Learning Guide

Therapeutic programmes and groups

27465 Contribute to therapeutic programmes and/or groups in a health or wellbeing setting / Level 3 / 5 credits
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Contents

Introduction

Therapeutic programmes

What are therapeutic programmes?

Types of therapeutic programmes

Therapeutic groups

Purpose of therapeutic programmes and groups

Target people

Applications of therapeutic programmes and groups

Contribution to meeting a person’s goals

Reducing the risks to people

Risks for therapeutic programmes

Risks for therapeutic groups

Your contribution to therapeutic programmes and/or groups

Therapeutic programmes and groups (US 27465) Learning Guide © Careerforce – Issue 2.0 | July 2015

Introduction

This learning guide is about therapeutic programmes and groups and how you can contribute to the success of these programmes and groups.

How to use your learning guide

This guide supports your learning and prepares you for the unit standard assessment. The activities and scenarios should be used as a general guide for learning.

This guide relates to the following unit standard:

  • 27465Contribute to therapeutic programmes and/or groups in a health or wellbeing setting (level 3, 5 credits).

This guide is yours to keep. Make it your own by writing notes that help you remember things, or where you need to find more information.

Follow the tips in the notes column.

You may use highlight pens to show important information and ideas, and think about how this information applies to your work.

You might find it helpful to talk to colleagues or your supervisor.

Finish this learning guide before you start on the assessment.

What you will learn

This topic will help you to understand:

  • What therapeutic programmes and groups are, and the differences between them
  • How you can contribute to therapeutic programmes and groups.

Therapeutic programmes

What are therapeutic programmes?

Many people living with and experiencing an injury, health and/or disability condition may require some interventions to help them:

  • restore or maintain their functional ability.
  • participate in activities of daily living and life roles.
  • restore or maintain positive self-image and feeling of worth.
  • restore or maintain healthy and continuing relationships (companionship).
  • encourage, support and promote independence.
  • have physical, cognitive, mental and emotional wellbeing.
  • have social involvement and a place to express and experience feelings and emotions and receive emotional support.

These interventions will have a therapeutic purpose. This purpose will be supported by an underlying set of rehabilitation principles that underpin the activities of the therapeutic programme and group, or both, in which the person engages.

The Accident Compensation Corporation of New Zealand defines rehabilitation as:

‘A process of active change and support to help a person with an injury to regain his or her health and independence, and therefore the ability to participate in his or her usual activities, as far as is practicable.’

Rehabilitation is concerned with the intrinsic worth and dignity of the person and with restoring them to a satisfying and purposeful life. It works to enable a person to live as independently as possible by working around, or compensating for, physical limitations.

The person’s therapeutic programme will outline all the actions that will occur to support that personwith their rehabilitation and to achieve their goals. This programme may have an individual component, a group component, or both.

The individual component will be the tasks and activities that are chosen specifically for that person. The person completes these independently, but with measured assistance from the delegating health professional or you. This is the person’s therapeutic programme.

The group component is when the person participates in a therapeutic programme with others as a group and not by themselves as an individual. Participating in the group allows the person to benefit from the social contact of the group and from interacting with others who understand their situation and feelings and who may be experiencing a similar situation.

Types of therapeutic programmes

Therapeutic programmes are structured interventions that have a specific focus in the treatment of a disability, injury or condition. An individualised therapeutic programme is designed to meet the unique health or disability needs of the person. The programme takes into account that person’s wishes, goals, health condition, personal knowledge about their condition and their own personal resources, for example, social, time and abilities.

Remedial programmes aim to assist people who have injured their muscles, ligaments, tendons and other soft tissues.

Restorative programmes are individualised programmes that address and remediate underlying impairments such as proprioceptive deficits and problems with balance, mobility, positioning and activities of daily living. The goal of restorative programmes is to restore function and independence where possible.

Maintenance programmes are designed to maintain the person at the highest possible level by providing exercise, cognitive and activity programmes.

Write
For a person you are currently supporting with a therapeutic programme, read each of the following questions and write your answers in the table below.
What is the type of therapeutic programme?
In your own words, describe the purpose of the programme. Consider whether the programme has a, remedial, restorative or maintenance focus (or a combination) and add this to your answer.
Why is this programme targeted towards this person?
What delegating health professional prepared this therapeutic programme for the person?
Occupational therapist
Physiotherapist
Speech language therapist
Other, for example, diversional therapist (you may write your own here)
What are the things the person does within this therapeutic programme?
For example, exercises, socialising. (you may write your own here)

Therapeutic groups

Therapeutic groups are where a number of people with similar needs, who would benefit from the same therapeutic programme or activity, participate in the programme as a group and not by themselves.

Therapeutic groups bring a range of individual people together who may have similar experiences or goals. These groups allow people to get the support of others and to feel they are not alone.

