Teenscope Program Development and Grant PDF

Program Development Grant - Teenscope
SIGNIFICANCE
Mental illness can occur at any age but is highly prevalent in children and adolescents,
with approximately 16.5 million children and teens meeting the Diagnostic and Statistical
Manual of Mental Disorders criteria for mental health conditions (5th ed.; American Psychiatric
Association, 2013). Historically, mental illness was tabooed in cultures around the world, but in
recent years has increased in public awareness, resulting in more accessible treatments and
resources. However, even with this mental health movement, “less than half of adolescents with
psychiatric disorders received any kind of treatment in the last year,” according to the U. S.
Department of Health and Human Services (2020, para. 1). These high rates of children and
teens with mental illness is a public health concern because they are at an increased risk for
substance use disorder, frequent use of drugs and alcohol to a point of impairment, and
neglecting home, school, and work responsibilities (Office of Adolescent Health, 2019). If these
mental health illnesses are not addressed and treated, they can additionally lead to suicidal
ideation, family, school, or peer problems, developmental-behavioral problems, early sexual
activity, and risk-taking behavior (Keiling et al., 2011).
The University of Neuropsychiatric Institute (UNI) has developed Teenscope, a daily
treatment program, to ensure youth with severe mental illness receive needed services.
Teenscope assists adolescents ages 13 to 18 with managing severe mental and behavioral
health needs. Teenscope participants receive 40 hours of treatment a week consisting of CORE
coping skills groups, Dialectical Behavioral Therapy, expressive therapy, mindfulness groups,
individual therapy sessions with social work and psychologists, family therapy, medication
appointments, and education specialist appointments. The Teenscope programming focuses on
addressing deficits by helping participants accept their condition, identify their strengths/abilities,
develop healthy coping skills and strategies for maladaptive thoughts and behaviors, and
implement habits to manage their symptoms in order to resume normal life. The disturbances in
mental wellbeing often cause participants to have difficulty with social participation skills and
decreased motivation to complete daily occupational tasks.
Gaps in Services
Current literature identifies that nearly half of adolescents with mental health disorders
do not receive services (Lipari et al., 2016). Those that are receiving services are doing so
either from a specialty mental health professional, via group programs, or via their primary care
physician. Of the three, the majority of adolescents receiving care are seen by their primary care
provider rather than a specialist. One of the primary reasons so many adolescents are being
seen solely by their primary care physician rather than by a specialist is many physicians’
inability to refer to outpatient specialists (Cunningham et al., 2009). The survey of primary care
physicians in Cunningham et al. (2009) found that two-thirds of physicians were unable to get
outpatient mental health services for their patients. More than half reported that a significant
reason they are unable to refer is due to a lack of providers. Due to this lack of providers to refer
to, primary care providers are more likely than mental health specialists to prescribe
medications as a means to combat symptoms (Anderson et al., 2015).
Promoting the development of occupational therapy programs in outpatient and
community settings will help to close the gap between physicians seeking services for their
patients and an inability to do so. Closing this gap will then improve the outcome of recovery for
adolescents with mental health concerns. The Life Skills Group program provides a greater
opportunity for adolescents with mental health challenges to work on life skills and social
interaction in conjunction with the coping and problem solving skills they are learning within the
already established Teenscope program. This opportunity will work towards decreasing the
public health concerns commonly seen when adolescents with mental illness are not treated or
treated improperly, thus helping to close the current gap.
Social skills are a consistent deficit for adolescents with mental illness. The youth in the
Teenscope program demonstrate simple social skills when engaging in program groups but lack
the ability to generalize social skills to everyday conversations. Increasing initial comfort with
social participation is a critical first step. Wood and colleagues (2013) created the DRUMBEAT
program, which uses the medium of drumming to address social skills with at-risk youth. The
results of the intervention consisted of improved social participation as well as improved
self-esteem and decreased negative behaviors. Similarly, Whatley et al. (2015) used gardening
to encourage social participation for individuals recovering from mental illness. They determined
gardening increases social inclusion and occupational involvement. Increasing self-esteem
through mediums such as drumming or gardening is an excellent first step to addressing social
skills.
Fox et al. (2020) encouraged the development of social skills further through repetitive
peer interactions for adolescents with Attention Deficit Hyperactivity Disorder (ADHD). This
method contributed to improved social interaction and the generalizing of the skills to multiple
environments and social situations. The more opportunities youth have to practice social skills
will increase comfort and confidence. Baker, Lang, and O’Reilly (2009) encouraged repetitive
social skill practice by incorporating video modeling to social skills training. They determined it
improves peer interactions and on-task behaviors while reducing inappropriate behaviors in
adolescents. Peer practice facilitates modeling, which is encouraged through video modeling.
Social skills training can be beneficial for teens transitioning back to normal life and engagement
in Instrumental Activities of Daily Living (IADLs). Grigas and colleagues (2019) addressed
higher levels of social participation in their work-related social skills training group for
adolescents with substance use disorders. They found a work-related social skills group
improved social functioning as well as improved self-efficacy and self-perceived work-related
functioning and confidence. Social skills can be improved and generalized to multiple situations
through mediums like drumming and consistent practice. Higher levels of social skills can be
developed when applied to IADLs, such as employment.
For the youth in the Teenscope program experiencing mental health disorders, it is
ordinary to have deficits or decline over time in their life skills or IADLs, including caring for pets,
completing chores, personal health management, and meal preparation to name a few. It is
common of this population for the focus to be on mental health symptoms resulting in a decline
of life skills participation or skill development, making it more vital to address this crucial area of
occupation. Ronngren et al. (2018) provides support for a multi week lifestyle program focused
on relaxation exercises, physical activity, nutrition, and education in various lifestyle activities.
The program focused on the physical, emotional, and social needs of this population through
addressing the contextual demands and other challenges experienced during IADL
performance. Participation in the program resulted in positive lifestyle habit formations and
increased perceived social support from group members. Moulier et al. (2019) also examined a
life-skills-based intervention program which addressed participant’s self-esteem, well-being, and
reported mood. The program promoted abilities to problem solve, make decisions, complete life
skills, and coping skills through participation in role-playing activities and group discussions. The
Teenscope program provides participants with a vast amount of treatments to improve and
manage their mental health. However, Teenscope does not directly address social participation,
engagement in ADLs and IADLs, and the development of healthy daily routines. By enabling the
participants of Teenscope to successfully participate in the everyday life skills necessary at this
stage of development, occupational deprivation can be addressed as well as increases in
participant’s positive reflection of themselves and their world.
Proposed Program
The Life Skills Group is a six-week long program with sessions held once a week for 90
minutes. The group will be held in conjunction with the other Teenscope groups and will follow
the hybrid program of a combination of in-person and virtual sessions. The Life Skills group will
be available and required for all Teenscope participants to attend. The first three weeks of the
program will focus on social participation by providing participants the opportunity to increase
their comfort and develop communication skills. The final three weeks will focus on increasing
personal volition and development of healthy routines including sleep hygiene, healthy meals
and good nutrition, and overall daily routines to promote engagement in life skills. During the
program’s life skills weeks, participants will be encouraged to implement social participation
skills when interacting with peers and staff during the group. Participants will be provided weekly
homework with the expectation to complete the assigned tasks outside of the group and come
ready to share at the next session. A detailed outline of the weekly treatment sessions can be
viewed in Appendix A.
Guiding Theories and Models
There are three models that inform the Life Skills Group program: Cognitive Behavioral
Therapy (CBT), the Model of Human Occupation (MOHO), and the Social Participation Model
(SPM). Through the use of CBT, participants will work towards adjusting the way they perceive
and react to situations, guiding them to distinguish between an internal or external activating
event, shifting from irrational to rational beliefs about the event, and in turn shifting from
negative to positive consequences of the event (Beck, 2011).
MOHO views impairments in occupational participation as more than just physical
(motor, cognitive, and sensory) or environmental deficits, but include the clients’ values, desires,
and motivation (Kielhofner, 2009). Teenscope participants report a lack of motivation to engage
in their ADLs and IADLs. Implementation of the MOHO model in this setting can be geared
towards providing participants with tools utilizing their strengths and skills to develop healthy
routines to increase their desire to engage in ADLs, IADLs, and social interactions.
Through utilizing the social participation model participants will work to manage their
emotions and behaviors, establish better communication routines and understanding of roles
with their parents, and increase positive participation during group sessions with peers (Olson,
2010). Through effective modeling and establishing a supportive environment, group facilitators
will educate and encourage implementation of needed emotional regulation and social
interactions skills.
Life Skills Group is intended to improve the overall social interaction skills and basic life
skills of Teenscope participants. The program will include social interaction training,
establishment of healthy routines to support good nutrition, sleep hygiene, and other areas of
healthy living, as well as other hands-on occupational practice to increase participant health
(see Appendix A for specifics). These skills will serve to improve participants well-being,
occupational performance, and quality of life.
INNOVATION
The Life Skills Group provides innovation by building upon the already established
programming provided by Teenscope staff, but shifts the focus towards social participation and
life skills. It can be adjusted to best serve the participants at any given point. The program is
designed to work off of consistent participant feedback, keeping it client centered through its
entirety. There will be an additional focus on enabling the participants to better generalize their
skills to contexts and situations outside of therapy.
The Life Skills Group uniquely focuses on enhancing social participation, engagement in
meaningful life skills, and development of healthy routines in adolescents with severe mental
illness. This combination of social participation, life skills, and routines, along with that is already
established within the Teenscope program, differs from any other developed programs for this
population. Current literature about programming for adolescents with severe mental illness do
not address all of these components within one program, but address them separately. These
skills go hand in hand and are an integral part of the lifelong occupational success of
adolescents. Thus, it is advantageous to combine social participation, life skills, and healthy
routines into one group, which is novel to UNI and other mental health settings.
APPROACH
Needs Assessment
Throughout the assessment process, data was collected through on-site training, facility
orientation, staff interviews, program observations, and surveys. An anonymous survey was
sent to Teenscope participants and staff and a parent programming survey was sent to
participants’ parents. The surveys were developed to identify perspectives and suggestions for
improvement from all involved parties of Teenscope. Results from the parent survey concluded
that overall parents are satisfied with the Teenscope program and services provided.
Additionally, some parents report discomfort with resuming in-person/live sessions due to safety
concerns while others find their child gets more out of the group meeting in person. To
accommodate both sets of concerns, Life Skills Group is programmed to be a virtual/in-person
hybrid program. Despite survey distribution, only one Teenscope participant completed it. Zero
responses were received from Teenscope staff. From the single participant response, we
gathered that they enjoy the Teenscope program, the staff, and are grateful for all of the support
they receive. In regards to social participation, self-care, and engaging in school or work
activities, they stated “Some days I feel great and some days I have no motivation and do not
want to get up.” Outreach to a community individual with mental illness who has past experience
with a similar program resulted in feedback concerning the importance of routines. This
individual reported it was difficult to carry on with established routines if something caused a
disturbance; they stated that they were unable to return to performing the routine because they
lacked the skill required to overcome the disturbance. Results from the needs assessment
confirmed that programming in this setting can be geared towards providing participants with
tools to develop and implement healthy routines to increase their desire to engage in basic
ADL/IADLs and social scenarios.
The Life Skills Group
The Life Skills Group will be integrated within the already established Teenscope
program. All Teenscope participants are eligible and will be required to attend the Life Skills
Group. Thus, recruitment and marketing are not needed. The program is intended to occur once
a week for six weeks. The program length is 90 minutes per session and will be a hybrid
program consisting of virtual and in-person sessions. The first three weeks of the program will
focus on social participation by providing participants the opportunity to increase their comfort
and develop communication skills. Weeks four through six will focus on basic life skills,
specifically, increasing personal volition and development of healthy routines including sleep
hygiene, healthy meals and good nutrition, and overall daily routines to promote engagement in
life skills. During the program’s life skill weeks, participants will be encouraged to implement
previously taught social participation skills when interacting with peers and staff during the
group. View Appendix A for a detailed outline of the specific treatment session plan and specific
social interaction and life skills covered each week.
To accommodate for participants joining Teenscope on a rolling basis, the Life Skills
Group is designed so participants can join no matter the week’s programming. If new
participants join in on a week where Action Over Inertia worksheets were assigned for
homework, they will be provided these worksheets to complete prior to the sessions start. On
weeks where homework is discussion based, participants will be encouraged to pull from prior
experience to contribute to group discussion.
Goal 1: Participants of The Life Skills Group will demonstrate improved social participation with
peers, parents, and Teenscope staff.
● Process objective: Social participation instructional materials will be provided to all
Teenscope staff to implement throughout the program duration, with materials evaluated for
effectiveness within 6 months.
● Outcome objective: Participants will independently engage in appropriate social
conversations within the group and at home.
● Outcome objective: Upon completion of the Life Skills Group, participants will
demonstrate self-reported improvements in social participation through an increase in score
on The Child Occupational Self Assessment (COSA).
Goal 2: Participants of The Life Skills Group will establish and implement healthy daily routines
to improve their mental health.
● Process objective: The Life Skills Group will provide three weeks of education and
activities focused on strategies and occupational skills which support healthy routines.
● Outcome objective: Upon completion of the Life Skills Group, participants will demonstrate
improved ability to follow and adhere to healthy daily routines, demonstrated via pre-post
evaluation of Action Over Inertia worksheet 2.10 (Activity Engagement Measure).
● Goal 3: Participants of The Life Skills Group will demonstrate an increased ability to
implement strategies when experiencing difficulty engaging in basic occupational tasks.
● Process objective: Life Skills Group will offer three weeks of education specifically
focused on developing strategies to increase motivation and volitional desire to engage in
occupational tasks like dressing, eating, cleaning, etc.
● Outcome objective: Within 6 weeks, participants will adhere to newly established healthy
routines 5/7 days a week via self-report.
Potential Problems and Alternative Strategies

