RT Program Plan

RT Program Plan
Name(s): Britney Huynh
Program Name: Gratitude Garden
Description of Program should comprise a 4-6 sentence summary that addresses the following two
points below:
1. A general overview of the program.
2. Describe how the overall program will enhance the opportunity to reach goals and objectives.
This program will consist of 4 sessions of at least 20 minutes. In these sessions, participant(s) will engage
in expressive arts tasks to promote positive coping and connectivity to social support. Participants will
create paper flowers, where participants will write positive affirmations/thoughts/memories/etc. for
themselves, their social support, other BMT patients, and supporting staff. The first session, participants
will utilize water colors to paint their “flowers” on paper. Second session, we will create flowers with
paper. Third and fourth session, participants will write their messages to themselves and others. This
task can provide positive emotions, based on current research, positive coping skills/mechanisms
significantly improve the recovery of transplant patients.
(____/3 points)
Target Population/Clientele (*Population, *Age, *Diagnosis; i.e. Adolescents, ages 12-16, with Autism
Spectrum Disorder):
Bone Marrow Transplant patients, 5 & up
(____/3 points)
Credentials (what certifications and/or training must the CTRS and/or volunteers/interns have to
successfully facilitate program/session):
CTRS must have first aid, CPR and AED training with the basic understanding of the movements.
(____/1 point)
Referral Criteria: Provide examples of what the referring professional (physician, OT, PT, Psychiatrist,
etc.) would need to see (e.g. symptoms, deficits/needs, strengths) in the client to refer individuals to
your program/intervention.
● Feelings of disconnect with family/friends

● Physician referral of legacy/end-of-life care
● Interest in gardening/outdoors
● Interest in expressive arts/arts & crafts
(____/2 points)
Goals & Objectives: Provide two goals and two objectives per goal for the intervention. Objectives must
contain conditions (circumstances under which the objective is intended to be achieved), behavior
(measurable action to be performed), and criteria (measurable indicator of goal achievement).
● G1: Promote feelings of connectedness to social support

o O1: Upon request, pt will identify at least 2 people in their social support.
o O2: By the 4th session, participants will create 4 positive flowers for individuals she has
identified
● G2: Promote positive emotions/feelings of hopefulness

o O1: At the end of each session, pt will verbalize 1 thought/feeling about the session
o O2: By end of the program, pt will identify and write at least 1 positive
characteristics/memory/affirmations for each person they have identified.
(____/6 Points)
Evidence-Based References: 20 points total - 10 points for each of 2 peer reviewed research articles not
dated before 2011.
1. 2 points-APA in-text citation (1 point) and full reference (1 point) per summary
2. The following sections to be addressed within a 4-6 sentence paragraph:
a. 3 points-Research Findings Summary
b. 3 points-Population Match (includes severity, age, etc.)
c. 2 points-RT Intervention Match
Liang, Y., Wang, H., Niu, M., Zhu, X., Cai, J., & Wang, X. (2019). Longitudinal analysis of the
relationships between social support and health-related quality of life in hematopoietic
stem cell transplant recipients. Cancer Nursing 42 (3), 251-257. DOI:
10.1097/NCC.0000000000000616
● In this article, researchers studied the connection between health-related quality of life
(QoL) and social support in 122 hematopoietic stem cell transplant patients. Health-
related QoL focuses on physical, psychological, and social domains and their overall
wellbeing. There is a correlation between high social support and higher QoL, similarly
with lower QoL and lower social support. It was found that the first 6 months post-
transplant is essential for their care. It is noted that social support is subjective to
perception and visible/practical support. (Liang, Wang, Nui, Zhu, Cai, & Wang, 2019)
Mische Lawson, L., Chau, J. & Schoel, A. (2016). Thematic analysis of tiles painted by blood
and marrow transplant patients during treatment. European Journal of Cancer Care 25
(6), 1044– 1055. DOI: 10.1111/ecc.12328
● In this journal, researchers focused on thematic analysis of tiles images of BMT patients
to allow patients to have an outlet to express emotions, promote positive thinking, and a
sense of control. Thematic analysis is a “novel qualitative approach that can enhance
knowledge of the experience of illness”. Based on seventy-one tiles faith, hope, positive
attitude, nature, and social support were the top five themes. This study is based on a
program specifically for BMT patients called “Tiles of Hope”, retrospectively studied
from fall 2009 to February 2012. The purpose of this study was to better understand the
perception of patients regarding their experience through their diagnosis/treatment
through expressive arts. The article emphasizes the benefits of art therapy to increase
coping, positive thinking, and QoL. (Mische Lawson, Chau, & Schoel, 2016)
Molassiotis, A., Van den Akker, O.B.A., Milligan D.W., and Goldman J.M. (1997). Symptom
distress, coping style and biological variables as predictors of survival after bone marrow
transplantation. Journal of Psychosomatic Research 42(3), 275-285. DOI: 10.1016/S0022-
3999(96)00298-X
● This article studied 31 patients post-transplant (1-2 years) assessing factors that correlate
with survival. A theory of psychological perception and personality characteristics can
indirectly impact the immune system’s function and/or other behaviors that can impact
the immune system. It was found those with short survival were associated with less
hopefulness and more acceptance of the situation. The article emphasizes the importance
of coping strategies and altering high-symptom distress increases psychological
adjustments and survival. (Molassiotis, Van den Akker, Milligan, & Goldman, 1997)
(____/20 points)
Recommended Length/Frequency/Duration of the Program: Identify the conditions and measures for
treatment by listing the following: length of time for the activities in the program (30/60/90+ minutes);
frequency of the program (1/2/3+ times per day/week/month); and the duration of the program needed
to see results (3/5/6/12+ weeks or until goals are met). Refer to EBP, provide in-text citation (1 point per
each measure)
Length of time for each activity: 30 minutes

