Glossary of Recreation Therapy and Occupational Therapy

1. Glossary
of
Recreation
Therapy
and
Occupational
Therapy
✍
David R. Austin

3. Glossary
of
Recreation
Therapy
and
Occupational
Therapy
Venture Publishing, Inc.

4. Copyright © 2001
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Library of Congress Catalogue Card Number 00-111038
ISBN 1-892132-19-2

5. Preface
This glossary of recreation therapy and occupational therapy terms is meant to serve as a study guide
for students and a reference book for practitioners. It may also be a valuable aid to those preparing for
comprehensive examinations, such as national certification exams or graduate school comprehensive
exams.
Recreation therapy and occupational therapy encompass a wide scope of activity. Therefore, I have
attempted to be eclectic in developing the glossary in order to reflect a full range of approaches to these
professions.
I would like to thank my colleagues, Professors Youngkhill Lee, Ph.D., CTRS, and Bryan
McCormick, Ph.D., CTRS, for their thoughtful reviews of the glossary. I would also like to thank Karen
Scott, M.S., OTR, of Bloomington Hospital, for her thorough review of the glossary and Professor
Celestine Hamant, M.S., OTR, SAOTA , of Indiana University, for identifying historical figures in
occupational therapy. While using this glossary, should you have suggestions to improve it please let me
hear from you.
David R. Austin, Ph.D., CTRS, FALS
Indiana University Bloomington
Phone: 812/855-3086
Email: daustin@indiana.edu

7. Glossary of
Recreation Therapy
and Occupational Therapy AA — accessibility
A
AA abscess
Alcoholics Anonymous Localized collection of pus
AAHPERD absence
American Alliance for Health, Physi- Petit mal epilepsy
cal Education, Recreation, and Dance; in
1950s had a Recreation Therapy Section abstinence
Refraining voluntarily from some activ-
AARP ity, such as sexual intercourse; or from a
American Association of Retired Persons substance, such as food or drugs
abasement abulia
Degradation of oneself; excessive compla- Inability to make decisions
cence or accepting punishment
abuse
abasia To misuse, attack or injure physically or
Inability to walk because of a lack of motor psychologically. The most common form
coordination, usually due to psychological is child abuse. Child abuse refers to a child
disturbance who has suffered repeated injuries (includ-
ing bone fractures, neurologic and psy-
abate chologic damage, and sexual abuse) at the
To decrease or reduce in severity or degree hands of a parent or adult
abduction Academy of Leisure Sciences (ALS)
Movement of a body part away from the Prestigious society composed of scholars
midline of the body who have made outstanding contributions
to knowledge about recreation and leisure
aberration
Deviation from what is typical or normal acathexis
Lack of feeling associated with an ordinar-
abnormal
ily emotionally charged subject
Diverging from the normal. The problem
with the term is that it can only be defined accessibility
in relation to what is normal, about which Elements in the built environment (site or
there is often much disagreement building) that allow approach, entrance,
and use of facilities by those with sensory
abrasion
or mobility impairments; having programs
Scraping or rubbing off skin or mucous
open to persons with disabilities
membrane

8. Glossary of
A accommodation — activity therapy
Recreation Therapy
and Occupational Therapy
accommodation acrophobia
Responding to the environment through Abnormal fear (phobia) of heights
new activity or thinking; contrast to Piag-
et’s assimilation acting out
Expression of emotional tension or intra-
accreditation psychic conflict in overt behavior rather
Voluntary process by which standards are than words; usually used to describe
applied to an institution in order to deter- impulsive, aggressive behavior in which
mine if they are met. For example, hospi- the person is not consciously aware of the
tals and health facilities may be accredited meaning of such act
by the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO). action therapies
College and university curricula may be Term to describe action-orientated thera-
accredited by an accrediting body pies such as recreation therapy or thera-
peutic recreation, occupational therapy and
acculturation music therapy; in contrast to “talk therapies”
The processes by which children are social-
ized to learn the behavior patterns of their activities of daily living (ADL)
social group or culture Activities usually performed in the course
of a normal day in a person’s life, such as
acid eating, dressing, bathing, grooming, and
Slang term for lysergic acid diethylamide homemaking
(LSD)
activity analysis
acme Process of systematically appraising what
The highest point; critical stage or crisis behaviors and skills are required for par-
point of a disease ticipation in a given activity
acoustics activity group
The science of sound; characteristics of a Activity in which several individuals par-
room that affect the distinctness with which ticipate
sounds can be heard
activity therapy
acquired immune deficiency syndrome (AIDS) Umbrella term used to describe activity or
Infectious disease that disables the immune action-oriented services including recre-
system. It is caused by the human immuno- ation therapy or therapeutic recreation,
deficiency virus (HIV). When HIV causes occupational therapy and music therapy;
the immune system to fail, a person may usually applied in psychiatric facilities
develop a variety of life-threatening illnesses

9. Glossary of
Recreation Therapy
and Occupational Therapy actualization — ADHD
A
actualization adapted physical education
Realization of one’s full potential Modified physical activity in educational
settings for students with disabilities
acuity
Sharpness; used in relation to the senses adapted recreation
such as visual acuity Term often applied to community-based
recreation programs designed for persons
acupuncture with disabilities
Pain control technique in which fine metal
needles are inserted under the skin at cer- adaptive equipment
tain locations Term related to equipment that enables a
person with a disability to function inde-
acute pendently; the term is being replaced by
Of sudden onset; not chronic the term, assistive devices
ADA addiction
Americans with Disabilities Act Compulsive craving for something; over
dependence on the intake of certain sub-
ADAAG
stances; older term for physiological de-
Americans with Disabilities Act Accessibil-
pendence on a chemical substance
ity Guidelines for Buildings and Facilities
adduction
adaptation
Movement of a body part toward the mid-
Response or adjustment to a stressor; fitting
line of the body
one’s behavior to meet the needs of one’s
environment which may involve a modi- adherence
fication of one’s impulses, emotions or Degree to which clients follow recommen-
attitudes dations of practitioners; also called compli-
ance
adapted activities
Altered activities which fit the needs, ADHD
interests and capabilities of individuals; Attention-Deficit Hyperactivity Disorder
changes may be made in rules or equipment
to accommodate the persons participating
Adapted Child
A transactional analysis ego-state that has
two functions, either conforming or rebel-
ling to what another person wants

