“The Health Protection/Health Promotion Model” 

David R. Austin, Ph.D.David R. Austin, Ph.D.

Learning Objectives:Learning Objectives:

• Define the term, conceptual models.• Explain what is meant by the actualization tendency.

• Name the theoretical perspective that underlies the Health Protection/Healthunderlies the Health Protection/Health Promotion Model.

• One major component of the Health j pProtection/Health Promotion Model is prescriptive activities, name the other two componentscomponents.

Just what is this profession all about?Just what is this profession all about?

To be a profession:

A  basic description of recreation therapy is primary.

We need to know what the profession paims to do.

Others Need to Know:Others Need to Know:

• Basic descriptions of recreation therapy are important for all audiences – from consumers to kindred professions.

• We need to articulate what is distinctive aboutWe need to articulate what is distinctive about recreation therapy to help others to understand and appreciate our profession.understand and appreciate our profession.

Conceptual Models

define and describethe profession

Without conceptual models to bl h l b d festablish clear boundaries for RT:

“…the profession would be doomed to b i f i l i dbasing professional preparation and practice on murky definitions that would not offer the clarity needed to advance the profession.”p(Austin, 2002, p. 2)

Concepts

What do we mean by concepts?What do we mean by concepts?

ConceptsConcepts

• “Words that describe mental images of• Words that describe mental images of phenomena.” (Fawcette, 1995)

• “Concepts represent a means to communicate mental images. Within the context of conceptual models, authors pcaution that concepts are abstract in nature.” (Austin 2002)nature.   (Austin, 2002)

Models

What are models?

ModelsModels

• “A simplified representation of realityA simplified representation of reality that explains the relationship of different concepts ” (Morgan 1996 p 29)concepts.  (Morgan, 1996, p. 29)

• “A model ought to make things simpler to understand It takes several differentunderstand. It takes several different elements, shows the relationship between them and makes them into abetween them, and makes them into a unified whole.” (Hagedorn, 1997)

Conceptual Practice Models(Kiehofner, 1997)

“Conceptual practice models aim toConceptual practice models aim to create explanations of some phenomena f ti l i th fi ld hilof practical concern in the field, while 

providing a rationale and methods for therapeutic interventions. Thus, a model has the dual purpose of explaining a p p p ggroup of phenomena and guiding practice related to those phenomena.”practice related to those phenomena.

RT Conceptual Models:RT Conceptual Models:

“ offer an image or visualization of the…offer an image or visualization of the component parts that make up the di i li f ti th d thdiscipline of recreation therapy, and then describe how these parts relate to one another. Conceptual models outline the purpose and scope of practice…”p p p p(Austin, 2002, p.4)

Evolution of RT Conceptual ModelsEvolution of RT Conceptual Models

• Early days there were general impressions provided y y g p pbut not truly conceptual models (e.g., “recreation for the ill and handicapped” or “recreation as a treatment tool ”)treatment tool. ).

• 1970s/1980s RT worked frantically to define itself (Leisure Ability Model was embraced).(Leisure Ability Model was embraced).

• 1980s saw dissatisfaction with the Leisure Ability Model (Hamilton & Austin, 1992).

• Health Protection/Health Promotion Model presented in 1991.

Questions to Examinef l d lComponents of Conceptual Models

• What is the mission or goal of the model?• Who is served?Who is served?• What is the nature of the professional’s role?Wh f diffi l f li ?• What are sources of difficulty for clients?

• What are the mode and focus of interventions?

• What is the theoretical  basis for the model?

Austin’s Health Protection/H l h P i M d lHealth Promotion Model

“The purpose of therapeutic recreation isThe purpose of therapeutic recreation is to recover following threats to health (health protection) and to achieve as high a level ofprotection) and to achieve as high a level of health as possible (health promotion).”

(Austin, D.R. (1998). The Health Promotion/Health Promotion Model. Therapeutic Recreation Journal 32 109‐117 )Therapeutic Recreation Journal, 32, 109 117.)

Table 4‐1Table 4‐1Health Protection & Health Promotion Model

Health Protection Health PromotionHealth Protection Health Promotion

Treatment or rehabilitation  Wellness orienteddue to illness or disability

Motivation to enhance healthMotivation to restore health

Health Promotion isHealth Promotion is…

“Health promotion is the process of assisting people to move toward a state g p pof optimal health.”

Evans, D.R.(1999). Health Promotion, wellness programs, lit f lif d th k ti f h l C diquality of life and the marketing of psychology. Canadian 

Psychology, 38, 1‐12.