When a person experiences an injury or a significant medical event such as a heart attack or stroke, they often have to make a significant adjustment to their changed circumstances. This adjustment takes time, and can see the person work through phases of shock, expecting to recover (denial), mourning, defensiveness and eventual acceptance. While undergoing this process, the person can also experience a range of emotions, from depression, denial, to aggression and feeling dependent until adjustment/adaption is made.

Therapeutic groups can play a vital role in supporting the person as they make this journey. The group can provide a place where the person can:

  • express their problems, concerns or fears.
  • feel as if they are with others who ‘understand’.
  • be listened to.
  • be supported.
  • be motivated and encouraged.
  • feel hope.
  • help others.

It is these beneficial outcomes that can make participation in a group so valuable for a person.

Therapeutic programmes and groups all have:

  • a purpose (what the programme seeks to achieve for people).
  • a target group (the people the programme is aimed at).
  • an application (the type of programme and what happens as a part of the programme).

Purpose of therapeutic programmes and groups

The purpose of therapeutic programmes and groups is to enhance a person’s wellbeing and quality of life by maximising the person’s ability to perform roles, complete tasks and to minimise the effects of any ‘residual disability’.

Therapeutic programmes often work to support the person’s physical functioning, with the purpose of:

  • improving or maintaining the person’s physical function and ability by completing enabling and purposeful activities.
  • helping a person learn a new or different way of doing a task.
  • using assistive equipment.
  • reducing limitations and increasing participation and independence.

Therapeutic groups often support the person’s mental/emotional wellbeing. Therapeutic groups can help a person to:

  • adjust to their changed circumstances (physical dysfunction).
  • gain ideas, information and knowledge from others in the group.
  • learn coping skills from other group members.
  • gain motivation and support.
  • share feelings, problems and perspectives with others and build a sense of belonging by being able to identify with a certain group.
  • have social interaction and relieve stress.
  • enhance their quality of life.

Target people

Therapeutic programmes are provided to a wide range of people from young children to aged adults. They cover a range of personal needs including:

  • providing opportunities to practice life skills to those who have lost them.
  • assisting recovery from accident, illness and/or surgery such as hip replacements, brain injury, heart surgery, spinal injury or strokes.
  • providing programmes to assist those with long standing health conditions and/or disabilities, such as MS, Parkinson’s disease, intellectual disabilities or amputations, to regain, maintain and improve function and achieve their goals.

Therapeutic programmes can be provided in a variety of settings such as:

  • hospitals.
  • rehabilitation centres.
  • people’s homes.
  • community settings (including, but not limited to, local centres, schools and preschools).
  • rest homes/residential facilities.

Applications of therapeutic programmes and groups

The application of therapeutic programmes and groups is the type of programme and how that programme or group is used to assist the person.

There are different types of therapeutic programmes and groups that will each have a different purpose and way of achieving that purpose. Therapeutic programmes and groups can be found in:

  • occupational therapy programmes.
  • physiotherapy programmes, such as:
  • cardiopulmonary programmes.
  • hydrotherapy programmes.
  • programmes of stretches, passive movement and positioning.
  • speech language therapy programmes.
  • structured and unstructured groups.

Occupational therapy programmes

Occupational therapy aims to promote health through enabling people to participate in their chosen activities (occupations). Occupational therapy programmes help people to:

  • have independent, productive and satisfying lives.
  • develop, recover or maintain their ability to participate in, and perform, meaningful and purposeful activities across the domains of self-care, work, recreation and leisure activities.
  • help compensate for any loss of function.
  • improve physical, cognitive and social abilities.

Occupational therapy programmes achieve these goals by collaborating with people to:

  • learn new ways of doing things following an illness or injury, for example a stroke or limb amputation.
  • use assistive devices such as raised toilet seats, eating utensils, walking frames, tools with long handles, shower chairs, etc.
  • make changes or adaptions to their home, work or school environment to allow them to continue to participate in their usual occupations.
  • participate in leisure activities.
  • develop ways to manage health and disability challenges to allow people to continue to live the life they want.
  • develop new skills, abilities or interests.
  • access supports available in the community.
  • help them identify and acknowledge the skills they have and build confidence and self-esteem if necessary.
  • link people with others experiencing a similar situation.

Physiotherapy programmes and groups

Physiotherapy programmes also work to help people to participate in life and in their communities in the fullest way possible. They seek to help the person maintain or regain their range of motion after injury, damage or impairment by using specialised knowledge of how the body works. These programmes work to:

  • provide treatment and rehabilitation
  • prevent injury
  • promote health

Physiotherapy programmes include:

  • cardio-pulmonary programmes
  • hydrotherapy programmes
  • programmes of stretches, passive movement and positioning

Cardiopulmonary programmes

Cardiopulmonary programmes assist people who have had cardiac (heart) or pulmonary (lung) surgery or are those with ongoing cardiopulmonary conditions. These programmes aim to increase energy, physical strength, endurance and independence. They provide exercises, education and motivation to increase the people’s ability to be physically active.