10. Glossary of
A adhesion — adventitiously blind
Recreation Therapy
and Occupational Therapy
adhesion individual psychology, inferiority complex,
Scar tissue that connects two surfaces that and overcompensation
normally are separate from each other;
adhesions are sometimes a complication of Administration on Aging (AoA)
surgery Principle U.S. agency to carry out the pro-
visions of the Older Americans Act
adipose
Fatty adolescence
Period from puberty to sexual maturity
adjunct
Additional treatment or procedure used for adrenal
increasing the efficacy of the primary treat- Flattened body above each kidney that
ment or procedure secretes steroid hormones, epinephrine, and
norepinephrine
adjunctive therapy
Somewhat dated term referring to supple- adrenalin
mental treatment; used in hospitals to Hormone secreted by the adrenal glands
categorize disciplines such as recreation (lying over the kidneys) in times of emer-
therapy or therapeutic recreation, occupa- gency or excitement; also called epinephrine
tional therapy, and physical therapy
Adult
adjustment Transactional analysis ego state that is
Individual’s functional alteration or adap- analytical, rational, and nonjudgmental. It
tion to the immediate environment or one’s is the objective part of personality
inner self
adult day care
adjustment disorder Supervised recreation, social, and health
DSM-IV-TR category for maladaptive re- services for older clients with cognitive,
actions to identifiable life events or circum- emotional, or physical impairments; pro-
stances vides respite for regular caregivers
ADL adventitious deafness
Activities of daily living Due to injury of the ear; in contrast to con-
genital deafness due to a defect in develop-
Adler, Alfred ment
(1870-1937) The first of Freud’s major
followers to break away, after disagreeing adventitiously blind
with Freud’s emphasis on the importance Condition of blindness that occurs to
of sexuality. Adler stressed concepts of people who have lost vision at some time
10

11. Glossary of
Recreation Therapy
and Occupational Therapy adventure/challenge therapy — AIDS-Related Complex (ARC)
A
after the first five years of life—the person age appropriateness
usually has some visual memory Activities that correspond with the individ-
ual’s chronological age
adventure/challenge therapy
Treatment technique in which outdoor ageism
recreation activities with elements of actual Word coined by Butler to describe the stig-
or perceived risk are performed by clients matizing effect of society’s past attitudes
who process on their experiences with a toward persons who are elderly
therapist
aggression
advocacy Behavioral act with the goal of doing injury
Working in support of the rights and needs or harm to a person or object
of others; usually used to refer to work-
ing in support of persons who have been agitated
handicapped Condition characterized by purposeless,
restless activity such as pacing. May serve
aerobic to release nervous tension associated with
With oxygen present stress, anxiety, or fear
aerobic exercise agnosia
Exercise that promotes cardiovascular fit- Inability to understand the significance
ness by increasing blood flow, heart rate, of sensory stimuli; inability to recognize
and metabolic demand for oxygen familiar objects or make sense of sensory
information
affect
A person’s feelings, tone or mood; one’s agoraphobia
emotional response Abnormal fear (phobia) of open spaces
afferent agraphia
Moving toward a specific site or reference Loss of the ability to write, resulting from
injury to the language center of the cerebral
aftercare cortex
Posthospitalization program of rehabilita-
tion designed to reinforce the effects of AIDS
therapy and to help clients adjust to their Acquired immune deficiency syndrome
environment; may be provided in ambula-
tory care, home healthcare, or community AIDS-Related Complex (ARC)
health setting Stage in the development of AIDS in which
the immune system begins to falter and
11

12. Glossary of
A Al-Anon — American Association of Retired Persons (AARP)
Recreation Therapy
and Occupational Therapy
some symptoms appear allied health professionals
Specially trained health workers other than
Al-Anon physicians, dentists, podiatrists, and nurses,
Organization of relatives of alcoholics such as recreation therapists, physical
patterned after the structure of Alcoholics therapists, and occupational therapists
Anonymous to facilitate discussion and
resolution of common problems Alzheimer’s disease
Type of dementia in which discrete patches
alcohol dependence (alcoholism) of brain tissue degenerate; causes gradual
Dependence on alcohol characterized by and progressive decline in cognitive func-
either tolerance to the agent or develop- tioning. Named for German neurologist,
ment of withdrawal phenomena on ces- Alois Alzheimer
sation of, or reduction in, intake. Other
aspects involve psychological dependence AMA
and impairment in social or vocational Against medical advice; American Medical
functioning. Association
alcoholics amblyopia
Persons who drink alcohol heavily and are Reduced vision in an eye that does not
addicted to it have an obvious cause. Sometimes termed
“lazy eye”
Alcoholics Anonymous (AA)
Self-help organization of alcoholics that ambulation
uses inspirational/supportive group meth- Walking with or without aids, such as
ods to aid in the rehabilitation of members braces or crutches
alexia ambulatory care
Inability to comprehend written words All types of health services that are pro-
vided on an outpatient basis, in contrast to
algophobia services provided in the home or to persons
Abnormal fear (phobia) of pain who are inpatients
alienation American Association of Retired Persons
Feelings of detachment from self or soci- (AARP)
ety; feeling estranged, separated and pow- National organization for people over age
erless in relation to oneself or others 50. Offers information, education, advo-
cacy, and services
12

