Therapeutic Recreation Internship Manual TR... · Therapeutic Recreation Specialist (CTRS). This is an unpaid internship. ... Providing a copy of the university internship manual

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Fulton State Hospital Rehabilitation

Services Department

Therapeutic Recreation Internship

Manual

Rev. 10/1/15

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Table of Contents FSH INFORMATION ON TR INTERNSHIP PROGRAM ..................................................................................... 3

Philosophy and Goals .......................................................................................................................................... 3 Purpose of Internship .......................................................................................................................................... 3 FSH Goals of the Internship ............................................................................................................................... 3 Responsibility of the Academic Institution ........................................................................................................ 3 Sequence of the Internship in the Curriculum .................................................................................................. 4 Internship Length ................................................................................................................................................ 4 Application and Interview Process..................................................................................................................... 4 Liability ................................................................................................................................................................ 4 Student Pre-Requisites for Field Placement ...................................................................................................... 4 Student's Roles and Responsibilities .................................................................................................................. 5 Evaluation of Internship Site .............................................................................................................................. 5 Student Advocacy ................................................................................................................................................ 5 Personnel Issues ................................................................................................................................................... 6

ABOUT FULTON STATE HOSPITAL ................................................................................................................... 6 HOSPITAL OVERVIEW ......................................................................................................................................... 7

Biggs Forensic Center ......................................................................................................................................... 7 Guhleman Forensic Center ................................................................................................................................. 7 Hearnes Forensic Center..................................................................................................................................... 8

ABOUT OUR LOCATION ...................................................................................................................................... 8 St. Louis & Kansas City, Missouri ..................................................................................................................... 9 Jefferson City, Missouri ...................................................................................................................................... 9 Columbia, Missouri ............................................................................................................................................. 9 Other Information ............................................................................................................................................... 9

REHAB SERVICES DEPARTMENT .................................................................................................................... 10 Services and Staff Composition ........................................................................................................................ 10 Rehab Services Department Mission, Vision, Values .................................................................................... 10

Mission ............................................................................................................................................................ 10 Vision .............................................................................................................................................................. 10 Values ............................................................................................................................................................. 10

Competencies and Objectives ........................................................................................................................... 11 Therapeutic Recreation Internship: Student Assignment Schedule (Flexible) ............................................ 12

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FSH INFORMATION ON TR INTERNSHIP PROGRAM

Philosophy and Goals

The Therapeutic Recreation (TR) internship at Fulton State Hospital (FSH) is designed to meet the requirements established by the National Council for Therapeutic Recreation Certification (NCTRC) for field placements. FSH will provide students a highly structured, field-centered experiential experience, supervised by a Certified Therapeutic Recreation Specialist (CTRS). This is an unpaid internship. FSH employs more than five CTRS’s that can provide supervision. The student intern will work in the Rehabilitation Services (RS) Department. The department consists of Recreation Therapy, Music Therapy, Occupational Therapy, Library Services and Vocational Training. There are more than 50 staff in the RS department. Purpose of Internship

Internships shall provide students with an opportunity to have practical experience in a setting which is providing established professional therapeutic recreation services, commensurate with the student's education level, previous experience, and professional goals.

The internship shall augment the formal classroom and related learning experiences to include application of theory and practical skills.

The internship shall be an active learning experience for the student to develop therapeutic recreation competencies in the service delivery process.

FSH Goals of the Internship

FSH will offer the student intern full time opportunities (40 hours per week for 14 weeks) to gain practical experience under qualified professional supervision (CTRS), including frequent evaluation and feedback.

FSH will provide the student intern with the opportunity for an experiential experience that meets NCTRC field placement requirements once successfully completed.

The student intern will have the opportunity to meet their academic requirements for a degree with a major or option in therapeutic recreation.

The internship shall provide an opportunity for students to establish realistic goals (based on evaluation of their experiences and performance) for their own professional development.

Responsibility of the Academic Institution

Supervising, evaluating, advising, and observing students during the internship.

Maintaining regular contact with the student and the site supervisor via phone or correspondence when a student is completing an internship.

