Leisure And Stress-Coping: Implications For Therapeutic .

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THERAPEUTIC RECREATION JOURNAL SPECIAL ISSUEVol. XLII, No. 1, 9–23, 2008Leisure and Stress-Coping: Implications forTherapeutic Recreation PracticeSusan L. Hutchinson, Andrea D. Bland, and Douglas A. KleiberAbstractWithin the field of leisure studies there is growing evidence of the value of leisure activityand experience in the course of coping with and adjusting to the kinds of acute and chronic lifestressors that clients in therapeutic recreation (TR) settings may encounter. A review of leisurecoping literature is provided, drawing on research and theory-building in the leisure studies field.Following this, implications for TR practice are outlined. This review identifies the need to giveparticular attention to individual differences in leisure’s influence in coping with stress, as well asto the effects of different leisure activities and experiences in developing guidelines for variousaspects of TR service, including TR assessment and intervention.KEYWORDS: coping, leisure, stress, therapeutic recreationSusan Hutchinson is an Associate Professor and Andrea Bland is a graduate student in the School of Healthand Human Performance at Dalhousie University in Halifax, Nova Scotia, Canada. Douglas Kleiber is aprofessor in the Department of Counseling and Human Development Services at the University of Georgiain Athens, Georgia.HUTCHINSON, BLAND, AND KLEIBERTRJ-Q1.indd 994/9/08 8:41:17 PM

Leisure and Stress-Coping:Implications for TherapeuticRecreation PracticeA considerable body of evidence now exists to support the contention that leisure canbe an important resource for coping with acuteand chronic life stressors. Yet, very little of thisresearch has been effectively translated for usewithin therapeutic recreation (TR) practice1.The purpose of this paper is to review leisureresearch and theory related to the contributionsof leisure in coping with stress and to suggestimplications for TR practice.We are focusing specifically on conceptualizations and evidence from leisure researchfor two reasons. First, based on research in avariety of TR settings, therapeutic recreationresearchers have already provided evidenceof: (a) the potential for family-centered TRprograms to be a coping resource for familymembers of institutionalized older adults (e.g.,Dupuis & Pedlar, 1995), (b) the importance ofTR for enhancing the coping skills of clientsliving with AIDS (Caroleo, 1999), (c) the effectiveness of a multidisciplinary approach tostress-coping interventions in TR for clientswith traumatic brain injury (Gongora, McKenney, & Godinez, 2005) and (d) the perceivedbenefits of a leisure education intervention forclients receiving treatment for substance orsexual abuse (Carruthers & Hood, 2002; Griffin, 2005). In addition, others writing abouttherapeutic recreation have drawn on theories and evidence from the social-psychologystress-coping literature to outline the potentialrole of TR in addressing a broad range of coping skills. For example, Bedini and Phoenix(1999) and Hood and Carruthers (2002) applied stress-coping theory and research to thedevelopment of TR practice models focused onthe relationships between stress-coping, leisureand well-being, and Stumbo (2002) presentedrecommendations for TR coping skills interventions for clients living with pain. To avoidduplicating such efforts, conceptual modelsand research evidence from the TR literaturewill not be reviewed here, although readers arestrongly encouraged to examine this literatureif contemplating the development of a stresscoping intervention in a TR practice setting.Second, by focusing on theory and research from the leisure studies field, our hope isto overcome the perception that “practitionersand researchers live in two different worlds”(McCormick & Lee, 2001, p. 385). Our ownresearch has focused on how and under whatconditions leisure can be a coping resourcein the face of severe and chronic stress (e.g.,Hutchinson & Kleiber, 2005a; Hutchinson, Loy,Kleiber, & Dattilo, 2003; Kleiber, Hutchinson,& Williams, 2002). Our purpose here is to worktoward bridging this research-practice gap, bysummarizing research evidence from leisurestudies regarding the role of leisure in copingwith stress and suggesting implications for TRpractice.Leisure-Coping ResearchWe have organized this summary by firstreviewing earlier conceptualizations of the leisure-stress-coping relationships. Following thiswe summarize findings from leisure researchwhich has identified: (a) individual factors influencing the leisure-stress-coping relationshipand (b) the effects of different forms of leisureactivities and experiences on stress-coping.Conceptualizing the Role ofLeisure in Coping with StressColeman and Iso-Ahola (1993) were theearliest leisure researchers to conceptualize therelationships between leisure and stress. Theysuggested that leisure-generated social supportand “self-determination dispositions” wouldbuffer the relationships between increased lifestress and mental and physical health. Leisuregenerated social support refers to the ways inwhich connections with others in leisure settings may provide people with important emotional and instrumental supports. Self-determination dispositions are the ways that leisurecontributes to: (a) developing or enhancingpeople’s beliefs in their abilities to take action on issues that matter to them and (b) experiencing self-determination through leisure.Coleman and Iso-Ahola noted that the intrinsicmotivation and perceived freedom inherent inmany enjoyable leisure experiences may contribute to the development of stable beliefs inone’s ability to be self-determined, which, inturn, will help people more effectively draw onAs noteworthy exceptions see articles by Cassidy; Iwasaki, Mactavish and Mackay; and Juniper for suggestions for leisureeducation/counseling in a 2005 special issue of the British Journal of Guidance and Counselling.110TRJ-Q1.indd 10LEISURE AND STRESS-COPING4/9/08 8:41:18 PM