13. Glossary of
Recreation Therapy
and Occupational Therapy American Hospital Association (AHA) — androgen
A
American Hospital Association (AHA) American Psychological Association (APA)
Trade association of hospitals, healthcare Largest organization of American psychol-
facilities, and medical administrators ogists
American Medical Association (AMA) American Speech—Language—Hearing—
National organization of medical doctors of Association (ASHA)
all specialties National professional organization for
speech and language pathologists and audi-
American Music Therapy Association (AMTA) ologists
National professional organization for mu-
sic therapists American Therapeutic Recreation Association
(ATRA)
American National Standards Institute (ANSI) National professional society for recreation
National nongovernmental organization therapists who have particular concern for
that publishes a variety of voluntary stan- the use of recreation as a clinical interven-
dards tion
American Occupational Therapy Association Americans with Disabilities Act (ADA)
(AOTA) Federal law, passed in 1990, to allow full
National professional organization for and equal access to services and facilities
occupational therapists and occupational by persons with disabilities
therapy assistants
amputation
American Occupational Therapy Certification Surgical removal of a limb or other part of
Board (AOTCB) the body
Credentialing board for occupational thera-
pists and occupational therapy assistants anal stage
Freud’s second stage of psychosexual
American Physical Therapy Association development extending from 18 months to
(APTA) 3 years in which most pleasure is derived
National professional organization for from stimulation of the anal zone by retain-
physical therapists and physical therapy ing and expelling feces
assistants
androgen
American Psychiatric Association (APA) Sex hormone present in both sexes but in
Professional organization of physicians greater quantity in males which influences
who specialize in the practice of psychiatry characteristics associated with males
13

14. Glossary of
A androgynous — APA
Recreation Therapy
and Occupational Therapy
androgynous anorexia nervosa
Having both male and female characteristics Disorder characterized by a prolonged
refusal to eat
angina pectoris
Condition marked by chest pain that gen- ANOVA
erally results from a brief or incomplete Analysis of variance statistical test to com-
blockage of the blood supply to heart tissue pare group means
anhedonia ANSI
Inability to experience pleasure from ac- American National Standards Institute
tivities that usually produce pleasure
antagonist
animal assisted therapy Muscle acting in opposition to another
Treatment approach in which interactions
with pets and other animals are used to antecedent
bring about therapeutic benefits Something occurring prior to a behavior
which influences the occurrence of that
ankylosis behavior
Fixation of a joint, as in rheumatoid arthritis
anterior
anniversary reaction Toward the front of the body; situated in
Behavioral reactions, symptoms or dreams front or in the front part of an organism
that occur at the same time of the year as a
significant past event antibiotic
Medication that destroys microorganisms
Annual in Therapeutic Recreation
Refereed publication of the American Ther- anticonvulsants
apeutic Recreation Association (ATRA) Drugs used to control epileptic seizures
anomaly anxiety
Malfunction or abnormality Unpleasant state of apprehension, ten-
sion or uneasiness from a vague or largely
anomia unknown or unrecognized source; charac-
Inability to name objects terized by increased heart rate, trembling,
sweating, and disrupted breathing
anorexia
Lack or loss of appetite for food APA
American Psychiatric Association; Ameri-
can Psychological Association
14

15. Glossary of
Recreation Therapy
and Occupational Therapy apathy — assertiveness training
A
apathy apraxia
“Don’t care” feeling or affect reflected in a Cerebral dysfunction; inability to initiate a
lack of interest or emotional involvement purposeful motor act by thinking about it
in one’s surroundings and carrying it out
APE aquatic therapy
Adapted physical education; programs of Use of pools for treatment and rehabilitation
modified physical activity in educational
settings to meet the needs of students with Arc
disabilities Association of Retarded Citizens
aphasia architectural barriers
Impaired ability to use or understand oral Structures such as buildings, walkways,
language and stairs that are usable by nondisabled
persons but present obstacles for people
APIE with disabilities to move about freely
Abbreviation for assessment, planning,
implementation, and evaluation, which are aromatherapy
the elements in the RT process. Pronounced Use of essential oils from plants for health
“a–pie” purposes
approach-approach conflict art therapy
Caused by having to choose between two Use of art as a therapeutic medium to pro-
desirable objects or goals that are com- mote self-awareness, nonverbal expression,
pletely or partially incompatible and human interaction
approach-avoidance conflict arteriosclerosis
Situation in which both positive and nega- Condition in which fatty patches have ac-
tive outcomes are inherent in the same cumulated and hardened on artery walls,
object or goal such as delicious Tex-Mex thereby reducing their elasticity
food that gives heartburn
arthritis
appropriateness of service Inflammation of a joint
Services that are medically necessary for
assertiveness training
the treatment of a particular condition; may
Behavioral therapy approach to assist
also refer to aspects of the normalization
people to become more assertive in sexual
principle (e.g., age appropriate)
expression or social relationships through
frank and direct interpersonal expression of
15

16. Glossary of
A assessment — attribution theories
Recreation Therapy
and Occupational Therapy
feelings and thoughts atherosclerosis
Arterial disorder in which the vessel walls
assessment harden (becoming thick, fibrotic, and calci-
Collection and analysis of information to fied), resulting in reduced blood flow to
determine the status of the client organs normally supplied by the artery
assimilation atonic
Subjective learning process by which new Weak or lacking normal tone or vigor
material is modified by established men-
tal structures and made a part of existing ATRA
knowledge; contrasts with Piaget’s accom- American Therapeutic Recreation Associa-
modation tion
assistive device atrophy
Any technology that enables a person with Wasting away of an organ or part of the
a disability to improve his or her functional body
level
attending behavior
Association of Retarded Citizens (Arc) Responses to relevant stimuli primarily
Organization to promote better understand- through the use of eye contact, posture,
ing of mental retardation. The organization gestures, and verbal behavior
now uses the expression “The Arc” to avoid
stigma associated with mental retardation Attention-Deficit Hyperactivity Disorder (ADHD)
DSM-IV diagnostic category with three
asthma subcategories: (1) Attention-Deficit Hyper-
Disorder of the respiratory system charac- activity Disorder, Predominately Inatten-
terized by bronchial spasms and difficulty tive Type; (2) Attention-Deficit Hyperactiv-
in breathing ity Disorder, Predominately Hyperactivity
Type; (3) Attention-Deficit Hyperactivity
asymptomatic Disorder, Combined Type
Without symptoms
attention span
ataxia Length of time an individual can concen-
Inability to coordinate muscular move- trate on one thing or participate in one
ments characterized by lack of balance or activity before losing interest
unsteadiness. In psychiatry the term may
be used to refer to a lack of coordination attribution theories
between feelings and thoughts Social psychology theories dealing with
attributing stable characteristics to other
16