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Providing a copy of the university internship manual to the FSH RTIII.

Ensure that the student is prepared to effectively participate in the clinical education phase of their overall program.

Ensure that the student has a satisfactorily completed the prerequisite portions of their academic curriculum and are eligible for clinical training.

Sequence of the Internship in the Curriculum

The full time internship shall be sequenced in the curriculum to occur after successful completion of required academic courses.

The internship should be initiated only after the student has acquired the necessary competencies (e.g. theory, knowledge, techniques, skills) that the college or university requires.

All required pre-internship and recreation core courses must be completed prior to the internship.

Internship Length The internship is structured to meet the requirements for CTRS established by NCTRC. This includes a minimum of 560 hours in 14 consecutive weeks. To enhance the learning experience, FSH prefers a student participate in a full time internship. Full time is considered 40 hours at Fulton State Hospital Application and Interview Process Each student interested in an internship at Fulton State Hospital must contact the RT III (TR Supervisor) and set up an interview. An application must be filled out with attachments. These attachments include:

Resume

Letter of recommendation

http://dmh.mo.gov/docs/fulton/fshapplication.pdf Fillable application link (fill, print, sign and send) -- or you can use the paper application below.

Liability Unless otherwise specified in an academic contract, the hospital provides liability coverage for the student. Student Pre-Requisites for Field Placement

It is recommended that the student have some psychology background, preferably in abnormal psychology.

It is recommended that the student have some prior job or volunteer experiences.

A large majority of degree coursework should be completed prior to the internship.

http://dmh.mo.gov/docs/fulton/fshapplication.pdf

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A reference letter addressing judgment skills, dependability, motivation, etc. should accompany the initial application.

Student's Roles and Responsibilities Responsibilities of the student in an internship setting shall be developed and defined in writing be the university and FSH. The student shall have access to this information prior to the decision of placement. Student's responsibilities shall include, but are not limited to:

Receiving, knowing and following the internship course outline and internship manual.

Signing the student's section of the agreement with FSH.

Following up and contacting the FSH Therapeutic Recreation Supervisor to make arrangements for the interview.

Maintaining contact as agreed upon with the internship supervisor.

Completing and submitting records, reports, and assignments on time during the internship.

Completing a self-evaluation, as well as evaluating the internship experience.

Completing necessary training to work at FSH.

Being familiar with and following the FSH policies and procedures.

Providing assigned TR services in a professional manner.

Following program procedures and individualized treatment plans.

Terminating relationships with clients at the end of the internship experience in a caring, professional manner.

Relating to the people at FSH with respect and dignity and adhering to their rights.

Maintaining confidentiality.

Maintaining a positive attitude and willingness to learn.

Seeking opportunities to learn that may not be part of the internship experience. (i.e. volunteer work, attending professional meetings and conferences, reading).

Willingness to evaluate job performance over the 14 week period, identifying strengths and limitations, and developing action plans for gaining competency in desired areas. This evaluation and action plan shall be communicated to the site supervisor on a weekly basis.

Evaluation of Internship Site An evaluation by the student of the site and the site supervisor will be done in an exit interview with the FSH Therapeutic Recreation Supervisor. (RT III). This will be completed before leaving FSH. Student Advocacy Students may on occasion encounter difficulty in meeting the demands of the internship program, conflicts with supervisors, problem clients, or a host of challenging situations. At such times, the student may sense the need for counsel, advice, or support from another TR professional, other than the supervisor. This is considered the student advocate.

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The student advocate will act as a liaison or mediator between student and supervisor in the event that difficulties arise between the student and the supervisor. The advocate will be available as a counselor to the student and will act as a sounding board during discussion of issues pertaining to student's time at FSH. The advocate will be available on an as needed basis to the student. Personnel Issues The student will be expected to work 40 hours a week while fulfilling the requirements of a 12-15 week internship (depending on school requirements). Flex time can be used if a student must take time off. This should be arranged with the supervisor. The student will be required to complete the following with the Personnel Department upon arrival:

Criminal Records Check (Fingerprinting) done by Highway Patrol/FBI

Department of Mental Health Central Registry

Diving of Aging Disqualification List

Division of Family Services (DFS) Records Check

Drug Screening If any of these items cannot be fulfilled, the intern cannot complete an internship at FSH. ABOUT FULTON STATE HOSPITAL In 1851, FSH admitted its first client becoming the first mental institution west of the Mississippi River. A decade after its opening, the hospital was closed during a period of local disorder brought about by the Civil War. From October 1861 to September 1863, operations were suspended, and for part of this time the hospital building was used as a barracks to house Federal troops. The original building at the hospital housed 72 clients and by 1950 the client census was reached 3,000. Today, mental health services emphasize active treatment in the least restrictive setting. Efforts are geared toward placement in the community with necessary support services provided at the community level. Since the 1980's with the momentum of the psychosocial rehabilitation movement. Fulton's population has dropped to around 400. Throughout its long history, FSH has been a pioneer, meeting urgent problems with innovative programs. The complex operation of FSH today reflects the efforts over many years of meeting its basic mission of treating mentally ill clients in a number of specialized programs. FSH is a long term psychiatric facility which centers on providing specialty services. Today, FSH enjoys full accreditation from TJC, Medicare and Medicaid.

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To meet the challenging needs of the population it serves, FSH remains flexible and innovative in its planning and programming. Fulfilling the FSH mission, “Partnership and Recovery”, is a challenging and rewarding experience. For more history, see the website at http://dmh.mo.gov/fulton/history.htm . HOSPITAL OVERVIEW

Fulton State Hospital serves a diverse client population, and a correspondingly wide variety of services including: forensic evaluations and admissions, competency restoration treatment, acute inpatient treatment for Department of Corrections inmates, substance abuse treatment, and long-term treatment and rehabilitation for individuals with severe and persistent mental disorders, personality disorders and intellectual developmental disabilities. Our long-term treatment and rehabilitation programs emphasize the application of state-of-the art technologies in the form of structured ward-wide programs. Biggs Forensic Center

The Biggs Forensic Center is the only maximum security forensic hospital in the state. It contains 13 wards with a total of 186 beds, and is specifically designed to treat male and female clients who have demonstrated dangerous behaviors toward others in combination possessing serous psychiatric and/or personality disorders. This highly specialized unit provides psychiatric evaluation and treatment in a secure environment, always with the desired goal of progressive movement from a highly structured setting such as Biggs to the less structured living situations found in the Guhleman Center. In this manner, the clients are given the opportunity to move through a system specifically designed to provide them an accompanying increased emphasis on demonstrated acceptable standards of social and behavioral responsibilities. The Biggs Forensic Center provides evaluation and treatment to the following clients: A. Those committed by state circuit courts as not guilty by reason of mental disease

of defect B. Those transferred by the Missouri Department of Corrections. C. Those whose aggressive behavior cannot be managed by other units of FSH

or by the Department of Mental Health. D. Those in need of pre-trial psychiatric evaluation. Treatment and evaluation is provided in several specialized treatment programs. Each program focuses treatment toward a particular population. Social Learning (SLP), Recovery and Self Motivation (RSM), New Outlook (DBT-NOP), Department of Corrections, Pre-Trial and Admissions are a few. Guhleman Forensic Center The Guhleman unit is a four ward, 100 bed facility. Treatment at Guhleman focuses on moving clients from a medium security to a minimum security setting. As clients

http://dmh.mo.gov/fulton/history.htm

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progress through the programs, they are expected to exhibit increasingly responsible behavior and in turn receive more freedom and privileges. Treatment at the Guhleman unit also prepares clients for integration back into the community or transfer to another to another care facility. Programs include: Social Learning, New Outlook and Recovery and Self-Motivation. Hearnes Forensic Center The Hearnes Forensic Center is a 22 bed unit. The mission of the Hearnes Forensic Center is to improve the lives of persons with intellectual development disabilities to live as independently and productively as possible, with eventual discharge to the community. Individuals on this ward have committed crimes and are typically admitted with forensic commitments of incompetent to proceed to stand trial, not guilty by reason of mental disease or defect, or permanently incompetent to stand trial. HFC utilizes the New Outlook Program which is based in Dialectical Behavior Therapy and Positive Behavior Support. The focus is on learning to self-regulate emotions and behaviors, and in developing social, work, and leisure skills for a happy, productive life.

SORTS The Sex Offender Rehabilitation and Treatment Services (SORTS) unit at Fulton State Hospital is a program for clients who have been civilly committed under Missouri State Statute 632.480 as Sexually Violent Predators. Clients who reside in the SORTS unit are those with serious histories of violent sexual offending and corresponding mental illnesses (i.e., paraphilias) that increase the likelihood of their criminal sexual behavior. In addition to sex offender treatment, SORTS clients represent a broad range of psychosocial treatment needs, including mental illness, personality psychopathology, trauma, geriatric and medical concerns, intellectual and developmental disabilities, isolation from family members and other supports, substance abuse, and lengthy histories of incarceration and hospitalization.

ABOUT OUR LOCATION

Fulton State Hospital is located in Fulton, Missouri. Fulton is a community of about 11,000 people located in central Missouri. A number of other State facilities are located in Fulton, including the Missouri School for the Deaf, and the State Reception and Diagnostic Center. The size of these facilities makes the State of Missouri the largest employer in the city of Fulton. In addition, Fulton is home to Westminster College (the site of Winston Churchill's famous "Iron Curtain" speech in 1946) and William Woods University. Both are private institutions with a combined enrollment of about 2100 students. Their presence in Fulton affords the community a variety of educational, athletic, and cultural events, including the Westminster College speaker series that has in recent years included George Bush, Ronald Reagan, Mikhail Gorbachev, Margaret Thatcher, and Lech Walesa. Fulton's website can be accessed at: http://fultonmo.org/

http://fultonmo.org/

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St. Louis & Kansas City, Missouri Fulton is approximately 100 miles west of St. Louis, and 150 miles east of Kansas City. Both cities are within easy driving distance to take advantage of a variety of cultural opportunities and recreational events, including concerts, theater and dance productions, professional athletic events, world-class art museums, botanical gardens, and zoological parks. Up to date information on happenings in these cities can be found at the following websites: http://stlouis.missouri.org/ and http://www.kansascity.com/. Jefferson City, Missouri "Jeff City", as it is called locally, is located 25 miles to the southwest of Fulton, and makes for an easy commute for many of the hospital's staff. It is the State Capitol, as well as the home of Lincoln University, a public university with an enrollment of about 3400 graduate and undergraduate students. Jefferson City's Chamber of Commerce website is located at: http://www.jcchamber.org/ Columbia, Missouri Columbia, located 30 miles west from Fulton, is Mid-Missouri's largest city. It has a population of 100,000 residents, not including the approximately 30,000 students who attend the University of Missouri's main campus there. Many of FSH's professional staff lives in Columbia, which offers a variety of unique shops, quality restaurants, cultural events, and recreational opportunities. Columbia is very much a "college town", with influences from not only the University of Missouri, but from Columbia College and Stephens College as well. More information about Columbia can be found at http://www.columbiamochamber.com/. Other Information Be sure to also check out http://www.mostateparks.com/ for information on Missouri's State Park system, including parks in and around Columbia and mid-Missouri. For a broader perspective on what the State of Missouri has to offer, refer to http://www.visitmo.com/.

http://stlouis.missouri.org/

http://www.kansascity.com/

http://www.jcchamber.org/

http://www.columbiamochamber.com/

http://www.mostateparks.com/

http://www.visitmo.com/

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REHAB SERVICES DEPARTMENT

Services and Staff Composition Rehab Services Staff are an integral part of the overall treatment and programming at FSH. The services included in Rehab Services are Occupational Therapy, Music Therapy, and Therapeutic Recreation. Each discipline strives to provide treatment on an individual or group basis to each client as determined through screening assessment and team meetings in accordance with the philosophy of each center, the facility and each client's needs. To meet the leisure needs of clients, staff encourages client to constructively utilize their time which is not obligated on an assigned schedule. Evening/weekend activities are designed to assist clients in independent broadening and/or strengthening their life skills, social skills and coping skills.

The Client Library as FSH offers services similar to those of a public library. A wide variety of library materials are available including both fiction and nonfiction books, magazines, newspaper,and music cassette tapes. There is a client library in each unit. The client library may also beused by staff members and is a wonderful source for programming ideas. The Professional Library at FSH specializes in medical aspects of psychiatry and psychology. A wide range of journals are available and many of the journals concentrate on certain disciplines within the hospital. Interlibrary loan service is also offered in the professional library, which enables our staff to obtain the most current information in their fields. Rehab Services Department Mission, Vision, Values

Mission

We involve clients in interactive task experiences that facilitate learning of necessary life skills needed to resolve problems and increase potential for wellness.

Vision

In our health care environment, we will create, teach and lead outcome based, experiential opportunities to our clients that will build on their assets, and improve quality of life.

Values

Promote healthy and productive interaction skills.

Promote wellness through education and participation.

Provide the opportunity to be creative.

Work together to foster cooperation.

Recognize the importance of leisure, fun and play.

Teach productive life skills.

Commitment to treatment of the whole person.

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Provide leadership through role modeling and teaching.

Provide meaningful, purposeful and goal oriented experiences.

Recognize importance of integration in the community.

Continuously improve competence through knowledge and skills.

Maintain and understanding the compassion for our clients. Competencies and Objectives Fulton State Hospital desires to help students become well-rounded employees by providing the opportunity to put in to practice what they have learned at their academic institutions. Upon successful completion of the internship, the student should have acquired skills and experience in the following areas:

Will demonstrate an understanding of the values of the FSH workplace and philosophy of TR Services in the Rehabilitation Services Department.

Ability to function as a contributing member of an interdisciplinary treatment team by being involved in an integrated treatment program.

Documentation - Will develop an understanding and working knowledge of an electronic medical record and of the medical chart.

Planning - Utilizing client and program need, and activity and task analysis, the student will demonstrate knowledge of selecting appropriate activities for treatment.

Group leadership - Will demonstrate the ability to conduct a variety of treatment groups by planning and leading groups based on client need, and designed to improve physical, cognitive, social, emotional and behavioral functioning.

Assessment - Utilizing a leisure assessment, the student will demonstrate abilities to identify client needs and strengths and make recommendations for further treatment and evaluation.

Communication - Will demonstrate effective written documentation skills through progress notes, special notes, assessments, referral/evaluations, treatment plans and reviews and requested written reports for the intern supervisor.

Communication - Will demonstrate effective oral communication skills through active participation in meetings, leading groups, delivering client information at treatment team meetings, and interactions with fellow treatment and discipline team members.

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Therapeutic Recreation Internship: Student Assignment Schedule (Flexible) Week # 1

Hospital Orientation/SMART Training Week # 2 – 3

Unit/Department Orientation with Supervisor, including reading manuals

Review and discuss FSH Internship Manual

Schedule weekly Supervisor/Student Meeting

Meet TR staff Program Training

Spend two days in each unit, and observe all RS discipline groups

Choose unit of interest

Electronic Medical Record (EMR) training

CIMOR training

Week #4

Continue Unit/Ward Orientation

Observe treatment groups on chosen program

Attend Treatment Team Meeting

Review Rehab Services Department Manual

Attend Security Training (where applicable)

Review Special Projects Requirements

Read professional journals related to population working with

Weekly Meeting with Supervisor

Become familiar with the Policy on Documentation Week #5

Attend Treatment Team Meeting

Begin Chart Reviews

Work on Activity and Task Analysis

Observe treatment groups on chosen program

Begin designing RT interventions based on client need, activity and task analysis and consistent with diagnosis, precautions and/or contraindications

Write Progress notes for assigned clients/ groups

Weekly Meeting with Supervisor Week #6

Attend Team Meeting

Plan and Implement interventions (groups) to improve physical, cognitive, social, emotional and behavioral functioning

Activity and Task Analysis

Co-lead treatment groups on a daily basis

Conduct and complete an annual Rehabilitation Services assessment

Chart Review for Assessment Material

Write Progress Notes on assigned clients/groups

Receive case management assignment and responsibilities

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Attend Team Meeting

Develop Outcomes and Objectives for Treatment Plan based on TR Assessment

Plan and Implement Interventions/Group Sessions on a daily basis

Complete Rehab Services Assessment as needed


Activity and task analysis continues as needed throughout internship

Define Special Project - Ex: Planning an event for the ward/program (includes marketing, budgeting, planning, purchasing)

Complete case management responsibilities


Week #8

Write Progress Notes for assigned clients/groups

Prepare a Case Study

Complete an Assessment

Attend and Participate in the Treatment Team Meeting

Plan and Implement Group Sessions on a daily basis

Order TR supplies

Evaluation of Progress

Assist with Writing a Treatment Plan Review


Week #9


Work on Case Study




Work on special project


Attend Team Meeting


Present Case Study to TR supervisor


Update a Treatment Plan

Work on special project


Week #11

Attend Team Meeting


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Complete Assessment

Analyze and evaluate data or information to modify interventions and make recommendations

Report Treatment Observation to Supervisor


Attend Team Meeting


Write progress notes on assigned clients/groups


Order TR supplies for future activities/groups

Finalize special project plans


Weeks #13 - 15

Attend Team Meeting


Write progress notes on assigned clients/groups

Complete and Present Special Project/Event

Present Case Study to TR staff


Complete all site and school assignments


Meet with RTIII for exit interview

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FULTON STATE HOSPITAL

REHABILITATION SERVICES

Therapeutic Recreation Department INTERNSHIP PROGRAM

Release of Information In accordance with the Citizen’s Right to Privacy Act, it is necessary for us to have a signed consent in order to release any information in the form of a recommendation for future employment. This applies to both practicing therapists who are changing jobs and to students who are seeking jobs after completing their fieldwork experiences. Please read the following: I, __________________________, give my consent to allow the Rehabilitation Services Department (Music, Recreation, and Occupational Therapy), Fulton State Hospital, Fulton, MO, to release, either in writing or verbally, any information regarding my performance as a therapist or student at the hospital. I understand that no information may be released without my signed consent. This consent form is valid from the date below until withdrawal of this consent is received in writing from the person whose signature is indicated below.

Signature Date

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Fulton State Hospital

Therapeutic Recreation Internship Application

Name:

Date:

School Address:

School:

City/State:

School Phone:

Home Address:

Home Phone:

City/State:

Degree Sought:

Present Academic Year:

Dates for Internship:

Please mark your interest areas:

Forensic – Maximum (Biggs) Forensic-Intermediate (GFC)

DD Minimum (Hearnes) SORTS

Evening/Weekend Leisure

List activities or skills you can use in therapy sessions or to teach staff and/or clients:

Describe your strengths and weaknesses as you see them:

Include:

A resume that includes all experiences you have had.

A letter of recommendation from your academic internship supervisor.

http://dmh.mo.gov/docs/fulton/fshapplication.pdf Fillable application link (fill, print, sign and send).

Return this application form and attachments to: Janie Smith, MS, CTRS or Karin Pestle, RTIII Fulton State Hospital 600 East 5th Street, Fulton, MO 65251 573/592-3240 (JS) [email protected]

573/592-2313 (KP) [email protected]

http://dmh.mo.gov/docs/fulton/fshapplication.pdf

mailto:[email protected]

mailto:[email protected]

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ALL INTERNSHIP CANDIDATES/POTENTIAL EMPLOYEES ARE CONTINGENT ON RESULTS FO BACKGROUND SCREENINGS, INCLUDED BUT NOT LIMITED TO:

Criminal Records Check (Fingerprinting) done by Highway Patrol/FBI

Department of Mental Health Central Registry

Diving of Aging Disqualification List

Division of Family Services (DFS) Records Check

References

Prior Employment History

Drug Screening

Documents

Therapeutic Recreation Internship Manual TR... · Therapeutic Recreation Specialist (CTRS). This is an unpaid internship. ... Providing a copy of the university internship manual