ASSESSING THE SOCIAL EFFECTS OF A Jared Allsop, CTRS, MS

THERAPEUTIC RECREATION SUMMER Indiana University

CAMP FOR ADOLESCENTS WITH
CHRONIC ILLNESS
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Title: Assessing the Social Effects of a Therapeutic
Recreation Summer Camp for Adolescents with Chronic
Illness

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CHRONIC ILLNESS
Extended duration of time,
 least three months
 Can be for the remainder of the individual’s life.
They require
 home health care
 frequent hospital visits.
Seven out of ten American deaths are attributed to
chronic illnesses (Centers for Disease Control and
Prevention, 2005).
CHRONIC ILLNESS
Research indicates that adolescents with a chronic
illness are at a heightened risk of developing
 Depression (Hamlett, Pellegrini, & Katz, 1992)
 Anxiety (Janoff-Bulman, 1989; Venning et al., 2007)
 Helplessness (Breslau, 1985)
 Increased behavioral problems (Witt, Riley, & Coiro, 2003)
 Increased social isolation and rejection from peer groups
(Rodenburg et al., 2005)
 Decrease life satisfaction (Weaver & Flannelly, 2004)
SOCIAL EFFECTS
Social Self-Efficacy
 Self-efficacy is a construct of Albert Bandura’s social cognitive
theory (1986)
 Self-efficacy is “the belief in one’s capabilities to organize and
execute the courses of action required to manage prospective
situations” (Bandura, 1995, p. 2).
 Social self-efficacy is one aspect of self-efficacy. Social self-
efficacy is vitally important to understanding how an individual
will act in various social settings.

Social Performance – is a behavioral

manifestation of social self-efficacy (Bandura,
1997)
SOCIAL SELF-EFFICACY
Social self-efficacy beliefs, can be
affected and modified by four
different sources of information:
 performance accomplishments, also
known as enactive attainment
 vicarious experiences
 verbal persuasive messages
 physiological signals (Bandura, 1986, 1997).
Social self-efficacy beliefs can be
strengthened or weakened by how
the information was received from
each source.
SOCIAL EFFECTS
Past studies have indicated that social effects
are linked with several health related outcomes.
Including
 increased life satisfaction (Hampton, 2000)
 increased psychological well being, and a decrease in both
hospital visits and the duration of those visits (Horn, Yoels,
Wallace, Macrina, & Wrigley, 1998; Lou, Dai, & Catanzaro, 1997)
 successful recovery from surgery (Orbell, Johnston, Rowley, Davey, &
Espley, 2001)
 Focusing specifically on
SOCIAL EFFECTS adolescents, social effects
have been confidently
linked with favorable
psychological, social and
behavioral outcomes.
Including:
increased joy (Natvig, Albrektsen, &
Ovarnstrom, 2003)

increase in self-esteem (Kumar &

Lal, 2006; Passmore, 2004)

increased life satisfaction

(Caprara, Steca, Gerbino, Paciello, & Vecchio, 2006)
 SUMMER CAMP
Benefits of summer
camps include
helping to develop
meaningful social
relationships (Briery & Rabian, 1999)

increased levels of social

acceptance (Melzer & Rourke, 2005)

increased levels of global

self-worth (Melzer & Rourke, 2005)

increased confidence with

their physical appearance
(Melzer & Rourke, 2005)
RECREATION THERAPY
Social self-efficacy and social performance align with
the field of therapeutic recreation.
THERAPEUTIC RECREATION
A Certified Therapeutic Recreational Specialist
(CTRS) can utilize the TR process to help
participants reach social outcomes that are
“applicable to real-life situations” (Richeson, Croteau, &
Jones, 2004, p. 12).