Frequency of the activity in the Program: 1-2 times a week (Mische Lawson, Chau, & Schoel, 2016)
Duration for goal achievement: 2- 4 weeks or until discharge (Mische Lawson, Chau, & Schoel, 2016)
(____/3 points)
Entrance Criteria (pre-requisite skills that client will need (at minimum) to participate in the program):
Provide a list of essential pre-requisite skills that a client will need (at minimum) to participate in
program. No more than four (Refer to domains on Activity Analysis form).
1. Fine motor skills control

2. Able to paint
3. Able to express gratitude
4. Able to write
(____/4 points)
Evaluation Measures: Identify how you will measure the success of the activity/program/intervention.
Must include the following criteria: (1) how is success measured (e.g., client goals are achieved, no
injuries, etc.); (2) identify, by name, specific assessment tools or measure to use for evaluation; (3)
methods for measurement (when & how the tools are used). 3 points (1 point per criteria)
Measure of success: goals are achieved
Tools for measurement: The Gratitude Questionnaire-Six Item Form (gq-6) (McCullough, 2002)
Methods for measurement: Beginning and End of program
(_____/3 points)
References (those used for EBP, but also any that informed the content and/or facilitation plan for the
program): List all resources used to research and complete this Activity Protocol. This list must be in APA
7th edition format, Times New Roman, 12-point font with proper indentation (unless otherwise
specified by instructor). See APA 7th manual and UNCW Writing Services, if additional assistance is
needed. 5 points (1/2 credit for listing resources and ½ credit for proper style)
10.1097/NCC.0000000000000616
McCullough, M. E. (2002). The Gratitude Questionnaire (GQ-6). [data set] Great good science
center - University of California Berkeley.
https://ggsc.berkeley.edu/images/uploads/The_Gratitude_Questionnaire.pdf
(6), 1044– 1055. DOI: 10.1111/ecc.12328
transplantation. Journal of Psychosomatic Research 42(3), 275-285. DOI:
10.1016/S0022-3999(96)00298-X
(_____/5 points)
____/50 Points
RT Treatment Protocol
Facilitator(s): Britney Huynh
Session Name: Painting garden
Description of session should comprise a 4-6 sentence summary that addresses the following two
points below:
1. A general overview of content for this session that will be included in the order that it will be
conducted
2. Reiterate how the content planned in this session will enhance opportunity to reach goals and
objectives
In this session, participants will utilize painting to initiate expressive arts tasks. This session is the first of
four to start the art aspect of making flowers. They will choose their color scheme to add personal
touches and sense of control. Though they cannot control the flow of the water, they can control the
general direction with brush strokes. This can be related to treatment, they do not have control over
their symptomology or outcomes, however they can control their physical and emotional engagement
that can indirectly affect their perception during treatment.
(____/3 points)
Equipment/Resources Needed for Session (attach additional resources if applicable; i.e. pictures,
cards, worksheets, PowerPoint(s), etc.):
1. Watercolor paper/sketch paper (any size, preferably thin paper)