17. Glossary of
Recreation Therapy AB
and Occupational Therapy atypical — bedsore
people based on our inferences from ob- autonomic nervous system
served behaviors, as well as making self-at- Division of the peripheral nervous system
tributions based on events that occur in our that carries messages between the central
own lives nervous system and the internal organs. It
has two parts: the sympathetic and para-
atypical sympathetic nervous systems
Unusual or uncharacteristic variations of a
disorder autonomy
Ability to function independently
auditory
Pertaining to hearing aversion therapy
Behavioral therapy technique that uses the
aura repeated pairing of unpleasant or painful
Visual sensation experienced before a stimulus with an undesirable behavior in
seizure order to eliminate the behavior
autism avoidance-avoidance conflict
Developmental disability characterized by Having to choose between two negative
an inability to relate to others, delay in de- objects or goals
velopment of communication skills, abnor-
mal responses to sensations and ritualistic Ball, Edith L.
behavior (1906-1997) Author in therapeutic recre-
ation known for her continuum of service
autogenic training model; she served on the faculty of New
Relaxation technique in which a series of York University
mental exercises involving sensations of
heaviness and warmth are used to exert barrier-free design
control over physiological processes Design of buildings and other built envi-
ronments that allows persons with disabili-
autonomic dysreflexia ties to make use of the facilities
Potentially dangerous complication in SCI
above the T-6 vertebra that involves high baseline information
blood pressure, sweating, chills, and head- Data or observations obtained before the
ache, frequently due to an overfull bladder application of any intervention
or impacted bowel. Also known as hyper-
reflexia bedsore
Sore caused by a lack of circulation to the
involved area; synonym for decubitus ulcer
1

18. Glossary of
B behaviorism — biopsychosocial approach
Recreation Therapy
and Occupational Therapy
behaviorism member at New York University for many
Approach to psychology founded by John years
B. Watson that emphasizes the examination
of overtly observable behavior bestiality
Sexual relations between a person and an
behavior modification animal
Approach that applies general learning
principles to modify behavior through sys- bibliotherapy
tematic manipulation of the environment; Therapeutic intervention in which books,
techniques include positive reinforcement, stories, poems, and other types of literature
shaping, prompting, and fading, among are used to enhance the expression of feel-
others ings and bring about insights
behavioral objectives bilateral
Statements of specific behavioral condi- On both sides; of, pertaining to, or having
tions, actions, and criteria directly related two sides
to long-term goals
biofeedback
behavioral therapy Means of receiving information (feedback)
Psychiatric treatment modality based on on various physiological processes (e.g.,
behaviorism that does not focus on psycho- brainwave activity, muscle tension, heart
dynamic causation but attempts to change rate, blood pressure, galvanic skin response)
unadaptive habits by use of techniques by use of electromechanical devices
such as assertiveness training and aversive
biopsy
therapy, among others
Removal and examination, usually micro-
benign scopic, of tissue from a living body
Relatively mild; likely to have a favorable
biopsychosocial
outcome; not malignant
Interrelationship of biological, psychologi-
Berne, Eric cal, and social factors
(1910-1970) American psychiatrist known
biopsychosocial approach
as the founder of transactional analysis
Holistic approach to treatment; implies the
Berryman, Doris L. etiology of a disease has biological, psy-
(1926-2000) Educator who developed the chological, and sociological determinants
first standards and criteria for recreation
services for residential institutions; faculty
1

19. Glossary of
Recreation Therapy BC
and Occupational Therapy biopsychosocial model — Canadian crutch
biopsychosocial model borderline personality disorder
View that health and illness involve the Disorder in which there is instability in a
interplay of biological, psychological, and variety of areas, including interpersonal
social factors in people’s lives relationships, behavior, mood, and self-
image. Interpersonal relations are often
bipolar disorder
intense and unstable, with marked shifts
Mood disorder in which the patient exhibits
in attitude. Impulsive and unpredictable
both manic and depressive episodes; once
behavior may occur. Inappropriate and in-
called manic-depressive illness
tense anger may occur. Identity problems
bisexual may occur as may problems of tolerating
Sexual orientation involving erotic feelings being alone and of emptiness or boredom
for members of both sexes
bowel program
bizarre behavior Habit or pattern for emptying the bowel at
Eccentric behavior that does not conform a specific time
to social expectations
bruxism
blocking Grinding the teeth, especially during sleep
Involuntary cessation of thought processes
bulimia
or speech
Episodic eating binges or excessive intake
blood pressure of food or fluid, generally beyond volun-
Pressure exerted by the blood upon the tary control
walls of the blood vessels, especially the
burnout
arteries
Stress reaction developed in persons
board-certified psychiatrist working in an occupation with unrelenting
Psychiatrist who has passed examinations occupational demands; helping professionals,
of the American Board of Psychiatry and including recreation therapists and occupa-
Neurology tional therapists, are subject to burnout
body language Canadian crutch
Expression of thoughts and emotions by Device with a metal cuff for the person’s
body posture and movement lower arms with a handle for the hand to
allow weight bearing that helps the per-
borderline mentally retarded son with a disability involving the lower
Individuals who possess an IQ of 70 to 85; extremities to stand or walk
they are not considered legally disabled
1

20. Glossary of
C cancer — catastrophic health insurance
Recreation Therapy
and Occupational Therapy
cancer carpal tunnel syndrome
Class of malignant diseases in which cells Painful disorder in the hand and wrist. Ac-
proliferate in an unrestricted manner, usu- tivities requiring sustained or repetitive use
ally forming a tumor of the hands and wrists may lead to nerve
compression, causing the syndrome
capitation
Method of payment in which the health- carryover
care provider is paid a fixed amount for Ability to use newly learned skills or infor-
each person served, no matter what the ac- mation from one setting to another
tual number or nature of services delivered
case conference
cardiac Multidisciplinary team meeting to discuss a
Pertaining to the heart client’s status
cardiogram case history
Tracing produced by the electrical impulses A brief report on the client’s background;
of the heart often prepared by a social worker
cardiovascular case management
Pertaining to the heart and blood vessels Problem-solving process through which ap-
propriate healthcare services are provided
care plan to individuals and families
Interdisciplinary plan to address the client’s
assessed needs; the expression care plan is castration
common in long-term care; other settings Removal of the sex organs. Used figura-
may employ the term treatment plan, reha- tively to denote state of impotence, power-
bilitation plan, or individual education plan lessness, helplessness or defeat
CARF cataract
Originally stood for Commission on Ac- Abnormal opacity or clouding of the lens
creditation of Rehabilitation Facilities. of the eye causing interference with light
Now known as CARF: The Rehabilitation reaching the retina
Accreditation Commission; an accreditating
body designed to improve the quality of catastrophic health insurance
life of persons undergoing medical reha- Health insurance that provides protection
bilitation, assisted living, etc. against the high cost of treating severe or
lengthy illness or disabilities
20