There are several potential problems with the Life Skills Group. The first potential
problem is that participants will continue to not generalize learned skills to their natural
environments. To facilitate generalization, the Life Skills Group assigns weekly homework to
complete outside of the group. There is still the possibility that participants could choose not to
complete the homework and miss out on the practice and opportunity to further develop their
skills. An alternative strategy to address this problem is to have the parents involved in
supporting the completion of homework and report to the group facilitator the completion and
how it went. A bonus of implementing this strategy is hearing from both the participant and the
parents on how skill generalization is going. Another problem to be considered during
programming is the need to get the participants involved and invested in the group sessions. In
order to increase interest and effective participation, the use of activity based learning will be
utilized in each session. Once participants are interested in the subject and are able to
successfully perform, their internal motivation increases resulting in increased outcomes. The
final problem analyzed is that of participants joining the group at various starting points
throughout the six weeks. In order to accommodate for this participants will be sent any
applicable homework worksheets or resources from the previous session to help them in being
prepared to join their first session. As review of subjects and strategies is built into the weekly
sessions, participants will also be given the opportunity to learn and ask questions as needed.
Program Effectiveness
The effectiveness of the program will be evaluated by the following:
● Upon completion of the Life Skills Group, participants will demonstrate self-reported
improvements in perception of abilities related to social participation and daily occupations
based upon the COSA.
● Upon completion of the Life Skills Group, participants will demonstrate improved ability to
follow and adhere to healthy daily routines, demonstrated via pre-post evaluation of Action
Over Inertia worksheet 2.10 (Activity Engagement Measure).
The Life Skills Group will be led by personnel from the staff currently running the
Teenscope program. Though it is preferred to have an occupational therapist run the program, a
therapist from another profession is able to run the weekly sessions including session
preparation, data collection and assessment of participants and the program as it is
implemented. Funding is required to cover staffing costs as well as resources needed for weekly
program sessions. Resources include worksheets, art supplies, kitchen equipment, food
supplies, and other resources as described in the attached budget breakdown and justification.
The program will be held in one of the Teenscope facility’s large treatment rooms for in person
sessions. A sensory room and calm down room are also available at the facility for participants if
sensory or emotional breaks are needed. Virtual sessions of the program will be held via Zoom.
The Life Skills Group’s Longevity

For the Life Skills Group to be sustained, it is necessary to have continual reviewing of
the program and revision based upon the needs of the participants. To ensure the occupational
focus of the group is maintained, OT students or an OT will provide consultative services as
needed. Consultative services will also ensure the group continues to address the intended
deficits with social participation and life skills.
References and Literature Cited
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Arlington, VA: American Psychiatric Publishing
Anderson, E., Chen, M. I., Perrin, J. M., & Van Cleave, J. (2015). Outpatient Visits and
Medication Prescribing for U.s. Children with Mental Health Conditions. Pediatrics. Doi:
10.1542/peds.2015-0807.
Baker, S. D., Lang, R., & O’Reilly, M. (2009). Review of video modeling with students with
emotional and behavioral disorders. Education and Treatment of Children, 32, 403–420.
http://dx.doi.org/10.1353/etc.0.0065
Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond. (2nc ed.). Guilford Press.
Cunningham, P. J. (2009). Beyond Parity: Primary Care Physicians' Perspectives on Access to

Mental Health Care: More PCPs Have Trouble Obtaining Mental Health Services for
Their Patients Than Have Problems Getting Other Specialty Services. Health affairs,
28( Suppl1), w490-w501.
Fox, A., Dishman, S., Valicek, M., Ratcliff, K., & Hilton, C. (2020). Effectiveness of social skills
interventions incorporating peer interactions for children with attention deficit
hyperactivity disorder: a systematic review. American Journal of Occupational Therapy,
74( 7402180070), https://doi.org/10.5014/ajot.2020/040212
Grigas, H., Warren, A., Zornes, C., & Connor, A. (2019). Psychosocial effects of work-related
social skills training among adolescents with substance use disorders: a pilot study.
American Journal of Occupational Therapy, 73(4),
https://doi.org/10.5014/ajot.2019.73S1-PO4049
Keiling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … &
Rahman, A. (2011). Child and Adolescent Mental Health Worldwide: Evidence for Action.
The Lancet, 378(9801), 1515-1525.
Kielhofner, G. (2009). Conceptual foundations of occupational therapy practice (4th ed.).