2. Water colors
3. Water in a cup (one for each person)
4. Paint brushes
5. Paper towels
6. Painter tape
(____/2 points)
Recommended Space: Identify the type of environment/space needed to perform the session (e.g.,
indoor/outdoor area; kitchen; multipurpose room; gymnasium; basketball court; hard/flat surfaces;
carpeted area; etc.).
H-VAC room on unit. Can be done in patient’s room or in recreational therapy room (Must have table
and chairs)
(____/1 point)
Step-by-Step Session Process

Housekeeping
Gather all materials needed for the session.

If in a recreational therapy room, prepare/clean surfaces prior to the arrival of participants. Ensure there
are enough chairs for all participants and RT(s).
Opening
Safety: Everyone uses hand sanitizer as they are coming into the room.
“Thank you all for joining! This is the first session of many to create flowers for ourselves and those who
are supporting you during your admission. In this session we are preparing our flower petals by utilizing
water colors to add your own personal touch.”
Experience
Pass out 4 sheets of watercolor paper to each participant.

(COVID precautions) Allow each participant to have their own watercolor set and brushes
“I have set out materials for you (all) to use. I am excited to see what color choices you decide. I would
plan to utilize the entire sheet of paper to optimize the space you have. The water will flow freely, as
you get to control the color choices and general placement. Similarly to the treatment process, it will
run its course but you have control over intake of your physical, emotional, and social well-being such as
coping mechanisms, physical activity, and other things to structure your days.”
Using painter’s tape, tape to table leaving ½ in border to prevent curling of page.
Ensure participants are utilizing green for the stems, once they finish, roll up the page (green on the
outside) to make them into the proper shape.
Allow patient(s) to freely paint. Allow conversations to discuss motivators and how treatment is going.
(Group) Allow patients to connect and support one another.
*Move finished pages as needed to add room, continuing to have it taped to table/other surface to dry*
Can showcase creations if desired
Closing/debrief
Can hold on to pages to store in office or patients can keep in their room
“Thank you for joining and participating, you have made such beautiful art and I am excited to see how
this will turn out. Next session, we will plan to turn these papers into flowers. Until then I hope you (all)
have a great day.”
(_____/20 points)
RISK MANAGEMENT: Identify all potential risks associated with the activity planned for this session.
List all potential risks within each domain of functioning (physical, cognitive, social, emotional,
environmental, spiritual) then identify a preventative action (a way this identified risk can be
minimized, eliminated or managed), which corresponds with the identified risk. If no risk is identified
in a domain area, write “currently, no foreseeable risk(s) in this domain” in each box (Identified Risk &
Preventative Action(s)). 12 points (1 point per box).
Domain Identified Risks Preventative Actions for Identified Risks

Physical 1. Nausea 1. Be aware of signs or
verbalization of needing to
2. Fatigue
throw up. Have a trash can or
3. Orthostatic bag nearby
4. Bleeding precautions 2. Allow for shorter sessions

through creating 1-2 flowers. Or
5. Cut try another day. Or can compete
6. Tremors in their room, sitting in a
comfortable position.
3. Allow patients to remain seated

and be aware of their needs. Call
nursing staff as needed
4. Ensure patients are cautious of

cutting themselves
5. If they do cut themselves, alert

nursing staff immediately
6. Validate that it should not affect

painting, as water will flow as it
naturally does.
Cognitive 1. Chemo brain 1. Provide validation and assist as

needed to process/think. If
unable to recall, provide a
change of direction or come back
to it later.
Social 1. Unable/difficulties to talk 1. Asking yes or no questions. Or
(mucositis) simple questions.
2. (Group) unable/difficulties to 2. Facilitate conversations and cue

discuss with others individual to discuss what they
are comfortable with
3. (Group) uncomfortable with
new people 3. Have participants introduce
themselves and (if comfortable)
talk about their diagnosis or
treatment course.
Emotional 1. Upset/emotional 1. Provide active listening,

emotional support, and provide
education on why this activity
can be beneficial to process
thoughts/emotions
Environmental 1. Cleanliness/Hygiene 1. Ensure patients are
washing/sanitizing hands before
2. Smells (from paint)
and after the session. Clean all
materials (scissors and writing
utensils) and surfaces before and
after the session as well
2. Can cause nausea, discuss if any