21. Glossary of
Recreation Therapy
and Occupational Therapy catchment area — cervical
C
catchment area brain; also called stroke
Geographic area for which a facility has
responsibility cerebrum
Upper and largest portion of the brain. It
catharsis has primary control over motor and mental
Release of impulses, thoughts, and re- activity
pressed materials accompanied by an
emotional response and tension release. CERT
Often used in connection with the release Comprehensive Evaluation in Recreation
of aggression Therapy Scale
catheter certification
Slender, flexible tube of metal, rubber or Process by which a nongovernment agency
plastic that is inserted into a body channel, or association evaluates and recognizes
often the bladder an individual as meeting predetermined
standards
CAT Scan (computerized axial tomography)
Computerized x-ray that produces high-res- Certified Occupational Therapy Assistant
olution images of the brain, blood vessels, (COTA)
arteries, and veins Individual who works under the direction
of an occupational therapist after complet-
central nervous system (CNS) ing an accredited course of study and pass-
Brain and spinal cord ing a certification exam
cerebellum Certified Therapeutic Recreation Specialist
Large portion of the brain that coordinates (CTRS)
motor activities and maintains body balance Certification by the National Council
for Therapeutic Recreation Certification
cerebral palsy (NCTRC) for a healthcare practitioner to
Condition characterized by the inability to practice therapeutic recreation at the pro-
control muscular movements due to injury, fessional level. Certification requires the
infection, or faulty development of the completion of the minimum of a bachelor’s
motor controls of the brain. It may involve degree in therapeutic recreation and exami-
involuntary movements, rigidity, paralyses, nation by NCTRC
facial grimacing, and speech disturbances
cervical
cerebrovascular accident (CVA) Pertaining to the neck or to the cervix
Restricted blood supply to a part of the
21

22. Glossary of
C cervical spine — clinic
Recreation Therapy
and Occupational Therapy
cervical spine chronological age
Seven bones or vertebrae of the spine in the Age in years
region of the neck
circulatory system
chaining Network of channels through which blood
Behavior modification technique of identi- circulates through the body
fying a series of steps involved in perform-
ing a specific task and guiding an individu- cirrhosis
al through the steps Degenerative disease in an organ of the
body marked by excess formation of con-
change agent nective tissue and subsequent contraction
Helping professional who serves as a cata- of the organ. Most commonly used in cir-
lyst for change in treatment and rehabilita- rhosis of the liver
tion
classical conditioning
change of life Form of learning in which existing re-
Menopause; the cessation of menses sponses are attached to new stimuli by pair-
ing those stimuli with those that naturally
charting elicit the response. Sometimes referred to
The act of written documentation (often as respondent conditioning
referred to as progress notes) on the clini-
cal record or chart of a particular client client
Individual to whom clinical services are
chemotherapy being provided; often referred to as a
Treatment of disease or disorder by admin- patient in medical settings or resident in
istration of chemical substances residential settings such as nursing homes
Child client-centered therapy
Basic transactional analysis ego state, Old term for person-centered therapy (see
which consists of feelings, impulses and person-centered therapy)
spontaneous acts. As a function of learning
history, this ego state can take the form of climacophobia
the Adapted Child or the Natural Child Morbid fear (phobia) of stairs
chronic clinic
Continuing over a long period of time or Outpatient establishment for the diagnosis
recurring frequently and treatment of illnesses
22

23. Glossary of
Recreation Therapy
and Occupational Therapy clinical impressions — coitus
C
clinical impressions cognitive
Informed, objective opinion of client Refers to the mental process of comprehen-
behavior or functional level based upon sion, judgment, memory and reasoning, as
sound professional training and experience contrasted with emotional and volitional
processes
clinical pathways
“Road maps” for the provision of multidis- cognitive-behavioral therapy
ciplinary clinical services. They are plans Therapy developed by Aaron Beck, based
that identify interventions and sequence on the idea that irrational ideas or faulty
them along a timeline. Their purpose is reasoning underlie individual’s thoughts
providing the most effective and efficient and beliefs
way to approach a diagnosis. Also known
as critical paths, clinical paths, critical cognitive dissonance
pathways, care maps, and care tracks Theory of Leon Festinger which proposes
a motivational state (dissonance) exists
clinical practice guidelines when an individual’s cognitive elements
Systematically developed guide to practice, (thoughts, attitudes, perceived behaviors)
based on research and best practices, that are inconsistent with each other. The
aids in clinical decision making unpleasant feeling of dissonance drives
the person towards inconsistency in
clinical psychologist thoughts, attitudes and behaviors
Individual with a Ph.D. or Psy.D. in clini-
cal psychology who aids in diagnosis, cognitive retraining or rehabilitation
treatment and prevention of mental and Management and treatment of such func-
emotional disorders tions and skills as arousal, perception,
discrimination, orientation, organization,
clinical supervision thinking, recall, and memory for persons
Cooperative process in which a supervisor with open or closed head injuries
helps an individual (supervisee) who has
direct responsibility for carrying out the cohort
agency’s clinical program to improve his or Individuals who share a common charac-
her clinical abilities and to achieve the ends teristic such as being of the same age
of the clinical program
coitus
clonic convulsion Sexual intercourse in which the penis is
Type of convulsion characterized by rhyth- inserted into the vagina
mic alternate involuntary contractions and
relaxation of muscle groups
23