their leisure in times of increased stress.Building on these earlier conceptualizations, Iwasaki and his colleagues (Iwasaki,2001, 2003; Iwasaki & Mannell, 2000) developed a leisure-coping model that distinguishesleisure coping beliefs from leisure coping strategies. Leisure coping beliefs refer to the extentto which people believe that they can use theirleisure to cope in times of stress. Beliefs aboutthe availability of leisure-based social supports(e.g., leisure friendships), as well as feelings ofself-determination, empowerment, and competence developed through leisure pursuits, mayhelp people feel more capable of managingperceived stress. These beliefs are consideredrelatively stable dispositions and are differentiated from leisure coping strategies, which areseen as situational leisure-based responses tostressful or challenging situations. These strategies can be either cognitive (e.g., reappraising a situation) or behavioral (e.g., exercise).Iwasaki and Mannell included leisure moodenhancement (e.g., “my leisure helped me feelbetter”), leisure palliative coping (e.g., “I tooka brief break through leisure to deal with thestress”), and leisure-companionship (e.g., “Ideal with stress through spending leisure timewith friends”) as leisure coping strategies.In support of these conceptualizations,there is evidence that people generate leisurebased coping beliefs about their abilities to beself-directed, competent, and autonomous intheir leisure and about the availability of social resources (Coleman & Iso-Ahola, 1993;Iso-Ahola & Parks, 1996; Iwasaki & Mannell,2000). In turn, these appraisals influence thevarious ways people may actually use their leisure to cope with stress. Iwasaki (2001, 2003)determined that people’s beliefs about theirleisure, rather than what they actually do intheir leisure, contribute most significantly tobuffering the effects of stress on psychologicalwell-being. To the extent people believe theyhave personal or social resources to manage astressful situation, they may perceive the situation as more manageable and, in turn, engagein more active coping (see also Hood & Carruthers, 2002). In addition, people’s abilities toeffectively manage a stressful situation will influence subsequent stress appraisals and copingbehaviors (Iwasaki, 2006). An important implication of this research, then, is recognition ofthe need to help clients receiving TR servicesHUTCHINSON, BLAND, AND KLEIBERTRJ-Q1.indd 11to examine and develop their leisure-copingbeliefs. In part, this will evolve from people’sknowledge and understanding of the potentialbenefits of leisure for coping with stress, butalso from their past experiences of coping inand through leisure.Overall, the research with relatively‘well’ adults demonstrates that leisure can bea stress-buffer; that is, in times of high perceived stress, leisure can reduce the negativeeffects of stress on people’s mental or physicalhealth (e.g., Iso-Ahola & Parks, 1996; Iwasaki& Mannell, 2000). Iwasaki (2001, 2003), forexample, found that both leisure coping beliefsand strategies made significant contributions tocoping with daily hassles in the lives of university students and, in turn, enhanced students’perceived coping efficacy, mental health andpsychological well-being. Iwasaki, Mannell,Smale and Butcher (2005) determined that relaxing and social forms of leisure contributedto immediate health outcomes as well as mental and physical health in a sample of adultsin high stress roles. It is notable that leisure’scontribution to coping with stress seems to operate significantly beyond the contribution ofother more general forms of stress-coping (e.g.,problem-focused coping; Iwasaki et al., 2005),but it is also noteworthy that research exploring the role of leisure in coping with stress andhealing from trauma among marginalized andnon-dominant population groups (includingpeople with disabilities) is emerging. For example, Iwasaki, MacKay, Mactavish, Ristock,and Bartlett’s (2006) community-based focusgroup study with individuals living with disabilities, Aboriginal persons with diabetes, andpeople who identified as gay or lesbian, foundthat the meanings gained through active leisureas a coping mechanism were closely tied tothe multiple identities of people (e.g., gender,ethnicity, disability, sexual orientation) and therealities of their lives (e.g., racism, ableism).Clearly, further investigations are needed notonly to build on and advance the leisure-copingliterature, but also to conduct applied researchwith people in TR settings who may live withsevere chronic stress.Individual Differences in LeisureStress-CopingTo develop practice-based guidelinesfrom the leisure research on leisure-based cop114/9/08 8:41:18 PM