nausea were to arise, tell RT as
soon as possible to remove smell
and reassess the situation.
Spiritual 1. Currently, no foreseeable risk(s) 1. Currently, no foreseeable risk(s)

in this domain in this domain
Potential Modifications/Back up plan - 7 points
Time-What you will do if you have less or more time than planned. 2 points
Space considerations-Alternatives if plans change (weather or scheduling). 1 point
Number of participants attending-What you will do if there are less or more participants as planned. 2
points
Complexity-What you will do if participants are lower or higher functioning as planned. Provide
alternative 2-3 alternative activities with a brief description in the event you are unable to conduct your
activity. 2 points
Time:
● More time:
○ Patients can continue to create as many water color art as tolerated.
○ If art is dried, start folding paper
■ Rose: (MASS art and craft, 2020)
● Taking a piece on construction paper of preferred color, draw a large
spiral on the entire page. Taking a pair of scissors, cut along the spiral.
Starting from the outer edge, roll the paper inwards till you get to the
center. Glue the end when it’s completely rolled.
■ Poppy: (MASS art and craft, 2020)
● Taking a piece on construction paper of preferred color, cut 3 circles (all
the same size, preferably small ~6cm). Fold each into 4ths (half, and half
again). Opening one half (leaving half a circle), place all on top of each
other. Staple the center and glue the outer side of each petal together.
● To add a leaf at the bottom, cut a 2 finger width and 4 finger length
green paper, fold in half, and cut a leaf shape. Open up the leaf and glue
it to the bottom of the flower
■ Lavender: (MASS art and craft, 2020)
● Taking a piece on construction paper of preferred color, cut in half to
create 2 long strips. Taking one of the strips, fold in half hotdog style.
Cut the folded edge about 1 cm apart towards open edges, leaving
about an inch of uncut space. Open folded paper, fold the other way,
and glue to uncut edges together. Take a green paper, roll it into a thin
stem. Glue one side of the uncut edge and roll around the stem starting
from the top to a downward spiral.
■ Sunflower: (MASS art and craft, 2020)
● Taking a piece on construction paper of preferred color, cut into a
square and fold accordion style. Fold in half, stapling enter, and cut the
ends to make a petal shape. Repeat with the same color paper. Glue
petals together to create a fan. Cut a small brown circle for the center
and glue.
■ Orchid: (MASS art and craft, 2020)
● Taking a piece on construction paper of preferred color. Cut to a large
square, fold one corner to the opposite (creating a triangle), and repeat
2 more times. Along the folded edge, create a flower petal/teardrop
shape and cut along the line. Open up the flower, leaving it in half, cut ½
in down each petal to further separate. Fully open flower, cut off one
petal. Glue one petal on top of the other, where there is a missing petal.
Taking a pen/pencil/other roll edges of petals.
● Less time:
○ RT can provide materials to continue painting for their free time.
○ Provide additional time next session.
Space:
● Can be completed in room, if patients do not have the energy/is not agreeable to be in a
different location.
Number of participants:
● Can be done with single participants or in a group.

● COVID: Groups must be no more than 3 patients.
Complexity:
● Having a variety of paint brushes (thickness) to aide with physical needs
● Large pieces of paper to provide more room to paint
(____/ 7 points)
session): List all resources used to research and complete this Activity Protocol. This list must be in APA
7th edition format, Times New Roman, 12-point font with proper indentation (unless otherwise specified
by instructor). See APA 7th manual and UNCW Writing Services, if additional assistance is needed. 5
points (1/2 credit for listing resources and ½ credit for proper style)
10.1097/NCC.0000000000000616
MASS art and craft. (2020, March 13). 23 easy ideas of small paper flower [Video file].
YouTube. https://www.youtube.com/watch?v=vJDyrSHxmhA
(6), 1044– 1055. DOI: 10.1111/ecc.12328
10.1016/S0022-3999(96)00298-X
(_____/5 points)
____/50 Points
Session Name:
points below:
conducted
objectives
In this session, participants will take painted paper from the previous session to fold/cut into flowers.
Many patients have described gardening as a preferred leisure task and due to the nature of treatment,
flowers and dirt are not allowed to be in the unit due to spores and other particles that can affect their
nonexistent/weakened immune system. This will promote coping with their preferred leisure task and
add some sense of normalcy to their day. Through guidance of folding/cutting, they can add personal
touches for those who they are dedicating it to.
(____/3 points)
Equipment/Resources Needed for Session (attach additional resources if applicable; i.e. pictures, c
1. Painted papers from last session