Philadelphia, PA: FA Davis Company.
Lipari, R. N., Hedden, S., Blau, G., & Rubenstein, L. (2016). Adolescent Mental Health Service
Use and Reasons for Using Services in Specialty, Educational, and General Medical
Settings. The CBHSQ Report. Substance Abuse and Mental Health Services
Administration (US).
Moulier, V., Guinet, H., Kovacevic, Z., Bel-Abbass, Z., Benamara, Y., Zile, N., Ourrad, A.,
Arcella-Giraux, P., Meunier, E., Thomas, F., & Januel, D. (2019). Effects of a
life-skills-based prevention program on self-esteem and risk behaviors in adolescents: a
pilot study. BMC psychology, 7(1), 82. https://doi.org/10.1186/s40359-019-0358-0
Office of Adolescent Health. (2019, May 1). Common Mental Health disorders in Adolescence.
Retrieved June 2, 2020, from
http://www.hhs.gov/ash/oah/adolescent-development/mental-health/adolescent-mental-h
ealth-basics/common-disorders/index.html
Olson, L. J. (2010). A frame of reference to enhance social participation. Frames of reference

for pediatric occupational therapy (pp. 306-348). Baltimore, MD: Lippincott Williams &
Wilkins.
Rönngren, Y., Björk, A., Kristiansen, L., Haage, D., Enmarker, I., & Audulv, Å. (2018). Meeting
the needs? Perceived support of a nurse-led lifestyle programme for young adults with
mental illness in a primary health-care setting. International journal of mental health
nursing, 27(1), 390–399. https://doi.org/10.1111/inm.12333
U. S. Department of Health and Human Services. (2020, May 14). Mental Health in
Adolescents. Retrieved June 2, 2020, from
hhs.gov/ash/oah/adolescent-development/mental-health/index.html#:~:text=Mood%20s
wings%20are%20common%20during,young%20people%20to%20get%20help.
Whatley, E., Fortune, T., & Williams, E. A. (2015). Enabling occupational participation and social
inclusion for people recovering from mental ill-health through community gardening.
Australian Occupational Therapy Journal, 62, 428-437. doi:10.1111/1440-1630.12240
Wood, L., Ivery, P., Donovan, R., & Lambin, E. (2013). “To the beat of a different drum”:
improving the social and mental wellbeing of at-risk young people through
drumming...discovering relationships using music - beliefs, emotions, attitudes, &
thoughts. Journal of Public Mental Health, 12(2), 70–79.
https://doi.org/10.1108/JPMH-09-2012-0002
BUDGET
Budget Item Cost
Space (e.g., rent or reservation fees)
Teenscope large treatment rooms, sensory room, and calm down $0

room
ZOOM $0
Supplies (e.g., materials, printing costs)
Weekly session worksheets $1,629

9￠/page; ~2 pages per week.
Worksheets for estimated 174 participants a year.
0.9 x 2 = 0.18 per week per client
0.18 x 52 = 9.36 per year for one client
9.36 x 174 = $1,628.64 a year for all clients
Handout resources $783

9￠/page; ~5 handouts per participant.
Handouts and resources for 174 participants per year
0.9 x 5 = 4.50 per client
4.50 x 174 = $783 a year for all clients
Writing utensils and art supplies $25

Pack of 60 ballpoint pens = $5.49
Pack of 500 pages of construction paper = $13.31
Pack of 96 crayons = $6.07
Cooking supplies and food $1,350

$150/group x 9 sessions a year
The Child Occupational Self Assessment (COSA) $40
Action Over Inertia Workbook $19
Equipment (e.g., tablets, computers)
Computers/electronic device for virtual sessions $0

Blender $45
Microwave $0
Marketing (e.g., flyers, advertising)
Marketing $0
Personnel (e.g., salary with % time/effort, hourly wage, benefits, consultant fees)
Teenscope Group Leader $48,870
Part time therapist $37/hour;

20 hours per week = $38,480/year
Benefits 27%: $38,480 x 0.27 = 10,389
$38,480 + $10,389 = $48,870
Psychiatric Aide/Technician $3,120
Part time technician $12/hour

Total Requested $55,881

BUDGET JUSTIFICATION
The Life Skills Group is a cost efficient service. The total requested amount for the
implementation of the Life Skills Group for one year is $55,881. This covers all operating costs
of the Life Skills Group such as treatment space, supplies, equipment, marketing, and
personnel. Weekly in person sessions will be held in one of the large treatment rooms within the
Teenscope facilities. The sensory room and calm down room within the Teenscope facility will
always be available for participants if a sensory or emotional break are needed during the
treatment sessions. Treatment, sensory, and calm down rooms are within the already
established Teenscope facilities and can be used for free for a savings of $3,120 (room rental is
$60 per meeting). Virtual sessions will be held via ZOOM and thus it is necessary for group
facilitators to have a ZOOM account. ZOOM account subscription is free for all University of
Utah employees, staff, and students saving $180.
Supplies necessary for the Life Skills Group will vary week to week depending on each
treatment session's subject and activities. Each week participants will be provided with weekly
session worksheets. If meeting face-to-face, printed worksheets will be provided for the
participants. If meetings are via ZOOM, an electronic copy of the handouts will be available for
sessions. Additional handouts and resources will be provided in printed or electronic form
weekly as needed for sessions. In-person sessions will use writing utensils and art supplies,
which are available within the Teenscope facility for the Life Skills Group use. However, $25 is
within the budget to replenish used supplies as needed. The Life Skills group will have a
cooking component. The cost of food will fluctuate depending on the wants and needs of the
foods requested by participants. To assess participant’s pre and post intervention social skills
functioning the COSA will be purchased and used as a means of self-assessment for the
Teenscope participants. Along with the COSA, the Action Over Inertia Workbook worksheets will
be used to assess the effectiveness of the program and to track the change in participants over
the course of the 6-week program.
The necessary equipment to run the program includes computers/electronic devices,
blender, and microwave. Computers or other electronic devices are required for virtual treatment
sessions. Devices for staff will be provided by UNI and participants will be responsible for having
and maintaining their own devices for a savings of $1,200. Cooking and healthy eating sessions
will use a blender and microwave to facilitate hands on participation and active demonstration. A
blender will be purchased for the Teenscope facility but the microwave will be borrowed from
the staff lunchroom microwave for a savings of $80.
The Life Skills Group is developed to be led by personnel already part of the Teenscope
staff. Ideally, the program would be facilitated by an occupational therapist but with proper
programming, the group can be implemented with no changes in staffing. The therapist
assigned to run the Life Skills Group would spend 20 hours per week on Life Skills Group
duties. During these 20 hours, the therapist would be running the group once per week for 90
minutes, and then using the additional time to prepare for weekly groups, adjust the program
when necessary, collecting data, and scheduling for evaluations and assessments of
participants. Each of Teenscope’s groups has a Psychiatric Aide/Technician present to help
facilitate. The Life Skills Group plans to follow this same structure to keep programming
consistent. Participants for the Life Skills Group are established within the Teenscope program
and thus no marketing personnel will be needed since marketing and advertising needs are
inapplicable. For a breakdown of the budget and costs calculations refer to the chart above
Life Skills Group
Protocol
Developed by University of Utah Occupational Therapy Students
Alissa Atisme, Trisha Snow, & Sarah Layton
Table of Contents
Group Overview……………………………………………………………………..Page 2
Group Goals and Objectives……………………………………………………….Page 2
Guiding Models……………………………………………………………………...Page 4
Group Sessions……………………………………………………………………..Page 6
Week 1: Communication Styles…………………………………………. Page 6

Week 2: Conflict Resolution……………………………………………… Page 9
Week 3: Communication Practice……………………………………….. Page 12
Week 4: Healthy Routines…………………………………………………Page 15
Week 5: Healthy Eating…………………………………………………… Page 19
Week 6: Maintaining Routines…………………………………………….Page 22
Budget and Justification…………………………………………………………….Page 25
Program Effectiveness & Longevity……………………………………………….Page 27
Appendix A: Pre-Post Assessment & Worksheet...………………………...…...Page 28
References…………………………………………………………………………..Page 29
1
Group Overview
The Life Skills Group is a six-week long program with sessions held once a week for 90
minutes. The group will be held in conjunction with the other Teenscope programming, and will
follow the hybrid procedure of a combination of in-person and virtual sessions. The Life Skills
group will be available and required for all Teenscope participants to attend. The first three
weeks of the program will focus on social participation by providing participants the opportunity
to increase their comfort and develop communication skills. The final three weeks will focus on
increasing personal volition and development of healthy routines including sleep hygiene,
healthy meals/good nutrition, and overall daily routines to promote engagement in life skills.
During the program’s life skill weeks, participants will be encouraged to implement social
participation skills when interacting with peers and staff during the group. Participants will be
provided weekly homework with the expectation to complete the assigned tasks outside of the
group and come ready to share at the next session.
To accommodate for participants joining Teenscope on a rolling basis, the Life Skills
Group is designed so participants can join no matter the week’s programming. If new
participants join in on a week where Action Over Inertia worksheets were assigned for
homework, they will be provided these worksheets to complete prior to the sessions start. On
weeks where homework is discussion based, participants will be encouraged to pull from prior
experience to contribute to group discussion.
Prior to engagement in the Life Skills Group, participants will complete two evaluations
(Action Over Inertia worksheet 2.10 - Activity Engagement Measure, and the Child Occupational
Self Assessment (COSA)) to determine baseline social and occupational status. The same
three evaluations will be administered at the end of the six week Life Skills Group to assess
participant progress and group effectiveness. See Appendix A for the list of evaluations.
Group Purpose
The Life Skills Group will uniquely focus on enhancing social participation and
engagement in meaningful occupational tasks. Throughout the six week program, participants
will be working towards increasing personal volition for everyday activities, and working through
scenarios related to social conflict, social participation, and the everyday life skills required to do
each. By the end of this program, participants will (1) demonstrate improved social participation
with leaders, peers, and family, (2) establish and implement healthy daily routines, and (3)
display increased ability to implement strategies when experiencing difficulty engaging in basic
occupational tasks.
Group Goals & Objectives