ing, one question to try to answer is: for whomis leisure a coping resource? We focus first onreviewing research that has examined leisurecoping at various points in the life course (adolescent, adult, and older adult populations), andthen on the thinking and research regardingleisure’s role in coping with severe and chronicstress.Leisure-coping across the life course.We could not find evidence of studies of leisure-based coping by younger-aged children,although outside the leisure studies field (e.g.,developmental psychopathology) others haveextensively examined the relationships between different forms of (non-leisure) copingand health outcomes (see Compas, ConnorSmith, Saltzman, Thomsen & Wadsworth,2001, for a review). In addition, randomizedcontrolled studies of coping skills interventions for children who are considered at risk forpoor psychological well-being have also beenconducted (e.g., Puskar, Sereika, & TusaieMumford, 2003). Notably, these interventionshave not incorporated a focus on leisure-basedcoping.As it relates to leisure-based coping inadolescence, Hutchinson, Baldwin, and Oh(2006) determined that middle school agedadolescents (aged 12-14) used a wide varietyof structured and unstructured leisure activitiesto actively manage perceived stressors in theirlives. They recommended that attention be given to enhancing youth’s social-emotional competence and to building skills that promote positive or adaptive coping and resilience. Otherstudies of older adolescents have demonstratedthat leisure engagement is related to reducedpsychological distress and increased optimism,perceived competence or self-efficacy, selfdetermination and social support (e.g., Cassidy, 2005; Passmore & French, 2000). Basedon his study of young adults’ leisure, Cassidyrecommended that attention be given to the development of patterns of leisure attitudes andengagement in childhood, as these influencesubsequent adult leisure behaviors relevant tohealth and illness. Taken together, designingTR interventions to teach youth to develop anduse their leisure to cope with stress will haveimportant health promotion and risk preventionimplications.In addition to research on the leisurestress-coping relationship with adults for12TRJ-Q1.indd 12whom stressful life events may be more transitory (e.g., during exams) or in the form of dailyhassles (e.g., Iwasaki, 2001, 2003; Iwasaki &Mannell, 2000) there is additional researchwith people in high stress work roles that supports the contention that leisure can counteractmore persistent forms of stress (e.g., Iwasaki,Mannell, Smale, & Butcher, 2002, 2005). Several authors (Iwasaki, 2006; Iwasaki, Mannell,et al.) have suggested that leisure can helpcounteract work stress and help people strivefor work-life balance, which has implicationsfor some clients in mental health TR settings.Gender differences in leisure’s utility as a coping resource in adulthood were also identified(Iwasaki & Smale, 1998). For example, Iwasakiand Smale found gender differences in terms ofthe impact of life events on psychological wellbeing, with women finding widowhood morechallenging than men and men finding unemployment or retirement more stressful. Iwasakeand Smale also found that, for the most part,people were able to overcome the negativeeffects of these events on their psychologicalwell-being when they placed more importanceon leisure goals.In regard to coping with work-relatedstressors in adulthood, Trenberth, Drewe andWalkey (1999) found that more passive formsof leisure were important for helping peoplerecuperate from work-related stress, whereasin a study of professional managers, Iwasaki,Mackay and Mactavish (2005) identified arange of leisure-based activities (e.g., volunteer work, spirituality, leisure-based travel)that were part of their “life survival strategies.”Unique gender differences were also noted inthat female managers emphasized the value ofleisure for health maintenance, whereas malemanagers viewed “playing hard” in their leisure as important to letting off steam. Again,these findings add support to the suggestionthat helping adults to acquire the knowledge,awareness, and skills to incorporate a rangeleisure options into their daily lives may be important for clients in mental health settings. Inaddition, if clients do not have work-life balance, or feel guilty taking time for themselves,leisure-based interventions should be focusedon helping them become aware of the needto develop an ethic of leisure-based self-care(Charters & Murray, 2006).Despite the reduction of stressors associLEISURE AND STRESS-COPING4/9/08 8:41:18 PM

