WHAT A
CONCEPT
Activity Professionals are presented with new and old
therapeutic modalities on a constant basis. Each therapeutic intervention is
designed to enhance the quality of life for the client. Today there are a
variety of therapies such as pet therapy, music therapy, aromatherapy and
validation therapy. Each one is well known and used by activity professionals
throughout the nation however, there is an under utilized therapeutic technique
which is referred to as remotivation therapy that provides a wonderful
opportunity for one to explore.
Remotivation therapy WAS defined by the National
Remotivation Therapy Org. Inc. (N.R.T.O.) as “Remotivation is a small group
therapeutic modality in nature, designed to help clients by promoting
self-esteem, awareness and socialization.” (1) Those who facilitate these groups
are referred to as Remotivation therapists. The N.R.T.O. Inc defines a
Remotivation therapist as one who “used with a group of clients in an effort to
reach the “unwounded” areas of each patient’s personality and to get them to
thinking about reality in relation to themselves. Remotivation differs from
other therapies because it focuses on the patient’s abilities rather than on
their disabilities. The major endeavor is to discuss and develop the patient’s
healthy aspect no matter how repressed they maybe.”
(2) The beauty of Remotivation therapy is that anyone can
do this therapeutic intervention.This modality occurs in Long term Care,
Assisted Living and Adult Day Care settings which can be provided by Social
Workers , nurses, chaplains and volunteers. Our clients deal with an
interdisciplinary team when it comes to their care. If this technique is used
it will enhance the quality of life for the clients.
Remotivation therapy is provided in a one to one or in
a small group setting. Considering that we have a diverse set of clients in LTC
it benefits those who have dementia, need more sensory stimulation and are
independent, also clients who are physically and cognitively able to participate
but choose not to or choose to do so. Remotivation therapy is a tool that can
reach non responsive individuals. This tool aids others with their
resocialization skills. According to the Handbook of Remotivation therapy it
states it “validates the residents world of non-reality.” (3) This same
technique will assist the client in maintaining or improving his physical and
cognitive abilities. Then the client will become more independent. A Remotivation therapy session is designed to create
fun. The session consists of five structured steps.
 STEP I Climate of Acceptance: the therapist greets
each member of the group. The facilitator says something positive to each
person.
STEP II The Bridge to the Real World: In this step,
the facilitator utilizes bounce questions to lead the group to the topic for the
day.
STEP III Sharing the world We Live In: this is where
a discussion on the topic is held in the everyday world
STEP IV An Appreciation of the Work of the World: In
this step, a discussion is held on the work aspect of the topic
STEP V Climate of Appreciation: The facilitator
individually thanks the clients for attending his/her session. The next meeting
is announced.
The Remotivation therapist creates an environment
where the client feels safe. In this environment whatever the client says is
accepted by the Remotivation therapist in a non-judgmental manner. Thereby a
trusting relationship is established between the client and the Remotivation
therapist. The Remotivation therapist accepts and appreciated what the client
provides. It could be actively participating in the session or reaming silent
throughout the session. It is the gift of their presence that the Remotivation
therapist acknowledges.
Introduction to Remotivation - 50% OFF |
 This 60 minute introductory inservice is designed to assist the Recreation/Activity Director, or Staff Educator in providing an overview of Remotivation as utilized with older adults and elders. This inservice comes with a handout, teacher's outline, certificate of attendance, inservice sign in sheet, flyer to announce the inservice, an interactive exercise, and an inservice evaluation form. Participants will be able to:
*define Remotivation.
*state at least 4 benefits of Remotivation.
*describe the 5 stages of Remotivation.
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Remotivation therapy is a wonderful tool to use for
the clients. It is a five step process that deals with the client’s unwounded
part of the brain. The clients do not dwell on the emotional aspect of the topic
because it is objective in nature. As the sessions progress, one will see the
change in the client. Today, I utilize Remotivation therapy in all of my
programs in my facility. This increases their self-esteem and socialization,
which provides the opportunity for the individual to focus on something other
than their illness. After a few sessions the clients are more social and
talkative. Remotivation therapy is a wonderful tool which Activity
professionals would benefit from using because it would enhance the quality of
life of our clients.