Goal 1: Participants of The Life Skills Group will demonstrate improved social participation with
peers, parents, and Teenscope staff.
● Process objective: Social participation instructional materials will be provided to all
Teenscope staff to implement throughout the program duration, with materials evaluated for
effectiveness within 6 months.
● Outcome objective: Participants will independently engage in appropriate social
conversations within the group and at home.
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● Outcome objective: Upon completion of the Life Skills Group, participants will
demonstrate self-reported improvements in social participation through an increase in score
on the COSA.
Goal 2: Participants of The Life Skills Group will establish and implement healthy daily routines
to improve their mental health.
● Process objective: The Life Skills Group will provide three weeks of education and
activities focused on strategies and occupational skills which support healthy routines.
● Outcome objective: Upon completion of the Life Skills Group, participants will demonstrate
improved ability to follow and adhere to healthy daily routines, demonstrated via pre-post
evaluation of Action OInertia worksheets 1.3 (My Current Activity Patterns) and 2.5 (My
Daily Routine & Structure).
Goal 3: Participants of The Life Skills Group will demonstrate an increased ability to implement
strategies when experiencing difficulty engaging in basic occupational tasks.
● Process objective: Life Skills Group will offer three weeks of education specifically
focused on developing strategies to increase motivation and volitional desire to engage in
occupational tasks like dressing, eating, cleaning, etc.
● Outcome objective: Within 6 weeks, participants will adhere to newly established healthy
routines 5/7 days a week via self-report.
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Guiding Models
There are three models that inform the Life Skills Group program: Cognitive Behavioral
Therapy (CBT), the Model of Human Occupation (MOHO), and the Social Participation Model
(SPM). Through the use of CBT, participants will work towards adjusting the way they perceive
and react to situations, guiding them to distinguish between an internal or external activating
event, shifting from irrational to rational beliefs about the event, and in turn shifting from
negative to positive consequences of the event (Beck, 2011).
Figure 1. Graphic depicting the process of CBT
MOHO views impairments in occupational participation as more than just physical

(motor, cognitive, and sensory) or environmental deficits, but include the clients’ values, desires,
and motivation (Kielhofner, 2009). Teenscope participants report a lack of motivation to engage
in their ADLs and IADLs. Implementation of the MOHO model in this setting can be geared
towards providing participants with tools utilizing their strengths and skills to develop healthy
routines to increase their desire to engage in ADLs, IADLs, and social interactions.
4
Figure 2. Graphic depicting the MOHO process to facilitate occupational engagement
Through utilizing the social participation model participants will work to manage their
emotions and behaviors, establish better communication routines and understanding of roles
with their parents, and increase positive participation during group sessions with peers (Olson,
2010). Through effective modeling and establishing a supportive environment, group facilitators
will educate and encourage implementation of needed emotional regulation and social
interactions skills.
Figure 3. Graphic depicting the process of the social participation model
5
Group Sessions
Weekly sessions are designed to be completed face-to-face or virtually, though some

aspects or activities may need to be modified or excluded based upon restrictions (refer to the
virtual adaptation section located in each group session overview). In the case of virtual
sessions, all paper resources or handouts will be emailed to participants and participant’s
parents one day prior to the session. Parent involvement will be requested to ensure needed
resources have been printed and are available for use during the session. If needed, resources
may be sent to participants at an earlier time to accommodate their needs. Due to certain
restrictions, it would be most beneficial to participants for groups five and six to occur
face-to-face.
Week 1: Social Participation - Communication Styles (90 minutes).

During this first session, leaders and participants will introduce themselves and learn the group
purpose and rules. Following will be education about communication styles and a group activity.
Required materials and resources: Blank paper, pens/pencils, colored pencils/crayons/markers,

small slips of paper for activity (charades, telephone), small piece of paper/notecard to record
homework, stopwatch or timer, and a bowl/vessel to hold small slips of paper.
*Virtual Adaptations: Remove the game of Telephone and Pictionary, and spend more time on
other session activities.
Group Introductions: (5-10 minutes)
● Instructor introductions
● Participant introductions
○ Name, age, “two truths and a lie” introduction game
Group Purpose: (2 minutes)
The Life Skills Group will uniquely focus on enhancing social participation and engagement in
meaningful occupational tasks. Throughout the six week program, participants will be working
towards increasing personal volition for everyday activities, and working through scenarios
related to social conflict, social participation, and the everyday life skills required to do each. By
the end of this program, participants will (1) demonstrate improved social participation with
leaders, peers, and family, (2) establish and implement healthy daily routines, and (3) display
increased ability to implement strategies when experiencing difficulty engaging in basic
occupational tasks.
Group Rules: (2 minutes)
● Take turns speaking

● Be respectful of all group members
● Remember, what happens in group, stays in group
● Come being open and willing to participate through sharing your thoughts and personal
experiences (when appropriate).
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Bulk Learning Section: (15 minutes)
● What is communication: communication is the act of transferring information from one

place, person, or group to another.
● Why is communication important: communication is essential to being able to explain
and receive information to and from others.
● Communication types:
○ Verbal communication: occurs when engaging in speaking with others.
○ Non-verbal communication: what we do while we speak. Can include facial
expressions, eye contact, hand movements, and touch.
■ Example 1: have one participant volunteer to say the following sentence,
once without non-verbal communication techniques, once with:
● “I went to the theme park and it was really cool. We rode a really
tall coaster and I ate so much cotton candy my mouth turned
blue.”
■ Ask participants to analyze the difference in the way the sentence came
across from one scenario to the next, and ask which style they feel better
told the story
■ Example 2: have one participant volunteer to say the following sentence,
once without non-verbal communication techniques, once with:
● “The school assembly on cheating was frightening and really
made me think hard about the importance of turning in my own
work.”
■ Ask participants to analyze the difference in the way the sentence came
across from one scenario to the next. Discuss how there is a time and a
place for certain non-verbal communication gestures.
○ Written communication: occurs through written words with the intention of being
read to by the second party. Written communication has the potential to
misrepresent what is meaning to be said based upon the lack of emotion and
context in this communication style.
○ Visual communication: provide examples such as instagram - through the use of
photographs and written communication to convey a message.
Communication style Activities: participants will take turns discussing their preferred mode of
communication (written, verbal, visual, a combination) and why. Then will Segway into this next
activity (30 minutes)
● Verbal: in a game of telephone, 4 participants will take turns conveying a sentence

selected from a hat, and play a game of telephone with it. They may only say the
sentence one time per participant.
● Non-verbal: in a game of charades, 4 different participants will take turns acting out an
abstract word selected out of a hat for peers to guess. They will have 1 minute each to
act this out for others to guess.
● Visual: one-by-one, 4 different participants (or the remainder of participants who have
yet to participate) will have one minute to draw out an abstract word (like happy,
peaceful, etc). Each will then compare drawings and have 1 minute or less to share why
they drew what they drew.
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● Combination: 4 participant volunteers (or selected at random) will use a combination of
the above communication tactics to convey one of the abstract words without explicitly
saying the word. They can use describing words, hand gestures, facial expressions, and
drawings. They will have 1 minute or less for others to guess.
Wrap-up: (15-20 minutes)
● Discussion of the ease and/or difficulty of guessing the word through each of these
different types of communication styles standing alone versus combining them all
together.
● Discussion about how they plan to change the way they communicate (or even keep it
the same) and why
● Discussion of their takeaways from the lesson
● Homework: have a conversation with 2-3 people closest to you and identify the
communication style they use most, and the communication style you most enjoy. Take
the time to educate one of them on the different styles of communication, which one you
noticed they use the most, and ask them what they think their preferred communication
style is. Educate them on your preferred style so they know best how to communicate
with you.
Resources
● Abstract words for activity:

○ Happy
○ Sad
○ Goofy
○ Angry
○ Melancholy
○ Hyper
○ Tense
○ Disgust
○ Fear
○ Surprise
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Week 2: Social Participation - Conflict Resolution
During this session, participants will learn about conflict; specifically how conflict begins, the
signs of conflict, how to cope with conflict and how to work through it. Followed by a role playing
group activity to implement learned strategies and skills.
Required materials and resources: pens/pencils, paper for role playing activity, and small pieces
of paper/notecard to record homework.
*Virtual Adaptations: NA - can be conducted as stated
Check In with participants on how their week went and revisit group rules (5 minutes)

Review Homework: (10 minutes)
● Last week, you were tasked to have a conversation with 2-3 people closest to you and
identify the communication style they use most, and the communication style you most
enjoy. Take the time to educate one of them on the different styles of communication,
which one you noticed they use the most, and ask them what they think their preferred
communication style is. Educate them on your preferred style so they know best how to
communicate with you.
○ How did it go?
○ Were you surprised what you learned about your loved ones’ preferred styles
compared to how they communicate with you?
○ What was the biggest takeaway from this homework assignment?
Group Introduction: (20 minutes)
● This week we will be focusing on conflict resolution

● How has your ability to work through conflict and tough situations changed since your
experience with your most recent debilitating mental health disturbance?
● Describe a situation where you were in a conflict and the result ended in even more
conflict?
○ Allowing as many participants as wanted to answer this question. We will be
using these scenarios for an activity later, so keep them in mind.
Bulk Learning Section - (10 minutes)
● How do conflicts arise?

