Recreative Resources

REMOTIVATION THERAPY

By Denise Lima-Laskiewicz ADC/EDU, ICRmT
Heal Through Words

 

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 is 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.

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.

Visit www.remotivation.com for more information.


Denise Lima-Laskiewicz, ADC, ICRmT 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.


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