2. Scissors (for each person)
3. Glue (for each person)
4. Stapler
5. Pens/pencils/markers
(____/2 points)
and chairs)
(____/1 point)

Housekeeping

If in a recreational therapy room, prepare/clean surfaces prior to arrival of participants. Ensure there are
enough chairs for all participants and RT(s).
Have examples of flowers prepared
Opening
“Thank you all for joining again! Last session, you (all) painted paper in preparation for today, where we
will be turning them into flowers. I have provided examples of the flowers we will be making, if any one
has a preference on which they would like to do first please feel free to let me know.”
Experience
Rose: (MASS art and craft, 2020)

Taking a piece on construction paper of preferred color, draw a large spiral on the entire page. Taking a
pair of scissors, cut along the spiral. Starting from the outer edge, roll the paper inwards till you get to
the center. Glue the end when it’s completely rolled.
Poppy: (MASS art and craft, 2020)

Taking a piece on construction paper of preferred color, cut 3 circles (all the same size, preferably small
~6cm). Fold each into 4ths (half, and half again). Opening one half (leaving half a circle), place all on top
of each other. Staple the center and glue the outer side of each petal together.
● To add a leaf at the bottom, cut a 2 finger width and 4 finger length green paper, fold in half,
and cut a leaf shape. Open up the leaf and glue it to the bottom of the flower
Lavender: (MASS art and craft, 2020)

Taking a piece on construction paper of preferred color, cut in half to create 2 long strips. Taking one of
the strips, fold in half hotdog style. Cut the folded edge about 1 cm apart towards open edges, leaving
about an inch of uncut space. Open folded paper, fold the other way, and glue to uncut edges together.
Take a green paper, roll it into a thin stem. Glue one side of the uncut edge and roll around the stem
starting from the top to a downward spiral.
Sunflower: (MASS art and craft, 2020)

Taking a piece on construction paper of preferred color, cut into a square and fold accordion style. Fold
in half, stapling enter, and cut the ends to make a petal shape. Repeat with the same color paper. Glue
petals together to create a fan. Cut a small brown circle for the center and glue.
Orchid: (MASS art and craft, 2020)

Taking a piece on construction paper of preferred color. Cut to a large square, fold one corner to the
opposite (creating a triangle), and repeat 2 more times. Along the folded edge, create a flower
petal/teardrop shape and cut along the line. Open up the flower, leaving it in half, cut ½ in down each
petal to further separate. Fully open flower, cut off one petal. Glue one petal on top of the other, where
there is a missing petal. Taking a pen/pencil/other roll edges of petals.
Stem:
Take a green piece of paper, roll it into a stem, and glue flowers on top. Cut and add leaves as desired.
Putting it together:
On the back of the flower, put glue in the center and place one end of the stem on it. Press if needed
and leave to dry.
Have everyone showcase their creations.
Closing/debrief
Can hold on to pages to store in office or patients can keep in their room
“Thank you for joining and participating, you have made such beautiful flowers today. Next 2 sessions,
we will be writing messages to ourselves,those who are supporting you, including friends/family and
staff, and other patients who are going through a similar process as you. You can start thinking of ideas
of who to write to or what you would like to write in preparation but not required. ”
(_____/20 points)

2. Fatigue



cutting themselves

6. Proceed with caution. If needed,

assist with cutting to prevent
bleeding.

to it later.

treatment course.

thoughts/emotions
Spiritual 1. Currently, no foreseeable risk(s) 1. Currently, no foreseeable risk(s)

in this domain in this domain

points
activity. 2 points
Time:
● More time:
○ Patients can continue to create as many flowers as tolerated, and can use construction
paper if all previous paper has been used.
● Less time:
○ RT can provide materials to continue flower making and instructions for their free time.
Space:
different location.