24. Glossary of
C colitis — congenital blindness
Recreation Therapy
and Occupational Therapy
colitis Comprehensive Evaluation in Recreation
Inflammation of the colon (large intestine) Therapy Scale (CERT)
often accompanied with weight loss and Original CERT assessment instrument is
pain for use in psychiatric settings and contains
the three areas of general information,
coma individual performance, and group perfor-
State of unconsciousness during which mance; a second CERT was developed for
most behaviors and reflexes are suspended use with clients with physical disabilities
and contains eight clusters of items
commitment
Legally hospitalizing persons for psychiat- compulsion
ric treatment Uncontrollable impulse to perform an act
repetitively
communication
Verbal and nonverbal transmission of ideas, computerized axial tomography (CAT Scan)
feelings, beliefs and attitudes that permits a Computerized x-ray that produces high-res-
common understanding between the sender olution images of the brain, blood vessels,
of the message and the receiver arteries, and veins
community mental health center (CMHC) conduct disorder
Mental health service delivery system Childhood disorder characterized by anti-
located in the community typically pro- social behavior
viding the following services: inpatient,
outpatient, partial hospitalization, emer- confidentiality
gency services, consultation and education, Protection of a client’s privacy through
specialized services for children and adults careful use of oral and written communica-
who are elderly, transitional halfway hous- tions
es, alcohol and drug abuse services, assis-
tance to courts and other public agencies, congenital
and follow-up care; sometimes referred to Present or existing from the time of birth
as centers for behavioral health
congenital blindness
complete injury Condition of blindness that is present at
Total paralysis (loss of movement) and loss birth or during the first five years of life;
of sensation (feeling) below the level of the congenitally blind person does not have
injury visual memory
24

25. Glossary of
Recreation Therapy
and Occupational Therapy conjoint therapy — criterion level
C
conjoint therapy cope
Therapy in which both marital partners are To deal or contend with problems success-
seen in a joint session fully
contagion coping
Spreading of a behavior within a group due Process by which persons deal with prob-
to reducing restraints about performing the lems or try to manage the stress they
behavior after seeing others doing it experience
continuing education unit (CEU) coping mechanisms
CEUs are awarded by professional organi- Learned ways of behaving to curb distress
zations or universities to individuals who or tension
participated in a structured educational
program such as a conference or workshop coronary heart disease (CHD)
Class of illnesses that result when a nar-
continuum rowing or blockage of the coronary arteries
A continuous whole whose parts cannot be restricts the blood supply to the heart
completely separated, such as the continu-
um of therapeutic recreation services countertransference
Idea from psychoanalysis in which the
contractures therapist unconsciously responds to the
Shortening and tightening of tissues around client as though he or she was a significant
a joint; decreasing movement other from the therapist’s past
control group “crack”
Research group used as a comparison with Purified cocaine alkaloid (also called “free-
the experimental group base”)
contusion credentialing
Bruise without an external break in the skin Recognition of professional or technical
competence
convulsive disorder
Epilepsy crisis intervention
Brief and instant treatment of acute psychi-
co-payment atric emergencies
Fee that must be paid by patients, despite
being insured, when they use healthcare criterion level
Predetermined standard of acceptable per-
formance
25

26. CD
Glossary of
Recreation Therapy
critical care unit (CCU) — debriefing and Occupational Therapy
critical care unit (CCU) cystogram
Specially equipped hospital area designed An x-ray of the bladder to see if reflux, the
and staffed by personnel skilled in rec- movement of urine backward into the blad-
ognizing and immediately responding to der, is present
cardiac emergencies
cystography
Critical Parent Examination of the bladder with an instru-
Transactional analysis ego state which is ment called a cystoscope to detect infection
critical and fault finding. Contrasts with and stones and determine how well the
the Nurturing Parent bladder is emptying
cunnilingus dance therapy
Kissing, sucking, and licking the female Use of dance, movement and rhythmic
genitalia activity as a medium for treatment or
rehabilitation. It is a nonverbal means of
custodial care expression employed with both individuals
Care provided to meet basic needs which and groups
does not offer active treatment
data
cutaneous Information
Pertaining to the skin
database
CVA (Cerebrovascular accident) Information obtained about a client’s past
Stoppage of blood circulation to a part of or present level of health during the assess-
the brain; also called stroke ment phase
cynophobia day hospital
Abnormal fear (phobia) of dogs Psychiatric facility that offers therapeutic
programs during daytime hours
cyst
Collection of fluid within any closed cavity debilitation
or sac Generalized weakness and lack of strength
cystic fibrosis (CF) debriefing
Disorder of the exocrine glands that causes Analysis following an activity which
those glands to produce abnormally thick permits clients to think about their partici-
secretions of mucus. The glands most af- pation, to examine their feelings, and to
fected are the respiratory, pancreatic, and discuss how they may use insights gained
sweat glands from the activity
26

27. Glossary of
Recreation Therapy
and Occupational Therapy decubitus ulcer — department
D
decubitus ulcer alcohol but also occurring as a result of
Bedsore or pressure sore brain inflammation and senile psychosis.
deductible delusion
Amount that the client must pay directly to Fixed false belief or conviction without
the provider (usually each year) before the foundation; often regarding one’s status
insurance plan begins to pay benefits (delusions of grandeur), persecution (delu-
sions of persecution) or oversuspiciousness
defense mechanisms (paranoid delusions)
Strategies that take place unconsciously to
protect oneself from a threat to the integ- dementia
rity of the ego or to protect oneself against Nonspecific but lasting deterioration of
painful negative feelings. Examples include intellectual functioning characterized by
denial, sublimation and rationalization failing memory, distractibility, impair-
ment in judgment and abstraction, reduced
dehydrate language facility, alterations in mood and
To remove water affect, and disturbance of orientation. Ac-
companied by changes in personality and
dehydration
ways of relating to others
Excessive loss of water from body tissues
denial
deinstitutionalization
Defense mechanism by which a person
Change in mental health care from tradi-
avoids emotional conflicts or anxiety by
tional, institutional care to the provision of
refusing to acknowledge thoughts, feelings,
community based services
desires, impulses and other factors that
would cause intolerable pain
déjà vu
Sensation or illusion that one is experienc-
department
ing what one has experienced before
Organizational unit within an agency that
may function as an independent unit or
delirium
may be an aspect of another unit, division
Confused state of consciousness often
or service area; an occupational therapy
characterized by delusions, hallucinations
department is an organizational unit of one
and illusions
or more staff structured as a work group
delirium tremens for the purpose of delivering occupational
Delirium characterized by intense trem- therapy services
ors, anxiety, hallucinations, and delusions
suffered by alcoholics after withdrawal of
2