○ Conflicts arise from differences between two people sharing in conversation.
Conflict occurs whenever people disagree over their values, motivations,
perceptions, ideas, or desires
● What are some signs that you are/are about to engage in a conversation of conflict?
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○ Heart beat increasing/racing, clammy hands, sweating more than usual, shaking
voice, etc.
■ Have you experienced any of these things during a conversation rooted in
conflict? How do you manage these feelings?
● How to cope:
○ Breathe deeply, stay focused on attacking the problem at hand, not the person
you are in conflict with, step away from the conversation to compose yourself,
etc.
■ Do you have any other coping strategies?
● How to work through the conflict:
○ The solution varies from situation to situation (discuss this and why not all conflict
can be handled the same)
■ Listen to the other person
■ Get your point across while remaining respectful
■ Offer up a solution
■ Explain your feelings and why you are feeling the way you are
Conflict Resolution Activity - Role Playing: (40 minutes)
● Using the situations provided by participants at the beginning of the session, participants
will each have a turn working through one of the scenarios
● 5 situations to work through total
● Have them begin by acting the scenario out the way it actually happened
● As a group, break down what went wrong, the feelings involved, and why it ended the
way it did
● Talk specifically about the physiological changes within the body that contributed to the
tense nature of the situation (fast heart rate, sweating, etc.)
○ Discuss positive ways in which participants could overcome these feelings and
ensure the situation ends positively.
● Using the same scenario, have the same participants act it out using the strategies
learned previously to ensure the situation ends better than originally.
● Re-reviewing the importance of conflict resolution

● Homework: practice these conflict resolution techniques on at least 2 people you are
close with. Even if you need to just simulate a conflict, the purpose is to practice and put
all that we went over today into real situations so that they become second nature.
Resources
Scenarios to role play with if participants are unable to pull from personal experience:
● You and your best friend are arguing over your weekend plans. She wants to go to the
movies to see a movie you think is dumb, and you want to go to the mall to meet up with
some of your other friends. You tell her the movie she wants to see is dumb and she
lashes back by saying none of the people you are wanting to see at the mall actually like
you. This ends in an explosive fight that may have ended your friendship.
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● Your parents won’t let you leave the house until you clean your room, but you are unable
to clean your room right now because of a depressive episode. The whole reason you
want to leave the house is so you can clear your head and refresh in the hope that this
will better help you have the motivation and drive to clean your room. When you try to
explain you begin raising your voice with your parents and they refuse to listen to
anything you have to say. You slam the door to your room, don’t get anything cleaned,
and feel like your depressive episode has now gotten worse.
● Your boss schedules you to work on a day you requested off 3 weeks ago. Upset, you
confront him about this issue and tell him that you refuse to work that day because you
have had these plans for 3 weeks and did all you were required to.
● You got a C on your literature report and truly feel you deserve a higher grade. When
discussing the grade with your teacher he states there is nothing he or you can do about
the grade.
● One of your siblings steals a valued possession from your room and accidentally breaks
it while playing with it.
● You are playing a board game with a friend. They play the game differently than you do.
You try to explain the correct rules but they refuse to agree.
● Your friend invited everyone over on friday night but you were not invited.
● You are shopping at a store and find a new piece of clothing you want to purchase and
to make matters better the item is on sale. When you check out you notice the discount
was not applied. You tell the cashier about the mistake but they state the sale sign is two
days old and the discount no longer applies.
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Week 3: Social Participation - Communication Practice
During this session, participants will have the opportunity to practice their learned
communication skills in various scenarios through multiple activities.
Required materials and resources: copies of various social comic strips, pens/pencils, common
conversation scenarios on small slips of paper, bowl/hat, small piece of paper/notecard to
record homework.
*Virtual Adaptations: Provide participants with social comic strip worksheets one day prior to the
group via email with instructions to have them printed and ready to use during the group.

● Discussion of how practicing these conflict resolution techniques went with the two
people closest to you.
○ How did it go?
○ What did you learn?
○ What did you find easy or hard?
○ How do you feel about your ability to work through a conflict now versus the start
of last week’s session?
● This week we will be focusing on practicing the communication skills learned in previous
weeks.
● Overview of communication styles and conflict resolution. How has your ability to
communicate with friends, peers, family, etc. changed over the past two weeks? How
has communication impacted your mental health?
● Describe a situation when you utilized communication or conflict resolution skills. What
was the outcome - positive or negative? Allow as many participants as wanted to answer
this question.

-Begin by educating what a social comic strip is (view resources).
Give each participant a social comic strip worksheet and a social scenario. Ensure each
participant has a different social situation such as friend conversation, disagreement with
parents, discussing a grade on an assignment with a teacher, requesting extra help/assistance
from your boss, etc (view resources for possible social scenarios). Each participant will be
assigned to fill out the comic strip finishing the conversation/resolving the conflict in an
appropriate manner. After finishing their comic strip each participant will share how they
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resolved their conservation on the comic strip with the group. Discuss as a group what skills
were used, what techniques were effective, and what could be improved.
Social Participation Activity: (30 minutes)

Explain: Social participation is more difficult in the moment. To practice communicating and
responding to conflict in the moment, we are going to role play different, yet common
conversations with leaders or other participants. Each participant will select a different scenario
(view resources) out of a hat. After each turn, discuss as a group what skills were used, what
techniques were effective, and what could be improved. If participants do not feel comfortable
role playing they can explain how they would handle the conversation.
● Overview about the importance of communication

● Group discussion about session and activity takeaways.
● Homework: Verbally communicate with friends or family a minimum of three times a day
and apply skills as needed. Record when you had each conversation and briefly state
how it went.
Resources
● Social comic strip overview/handout -

○ https://www.erinoakkids.ca/ErinoakKids/media/EOK_Documents/Autism_Resour
ces/Comic-Strip-Conversations.pdf
● Blank comic strips -

○ https://www.teacherspayteachers.com/Product/Blank-Comic-Strip-65411
○ https://www.twinkl.com/resource/t2-e-4960-blank-comic-strip-template
Social Scenarios -
● Your teacher hands back your recent math test with a graded score lower than you
anticipated. You are confused because you studied really hard and felt like you aced it.
While reviewing your answers you realize the teacher made a mistake calculating your
score and you should have a higher score. How do you address the mistake with your
teacher to get your higher score?
● Someone at school says “hi” and asks about how your weekend was, but you do not
know them. What do you do?
● You really want to hang out with your friends tonight but your parents say “no” without
any explanation. What do you do?
● You have a family trip next week that you have been looking forward to for a long time.
You have been trying to get coverage for your assigned shifts at work but have not been
able to get one shift covered and you asked everyone. You set up a meeting with your
boss to discuss your predicament. What do you say?
● Someone in your class says they heard a rumor about you that is not true. What do you
do?
● You are waiting in line to order your food at a local restaurant. The person in line behind
you is bothering you. What do you do?
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● You are babysitting the next door neighbors children. One of the children draws a picture
of you that she is excited to give you. When she hands it to you, you do not think it looks
good. What do you do?
● One of your friends asks to hang out on Friday. You say “yes”. But on Thursday night a
friend you like better asks you to hang out on friday. What should you do?
● Your co-worker always gives you a “high five” when you come into work. It makes you
feel uncomfortable. What do you do?
● Your job plays very loud music over the PA system that makes it difficult for you to
concentrate and complete your work. You know headphones would dampen the sound
and make it easier to work but your job does not allow you to wear headphones. How do
you ask your boss for this accommodation?
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Week 4: Life Skills - Healthy Routines
During this session participants will learn about the importance of creating healthy routines to
increase positive participation in daily occupations and social participation. They will learn
strategies to create healthy habits, roles and routines then create a plan to implement a new
healthy routine to their life.
Required materials and resources: Copies of Action Over Inertia worksheet 1.3 (My Current
Activity Patterns), copies of Action Over Inertia worksheet 2.5 (My Daily Routine & Structure),
pens/pencils, small piece of paper/notecard to record homework.
*Virtual Adaptations: Prepare to demonstrate/display apps through screen sharing. Provide

participants with required worksheets one day prior to the group via email with instructions to
have them printed and ready to use during the group.

Review Homework: (5-10 minutes)
● Review the communication skills participants used in their conversations with friends and
family. Share recorded experiences or thoughts.
○ What skills were the most useful?
○ What difference does it make to use the learned skills in your relationships and
communication?
● This week we’ll be focusing on the importance of having healthy routines in our daily
lives. We’ll continue practicing the communication skills learned in previous weeks.
● Overview of how routines influence our participation in daily life as well as our mental
health. When you have no structure to your day, how does that make you feel? How
does that affect how productive you are?
● Examining current routines/activity patterns and how they are influencing our lives can
help us know what to work on or change for better results.
● How to develop healthy routines that can be applied to various areas of life depending
on your needs, including examples such as morning/evening routines, sleep hygiene,
school, hygiene, medication management, or other self-care activities.
● Have participants identify current activity patterns/routines.

