1. Abstract
Our chapter chose Theme 6, “Nostalgia as Play,” for our project. We were interested specifically in the question of how therapeutic recreation could address and relieve trauma. Because there was already so much research on play therapy in children, we focused on older age groups, and therefore posed the following research question: “Is therapeutic recreation effective in remedying trauma disorders in adolescents and adults?” Through our research, we tried to not only build a broader understanding of how therapeutic recreation might be helpful for these older groups, but determine how therapeutic recreation relates to nostalgia and a connection to the past. Once we had compiled our research by analyzing peer-reviewed articles and journals, we met with experts in the field, both from BMCC and from Newport Academy, a mental health treatment program specifically directed towards teens and young adults. Speaking to professionals in the field granted us insight into therapeutic recreation that would otherwise have been difficult to glean from research alone. We learned that, as a supplement to talk therapy, therapeutic recreation works well within older demographics, for the latter allows the patient to grapple with trauma nonverbally. Both interviews were recorded and posted to a website (designed by one of our chapter members), which served as a platform through which we could share to a broader audience the opinions of professional clinicians who are familiar with therapeutic recreation. We found that, while therapeutic recreation is still not as fully explored in older age groups when compared to its examination for children, the field has demonstrated real promise, in regards to future research, as well as implementation.
2. Theme: Nostalgia as Play
From the current Honors Program Guide the chapter chose to focus on Theme 6: Nostalgia as Play. When we first, as a chapter, began working on the Honors in Action project, we voted between the seven themes discussed in the Honors Program Guide. The result of our voting was Theme 6, which delved into how our memories of the past, or of a past we didn’t experience, could reappear in various mediums. Through play, we reflected upon the possibility of revisiting nostalgic memories. Oftentimes, nostalgic memories in people with Post-Traumatic Stress Disorder, or other trauma disorders, intertwine with the trauma they experienced. Such a process raises difficulties for traumatized people to separate good experiences from the bad when looking back on their lives. Our chapter’s project aimed to clearly expand upon the questions raised by the guide by looking a therapeutic recreation, a medium that could potentially help people process traumatizing memories in a creative and alternative format.
3. Research Objectives
After deciding on our theme, we focused on building, and then specifying, our research question and the objectives we endeavored to reach through our findings. We eventually pronounced our research question to be “Is therapeutic recreation effective in adolescents and adults?” Many people use play as a resource for younger demographics and children, but we wanted to examine the extent to which therapeutic recreation could also benefit older patients. In addition, we wanted to clarify, more concretely, the connection between nostalgia and therapeutic recreation in empirical research, rather than merely rely on the abstract concepts and ideas that could bridge the two, such as emotional benefits or individual experiences. Our chapter’s research objectives focused on having each chapter member scrutinize the history, practice, and training for the therapeutic work, as we believed understanding the foundations of therapeutic recreation would assist us in addressing our research question.
4. Research
Chapter officers categorized our research into several sub-questions they wanted to cover in our research: How does nostalgia affect the human mind? How is therapeutic recreation connected with nostalgia? How does therapeutic recreation work in adolescents, adults, and African-Americans? We included the latter due to a question that preliminary chapter discussions had raised: In what unique ways could oppressed groups perhaps benefit from therapeutic recreation? Chapter members then shared their research within weekly chapter meetings and on a shared Google Document.
We concluded that therapeutic recreation could indeed potentially be effective for people within any demographic, including adolescents and adults. Our research found that therapeutic recreation is used as an alternative to more traditional kinds of therapy, such as talk therapy, though expert opinions have stated that therapeutic recreation works best with psychiatric medication and/or talk therapy. There are several methods used for this type of treatment, such as equine therapy, a type of therapy that involves a patient interacting with horses, to treatments that use dance and other forms of physical movement. The empirical and quantitative data supporting the effectiveness of these practices is, however, still relatively lacking, so we believe researchers should conduct further studies regarding the above.
5. Sources
Source 1
Brumfield, K. A., “African-American Parents’ Perceptions of Play, Counseling, and Play Therapy” (2006). University of New Orleans Theses and Dissertations. 417. Retrieved from HYPERLINK “https://scholarworks.uno.edu/td/417″https://scholarworks.uno.edu/td/417
Brumfield’s dissertation found that, within the African-American community, there are a variety of cultural perceptions which hinder parents from seeking counseling for their children (Brumfield 78). The African-American community attaches a stigma to mental health counseling or therapy, as it is generally not, for them, a cultural norm. African-Americans often assume that if a child needs any form of therapy, the latter must be “crazy.” In addition, parents fear that therapy will damage their reputation. Studies have shown, however, that African-American children who suffer from adverse childhood experiences do benefit from counseling, including therapeutic recreation.