28. Glossary of
D Department of Health and Human Services (DHHS) —
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Recreation Therapy
and Occupational Therapy
Department of Health and Human Services developmental disability
(DHHS) Disability originating before age 18 that
Cabinet-level department of the U.S. may be expected to continue for an indefi-
government that contains units such as the nite period and that constitutes a substantial
Public Health Service, Administration on impairment. Developmental disabilities
Aging, Social Security Administration, and include epilepsy, cerebral palsy, mental
National Institutes of Health retardation and autism
dependency diabetes mellitus
Reliance on another (usually a helping pro- Syndrome arising from an absolute or rela-
fessional) for psychological support tive lack of body insulin; symptoms stem
from excess glucose and include thirst,
depersonalization frequent urination and fatigue. In Type I
Feelings of unreality or strangeness con- diabetes mellitus (previously known as ju-
cerning either the environment, the self, or venile diabetes) there is little, if any, insulin
both being made by the body. In Type II there
may be sufficient endogenous insulin but
depression
the body is unable to use it properly
Wide-range feeling running from unhap-
piness to extreme dejection. As a clini- diabetic
cal syndrome it involves deep sadness or A person with diabetes caused by a de-
despair, feelings of worthlessness, morbid ficiency of insulin being secreted by the
thinking and greatly reduced psychomotor islands of Langerhans
activity
diabetic coma
depth perception Excessively high level of sugar in the
Perception of distance between the stimu- blood resulting from insufficient insulin in
lus and the subject the body
dermatitis Diagnostic and Statistical Manual of Mental
Inflammation of the skin Disorders (DSM)
American Psychiatric Association’s official
detoxification
classification of mental disorders, first pub-
Process of the removal of the toxic effects
lished in 1952. DSM-IV was published in
of a drug from the body
1994. A revised version, DSM-IV-TR, with
new statistical information, was published
development
in 2000.
Progressive increase in skill and capacity
2

29. Glossary of
Recreation Therapy
and Occupational Therapy diagnostic related groups (DRGs) — diversional program
D
diagnostic related groups (DRGs) discharge plan
Classification representing 23 major diag- Plan that summarizes the treatment or
nostic categories that aggregates patients rehabilitation provided, the client’s re-
into case types based on diagnosis, age, sex, sponse, current level of functioning, and
treatment procedures, and discharge status, recommendations for continued services or
predicting use of hospital resources and aftercare as necessary; used when client is
length of stay. It has been used as a basis discharged or services are discontinued
for system of prospective payment under
Medicare disease
Literally, the lack of ease; a pathological
dialysis condition in which physiologic or psycho-
Process of separating or removing certain logic functions of the body deviate from
substances from the blood when the kid- what is considered to be normal
neys fail to perform their normal function
disoriented
diplegia Confused as to time, place, and person
Paralysis of corresponding parts on both (the position of the self in relation to other
sides of the body (i.e., both arms or both persons); characteristic of organic mental
legs) disorders
diplopia displacement
Double vision Defense mechanism in which emotions
are transferred from the original person or
directionality object to a less formidable, or safer, target.
Awareness of and distinction between and It is the “kick the cat” defense
among left, right, up, down, front, back,
etc., in the world around one. Awareness distal
of directional relationship in space Farthest from the center, from the medial
line, or from the trunk; opposed to proxi-
disability mal; far or distant from the origin or point
Physical or mental impairment that sub- of attachment
stantially limits one or more of an individu-
al’s life activities diversional program
Program of activities designed to divert
discharge goal attention from the client’s problems or
Outcome to be exhibited by the client upon concerns. Term may refer to activities to
discharge from the service or agency alleviate the boredom of the institutional
routine, or to alleviate fear of hospitaliza-
2

30. Glossary of
D Dix, Dorothea — dysphagia
Recreation Therapy
and Occupational Therapy
tion and illness, and to stimulate interest in drug addiction
getting well Condition characterized by an over-whelm-
ing desire to continue taking a drug to
Dix, Dorothea which one has become habituated through
(1802-1887) Social reformer known for her repeated use
work in improving prison conditions and
care of persons with mental illness drug dependence
Psychological or physiological reliance on
documentation a chemical agent
Act of recording client assessments and in-
terventions in the client’s chart. The chart DTs
is a permanent record that is considered a Delirium tremens
legal document and is audited to evaluate
changes and quality of care dual diagnosis
To indicate a client or patient has more
dorsal than one major diagnosis; the most com-
Pertaining to the back or posterior; directed mon dual diagnosis is mental illness and
toward or situated on the back surface substance abuse
Down’s syndrome duration
Common type of mental retardation Length of treatment or rehabilitation
brought on by a congenital condition services, e.g., services will be provided
resulting from a chromosomal abnormal- for three weeks or until client goals are
ity. At one time referred to as mongol- reached
ism. Children with Down’s syndrome are
characterized by widely spaced and slanted dyad
eyes, a flat face, small ears and congenital Two-person relationship
anomalies of the heart
dysfunctional
DRGs Unable to function normally
Diagnostic related groups
dyslexia
drug abuse Impairment in the ability to read
Use of a drug to obtain effects for which it
dysphagia
is not prescribed
Difficulity in swallowing
30