On RT in HP/HP ModelOn RT in HP/HP Model

Recreation therapy may be conceived to be much like traditional medically oriented allied health professions in its concern forallied health professions in its concern for preventing and alleviating illness. 

h hAt the same time, RTs join physicians practicing “well medicine” in their desire to bring about the self‐actualization of their gclients or to help them to enjoy optimal health and wellness.

Health Protection/Health PromotionM d lModel

• Mission/Goal: Enabling recovery following threat to health and the achievement of optimal health.

• Who: Clients are self‐defined…anyone wishing y gto improve their health.

• Professional role:Moving clients towardProfessional role: Moving clients toward gaining control and independence.

Reformulation of HP/HP ModelReformulation of HP/HP Model

• Mission/Goal: Enabling recovery or adaptive i f ll i h h l h d hcoping following threat to health and the 

achievement of optimal health.

Austin (in process) Theoretical Thinking and the RT Process( p ) g

In the initial formulation of the Health Protection/Health Promotion Model recreation was seen as a means to regaining or restoring health (Austin, 1991).

Austin (in process) Theoretical Thinking and the RT Process( p ) g

It would seem, however, that the model could be expanded to include using recreation p gto assist clients to maintain health to the highest level possible for them, or at least to g p ,help them to better cope with their illnesses or disabilities. This reformation permits the pmodel to be better applied to clients with chronic illnesses or disabilities.

Austin (in process) Theoretical Thinking and the RT Process( p ) g

• For these clients regaining health by curingFor these clients regaining health by curing the condition may not be realistic. 

• But these clients may be able to engage inBut these clients may be able to engage in recreation in to reduce or prevent further deterioration in their conditions or to improve the quality of their lives by coping adaptively with their illnesses or disabilities when their ill di bili i d di fillnesses or disabilities produce discomfort, stress, or other symptoms.

Health Protection/Health PromotionM d lModel

• Sources of difficulties: Entire range of the illness/wellness continuum poor health to optimal health Client may enter anywhereoptimal health….Client may enter anywhere along the continuum.

• Mode/Focus: Prescriptive activities RecreationMode/Focus: Prescriptive activities, Recreation, and Leisure

• Theory Basis: Humanistic theory that sees peopleTheory Basis: Humanistic theory that sees people as striving for wellness/maximizing their potentials (i.e., the actualizing tendency).

3 Major Componentsf / d lof HP/HP Model:

• Prescriptive Activities

• Recreation

• Leisure

Video on theH l h P i /H l h P i M d lHealth Protection/Health Promotion Model

• The video depicts the major parts of the p j pHealth Protection/Health Promotion Model and answers the questions to examine the components of any conceptual model.

• In it I am interviewed by Dr. Bonnie Gruver.

Participant ExerciseParticipant Exercise

(Please get with 2 people around you.)( g p p y )

• Discuss what you think are the pros and cons of the Health Protection/Health Promotionof the Health Protection/Health Promotion Model.

• Do you personally prefer the model as a basis• Do you personally prefer the model as a basis for practice?D it h d fit ithi ?• Does it have a good fit within your agency?

“I Learned Exercise…”I Learned Exercise…

• I learned that I…• I relearned that I• I relearned that I…• I realized that I…• I was happy that I…• I was surprised that I• I was surprised that I…

Selected References

• Austin, D.R. (2002). Conceptual models inAustin, D.R. (2002). Conceptual models in therapeutic recreation. In D.R. Austin, J. Dattilo, & B.P. McCormick (eds.) Conceptual Foundations for Therapeutic Recreation. State College, PA: Venture Publishing, Inc.

• Austin, D.R. (2009). Therapeutic Recreation Processes d h ( th d ) hand Techniques (6th edition). Champaign, IL: 

Sagamore Publishing, Inc.

Resources• To view “Models of Practice: The Health Protection/Health 

Promotion Model” via streaming at no cost go to: g ghttps://scholarworks.iu.edu/dspace/handle/2022/3378

• The video is one of 23 Recreation Therapy Videos listed. Click th titl f th id d dd ill Cli kon the title of the video and an address will come up. Click on 

the address and the video will come up. Click on the triangle in the center to start the video.

• An additional free service of the Indiana University Library is providing free access to an online version of the Glossary of Recreation Therapy and Occupational Therapy Go to:Recreation Therapy and Occupational Therapy. Go to: https://scholarworks.iu.edu/dspace/bitstream/handle/2022/6474/Austin_Glossary.pdf?sequence=1

RT BlogRT Blog

• The RT Blog is maintained by the Hoosier RTThe RT Blog is maintained by the Hoosier RT (aka David R. Austin).

• The address of the RT Blog is:• The address of the RT Blog is:http://rt‐blog.blogspot.com/

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