Complexity:
● Have a variety of flower making step-by-steps prepared (DIY paper artist#RD#, 2013)
○ Taking a square, fold triangles x2. Cut a teardrop shape and open.
○ Taking a square, fold triangle x3. Cut a triangle shape and open.
○ Cut a thin strip of green for the stem.
(____/ 7 points)
DIY paper artist#RD#. (2018, January 13). DIY- paper craft flower garden making: How to
make paper flower garden easy. [Video file]. YouTube. https://www.youtube.com/watch?
v=56U2_Ufbo_k
10.1097/NCC.0000000000000616
MASS art and craft. (2020, March 13). 23 easy ideas of small paper flower [Video file].
YouTube. https://www.youtube.com/watch?v=vJDyrSHxmhA
(6), 1044– 1055. DOI: 10.1111/ecc.12328
10.1016/S0022-3999(96)00298-X
(_____/5 points)
____/50 Points
Session Name:
points below:
conducted
objectives
This session is part 3 of 4. Participants will take their flowers they made in the previous session to write
notes for themselves to provide motivation/hope and to their social support to promote connectivity
and gratitude for them. They can write quotes, memories, messages, or anything they desire/feel
appropriate to reach those goals. They will write them on tags and tie them to the flowers. They can
keep the flower for themselves for motivation for the remainder of admission and can hold on to/give
the flower to their preferred person when desired.
(____/3 points)
1. Construction paper
3. Sharpie/Markers/Pencil/Pen (variety)
4. String
5. Hole puncher
(____/2 points)
and chairs)
(____/1 point)
Housekeeping

Opening
“Thank you all for joining once again! Last session, we got to make our flowers. Today with these
flowers, you can write words of appreciation/affirmations to yourself to provide hope and to your social
network (family, friends, others) to feel more connected with them.”
Experience
“Who in your life are you dedicating the flowers to?”

“What messages are you writing to yourself?”
Note:
Cut a piece of paper into a tag shape (if desired) square cutting off two corners.
“Here is where you will write your message, it can be anything you wish to write: a quote, phrase, or a
message”
Cut a hole at the top with hole puncher and tie on to stem with string
Have everyone share their messages, if comfortable
Closing/debrief
“Thank you for joining and participating, you have made such beautiful flowers with amazing words.
These flowers you can keep in your room to provide motivation to yourself and share them with your
desired person for when you discharge, if they visit, or if a visitor can take it to them for you.”
(_____/20 points)
2. Fatigue



cutting themselves

6. Assist with writing if needed. Can

use short messages

to it later.

treatment course.

thoughts/emotions

Spiritual 1. Identified religious figure(s) 1. Patients can write flowers for

religious figures as prayer/for
2. Wants to write religious
hopefulness
message
2. Cue patients to be aware of
different people’s beliefs
points
activity. 2 points
Time:
● More time:
○ Patients can continue to create as many flowers as tolerated.
○ Patients can identify another person in their social support to create flowers.
● Less time:
○ RT can provide materials to continue flower making/writing for their free time.
Space:
different location.

Complexity:
● Provide prompts to assist with writing
○ “Thank you for what you do” (social support)
○ “I appreciate what you do for me” (social support)
○ “You got this” (self)
○ etc.
(____/ 7 points)
10.1097/NCC.0000000000000616
(6), 1044– 1055. DOI: 10.1111/ecc.12328
10.1016/S0022-3999(96)00298-X
(_____/5 points)
____/50 Points
Session Name:
points below:
conducted
objectives
This session is the final session. Participants will take their flowers they made in a previous session to
write notes for other BMT patients to provide motivation/hope/connection and to general/specific
health care providers to promote connectivity and gratitude for them. They can write quotes, memories,
messages, or anything they desire/feel appropriate to reach those goals. They will write them on tags
and tie them to the flowers.
(____/3 points)
1. Construction paper
3. Sharpie/Markers/Pencil/Pen (variety)
4. String
5. Hole puncher
(____/2 points)
and chairs)
(____/1 point)
Housekeeping

Opening
“Thank you all for joining once again! Last session, we got to take the flowers and write messages to
yourself and those who are supporting you. Today with these flowers, you can write words of
appreciation/affirmations to the staff who have been with you during this process and other BMT
patients to let them know they are not alone.”
Experience
“Is there someone specific you are writing to (staff)?”