31. Glossary of
Recreation Therapy DE
and Occupational Therapy dysphasia — egogram
dysphasia edema
Difficulty in comprehending oral language Abnormal accumulation of fluid in intercel-
or in trying to express verbal language; the lular spaces in the tissues
older term for aphasia
EEG
dyssocial behavior Electroencephalogram
Behavior of persons who are not classifi-
able as antisocial personalities, but who effective listening
are predatory and follow criminal pursuits. Active process that can be used in any
Formally termed sociopathic personalities interpersonal transaction. It involves four
major skills: attending, paraphrasing, clari-
eating disorders fying, and perception checking
Marked disturbances in eating behavior
including anorexia nervosa and bulimia efferent
Conveying away from a center
ECG or EKG
Electrocardiogram or electrocardiograph efficacy
Having the desired influence or outcome
echolalia
Automatic repetition of another person’s ego
words or phrases Part of the psychoanalytic personality
(along with the id and superego). It is the
eclectic approach rational part that mediates between the id
Utilization of therapeutic approaches and and superego
techniques selected from various sources or
theoretical orientations egocentric
Self-centered
ecology
Study of the mutual relationship between egogram
people and their environment Concept from transactional analysis. The
egogram is a visual representation of one’s
ECT personality using a bar graph to display
Electroconvulsive therapy the amount of energy emanating from the
five functional ego states (Critical Parent,
eczema Nurturing Parent, Adult, Free Child, and
Skin condition in which fluid is excreted Adapted Child)
through the skin
31

32. Glossary of
E egoist — encounter group
Recreation Therapy
and Occupational Therapy
egoist emaciation
Selfish person who seeks to satisfy his or State of being extremely thin
her own interests at the expense of others
embolism
ego states Obstruction in a blood vessel caused by the
Concept of transactional analysis that states presence of an embolus too large to pass
there are three structural ego states that through it (e.g., blood clot)
represent distinct and independent levels
of psychological functioning (the Parent, embolus
Adult, and Child) Any foreign matter, such as a blood clot or
air bubble, carried in the blood stream
EKG or ECG
Electrocardiogram or electrocardiograph emesis
Vomiting
electrocardiogram (EKG or ECG)
Tracing showing changes in electric poten- empathy
tial produced by contractions of the heart Ability to perceive the world from the
and used to diagnose heart disease client’s frame of reference or to put oneself
in another’s place and understand his or her
electroconvulsive therapy (ECT) feelings and behaviors
Treatment used to combat depression and
schizophrenia in psychiatric patients. An empirical
electric current is applied to the brain Based on facts and experience rather than
through electrodes on the scalp, causing theory or philosophical principles; system-
convulsions. Sometimes termed electro- atic observation and experiment
shock treatment (EST)
encephalitis
electro-ejaculation Inflammation of the brain
Means of producing sperm by electrical
encopresis
stimulation from men with ejaculatory
Involuntary passage of feces, usually dur-
dysfunction
ing sleep at night
electroencephalogram (EEG)
encounter group
Graphic record of the electrical activity of
Group whose major goals are awareness
the brain
and genuineness. Concern is not so much
elopement with the transfer of learning but with the
“Running” (unauthorized departure) from a encounters among members. Sessions tend
psychiatric treatment facility to be emotionally charged, dealing with
32

33. Glossary of
Recreation Therapy
and Occupational Therapy endemic — existentialism
E
feelings of love and aggression erotic
Conscious or unconscious sexual feelings;
endemic sensually related
Belonging, native, restricted or peculiar
to a particular people, country, locality or ESP
region Extrasensory perception
endotracheal tube EST
Tube inserted into the mouth or nose that Electroshock therapy
serves as an artificial airway. It passes
through the vocal cords, and therefore etiology
speech is not possible with this tube in Cause of a disease or disorder
place. It is the tube that connects a respira-
euphoria
tor to the patient
Altered state of consciousness character-
enuresis ized by an exaggerated feeling of well-be-
Involuntary passage of urine; bed wetting ing, with or without foundation
epidemiology euthanasia
Statistical study of incidence, prevalence, “Mercy killing,” or putting to death pain-
and distribution of diseases in a population lessly
epilepsy exacerbate
Disorder characterized by recurrent sei- To increase the severity; to make worse; to
zures caused by disturbances of the electri- aggravate
cal activity of the brain
exhibitionism
eremophobia Exposure of one’s genitals to a person of
Abnormal fear (phobia) of being by oneself the opposite sex in socially unacceptable
situations
Erikson, Erik
(1902-1990) Psychoanalyst noted for his existentialism
theory of psychosocial development Philosophical theory that stresses the way
in which a person experiences the pheno-
erogenous zone menologic world and takes responsibility
Area of the body particularly susceptible to for existence. It is holistic and self-deter-
erotic arousal when stimulated, especially ministic in contrast to deterministic points
the oral, anal and genital areas of view
33

34. E F
Glossary of
Recreation Therapy
extended care facility — fetishism and Occupational Therapy
extended care facility fading
Institution providing medical, nursing or Gradually removing assistance when help-
custodial care for clients over a prolonged ing a client perform a task or learn a skill
period; includes intermediate or skilled
nursing home care failure to thrive (FTT)
Physical and developmental retardation of
extension infants or children resulting from physical
To straighten a joint; opposed to flexion or emotional neglect
extensor FALS
Any muscle that extends a joint Fellow in the Academy of Leisure Sciences
extinction family therapy
Weakening of a reinforced operant re- Treatment of more than one member of a
sponse as a result of ceasing reinforcement. family in the same session. The assump-
Also, the elimination of a conditioned tion is that a mental disorder in one mem-
response by repeated presentations of a ber of a family may be manifestation of
conditioned stimulus without the uncondi- disorder in other members and may affect
tioned stimulus interrelationships and functioning
extrasensory perception (ESP) fee-for-service
Experiencing of an external event by Type of reimbursement in which a health
means other than the five senses, as by provider charges a client (or third-party
telepathy or clairvoyance payer) a specific price for a specific service
extrinsic fellatio
Coming from the outside; doing something Kissing, sucking, and licking the male
for reasons of reward or punishment ex- genitalia
ternal to the activity itself; contrasted with
intrinsic motivation fetal alcohol syndrome (FAS)
Fetal abnormalities associated with heavy
facilitation alcohol consumption by the pregnant
Enhancement of any action or function woman
FACTR fetishism
Functional Assessment of Characteristics Practice of arousing sexual desires with
for Therapeutic Recreation inanimate objects
34