ated with juggling multiple role responsibilitiesin adulthood (Zuzanek, Robinson, & Iwasaki,1998), health-related and relational concerns(e.g., caregiving, widowhood) often becomesources of stress for older adults. Nonetheless, various forms of leisure engagement havebeen found to be adaptive in later life (Dupuis& Smale, 1995; Hutchinson, Yarnal, Son, &Kerstetter, 2007). For example, regular participation in hobbies and crafts, visiting friends,and swimming were all associated with betterpsychological well-being and lower levels ofdepression for older adults in the Dupuis andSmale study. Likewise, Hutchinson et al. foundthat older women who participated in an allwomen’s social group (the Red Hat Society )indicated that participation helped them feelbetter able to manage stress in their lives.Taken together, these studies provideevidence that leisure can be a positive copingresource across the life course. Still, the variations evidenced across gender and within andacross age cohorts also highlight the need forTR practitioners to adopt a person-centered approach to understanding perceptions of stress,and to helping people identify their leisure-related goals and the types of leisure activitiesmost likely to positively contribute to theircoping repertoire.Leisure and coping with severe and chronic stress. Beyond coping with normative lifestressors, some leisure scholars have focusedon leisure’s role in coping with more severeand chronic stress, such as the stress associatedwith negative life events (e.g., homelessness,abuse) chronic health conditions, or permanentdisabilities (Iwasaki & Bartlett, 2006; Iwasaki,Bartlett, & O’Neil, 2005; Kleiber, Brock, Lee,Dattilo, & Caldwell, 1995; Klitzing, 2003; Lee& McCormick, 2002)2. Beyond the stressorsassociated with the trauma or health condition,research by the above leisure scholars alsohighlights additional forms of stress (such asstigma, discrimination, negative stereotypesand abuse) experienced by people who are marginalized due to their race, sexual orientation,disability, or social class (Iwasaki et al., 2006).People who are discriminated against or oppressed due to their gender, ethnicity, disabilityor sexual orientation are often disadvantagedsocially, culturally, economically or politically(Iwasaki et al., 2006). This research emphasizes the need for TR practitioners to attend tothe multiple identities and realities of clients inTR settings (e.g., as women, disabled, lesbian)and to understand how daily experiences ofdiscrimination or marginalization may shapeperceptions of stress and leisure.Regardless of the nature of the stressor,it seems that time spent with supportive othersand in personally meaningful forms of leisurehelps promote coping and resilience in the faceof chronic stress. Propositions by Kleiber andcolleagues (Kleiber, 1999; Kleiber et al., 2002)help explain leisure’s role in coping with andadapting to negative life events. They writeabout leisure’s role in self-preservation andself-restoration, which parallel concepts ofcoping and adjustment. Self-preservation refers to the ways leisure can buffer the impactof negative life events by being distracting andby generating optimism about the future. Aswith the research with typical adult populationsdescribed earlier, there is evidence that leisurein many different forms can serve as a positivedistraction for individuals experiencing severeand chronic stress and that its importance as acoping resource extends from hospitalizationto residential care settings to community living(Hutchinson, Afifi, &, Krause, 2007; Hutchinson et al., 2003; Hutchinson & Kleiber, 2005a).While there are clearly times that some leisureactivities can be maladaptive (e.g., drinkingor partying if engaged in to excess and in theabsence of other more healthy engagements),leisure activity engagement that enables peopleto take their mind off their problems and to experience enjoyment and less stress often fulfillsthe stress-buffering role of leisure identifiedearlier. In addition to the positive emotions andthoughts generated from these experiences, leisure can contribute to ongoing coping effortsby providing people with something to lookforward to and helping them feel more capableof managing the ongoing stressors in their lives(Kleiber et al.). This is particularly importantwhen the situation cannot be changed, as isoften the case with individuals receiving TRservices.In addition to buffering the immediate im-We could not find evidence in the leisure literature of research that has examined whether or not leisure is a coping resourcefor people living with severe cognitive impairments, such as dementia or a develo

stress-coping literature to outline the potential role of TR in addressing a broad range of cop-ing skills. For example, Bedini and Phoenix (1999) and Hood and Carruthers (2002) ap - plied stress-coping theory and research to the development of TR practice models focused on the relationships between

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