○ Complete Action Over Inertia worksheet 1.3 (My Current Activity Patterns) to help
them start identifying areas of their daily routines that are problematic.
15
○ Complete Action Over Inertia worksheet 2.5 (My Daily Routine & Structure).
Allow for discussion of routines, activities, or tasks that participants have trouble
doing or are lacking in their lives.
● Educate about strategies (see suggestions in resources section) to build new routines or
to alter existing ones to be healthier.
○ Educate/Demonstrate the use of technology to help keep routines. (See list of
apps in resources section below.)
● Provide examples of strategies to create healthy routines including examples such as:
○ Sleep Hygiene- ways to create a sleep routine (timing, electronic use, activity
leading up to bedtime, sensory influences, etc.)
○ Morning routine- using the environment and approach to make this easier,
healthier, and more productive (establishing simple and set self care routines,
setting items out the night before, etc.)
○ Completing Homework- creating a homework specific space at home, setting
timeframes and break times, etc.)
■ More strategies listed in the resource section below
Create A Routine Plan: (25 minutes)
Participants will each choose 1 area of their life (time during the day, specific
occupation/activities) they identify as having trouble with or wanting to improve. Using the
strategies taught, they will plan a new healthy routine in order to increase positive performance
in that activity and thus also improve mental health. They can also choose to use an existing
routine and make adjustments as needed to make it healthier and more effective. Assistance
can be provided by the therapist and other participants. Participants will share the routine with
the group and what steps they are going to take to implement it in the coming week.
● Overview the importance of establishing healthy routines and making necessary

changes when something is not working well/unhealthy.
● Homework: Fill out Action Over Inertia worksheet 2.1 (Daily Time Use Log) for 1
weekday and 1 weekend day to record how they are spending their time. Follow the
routine plan they created during the session and report back how well they implemented
it during the next week.
Resources
● Strategies to build a new healthy routine or make adjustments to existing habits/routines:

○ Add your new habit/routine directly before, during, or after something you already
do regularly. Example: Take your daily vitamin when you brush your teeth before
bed.
○ Habits and routines take time and effort to make consistent. Do not give up if you
mess up. Keep doing your best everyday to follow your plan.
○ Sleep Hygiene - Ways to create a sleep routine

■ Consistent timing (go to bed and wake up at similar times each day)
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■ Limit or avoid sleeping in
■ Be mindful of napping during the day
■ Be mindful of food consumption prior to sleep routine (ex. Caffeine, sugar,
water, etc.)
■ Limit electronic use prior to bedtime
■ Monitor activity leading up to bedtime to best fit your own needs and
preferences
■ Monitor sensory influences- are bright lights or loud noises making it
difficult? What type of sensory environment/experience can you create or
remove to help you relax?
■ Relax body and mind with mindfulness practices such as diaphragmatic
breathing, progressive muscle relaxation, etc.
○ Morning routine
■ Wake up at similar time each day and limit sleeping in
■ Establishing simple and set self care routines
■ Set items out the night before
■ Use a check-list to ensure you complete every required step
■ Make the routine enjoyable by using things like music, aromatherapy, or
audiobooks to motivate you while completing each task.
■ Begin the day with yoga or mindfulness to jumpstart and prepare your
mind and body before you begin your day
■ Fuel your body for the day by eating a healthy breakfast
○ Completing Homework
■ Creating a homework specific space in your home
■ Create an environment that supports your individuals need to remain
focused and engaged
● Place yourself in a well lit environment
● Reduce noise and distractions
● Monitor sensory influences and limit or increase sensation that
increases focus (ex. quiet music, standing, etc.)
■ Set timeframes and break times to keep you on task and motivated
■ Place your phone and other unnecessary electronic devices in another
room to limit distractions
Routine Building Apps
● Habitnow: Daily Routine, Habits, and To-Do Lists

○ Helps individuals keep an organized routine as they build new daily habits.
○ Users are able to define habits according to their needs, keep daily, weekly, or
monthly, goals, set up reminders, track progress over time, and reach goals and
win “medals.”
○ There are daily lists of habits that are scheduled.
○ https://play.google.com/store/apps/details?id=com.habitnow&hl=en_US
● It’s Done!
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○ A task management app that allows you to organize your daily tasks in a
customizable way including setting reminders, tracking tasks, prioritizing or
categorizing tasks, and even notifying others when tasks are completed.
○ Tasks are customizable
○ Can take photos of natural environment and associate with the task
○ http://www.itsdoneapp.com/
● Microsoft To Do (used to be Wunderlust)
○ Organization and time management app
○ Creates task lists and reminders that can be shared with others and across
devices
● Alarmed
○ Organization, reminders, alarms
○ Can be personally customized
○ Both timed and location reminders are available with the option to add notes
○ “Nag-me” feature makes it so it will automatically repeat reminders at regular
intervals for a period of time selected by the user or until the user marks it as
being done
○ Can use Siri to create reminders
○ Categories made to help user organize reminders and timers
○ https://apps.apple.com/us/app/alarmed-reminders-timers/id371886784
● Galarm
○ Social alarm clock app that enables one to create and share alarms and
reminders with one’s contacts
○ Can act as a daily planner and enables one to manage tasks efficiently
○ Can share alarms with others, they can share alarms with you
○ https://www.galarmapp.com/
● Pill Reminder and Medication Tracker- My Therapy
○ App that helps remind individuals to take meds, tablets, or contraceptives.
○ This app has a place to enter contact information for health care providers for
simple look up when needed.
○ Can add medical appointment times into the app
○ Can add friends or family members to help include accountability
○ https://play.google.com/store/apps/details?id=eu.smartpatient.mytherapy&hl=en_
US
● Hygiene helper app
○ Routines, medication management, home management (customizable)
○ Provides a morning/evening checklist to help stay on top of hygiene
○ https://apkpure.com/hygienehelper/edu.uci.ics.hygienehelper
● My Fitness Pal
○ Helps individuals track their food and water intake, exercise tracker (calories
burned), and monitor their goals. Reminders available for tracking food, water,
and exercise
○ https://www.myfitnesspal.com/apps
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Week 5: Life Skills - Healthy Eating
This week participants will learn how to cook a healthy breakfast, lunch, snack, and dinner that
will help enable health for engagement in daily roles and routines. They will also learn more
about elements of healthy eating and principles of food safety.
Required materials and resources: Recipes, food ingredients to prepare breakfast, lunch, snack,
and dinner, cutting boards, knives, bowls, utensils, plates, serving utensil, blender, microwave,
blank paper for notes, pens/pencils, small piece of paper/notecard to record homework.
*Virtual Adaptations: Prepare to demonstrate various food preparations and food safety
procedures. Have a space available to use for demonstrations and use of equipment. Provide
participants with recipes and resources for the session one day prior to the group via email for
use and to reference during the group. Alternative activity/homework is to locate one healthy
and quick meal using provided resources or the internet.

● Review worksheet 2.1 and what participants noticed about how they are spending their
time, the routines they currently have.
● Review how it went implementing their routine plans.
○ What problems did they encounter?
○ What changes can they make?
○ What went well? How did it help?
● This week we will be focusing on healthy eating and how to implement and develop the
habit of healthy eating into daily life. We’ll continue practicing the communication skills
learned in previous weeks.
● Healthy food overview: Introduce “Choose My Plate” and educate about eating a variety
of food groups each day. Eating a variety of food groups ensures your diet will provide
adequate nutrients and energy to last throughout the day. Discuss how healthy eating
impacts our ability to accomplish daily goals and our mental health status.
● Have a variety of healthy foods (necessary to make the sessions meals) on the table.
Introduce each food item and its health benefits.
● Educate about ways to implement healthy eating habits.
● Teach safe ways to cut and prepare food for safety.
○ Safe Knife Handling
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○ Food Temperatures
○ Blender and microwave use instructions and demonstration
○ Healthy, cheap, and quick Meal Ideas
Healthy Eating Activity: (40 minutes)

Activity will be for participants to prepare a quick yet healthy breakfast, lunch, snack, and dinner.
Depending on the number of participants, split them into equal groups and assign them one
recipe. Have participants complete the meal to share with all participants. Once the meals are
complete, share each item with all participants and discuss if they like or dislike the meals.
Discuss why they are healthy. Discuss how they could be implemented into daily life.
Wrap-up: (5 minutes)
● Overview the importance and benefits of healthy eating

● Homework: Eat at least 1 healthy meal each day
Resources
Healthy Foods: “Choose My Plate” https://www.choosemyplate.gov/
● Healthy Eating Habits

● “Choose My Plate for Teens”
https://www.choosemyplate.gov/browse-by-audience/view-all-audiences/students/teens
● “Healthy Eating for Teens”
https://www.aboutkidshealth.ca/Article?contentid=638&language=English
● “Take Charge of Your Health: A Guide for Teenagers”
https://www.niddk.nih.gov/health-information/weight-management/take-charge-health-gui
de-teenagers
● Meal prep: Spend time when you feel good to make some easy make ahead recipes so
when you’re not feeling great you still have some easy and healthy options.
Food Safety
● Safe Knife Handling https://ftiinc.org/safe-knife-handling-practices/