Hydrotherapy programmes

In hydrotherapy programmes, exercises are done under water or in a pool. Hydrotherapy uses the physical qualities of water, such as buoyancy, resistance and temperature to support the person. The person is able to move more easily in water because the water’s buoyancy reduces the effects of gravity.

Hydrotherapy is used with people to:

  • improve functional mobility.
  • improve muscular and cardiopulmonary endurance.
  • enhance wound healing and recovery from surgery and burns.
  • aid rehabilitation, for example people with spinal injuries.
  • aid recovery from injuries, such as sports injuries or accidents.
  • assist people to manage the symptoms of health or disability conditions, for example, asthma, osteoarthritis or rheumatoid arthritis.

Programmes of stretches, passive movement and positioning

Stretches are movements that lengthen muscles or muscle groups without causing tears or injuries. Passive movements are movements of the body by an outside force without voluntary action or resistance by the person. Positioning is about placing the body into postures and positions that are appropriate and supportive for the person.

Therapeutic programmes of stretches, passive movement and positioning can be used to:

  • prevent injury by warming up muscles.
  • place the body in a position or shape that prevents or reduces pain, discomfort or difficulty in functioning.
  • facilitate movement within safe boundaries.
  • improve mobility.
  • improve balance and coordination.
  • increase flexibility and range of motion.
  • improve circulation.
  • relieve stress.
  • improve posture.

Speech language therapy programmes

Speech language therapy programmes are used with children and adults to improve communication (language and social communication) and help treat swallowing difficulties.

These programmes work with people to improve:

  • speech and language difficulties following a stroke, illness or accident for example a traumatic brain injury.
  • communicating when the person has a hearing loss.
  • communicating, speaking and eating following a laryngectomy (surgical removal of the larynx (voice box)).
  • stuttering/stammering.
  • ability to swallow, such as from a health or disability condition, for example, multiple sclerosis or a head or neck injury.
  • communication when voice disorders are present (problems with the pitch, loudness or quality of the voice), from a health or disability condition or injury.

Write
Based on the people you are currently supporting with therapeutic groups, complete this table.
Programme / Purpose

Structured and unstructured groups

There are many different types of therapeutic groups. Groups can be structured or unstructured. Structured groups have a clear therapeutic goal and plan for each session, often with the same people attending regularly.

Unstructured groups have a focus of participation in an activity for the sake of it and support people’s needs to be occupied in an interesting way, to be with other people and to develop leisure interests. Unstructured groups usually have a wide variety of people attending, and they do so for their own reasons.

Both structured and unstructured groups have therapeutic value. Some examples of therapeutic groups follow.

Sit and be fit

Sit and be fit is an award winning television/video exercise series. The classes are designed for older adults and those people who are undergoing rehabilitation from an injury or illness. Sit and be fit allows exercises to be done on a chair to reduce physical strain and maximise physical benefit.

Sit and be fit classes can help a person to:

  • feel good about themselves, meet new people and have fun.
  • maintain their physical condition, improve mobility and reduce the potential for falls.
  • reduce stress and anxiety.
  • improve their posture and control weight.
  • have improved body functions such as sleep, digestion and heart and lung function.

Cardiac walking groups

Cardiac walking groups assist people to recover/rehabilitate from a cardiac event or surgery. These groups have a variety of names and may also include other forms of gentle exercise such as yoga or Tai Chi. These groups are also a forum for members to learn more about staying well and to benefit from the social interaction with others.

Other groups

Other therapeutic groups may include activities such as newspaper reading, quizzes, card games, gardening, cooking, fishing and outings to places of interest.

Write
For a person you are currently supporting with a therapeutic group, read each of the following questions and write your answers in the table below.
What is the type of therapeutic group?
In your own words, describe the purpose of the group.
Why is the group targeted towards this person?
What delegating health professional recommended this therapeutic group for the person?
This could the occupational therapist, physiotherapist, speech language therapist, or another, for example, a diversional therapist.
What are the things the person does within this therapeutic group?
What are the benefits the person gains from participating in the group?

Contribution to meeting a person’s goals

Each person will have goals that are important to them. These goals will relate to the person’s wellness and quality of life. For example:

  • being able to complete activities of daily living or other tasks.
  • gaining more independence in something they want to do.
  • participating in life roles.
  • gaining new roles or responsibilities.
  • learning new skills.
  • restoring and/or maintaining their function.
  • re-joining (or recommencing) their social circle/network.
  • participating in family, community and/or civic life.

Achieving these goals may involve achieving smaller sub-goals, such as: