Title

TTAP Method in Finland

Social Sciences 400: Therapeutic Thematic Arts Programming (TTAP Method) in HAMK International Summer School, Finland
Prerequisite: There are no prerequisites for this class held in Finland
Class time: 35 hours in class, at least 10 hour clinical case study required upon return.

APPROXimate TRAVEL/ROOM /BOARD: (student responsibilities)

1. Round Trip Ticket to Finland is approximately $800.00
2. Room is approximately 20 Euro per person per day. (7 days, approx. 140 euros)
3. Daily breakfast and lunch, provided in the school cafeteria for 10 euro. (7 days, approx. 70 euros)
4. All Transfers from Helsinki Airport to Campus, by bus. (approx. 10 euro each way)
5. Course credits paid to STAC: $1,000.00

History of the TTAP Method©

The TTAP Method was first introduced to the field of Art and Therapeutic Recreation, pre-publication, at the New York State Therapeutic Recreation Association’s Annual Conference in March of 2006 and the American Art Therapy Conference in November.  The methodology was then highlighted at the annual American Society on Aging, as an innovative practice developed out of research in therapeutic art and recreation. The TTAP Method was officially published through Health Professions Press in January of 2007. The first international educational application of the TTAP Method was taught during the summers of 2006, and subsequently taught in 2007 and 2009  at Helsinki University of Applied Sciences.  The Finnish Association for Alzheimer’s Care Journal published an article titled; The benefits of the TTAP-Method, 2006 (P.3-5).

The TTAP Method has been taught and researched at St. Thomas Aquinas College since 2008, and outcomes of students findings have been published in the New York State Therapeutic Recreation Journal and the American Therapeutic Recreation Research Institute as well as the American Journal of Art Therapy. The book today is on the publisher’s best seller list in the United States and has been translated into Finnish through the collaboration of HAMK University and Health Professions Press.

Overview of the TTAP Method©

The TTAP Method is a innovative nine step therapeutic modality which is based on the belief that the use of themes - social, cultural or personal, enhances the ability to provide a “person centered approach” to art and therapeutic recreation and is fundamental to the care and treatment of all populations.  The method can be easily adapted to suit the unique needs of special populations, such as those who are suffering from disabilities including Alzheimer’s disease and related dementias. The modality’s methodology structures therapeutic recreation and art programming first through the utilization of conversation about a specific theme, and illustrates how to move through music and meditation, mental imagery, painting, sculpture, dance and movement, poetry and writing, food motivated sensory events and phototherapy, with each aspect of the method utilizing a thematic approach tailored to the special needs of the specific patient population. 

Creating programming around themes naturally increases personal shared conversations, which provide person-centered programming.  The TTAP method instantly enables a “Flow” effect to flourish which naturally transports the individual within the group to a place of creativity and independence, while providing continued opportunities for self worth and self esteem. The TTAP Method's nine-step process structures the therapist with multiple examples of how to develop programming. This approach is firmly based in neuroscience research on the brain's complex structure and functioning over the last 10 years, life span developmental theory, and cell re-growth now commonly termed neuroplasticity.

Course Objectives and Student Outcomes:

This course will provide students with a taste of international study abroad with the benefit of classes being taught in the English language. 

This innovative methodology is being provided in Finland through the Finnish Alzheimer’s Association, community centers and long term care facilities. Utilizing a series of in-class lecture sessions, group experiential learning and observation at clinical sites, students will be taught how the TTAP Method is structured to be optimally utilized and replicated in Social Science research.

The student will develop and demonstrate an understanding of three main areas that the TTAP Method© is founded upon; neuroscience, developmental theories and learning theories. An in-depth overview on how the TTAP Method© stimulates both right and left brain functioning through activities in both well individuals and those with Alzheimer’s disease. This course will cover the most recent and basic functional organization of the brain, neuroplasticity, including neurons, neurotransmitters and areas of the brain involved in transforming perceptual inputs into physiological responses and behaviors (Damasio, 1998, 1999; Golomb, J.,1996, Grober, E., 1999; Kandel, Schwartz & Jessel, 2000; LeDoux, 2000; Levine Madori, 2007).

This course offers a review of the developmental theorists starting with Erickson, and creates an understanding of how we have changed our psychological perspectives over the last 3 decades, to realize the significance of Gerotranscendence (Torsham, L., 2005). The TTAP Method© utilizes person centered themes within the art/recreation therapy process to engage participants, resulting in feelings of positive self regard, optimal life review and increased sense of self. This method substantiates how art/recreation therapy is quickly becoming a powerful window into brain functioning and self discovery, incorporating Bloom’s learning theories into each step (Cozolino, 2002; Luzebrink, 2004; Hass-Cohen, 2005; Levine Madori, 2005, 2009).

Examples of current research studies utilizing this innovative method with the Alzheimer’s population will be presented from the United States, Finland, Australia, New Zealand and Russia. The utilization of personal or environmental themes will be discussed through individual and group case studies.

Lastly, students will learn from a multimodal approach, incorporating lecture, visual power points, guided imagery, personal experiential and hands on art material experiential in which participants explore a personal theme through the creation of artwork.

Student outcomes:  

1. Students will develop a clear understanding of how this programming technique stimulates all areas of the brain while enhancing all psychological domains.
2. Students will explore how the TTAP Method© creates multiple opportunities to experience social, emotional and physical benefits that are incorporated for integration into the group experience through lecture and personal experientials.
3. Students will explore and learn how through the use of object relations and personal themes, the TTAP Method© enhances feelings of support, thus increasing social participation.
4. Through case studies, movies and experientials, students will witness how the TTAP Method© naturally increases amount of time spent in programming, while providing a multitude of creative art experiences.
5. Though hands on experiences in the classroom and in clinical settings in Finland, students will understand how the TTAP Method© programming increases the opportunities which enable the “flow” process to occur.
6. Witness through observation of the Finnish Alzheimer’s Association and Community Centers in Finland how the TTAP Method© is used in various healthcare professions.

Instrumental procedure:

Classes will include lectures, power point discussions, analysis of research articles on the method, and direct observation/supervision of clinical programs in Finland.

The structure of this course will take place over a five day, 7 hour class, to be held in the HAMK University of Applied Sciences. 

Assignments:

The students will have three responsibilities to successfully complete this 3 credit course:

1. Attendance in class and field visits
2. Case Study of individual or group utilizing TTAP Method©, incorporating research into case study.
3. Daily Journal

Grading:

The course adheres to the grading policy of St. Thomas Aquinas College as outlined in the College catalog.

Attendance/Participation:

Punctual and regular attendance is mandatory and critical. It is the expectation of this course that there are no absentees, due to the nature of the course. Each student will learn from one another, through observation and participation as well as through text and research readings.

Student Travel Responsibility:

It will be the complete responsibility of the student to implement, organize, and schedule all travel needs which include but are not limited to the following:

Air fare, transportation to and from airport (departures and arrivals), transportation to HAMK University (located 1 hour from Helsinki Airport, bus service available at approximately 10 Euro’s), transportation to airport after last class on Friday , and all scheduled travel needs.

Texts:

Levine Madori, L. (2007). Therapeutic Thematic Arts Programming for Older Adults. Health Professions Press, Baltimore, Maryland.

DVD’s on reserve, not required but suggested in STAC Library:

Levine Madori, L. (2008). Utilizing Art Therapy with Alzheimer’s Population©.1 ½ hour, self published.
Levine Madori, L. (2008). Therapeutic Thematic Arts Programming with Alzheimer’s  Population©1 ½ hour, self published.
Levine Madori, L. (2008). Guided Imagery and the use of Object Relations Theory with Skilled Nursing Care Residents in SNF©1 ½ hour, self published.

Articles required to read:

Levine-Madori, L. (2009). Using the TTAP Method for Cognitive and Psychosocial Wellbeing, American Journal of Therapeutic Recreation, Weston Mass. (July, 2009).
Levine-Madori, L., Alders, A. (2010).Using TTAP Method© for Cognitive and Psychosocial Wellbeing. American Art Therapy Journal (accepted submission, 2010)
Levine-Madori, L. (2009). Students at St. Thomas Aquinas College, Researching the TTAP Method© at Bergen Regional Medical Center. American Therapeutic Recreation Research Institute, October, 2009.

Review of Literature and Case study of TTAP Method:

Students are required to select a specific aspect of research within the area of Therapeutic Recreation, Art Therapy and/or Alzheimer’s disease which parallels the chosen population of the case study. Research sited must be taken from professional Journals from 2000 onwards.

Topics can include: emotional, social, physical or cognitive needs related to TR and AD, clinical program issues, social withdrawal, enhanced verbalization as it relates to cognition, stress as an element in cognitive decline and or physical needs of the population as it relates to TR/AD. Students will be required to incorporate the research into the REQUIRED case study.

For guidelines on format, endnotes, and bibliographies, go to the library and locate the citation guidelines of the American Psychological Association (APA).

Journal

Students will be required to keep a daily/weekly journal that will reflect on clinical field experiences, weekly required readings and personal or professional issues that will aide in the students professional growth.

Class work Development of Program Design within the clinical setting

Students will be assigned into small groups, given a specific patient population and asked to develop a group intervention. Each student will have the responsibility to develop, implement and evaluate a TR intervention within the TTAP Method© framework. Group will present intervention on the last day of class and will be graded on professional presentation.

Your grade will consist of the following:

Details of the papers will be provided in class.

Class Policy

All assignments are due on time. Late papers will not be accepted.

5 day Outline of the course

Academic Integrity

Academic Integrity, a commitment to honesty, fairness, respect, and responsibility, is the foundation of the learning process.  All members of the St. Thomas Aquinas College community are held to the highest standards of academic honesty.  While we recognize the participatory nature of education, we take academic integrity very seriously, and the College policy on academic dishonesty details consequences that can include dismissal from the College.  That policy can be found in both the Student Handbook and the College Catalog.

As a student in this class, you must demonstrate your commitment to academic integrity by submitting work which originates in your own imagination, analytical faculties, or your own knowledge, which you have done yourself, and which represents your very best efforts.  When appropriate, your work should be supplemented and supported by other sources; however, you must always insure that these sources are properly cited using the recommended documentation system.

Disability Statement

Students requiring accommodations for documented disability should notify the instructor before the end of the first week of class.

About the Author/ Professor:

Linda Levine Madori, PhD, ATR-BC, LCAT has worked in the field of gerontology for 25 years as a therapist, educator, advisor, researcher, supervisor and author of new methodology entitled Therapeutic Thematic Arts Programming for Older Adults with regard to providing programming to the older population and specifically those afflicted with Alzheimer’s disease.

In September 2006, Dr. Levine Madori was awarded a five year Fulbright Senior Specialist Scholarship and traveled to teach her new and innovative therapeutic approach in both New Zealand at Waikato University and in Australia at Victoria University from February to May, 2007.  Upon her return, in May of 2007, Dr. Levine Madori was honored through The New York State Therapeutic Recreation Association and received the Distinguished Service Award. In 2008, she was nominated for the Academic Leadership Award through the American Society on Aging and the National Council on Aging in America as well as the Clinician Award through the American Therapeutic Recreation Association. In December, 2008, Dr. Levine Madori was notified that the Finnish Fulbright Organization has officially requested her to receive a second Fulbright and teach at 3 Universities and the Finnish Alzheimer’s Association for a 6 week period in 2009.  The TTAP Method is currently being studied at both Cornell University with Mild/ MCI patients as well as New York University’s application for upcoming new researchers (invitational submission, December 2008). The TTAP Method has had national recognition and is being taught in over 40 universities Art Therapy Graduate Programs and Therapeutic Recreation Programs, due to the innovative multimodal approach.

References:

• Alzheimer’s and Related Disorders Association Inc. (2008). Alzheimer’s disease program. Los Angeles, CA: Author.
• American Psychiatric Association (2005). Diagnostic and statistical manual of mental disorders. (4^th ed.). Washington, DC:  
• Austin, D. (2009). Therapeutic recreation, processes and techniques. New York: Sagamore Publishing
• Buettner, L. (1988). Utilizing developmental theory and adaptive equipment with regressed geriatric patients in therapeutic recreation. Therapeutic Recreation Journal. 22(3), 72-79.
• Buettner, L. (1999).  Simple Pleasures: A multilevel, sensorimotor intervention for nursing home residents with dementia.  American Journal of Alzheimer’s Disease. July, 137-142.
• Buettner, L., Lundegren, H., Lago, D., Farrell, P., & Smith, R.(1996). Therapeutic recreation as an intervention for persons with dementia and agitation: An efficacy study. American Journal of Alzheimer’s Disease. 12, (4), 1-8.
• Buettner, L., Kernan, B., Carroll, G. (1990). T.R. for frail elderly: A new approach. Global Therapeutic Recreation. University of Missouri Press, 1, 82-88.
• Buettner, L., & Ferrario, C. (1997). Therapeutic Recreation and Nursing; A team intervention for nursing home residents with dementia.  Annual in Therapeutic Recreation. No. V11, 1997
• Buettner, L., & Martin, S. (1994).  Never too old, too sick, or to bad for T.R..Global Therapeutic Recreation 111.  University of Missouri Press, 3, 135-140.
• Cohen-Mansfield, J., Marx, L., & Rosenthal, A. (1990). Dementia and agitation in nursing home residents: How are they related? Psychology and Aging, 5(1), 3-8. 
• Cohen-Mansfield, J., Werner, P., & Rosenthal, A. (1992). Observational data on time use and behavior problems in nursing homes. Journal of Applied Gerontology, 11(1), Vol. 3, 111-121.
• Dunn, N., & Wilhite, B. (1997). The effects of a leisure education program on leisure participation and psychosocial well-being of two older women who are home-centered. Therapeutic Recreation Journal, 1^st Qtr.
• Levine Madori, L. (2007). Therapeutic Thematic Arts Programming for Older Adults. Health Professions Press, Baltimore, Maryland.
• Lynch-Sauer, J. (1990). When a family member has Alzheimer’s disease: A phenomenological description of caregiving. Journal of Gerontological Nursing, 16(9) 8-11.
• Malkin, M. & Howe, C. (1999). Research in Therapeutic Recreation, Concepts and Methods. State College, PA: Venture Publishing.
• National Institute of Health (1995).  Alzheimer’s disease: unraveling the mystery. (NIH Publication No.95-3782) Silver Spring, MD: ADEAR Printing Office.
• National Institute on Aging. Alzheimer’s disease. Chicago: An information booklet distributed by Alzheimer’s disease and retarded disorders Association, Inc.
• National Council on the Aging, Inc. Facts and myths about aging. Washington, DC: 
• National Council on the Aging, Inc. Abstracts in Social Gerontology. Washington, DC: 
• National Institute of Health (1995). Alzheimer’s disease: Unraveling the mystery (NIH Publication No.95-3782). Silver Spring, MD: ADEAR Printing Office.
• National Therapeutic Recreation Society. (1982). Philosophical position statement. Alexandria, VA: Author. Tabourne, C. E. S. (1995). The life review program as an intervention for an older adult  newly admitted to a nursing home facility: A case study. Therapeutic Recreation Journal, 3^rd Qtr., 228-240.
• Reisberg, B. (1984). Stages of cognitive decline. American Journal of Nursing, 84(2), 225-228.
• The Reconciliation Act of 1987 (OBRA).United States Government. Washinton, DC.
• Voelkl, J. E., Galecki, A. T., & Fries, B. E. (1996). Nursing home residents with severe cognitive impairments: Predictors of participation in activity groups. Therapeutic Recreation Journal, 1^st Qtr., 27-40.
• Voelkl, J. E., & Mathieu, M. (1995). Intra-individual variation in the subjective experiences of older adults in a nursing home. Therapeutic Recreation Journal, 2^nd Qtr., 114-123.