“What messages are you writing to yourself?”
Note:
Cut a piece of paper into a tag shape (if desired) square cutting off two corners.
“Here is where you will write your message, it can be anything you wish to write: a quote, phrase, or a
message”
Cut a hole at the top with hole puncher and tie on to stem with string
Have everyone share their messages, if comfortable
Closing/debrief
“Thank you for joining and participating, you have made such beautiful flowers with amazing words, I
will take these flowers and place them somewhere in the unit or pass them out to other patients.
(_____/20 points)

2. Fatigue



cutting themselves

6. Assist with writing if needed. Can

use short messages
to it later.


treatment course.
thoughts/emotions
Spiritual 1. Identified religious figure(s) 1. Patients can write flowers for

religious figures as prayer/for
2. Wants to write religious
hopefulness
message
2. Cue patients to be aware of
different people’s beliefs
points
activity. 2 points
Time:
● More time:
○ Patients can identify another person in their social support to create flowers.
● Less time:
○ RT can provide materials to continue flower writing in their free time.
Space:
different location.

Complexity:
● Provide prompts to aide with writing messages

○ Can use generic phrases
○ Staff “thank you for being there”, “thank you for the work that you do”, etc.
○ BMT patient “I believe in you” “ you got this” “you can get through this” etc.
(____/ 7 points)
10.1097/NCC.0000000000000616
(6), 1044– 1055. DOI: 10.1111/ecc.12328
10.1016/S0022-3999(96)00298-X
(_____/5 points)
____/50 Points

RT Program Plan

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RT Program Plan

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RT Program Plan

Name(s): Britney Huynh

Program Name: Gratitude Garden

1. A general overview of the program.

Bone Marrow Transplant patients, 5 & up

● Feelings of disconnect with family/friends

● G1: Promote feelings of connectedness to social support

● G2: Promote positive emotions/feelings of hopefulness

Length of time for each activity: 30 minutes

1. Fine motor skills control

Measure of success: goals are achieved

1. Watercolor paper/sketch paper (any size, preferably thin paper)

Step-by-Step Session Process

Gather all materials needed for the session.

Pass out 4 sheets of watercolor paper to each participant.

(Group) Allow patients to connect and support one another.

Domain Identified Risks Preventative Actions for Identified Risks

4. Bleeding precautions 2. Allow for shorter sessions

3. Allow patients to remain seated

4. Ensure patients are cautious of

5. If they do cut themselves, alert

6. Validate that it should not affect

Cognitive 1. Chemo brain 1. Provide validation and assist as

2. (Group) unable/difficulties to 2. Facilitate conversations and cue

Emotional 1. Upset/emotional 1. Provide active listening,

2. Can cause nausea, discuss if any

Spiritual 1. Currently, no foreseeable risk(s) 1. Currently, no foreseeable risk(s)

Potential Modifications/Back up plan - 7 points

Space considerations-Alternatives if plans change (weather or scheduling). 1 point

● Can be done with single participants or in a group.

1. Painted papers from last session

Step-by-Step Session Process

Gather all materials needed for the session.

Rose: (MASS art and craft, 2020)

Poppy: (MASS art and craft, 2020)

Lavender: (MASS art and craft, 2020)

Sunflower: (MASS art and craft, 2020)

Orchid: (MASS art and craft, 2020)

Have everyone showcase their creations.

Domain Identified Risks Preventative Actions for Identified Risks

Physical 1. Nausea 1. Be aware of signs or

4. Bleeding precautions 2. Allow for shorter sessions

3. Allow patients to remain seated

4. Ensure patients are cautious of

5. If they do cut themselves, alert

6. Proceed with caution. If needed,

Cognitive 1. Chemo brain 1. Provide validation and assist as

2. (Group) unable/difficulties to 2. Facilitate conversations and cue

Emotional 1. Upset/emotional 1. Provide active listening,

Spiritual 1. Currently, no foreseeable risk(s) 1. Currently, no foreseeable risk(s)

Potential Modifications/Back up plan - 7 points

Space considerations-Alternatives if plans change (weather or scheduling). 1 point

● Can be done with single participants or in a group.

Gather all materials needed for the session.

“Who in your life are you dedicating the flowers to?”

Have everyone share their messages, if comfortable

4. Bleeding precautions 2. Allow for shorter sessions

3. Allow patients to remain seated

4. Ensure patients are cautious of

5. If they do cut themselves, alert

6. Assist with writing if needed. Can

Cognitive 1. Chemo brain 1. Provide validation and assist as

2. (Group) unable/difficulties to 2. Facilitate conversations and cue