broad Based Partner Affiliations
Create Global market Certification
Lead in Consumer Protection
Create innovative Education/Training/Research Opportunities for Consumers,
Practitioners and Policy Makers.
ATRA:
The mission of the American Therapeutic Recreation Association is to serve as a member-driven
association that collectively supports the recreational therapy profession. In addition the vision
of the American Therapeutic Recreation Association is to be the premiere professional
membership association representing recreational therapists, consumers and stakeholders.
This organization is essential to the therapeutic recreation program because it outlines the format
of how the client and the program should interact with each other as well as emphasizes the
importance of a larger community to support the program.
Certification:
To be awarded the Certified Therapeutic Recreation Specialist (CTRS) credential, the candidate
must meet the eligibility requirements and pass a knowledge-based exam. When the candidate is
awarded the CTRS credential, it serves as evidence that the individual, through knowledge and
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experience, has met NCTRC's CTRS Certification Standards. The award of the CTRS credential
is a limited license to use the titles of "Certified Therapeutic Recreation Specialist" and
"CTRS" subject to NCTRC's Certification Standards.
Candidates are eligible to register for the NCTRC certification exam if they are in compliance
with NCTRC's Certification Standards, including the Prerequisites, and they have been found by
NCTRC to meet all professional eligibility requirements through either the academic or
equivalency path.
What requirements do I need to complete for an acceptable internship?
You will need to complete a minimum 560-hour, fourteen (14) consecutive week internship in
therapeutic recreation services that uses the therapeutic recreation process as defined by the
current NCTRC Job Analysis Study under the supervision of both academic and agency field
placement supervisors who are NCTRC CTRS certified. Make sure you complete at least 20
hours per week and no more than 45 hours per week. Your primary CTRS Supervisor must be
employed full time and work a minimum of 32 hours a week at the agency with at least 50% of
the job duties in TR services.

Conceptualization:
Statement of Purpose: Our Mission is to provide therapeutic recreation services for children and
adolescents aged 4-18, in a safe and nurturing environment by providing opportunities to
improve their physical, mental and emotional well-being through leisure activities, while
providing knowledge and opportunities to utilize their leisure interests in both clinical and
community settings.
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Goals:
1. To provide activities that improve fine motor coordination
2. To improve clients cognitive functioning
3. To improve clients physical abilities
4. To improve clients emotional well-being
5. To provide opportunities for clients and the community to participate in leisure activities
6. To provide knowledge and help form a basic understanding of the therapeutic recreation
and the importance of leisure activities
7. To help improve the clients quality of life
8. To provide clients with opportunities for social interaction and to build community
9. Provide knowledge that increases the clients awareness of leisure opportunities
10. To provide multiple opportunities for leisure skill development
Possible Program Titles:
Program: Writing classes/ Typing classes
(1,2,3)
Writing classes will provide clients with a chance to practice their handwriting and english
sentence construction skills this could be helpful for clients who are recovering from a stroke or
brain injury this program could be done ideally in a community setting so that the clients could
learn from one another and celebrate in their accomplishments yet a client wanted more
individual addition they would be given extra sessions. If the client isnt cognitively ability to
write then a computer will be provided or an assistant will be available at any time.
Program: Sports
(1,2,3,4)
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- A sports program will allow a client to work on their fine and gross motor skills, improve their
athletic ability using either an aquatic or more physical sports aka football, soccer and tennis the
feelings of completely these sports at the clients own level will allow a higher level or self
esteem and lesser the chances of a client dealing with learned helplessness or low self-efficacy
Program: Community outreach/Charity
(1,2,3,4,5,7,8,10)
-This is program will allow for the client to interact with other clients within the program and the
community also will allow for the community to become educated about the program and have a
chance to respond and in turn help out the clients. Overall both the client and community
mutually benefit because the client gains physical, emotional, and cognitive skills while the
community gains a new set of volunteers to aid in a project.
Program: Psychological Counseling
(4,6,7,10)
The counseling program will allow clients to learn from one another as well as individually and
grow in their journey of personal discovery and learn how to cope with their disability or
handicap. This will be achieved through trained cognitive therapist as well as the recreational
therapist.
Program: Faith Development:
(all 1-10)
This program is optional but would allow the client to cope with the their disability in the context
or spiritual growth, understanding and would be open to any and all religions. This program will
include scriptural reading, church visits within the hospital and community, crafts and prayer
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groups. In addition this would be open to the parents of the children as well as the children
themselves.

Investigation:
1. To provide activities that improve fine motor coordination
We decided on this goal because we feel that as a Recreational Therapist the patients will
want to improve there fine motor coordination. This will be a big reason why patients come to
us.
2. To improve clients cognitive functioning
Many patients who have had a change in their life which has caused them to reach out for
recreational therapy will need to be addressed and worked on before we move forward with the
physical aspect of therapy. We want our patients to improve their mental state along with their
physical state.
3. To improve clients physical abilities
Clients will come to us searching for a way to improve their physical abilities. We choose
this as a goal because it will be the goal of many of our clients.
4. To improve clients emotional well-being
Emotionally the clients may be going through a tough time which is why we choose this
goal. Our clients will most likely be going through a tough change and we want to make sure
their emotional well being is stable.
5. To provide opportunities for clients and the community to participate in leisure activities.
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We want to provide opportunities for the community to get involved. This helps the
community that we serve but also our clients. It gives them an opportunity to meet new people
and grow.
6. To provide knowledge and help form a basic understanding of the therapeutic recreation
and the importance of leisure activities.
Many clients and people in the community do not know what the benefits are of recreational
therapy. It is our job as recreational therapists to teach and provide knowledge of our field to our
clients and community.
7. To help improve the clients quality of life.
Our goal to improve the clients quality of life is very important. We want them to be happy
and enjoy life and the clients might not realize this is their goal. But underneath everything this is
what they are searching for. They want to be happy in their everyday life.
8. To provide clients with opportunities for social interaction and to build community
We want to provide opportunities for the community to get involved. This helps the
community that we serve but also our clients. It gives them an opportunity to meet new people
and grow.
9. Provide knowledge that increases the clients awareness of leisure opportunities
We want to provide the client with opportunities outside of therapy to be able to practice
and do leisure activity. The more you participant and do leisure the better you will be. Helping
patients know what is available to them will allow them to do leisure after their therapy is done.
10. To provide multiple opportunities for leisure skill development
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To provide the clients will multiple opportunities with leisure will ensure that they will not
get bored with the same repetition of activities. It will allow them to become aware of many
activities and to find ones they truely enjoy.

After conducting an investigation and looking through our goals we have determined that we can
combine some of our goals. We believe that goal two and four can be combined.
2. To improve clients cognitive functioning
4. To improve clients emotional well-being
These goals are after the same thing. We want to be able to improve the client's mental state. The
goal we would combine them to become would be To improve the clients mental well-being.
Two more goals that I feel can be combined to form one is goals 5 and 8.
5. To provide opportunities for clients and the community to participate in leisure activities.
8. To provide clients with opportunities for social interaction and to build community.
These goals are after the same thing. We want to be able to provide opportunities for our clients
to interact with the community. The goal we would form is To provide opportunities for our
clients to participate in leisure activities throughout the community.