● Food temperatures
https://www.foodsafety.gov/food-safety-charts/safe-minimum-cooking-temperature
● “Be Food Safe” handout from choosemyplate.gov
https://choosemyplate-prod.azureedge.net/sites/default/files/tentips/DGTipsheet23BeFoo
dSafe_0.pdf
● Healthy, cheap, and quick meal idea websites:
○ https://www.budgetbytes.com/
○ https://www.joyfulhealthyeats.com/
○ https://www.loveandlemons.com/
○ https://goodcheapeats.com/
Ideas of foods for Healthy Eating Activity: (blender or microwave preparation only recipes)
● Breakfast-
20
○ Smoothie bowl
■ https://minimalistbaker.com/favorite-smoothie-bowl-5-minutes/
■ https://tasty.co/article/lindsayhunt/smoothie-bowls (scroll to bottom for
recipes)
○ Smoothies
■ Strawberry banana smoothie
https://www.loveandlemons.com/strawberry-banana-smoothie/
■ Creamy peanut butter banana smoothie
https://www.joyfulhealthyeats.com/creamy-peanut-butter-banana-smoothi
e-recipe/)
■ 4 make ahead easy smoothie packets
https://www.joyfulhealthyeats.com/4-make-ahead-easy-smoothie-packs/)
○ 5 minute savory microwave breakfast mug
https://www.budgetbytes.com/5-minute-savory-microwave-breakfast-mug/)
● Lunch-
○ Protein Bowls https://tasty.co/recipe/protein-packed-buddha-bowl
■ Substitutions to make it microwave prepared
● Do not fry tofu
● Use pre cooked vegetable packs
● Use microwavable quinoa packs
○ Salads -can add various veggies, boiled eggs, canned beans, lunch meats, etc.
○ Black bean quesadilla (https://www.eatthis.com/microwave-recipes/)
● Snacks-
○ Hummus and veggies
■ https://www.gimmesomeoven.com/classic-hummus/
■ https://www.foodnetwork.com/recipes/food-network-kitchen/edamame-hu
mmus-recipe-1928183
■ https://www.bonappetit.com/recipes/slideshow/hummus-recipes
○ Hard boiled eggs
(https://justmicrowaveit.com/how-to-boil-eggs-in-the-microwave/)
○ Avocado toast (https://www.loveandlemons.com/avocado-toast-recipe/)
○ Pre cut veggies or fruits
● Dinner-
○ Lemon and garlic broccoli
(https://www.cooksmarts.com/articles/microwaved-broccoli-with-lemon-and-garlic
-recipe/)
○ Meatloaf in a mug (https://www.tasteofhome.com/recipes/meat-loaf-in-a-mug/)
○ Chicken fajitas
(https://momspotted.com/2009/08/chicken-fajitas-recipe-in-less-than-15-minutes.
html)
○ 5-minute vegetarian burrito bowl
(https://www.healthy-liv.com/5-minute-vegetarian-burrito-bowl/)
○ No cook blender tomato soup (heat in microwave)
https://www.seriouseats.com/recipes/2016/01/no-cook-blender-tomato-soup-recip
e.html
21
Week 6: Life Skills - Maintaining Healthy Routines & Program Wrap Up
This week participants will learn about ways to follow through with their daily routines even
when they lack the motivation to do so or run into other problems. They will learn about and
establish their own WRAP plan for when they leave the program. There will also be a final
program wrap up.
Required materials and resources: Copies of the WRAP plan handout, pens/pencils, small piece
of paper/notecard to record homework.
*Virtual Adaptations: Prepare to share online resources and apps through screen sharing.
Provide participants with required worksheets one day prior to the group via email with
instructions to have them printed and ready to use during the group.

● Review participants' healthy eating from the past week. Were they able to eat 1 healthy
meal each day?
○ How did this make them feel?
○ What difference did it make?
○ What was hard about it? What could they do to make it easier?
Group Introduction: (10-15 minutes)
● This week will focus on what to do when something goes wrong or it’s hard to stick to
your healthy routines.
● We will also be wrapping up the Life Skills Group and will take some time to reflect on
the experience as well as what’s needed moving forward after the Teenscope program.
● Overview of past strategies on how to create and implement healthy routines.
● Educate on what a WRAP action plan is and how it can be used to help the participants
when they encounter situations that could cause deviation from routines or exasperation
of mental health conditions.
○ https://mentalhealthrecovery.com/wrap-is/
○ Wellness Toolbox - discuss ideas for all participants
○ Daily Plan
○ Stressors
○ Early Warning Signs
○ When Things are Breaking Down
○ Crisis Plan
22
○ Post-crisis Plan
● Discuss questions participants may have, examples of the different components, and
how this strategy could make a positive difference.
Create Individual WRAP Action Plans: (25 minutes)
Participants will be given the WRAP action plan handout and asked to create their own action
plans. As this will be designed to be used after the Life Skills Group and Teenscope program
ends, particular emphasis should be made to participants to base it off of their home and
personal lives/experiences.
Program Wrap-up: (30 minutes)
● Allow time for group discussion allowing participants to speak about what they thought of
the program, what they liked, what they are going to miss, what they may be nervous or
scared about moving forward, etc.
● Brief overview of the 6 weeks and sessions covered in the program will be given.
● Review resources and tools the participants were given or developed that they can use
moving forward.
● Educate on community resources and ways to find assistance needed after release from
the program.
● Have participants complete the post-program assessments and evaluations
Resources
● WRAP plan overview- https://mentalhealthrecovery.com/wrap-is/
● WRAP plan handout-
○ Can use this with a free trial or as a general template
https://www.pdffiller.com/410215223--wrap-plan-
○ Another option is https://www.getselfhelp.co.uk/docs/WRAP.pdf (provides a more
thorough walkthrough of each step to create a WRAP plan, Wellness Toolbox,
establishing support systems, and other helpful information.
● Wellness Toolbox
○ https://mentalhealthrecovery.com/info-center/wellness-toolbox/
○ A personal blog post about someone’s experience with a wellness toolbox and
WRAP plan (may want to look at this or others to share personalized experiences
with participants)
■ https://makebpdstigmafree.wordpress.com/2013/11/03/my-wellness-toolb
ox/
■ https://makebpdstigmafree.wordpress.com/2013/10/24/wrap-wellness-rec
overy-action-plan/
Apps
● Mindshift CBT - Anxiety Canada
○ App is geared towards helping those dealing with anxiety. It uses
strategies/principles from CBT to help individuals be relaxed and mindful, to
develop and reorient more effective ways of thinking, and to have
resources/behavioral strategies to deal with symptoms of anxiety.
● Mindfulness Coach - US Department of Veterans Affairs (VA)
23
○ Mindfulness Coach helps individuals learn how to practice mindfulness in their
daily lives. It provides a gradual, self-guided training program designed to help
you understand and adopt a simple mindfulness practice. Mindfulness Coach
also offers a library of information about mindfulness (for example “What is
Mindfulness?”, “How to Anchor Your Attention”), 12 audio-guided mindfulness
exercises and a growing catalog of additional exercises available for free
download, goal-setting and tracking, a mindfulness mastery assessment to help
you track your progress over time, customizable reminders, and access to other
support and crisis resources. Mindfulness Coach is free, doesn’t take or share
any of your personal information, and doesn’t require add-on purchases.
● WRAP app
○ https://mentalhealthrecovery.com/wrapapp/
24
Budget
Budget Item Cost
Space (e.g., rent or reservation fees)
Teenscope large treatment rooms, sensory room, and calm down $0

room
ZOOM $0
Supplies (e.g., materials, printing costs)
Weekly session worksheets $1,629

9￠/page; ~2 pages per week.
Worksheets for estimated 174 participants a year.
0.9 x 2 = 0.18 per week per client
0.18 x 52 = 9.36 per year for one client
9.36 x 174 = $1,628.64 a year for all clients
Handout resources $783

9￠/page; ~5 handouts per participant.
Handouts and resources for 174 participants per year
0.9 x 5 = 4.50 per client
4.50 x 174 = $783 a year for all clients
Writing utensils and art supplies $25

Pack of 60 ballpoint pens = $5.49
Pack of 500 pages of construction paper = $13.31
Pack of 96 crayons = $6.07
Cooking supplies and food $1,350

$150/group x 9 sessions a year
The Child Occupational Self Assessment (COSA) $40
Action Over Inertia Workbook $19
Equipment (e.g., tablets, computers)
Computers/electronic device for virtual sessions $0
25
Blender $45
Microwave $0
Marketing (e.g., flyers, advertising)
Marketing $0
Personnel (e.g., salary with % time/effort, hourly wage, benefits, consultant fees)
Teenscope Group Leader $48,870
Part time therapist $37/hour;

Benefits 27%: $38,480 x 0.27 = 10,389
$38,480 + $10,389 = $48,870
Psychiatric Aide/Technician $3,120
Part time technician $12/hour