Assessments
Planning
Implementing
Evaluating
Documentation
THERAPEUTIC RECREATION
Past research has shown several positive
outcomes through applying self-efficacy to
various therapeutic recreation programs
 Maughan and Ellis (1991)
 Tate and Ellis (1997)
 Wise and Hale (1999)
 Autry (2001)
 Harrison and McGuire (2008)
PURPOSE
Therefore, the purpose of this
study was to examine the
effects of a therapeutic
recreation based summer
camp on social self-efficacy
levels and social performance
with peers among adolescents
with chronic illness.
HYPOTHESES
H1: Summer camp programs utilizing therapeutic
recreation programming to increase social self-
efficacy among adolescents with chronic illness will
be more effective at increasing social self-efficacy
than summer camp programs not utilizing therapeutic
recreation.
H2: In addition to self-reported social self-efficacy
measures, participants in the therapeutic recreation
based summer camp session will exhibit a greater
increase in social performance with peers over the
traditional summer camp session.
METHODS – SAMPLE
Adolescents with
Neurofibromatosis.
Camp Kostopulos in Salt
Lake City, Utah.
They came from across the
country, from a variety of
socio-economic
backgrounds, and were
between the ages of 11
and 22 years of age.
NF VIDEO
METHODS - SETTING
Two camp sessions with 35-
45 adolescents.
These seven day camp
sessions provide a variety of
summer activities including:
Horseback riding
High and low ropes course
Initiative based activities
Swimming
Field games
Hikes
Field trips to a water park and
historic Park City, Utah.
METHODS - PROCEDURES
The instrument that was used for this study to
test hypothesis one was the Muris (2001) Social
Self-Efficacy Scale (SSES).
Examples
 4. How well can you work in harmony with youth your age?
Not Very Well 1 2 3 4 5 Very Well
 5. How well can you tell other youth that they are doing
something that you don’t like?
Not Very Well 1 2 3 4 5 Very Well
METHODS - PROCEDURES
To test hypothesis two, the adapted version of the Social
Skills Questionnaire (SSQ) from Levinson (2004) was used.
This system is used by Camp K daily to compare the
camper’s social performance with other peers .
Examples
 1. This camper participated in social activities at camp
1 2 3 4 5 1st Day of Camp
1 2 3 4 5 2nd Day of Camp
 2. This camper is able to manage him/herself during both positive
and negative social interaction with peers
1 2 3 4 5 1st Day of Camp
1 2 3 4 5 2nd Day of Camp
 METHODS - PROCEDURES
Session 1 – Control Group
using the traditional Camp
K model.
Session 2 – Treatment
Group using the
therapeutic recreation (TR)
model.
DATA ANALYSIS

H1 - SSES: ANCOVA, Alpha set at .05

H2 - SSQ: Repeated Measures ANCOVA, Day 1 was
used as a covariate
RESULTS
79 campers with NF
participated in this study.
 35 in Session 1, the traditional Camp K
model,
 44 in Session 2, the TR model

37 female & 42 male

Age Range 11 to 22 years,
with a mean age of 15.87
years.
 H1
Summer camp programs utilizing therapeutic recreation
programming to increase social self-efficacy among
adolescents with chronic illness will be more effective at
increasing social self-efficacy than summer camp
programs not utilizing therapeutic recreation.
This hypothesis was not supported by these data (p >
.05).
 H2
In addition to self-reported social self-efficacy
measures, participants in the therapeutic recreation
based summer camp session will exhibit a greater
increase in social performance with peers over the
traditional summer camp session.
The second hypothesis was supported by statistical
analysis.
The time*model interaction was significant (F4,71 =
9.868, p < .001, λ = .643).
DISCUSSION
Hypothesis one was not supported. This does not
appear to be consistent with existing literature.
 Thurber, Scanlin, Scheuler, and Henderson (2007).
 Melzer and Rourke (2005).
 Harrison and McGuire (2008).
DISCUSSION
Hypothesis two was supported. This suggests that levels of
social performance can be more positively affected through
the use of therapeutic recreation within summer camp
programs.
These findings do appear to be consistent with existing
literature.
 Winfree, Williams, and Powell (2002).
 Melzer and Rourke (2005).
 Wise (2008).
IMPLICATIONS FOR PRACTICE AND RESEARCH

Theory based practice (Social Cognitive Theory)

TR Process
Educated, Dedication Professionals
Self-reports
LIMITATIONS

Self-Reporting
Raters
Random assignment
CONCLUSION

Through this study it is clear that agencies and

organizations that rely on theory-based
programming, while utilizing the RT process and
employing highly trained recreational staff can
help can have a profound impact upon the social
lives of the individuals they serve.
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