TAKING IT IN
STEPS
In these Remotivation therapy sessions the facilitator asks
questions which is related to the topic at hand. The topic is determined by the
Remotivational therapist. One question leads to another which is referred to as
bounce questions. The Remotivational therapist also uses visual and audio cues
during the session. If the clients are suffering with cognition deficits or
A.D. there needs to be more visual cues. The facilitator creates an environment
where the clients feel safe. In this environment whatever the client says is
accepted by the Remotivational therapist in a non-judge mental manner. Thereby
a trusting relationship is established between the client and the Remotivational
therapist. The Remotivational therapist accepts and appreciates what the client
provides which could be actively participating in the session or remains silent
throughout the session. The gift of their presence is what the Remotivational
therapist acknowledges.
Remotivation therapy is broken into five steps because each one
serves a function for the client and Remotivational therapist. The first step
is referred to as the Climate of Acceptance which is a very important step in
the therapeutic context of the session. The clients are set up in a circle of
8-10 people. In the circle the Remotivational therapist goes around to each
individual to greet the client. While the Remotivational therapist is doing
this, he greets the clients by name. Then the Remotivational therapist
compliments the individual on his/her personal appearance, jewelry or clothing.
It is okay to touch the client in an appropriate way, such as a hand shake or
laying a hand on his shoulder. In so doing, the facilitator is informing the
client that I paid attention to you. It also informs the individual that you
are important and the Remotivational therapist accepts the person for who they
are; including the illness.
The second step is called Bridge to the Real World. In this
step the Remotivational therapist leads the session in a question and answer on
the topic. The topic is normally broad then leads to a specific point.
Normally there are three to four questions in Step II with four possible answers
which the Remotivational therapist writes in advance. This way the answer leads
to the next question. If a client chooses not to reply that is acceptable. Also
the client may not know the answer to the question. If this is the case than
thank the individual and proceed to the next individual asking the same
question. The last question in step II leads into the poem which is objective in
nature. The poem is provided by the National Remotivation Therapy Organization
Inc. When one is certified as a Certified Remotivation therapist , then
programs and poems can be written up by the individual. The poem is read the
clients or the clients can read it aloud to the group. Do not forget to use
visual and audio aids to augment the program. The lower the mental cognition
the more visual and audio clues are better. Once this is accomplished the
Remotivational therapist leads the session into Step III
Step III is called “Sharing the World in Which We Live”. In
this part of the step the Remotivation therapist expands on the topic by asking
8-10 questions about the topic. The questions are not emotionally based but
objective in nature. Each person in the group is asked the same question. The
questions are asked in newspaper format such as: What, when, where, why and how.
During Step III if the group goes on a tangent or a conversation
about the topic that is good. When the group goes off on an tangent it is
sharing their experiences. For example, if the topic is camping. One of the
questions that could be in Step III is “Where does a family go camping?” Each
one in the group replies, a park, the beach or the backyard. Another client
could reply that my family camped backyard one time per month. Then others could
add to the conversation. Eventually the Remotivational therapist brings the
group back to the discussion. However, the Remotivational therapist need not
finish step III because the tangent took care of it. The Remotivational
therapist moves on to step IV.
Step IV is referred to as Appreciation of the Work World. In
this step the questions are related to the Work World and again the questions
are objective in nature. The question begin with the newspaper format such
as: What, when, where, why and how.
When moving from Step III to step IV the Remotivational
therapist asks a transitional question. For example, to use the transitional
question from the previous example about camping. The transitional question
could be how many people have gone camping? The rest of the questions center
around the work of camping. Such as where does one get camping supplies? What
national parks or state parks allow camping? What type of equipment is used for
camping? Again the facilitator prepares 8-10 questions to ask the group. The
same question is asked from everyone. Remember that as the facilitator,
whatever response you receive is okay. If there is no response it is okay.
The last step in the Remotivation therapy session is called
“Climate of Appreciation”. This step is a reverse of step I. In this step the
Remotivational therapist thanks each person individually for attending the
group. Remember, even if the individual does not say a word, choosing to remain
silent throughout the session that is perfectly acceptable. This individual is
giving you the ultimate gift, the gift of his presence in your session that
you’re acknowledging. Inform the group of when the next session occurs and
invite the clients to attend. There is no need to tell them the topic. Also the
facilitator can sum up the topic of the session that was held for the day.
Denise Lima-Laskiewicz, ADC, is the owner of Heal Through
Words, a NJ-based Therapeutic Writing program for Nursing Home and Assisted
Living residents. Contact Denise at healthroughwords@aol.com or esc85@aol.com
*Please note that the National
Remotivation Therapy Organization has dissolved but the remotivation theory is still applicable.
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