RCTX 3263 Recreational Therapy Treatment Protocol

I. ​Modality​ ​category​- Emotional control

II. ​Name of Intervention Activity​ – Emotion wheel

III. ​Materials Needed​.

● Chairs (6)
● Table (1)
● Packs of colored pencils (6)
● Pieces of plan white paper (6)
● Black pens (6)
IV. ​Recommended Group (Group & Size)
a. Age range: Adolescents (8-10)
b. Recommended group: The recommended group size is no more than six people, but no less than
two. A small group size is suggested so participants can take turns sharing and stay on task.
c. This activity can be modified to fit different age groups from children to older adults.
d. Our target group is adolescents with military parents who have depression.

V. ​Description of Treatment Population/Diagnosis​ – Adolescents with military parents who are

experiencing depression because their parent(s) are away from the home.
Physical Domain​ A patient with depression may suffer from chronic pain, headaches, muscle and joint
pain, chest pain, and digestive problems.
Psychological Domain​ Depression can cause suicidal thoughts, low mood or sadness, irritability, no
motivation, anxious, worried, helpless, and makes it difficult to make decisions.
Social Domain​ Individuals with depression tend to have a diminished friend group, become anti-social,
isolate themselves, neglect hobbies and family, and do not participate in activities.
Cognitive Domain​ Depression can cause slow reaction time, memory loss, negative or distorted thinking,
forgetfulness, and indecisiveness.

VI. ICF Functional Outcome Area Classification

Pain
Primary Code: b280, Sensation of Pain
● Sensation of unpleasant feeling indicating potential or actual damage to some body structure.

Secondary Code: b289, Sensation of pain, other specified and unspecified.

Specific Mental Functions

Primary Code: b152, Emotional Functions
● Specific mental functions related to the feeling and affective components of the processes
of the mind.

Secondary Code: b160, Thought Functions

 ● Specific mental functions related to the ideational component of the mind.

Activities and Participation

Primary Code: d720, Complex Interpersonal Interactions
● Maintaining and managing interactions with other people, in a contextually and socially
appropriate manner, such as by regulating emotions and impulses, controlling verbal and physical
aggression, acting independently in social interactions, and acting in accordance with social rules
and conventions, when for example playing, studying or working with others.

Secondary Code: d7200, Forming Relationships

● Beginning and maintaining interactions with others for a short or long period of time, in a
contextually and socially appropriate manner, such as by introducing oneself, finding and
establishing friendships and professional relationships, starting a relationship that may become
permanent, romantic or intimate.

Memory Functions
Primary Code: b144, Mental Functions
● Specific mental functions of registering and storing information and retrieving it as needed.

Secondary Code: b1442, Retrieval and Processing Memory

● Specific mental functions of recalling information stored in long-term memory and bringing it
into awareness.

PROVIDE THE ENTIRE DEFINITION OF YOUR OUTCOME

VII. ​Treatment Objectives for Technique
Goal: To improve emotional coping and socialization
● Patient will form a relationship with another person (ICF #d7200) after 2 activity
sessions.
● Patient will regulate their behaviors in a socially appropriate manner (ICF #720) after all
5 coping sessions.

VIII. Facilitation Process - ​This is the first of five sessions that will take place over the next five
weeks. There will be one, thirty to forty five minute session per week.
1. Have participants sit in a chair at the table.
2. Pass out one pack of colored pencils, white paper, and black pen to each participant.
3. The objective is for each participant to draw a circle on their paper, section it off for each emotion
they feel, and select a color to color that section that represents the emotion or emotions they are
feeling.
4. First you will show the participants an example of a completed emotion wheel.
5. Explain to the participants how to draw a circle and how big it should be to cover most of the
paper.
6. The participant will section off the circle based on the amount of emotions they are feeling.
 7. The participant should color each section of their circle the color they feel represents their
emotion the best.
8. Each participant will label each emotion section of their circle with their black pen.
9. Once each participant has completed their emotion wheel everyone will share with the group
what they have created.

IX. ​Contraindications and/or Precautions

● Caution colored pencils could be used for self inflicting harm.
● Patients may show lack of interest or low self esteem.
● A small group is required to maintain focus and encourage patients.

X. ​ ariations
V
● Reduce the number of colored pencil choices for those who are indecisive.
● To increase difficulty for older age groups add a section to describe their emotions for each color
in a few sentences.
● To decrease difficulty and decision making have a list of color and emotion examples to choose
from, instead of them coming up with colors and emotions on their own.

XI. ​ rocessing Questions

P
1. What are some of the emotions you listed on your emotion wheel?
2. Why did you choose the color you did for each emotion?
3. Please tell me about a time in your life you experienced a happy emotion with your parent that is
deployed?
4. Discuss something you learned about your emotions from completing this activity?
5. What is one way you can cope or deal with one of the emotions on your wheel?

XII. Evidence-Based Abstract

Blomdohl, C, et al. (2013, July). A realist review of art therapy for clients with depression. ​The
Arts in Psychotherapy. ​Vol. 40, issue 3. Retrieved from
https://www-sciencedirect-com.jproxy.lib.ecu.edu/science/article/pii/S0197455613001123
A study was conducted by the Swedish Council of Technology Assessment in Health Care to
determine if art therapy is an effective treatment option for individuals with depression. Adults
who had depression ranging from age eighteen to sixty-four were studied. The study identifed
eight different therapeutic domains that can be utilized through the use art therapy in the
treatment of depression: self-exploration, self-expression, communication, understanding and
explanation, integration, symbolic thinking, creativity, sensory stimulation, and clinical
application. All of the therapeutic factors just listed line up with ICF’s definition of depression.
All of the individuals participating in this study benefitted in at least one of the domains. In
review, this study demonstrated the benefits of art therapy to individuals who have depression.
XIII. Resources/ References for Activity
Nan, J., & Ho, R. (2017, August). Effects of clay art therapy on adults outpatients with major
depressive disorder: A randomized controlled trial. Retrieved from
https://www-sciencedirect-com.jproxy.lib.ecu.edu/science/article/pii/S016503271630448
7
Blomdahl, C., Gunnarsson, B. A., Guregård, S., Rusner, M., Wijk, H., & Björklund, A. (2016).
Art therapy for patients with depression: Expert opinions on its main aspects for clinical
practice. ​Journal of Mental Health,​ ​25​(6), 527-535. doi:10.1080/09638237.2016.1207226

Irimia R, Gottschling M (2016). Biodiversity Data Journal 4: E7720.

http://doi.org/10.3897/BDJ.4.e7720.​ (2015). ​Europian Psychiatry, 30, ​1324.
doi:10.3897/bdj.4.e7730

XIV. Submitted by: Ryan Kesler Norton and Catherine Blalock