Source 2
Lyshak-Stelzer F., et al. (2007). Art Therapy for Adolescents with Posttraumatic Stress Disorder Symptoms: A Pilot Study. Art Therapy: Journal of the American Art Therapy Association, 163-169. Retrieved from HYPERLINK “https://files.eric.ed.gov/fulltext/EJ791440.pdf”https://files.eric.ed.gov/fulltext/EJ791440.pdf
Lyshak-Stelzer’s study divided adolescents with heavy PTSD symptoms partaking in art therapy into two groups, one which took part in crafts-based art therapy, and another which composed at least 13 collages or drawings collected in a handmade book format to express a narrative of his or her ‘life story’. The latter group showed significantly greater reduction in PTSD symptoms; when the teenagers could build a narrative and restructure their views on their past, they improved more.
It is interesting to note that, within the study, patients who made general crafts showed less improvement than the patients who composed art that focused specifically on their own lives. We can see here an element of the therapeutic effects of nostalgia; even for people suffering from PTSD symptoms, looking to the past can have a healing effect. One can speculate that it is the ability to better understand the past–whether that be one’s “life story” or even the story of the people and places around you–that allows one to comfortably move on to the future. While talk therapy could be effective, something like art therapy is also very useful in groups like adolescents, who are perhaps not as linguistically developed as adults.
Source 3
Lapum J., et al. (2019). Sole Expression: A Trauma-Informed Dance Intervention. Journal of Aggression, Maltreatment & Trauma, 566-580. Retrieved from HYPERLINK “https://www-tandfonline-com.bmcc.ezproxy.cuny.edu/doi/abs/10.1080/10926771.2018.1544182?journalCode=wamt20″https://www-tandfonline-com.bmcc.ezproxy.cuny.edu/doi/abs/10.1080/10926771.2018.1544182?journalCode=wamt20
A 5-year research program in Canada focused on using hip-hop as an outlet for youth who have experienced trauma. Dance can relieve physically the body from tension and trauma symptoms, as well as connect the cultural concepts and philosophies of hip-hop to therapy. The 10-week dance program researching the effectiveness of dance therapy in children and adolescents (11-17) found that dance improved trauma symptoms, such as anxiety and depression from the event(s), especially in patients who had higher scores of anxiety and depression compared to others.
Source 4
Schouten, K. A., et al. (2015). The Effectiveness of Art Therapy in the Treatment of Traumatized Adults. Trauma, Violence & Abuse, 220-228. Retrieved from HYPERLINK “https://www.jstor.org/stable/26638352″https://www.jstor.org/stable/26638352
Schouten asserted that art therapy is effective in treating adults with trauma disorders through systematically reviewing six different research studies using art therapy. Organizing these studies under categories of art therapy being used alongside other therapeutic practices, and utilizing a scale to quantify the potency of art therapy in helping the symptoms of traumatized adults, such as flashbacks and anxiety, Schouten found that there were still many strides to make in therapeutic recreation. As “Art therapists and other creative art therapists do not have an established research tradition,” (226) it can be very difficult to compare and find solid results regarding therapeutic recreation’s success due to the wildly different methodology used by different practitioners and the patient responses to the techniques.
Source 5
Kentaro O., et al. (2016). Memory and reward systems coproduce ‘nostalgic’ experiences in the brain. Social Cognitive and Affective Neuroscience, 1069-1077. Retrieved from HYPERLINK “https://academic.oup.com/scan/article/11/7/1069/1753389″https://academic.oup.com/scan/article/11/7/1069/1753389
Kentaro hosted a study with young women to research the connection between nostalgia-related imagery and the memory-reward system through a functional magnetic resonance imaging study (fMRI). After receiving results from the fMRI that proved the correlation between nostalgia and neural responses to it, the researchers concluded that “…nostalgia consists of two factors: emotional and personal significance and chronological remoteness.” (1074). That is to say, the further a meaningful past event occurred in time, the more nostalgic it will be for someone.
Source 6
Patterson L., et al. (2018). Play therapy with African American children exposed to adverse childhood experiences. International Journal of Play Therapy, 215-226. Retrieved from HYPERLINK “https://doi.org/10.1037/pla0000080″https://doi.org/10.1037/pla0000080
Regarding medical treatments, race and ethnicity play a considerable role in participation. The study highlighted the African-American population, for the youth of this ethnic group has a staggering discrepancy range dealing with the subject of mental health. Studies show that youth of African-American descent residing in low-income neighborhoods are prone to experiencing a plethora of unfavorable crossroads throughout several domains (Patterson, et al. 216). The overexposure to acts, such as domestic violence, community violence, and direct victimization, contributes to the development of mental health disorders in African-American youth, including severe depression and anxiety.
Source 7
Motta, R. W. (2020). Nature- and animal-assisted therapies for PTSD. In R. W. Motta, Alternative therapies for PTSD: The science of mind–body treatments, 107–124. American Psychological Association. HYPERLINK “https://doi.org/10.1037/0000186-007″https://doi.org/10.1037/0000186-007
Motta found that those with PTSD, especially those with trauma from military service, can benefit from the “gut” positive reactions from nature and animals in a therapeutic environment. Nature-assisted therapy (NAT) and animal-assisted therapy (AAT) is argued to be observed in many different cultures as an age-old practice, such as Japanese shirin yoku, and in daily life through service animals. One of the main positives of therapeutic recreation is that it can assist a traumatized individual without the requirement of revisiting the traumatic events, so “…NAT is far less likely to elicit the avoidance response that plagues so much of the psychotherapeutic attempts to manage PTSD.” (110)
Source 8
Trnka, S. (2015). Playing cowboys and Indians: the therapeutics of nostalgia. Canadian Slavonic Papers, 284-298. Retrieved from HYPERLINK “https://www.jstor.org/stable/26774790″https://www.jstor.org/stable/26774790
Susanna Trnka’s research into Czech re-enactments of Cowboys and Indians, or “tramping,” found great physical and mental benefits when recreating past events or a collective understanding of the past. With tramping, those who take part in these re-enactments have also used therapeutic recreation as a counter-cultural practice against the Soviet Union, further amplifying the power nostalgia holds in deconstructing individual or collective beliefs. Trnka’s study into a specific nostalgic practice in Czechian circles translates surprisingly well into our research, as the effectiveness of a creative outlet for a personal or shared trauma can be found in many other practices, such as art therapy and other counter-cultural hobbies.
6. Action and Collaborative Objectives
Our action component comprised two interviews with professional psychological counselors, and then constructing a website to showcase the project and its findings. As we began, our main objective was to raise awareness of the effectiveness of therapeutic recreation through collaborating with experts and creating media that could highlight our findings. Through our initial chapter discussions concerning Theme 6, and thanks to a chapter member’s ties to the organization, Newport Academy emerged as our primary collaborator. Located in Darien, CT., Newport Academy is a residential treatment center for adolescents that utilizes several kinds of therapeutic recreation, and we believed that its therapists would be able to provide valuable insight concerning recreational therapy in demographics older than children. Newport is quite an expensive institution, however, and much of the focus is on inpatient care. In order to garner a broader perspective, then, the chapter also interviewed Neda Hajizadeh, the clinical director of BMCC’s Counseling Center. We constructed the website to showcase our interviews, research, and other findings to our colleagues on campus.
7. Action
For the Newport Academy interviews, our chapter met with Danielle Croteau, a licensed counselor at Newport Academy, and Germaine Michaud, also a licensed counselor and clinical director at the same facility. We learned about Newport’s various experiential and recreational therapy programs, as well as about how patients responded to the therapy. The clinicians spoke about how different modalities work better or worse for some patients, as well as potential difficulties which could/do emerge. We prepared the following questions beforehand:
- How do you define therapeutic recreation?
- How have patients at this facility benefitted from therapeutic recreation?
- What are the main obstacles and limitations when utilizing therapeutic recreation?
- Is there a different goal with the practice of therapeutic recreation compared to conventional therapies?
- Are there any patients who are initially opposed to receiving this therapy? What are their expectations when receiving it?
- Is there any difference in effectiveness based on demographic, such as age, gender, or ethnicity?
We then moved on to Q and A, opening the floor to questions from the officers, advisors, and members. Many of our questions emerged from our research, and we formulated them, so as to illuminate more on what we had already learned, as well as solicit more effectively the perspective of practitioners actually working in recreational therapy.
The interview with Neda Hajizadeh, clinical director of BMCC’s counseling center, was conducted in the school’s podcast/audio recording booth. Questions were similar to those we utilized in the Newport interview, although the conversation was shorter (around ten minutes). Hajizadeh spoke of her own interest in recreational therapy, as well as how it might be integrated into the counseling center in the future.
In order to compile and present our findings exploring effectiveness of therapeutic recreation in a variety of demographics, we posted both interviews on the website. Besides the interviews themselves, we listed our prepared questions, as well as provided some context for the interviews.
8. Outcomes
The findings of our research and interviews led us to conclude that therapeutic recreation is quite effective for adolescents and adults who will engage with it. We’ve found that therapeutic recreation is often used with talk therapy and prescribed medication, as well an alternative for those who have great trouble processing their trauma “normally” through talk therapy. Building and editing the website for our action component gave us an opportunity to post the insightful interviews, whilst creating a space through which we could reach a wider audience beyond the walls of BMCC and CUNY.
The Honors in Action project impacted our chapter, our campus, and beyond by creating an opportunity to learn about therapeutic recreation, a way to work through trauma that proves useful to anyone. Our research question also indirectly created a space for our chapter members to be vulnerable with each other, for chapter discussions often revealed individual experiences within the mental health system. Learning not only about a way to treat our past’s unhealed wounds, but to positively affect our academic community and beyond, made this project truly worthwhile.
PROJECT PARTICIPANTS
Dante Clemente
Katell Pleven
Ime Ekpo
Nathan Mandell
Tauhidul Islam
Stephan Deen
Elizaveta