Total Requested $55,881
Budget Justification
The Life Skills Group is a cost efficient service. The total requested amount for
implementation of the Life Skills Group for one year is $55,881. This covers all operating costs
of the Life Skills Group such as treatment space, supplies, equipment, marketing, and
personnel. Weekly in person sessions will be held in one of the large treatment rooms within the
Teenscope facilities. The sensory room and calm down room within the Teenscope facility will
always be available for participants if a sensory or emotional break are needed during the
treatment sessions. Treatment, sensory, and calm down rooms are within the already
established Teenscope facilities and can be used for free for a savings of $3,120 (room rental is
$60 per meeting). Virtual sessions will be held via ZOOM requiring group facilitators to have a
ZOOM account. ZOOM account subscription is free for all University of Utah employees, staff,
and students saving $180.
Supplies necessary for the Life Skills Group will vary week to week depending on each
treatment session's subject and activities. Each week participants will be provided with weekly
session worksheets. If meeting face-to-face, printed worksheets will be provided for the
participants. If meetings are via ZOOM, an electronic copy of the handouts will be sent to
participants prior to sessions. Additional handouts and resources will be provided in printed or
electronic form weekly as needed for sessions. In-person sessions will use writing utensil and
art supplies, which are available within the Teenscope facility for the Life Skills Group use.
However, $25 is within the budget to replenish used supplies as needed. The Life Skills group
26
will have a cooking component. The cost of food will fluctuate depending on the wants and
needs of the foods requested by participants. To assess participants pre and post intervention
social skills functioning, The COSA Manual will be purchased and used as a means of
self-assessment for the Teenscope participants. Along with the The COSA Manual, the Action
Over Inertia Workbook w orksheets will be used to assess the effectiveness of the program and
to track the change in participants over the course of the six-week program.
The necessary equipment to run the program includes computers/electronic devices,
blender, and microwave. Computers or other electronic devices are required for virtual treatment
sessions. Devices for staff will be provided by UNI and participants will be responsible for having
and maintaining their own devices for a savings of $1,200. Cooking and healthy eating sessions
will use a blender and microwave to facilitate hands on participation and active demonstration. A
blender will be purchased for the Teenscope facility but the microwave will be borrowed from
the staff lunch room microwave or cafeteria microwave for a savings of $80.
The Life Skills Group is developed to be led by personnel already part of the Teenscope
staff. Ideally, the program would be facilitated by an occupational therapist but with proper
programming the group can be implemented with no changes in staffing. The therapist assigned
to run the Life Skills Group would spend 20 hours per week on Life Skills Group duties. During
these 20 hours, the therapist would be running the group once per week for 90 minutes, and
then using the additional time to prepare for weekly groups, adjust the program when
necessary, collecting data, and scheduling for evaluations and assessments of participants.
Each of Teenscope’s groups have a Psychiatric Aide/Technician present to help facilitate
sessions. The Life Skills Group plans to follow this same structure to keep programming
consistent. Participants for the Life Skills Group are established within the Teenscope program
and thus no marketing personnel will be needed since marketing and advertising needs are
inapplicable. For a breakdown of the budget and costs calculations refer to the chart above.
Program Effectiveness and Longevity

The effectiveness of the program will be evaluated by the following:
● Upon completion of the Life Skills Group, participants will demonstrate self-reported
improvements in perception of abilities related to social participation and daily occupations
based upon the COSA.
● Upon completion of the Life Skills Group, participants will demonstrate improved ability to
follow and adhere to healthy daily routines, demonstrated via pre-post evaluation of Action
Over Inertia worksheet 2.10 (Activity Engagement Measure).
For the Life Skills Group to be sustained, it is necessary to have continual reviewing of
the program and revision based upon the needs of the participants. To ensure the occupational
focus of the group is maintained, OT students or an OT will provide consultative services as
needed. Consultative services will also ensure the group continues to address the intended
deficits with social participation and life skills.
27
Appendix A:
Pre-post group participation assessments and surveys:
● Action Over Inertia Worksheet 2.10 (Activity Engagement Measure).

● Child Occupational Self Assessment (COSA) pg. 87-90 OR pg. 101.
28
References
Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond. (2nd ed.). Guilford Press.
Kielhofner, G. (2009). Conceptual foundations of occupational therapy practice (4th ed.).

Philadelphia, PA: FA Davis Company.
Olson, L. J. (2010). A frame of reference to enhance social participation. Frames of reference

for pediatric occupational therapy (pp. 306-348). Baltimore, MD: Lippincott Williams &
Wilkins.
29

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Program Development Grant - Teenscope

Potential Problems and Alternative Strategies

The Life Skills Group’s Longevity

Cunningham, P. J. (2009). Beyond Parity: Primary Care Physicians' Perspectives on Access to

Kielhofner, G. (2009). Conceptual foundations of occupational therapy practice (4th ed.).

Olson, L. J. (2010). A frame of reference to enhance social participation. ​Frames of reference

Budget Item Cost

Space​ (e.g., rent or reservation fees)

Teenscope large treatment rooms, sensory room, and calm down $0

Supplies ​(e.g., materials, printing costs)

Weekly session worksheets $1,629

Handout resources $783

Writing utensils and art supplies $25

Cooking supplies and food $1,350

The Child Occupational Self Assessment (COSA) $40

Action Over Inertia Workbook $19

Equipment​ (e.g., tablets, computers)

Computers/electronic device for virtual sessions $0

Marketing ​(e.g., flyers, advertising)

Teenscope Group Leader $48,870

Part time therapist $37/hour;

Psychiatric Aide/Technician $3,120

Part time technician $12/hour

Total Requested $55,881

Group Goals and Objectives……………………………………………………….Page 2

Week 1: Communication Styles…………………………………………. Page 6

Budget and Justification…………………………………………………………….Page 25

Program Effectiveness & Longevity……………………………………………….Page 27

Appendix A: Pre-Post Assessment & Worksheet...………………………...…...Page 28

Group Goals & Objectives

Figure 1. Graphic depicting the process of CBT

MOHO views impairments in occupational participation as more than just physical

Figure 3. Graphic depicting the process of the social participation model

Weekly sessions are designed to be completed face-to-face or virtually, though some

Week 1:​ Social Participation - Communication Styles (90 minutes).

Required materials and resources:​ Blank paper, pens/pencils, colored pencils/crayons/markers,

Group Introductions​:​ (5-10 minutes)

Group Purpose:​ (2 minutes)

Group Rules​: (2 minutes)

● Take turns speaking

● What is communication: communication is the act of transferring information from one

● Verbal​: in a game of ​telephone​, 4 participants will take turns conveying a sentence

Wrap-up​:​ (15-20 minutes)

● Abstract words for activity:

*Virtual Adaptations: NA - can be conducted as stated

● Take turns speaking

Review Homework​: (10 minutes)

Group Introduction​: (20 minutes)

● This week we will be focusing on conflict resolution

Bulk Learning Section​ - ​(10 minutes)

● How do conflicts arise?

Conflict Resolution Activity - Role Playing:​ (40 minutes)

Wrap-up​:​ (5-10 minutes)

● Re-reviewing the importance of conflict resolution

● Take turns speaking

Review Homework​: (10 minutes)

Group Introduction​: (20 minutes)

Bulk Learning Section​ - ​(20 minutes)

Social Participation Activity:​ (30 minutes)

Wrap-up​:​ (5-10 minutes)

● Overview about the importance of communication

● Social comic strip overview/handout -

Olson, L. J. (2010). A frame of reference to enhance social participation. Frames of reference

Space (e.g., rent or reservation fees)

Supplies (e.g., materials, printing costs)

Equipment (e.g., tablets, computers)

Marketing (e.g., flyers, advertising)

Week 1: Social Participation - Communication Styles (90 minutes).

Required materials and resources: Blank paper, pens/pencils, colored pencils/crayons/markers,

Group Introductions: (5-10 minutes)

Group Purpose: (2 minutes)

Group Rules: (2 minutes)

● Verbal: in a game of telephone, 4 participants will take turns conveying a sentence

Wrap-up: (15-20 minutes)

Review Homework: (10 minutes)

Group Introduction: (20 minutes)

Bulk Learning Section - (10 minutes)

Conflict Resolution Activity - Role Playing: (40 minutes)

Wrap-up: (5-10 minutes)

Review Homework: (10 minutes)

Group Introduction: (20 minutes)

Bulk Learning Section - (20 minutes)

Social Participation Activity: (30 minutes)

Wrap-up: (5-10 minutes)

Review Homework: (5-10 minutes)

Group Introduction: (20 minutes)

Bulk Learning Section: (25 minutes)

Create A Routine Plan: (25 minutes)

Wrap-up: (5-10 minutes)

○ Sleep Hygiene - Ways to create a sleep routine

Review Homework: (5 minutes)

Group Introduction: (5 minutes)

Bulk Learning Section - (30 minutes)

Healthy Eating Activity: (40 minutes)

Healthy Foods: “Choose My Plate” https://www.choosemyplate.gov/

● Safe Knife Handling https://ftiinc.org/safe-knife-handling-practices/

Review Homework: (3 minutes)

Group Introduction: (10-15 minutes)

Bulk Learning Section: (20 minutes)

Create Individual WRAP Action Plans: (25 minutes)

Program Wrap-up: (30 minutes)

Space (e.g., rent or reservation fees)

Supplies (e.g., materials, printing costs)

Equipment (e.g., tablets, computers)

Marketing (e.g., flyers, advertising)

Olson, L. J. (2010). A frame of reference to enhance social participation. Frames of reference