Recreational Therapy

Occupational Description

Recreational therapy is defined as “a treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restriction to participation in life situations caused by an illness or disabling condition” (American Therapeutic Recreation Association [ATRA], 2009). Recreational therapy, an aspect of therapeutic recreation, is a skilled therapy provided as active treatment (as defined by the Centers for Medicare and Medicaid Services). Recreational therapy is part of the broader field of therapeutic recreation, which also encompasses trained professionals dedicated to providing outcome-based recreation services to all citizens.

Job Description

Recreational therapists are professionally trained practitioners who:

Individually assess the patient or consumer
Plan intervention programs
Implement safe and effective evidence-based recreational therapy interventions
Evaluate the effectiveness of intervention programs
Manage recreational therapy practice

Recreational therapists provide individualized and group recreational therapy interventions for individuals experiencing limitations in life activities and community participation as a result of a disabling condition, illness or disease, aging, and/or developmental factors, including those at risk. Recreational therapists use a variety of educational, behavioral, recreational, and activity-oriented strategies with clients to enhance functional performance and improve positive lifestyle behaviors designed to increase independence, effective community participation, and well-being. Recreational therapists are effective members of treatment teams in health care and community-based health care and human service agencies.

The day-to-day work experience of recreational therapists can vary dramatically, depending on the setting and clients they serve. The recreational therapist works with the client, family, members of the treatment team, and others to design and implement an individualized treatment or program plan, depending on the setting. During a typical day, a recreational therapist will respond to physician orders for assessment and treatment, conduct individualized assessments, and provide individual and group-based interventions to address treatment goals for patients on their caseload. Treatment interventions might include a stress management group or use of various relaxation and other techniques including, but not limited to:

leisure skill/education
assertiveness training
stress management
social skills
community reintegration
A high or low ropes course or initiatives interventions
Adapted sports
Animal assisted interventions
Manual, visual, and expressive arts
Horticulture
A therapeutic outing designed to meet specific goals for community integration
A family intervention
A therapeutic exercise or aquatic therapy session

Recreational therapists also verbally process intervention experiences with patients to enhance the impact the activity experience has on achieving treatment goals. In a typical day the recreational therapist will also document interventions provided, note patient progress, or develop a discharge plan with a plan for aftercare.

An important responsibility for a recreational therapist in clinical settings is to advocate for individuals with disabling conditions to improve integration and community participation, especially through recreational activities, after discharge from a health care facility. This includes addressing such issues as limited knowledge of opportunities, transportation resources, inaccessible facilities attitudinal barriers, and legislation that affects people with disabling conditions. Professional activities may also include developing appropriate support groups, advocacy, and social networking strategies.

Employment Characteristics

In clinical settings, such as hospitals, psychiatric or skilled nursing facilities, substance abuse programs, and rehabilitation centers, recreational therapists treat and rehabilitate individuals with specific medical, social, and behavioral problems, usually in cooperation with physicians; nurses; psychologists; social workers; and speech, physical, and occupational therapists. In long-term, continuing care or residential facilities, recreational therapists may be involved in providing treatment as well as activities designed to maintain functioning and enhance the life quality of residents. In community settings, therapeutic recreation specialists work in adult care, outpatient programming, adaptive sports and recreation programs, home health, private consulting, developmental disabilities services, and other health and human services. Therapeutic recreation specialists working in parks and recreation services facilitate the inclusive recreation services for individuals with disabling conditions.

Recreational therapists should have assessed competency (knowledge, skill and ability) in the following recreational therapy content areas:

Foundations of professional practice
Individualized patient/client assessment
Planning treatment interventions
Implementing treatment interventions
Evaluating treatment/programs
Managing recreational therapy practice

Recreational therapists should also have assessed competency (knowledge skill and ability) in the following support content areas as a foundation of understanding health and human functioning:

Anatomy and physiology
Human growth and development (lifecycle)
Psychology
Abnormal psychology
Disabling conditions

Many may also have support content in:

Counseling
Kinesiology
Cognitive or educational psychology
Group dynamics and leadership
First aid and safety
Motor skill learning
Pharmacology
Health care organization and delivery
Legal aspects of health care
Recreation and leisure services

Knowledge of disabling conditions; physical, social, cognitive, and affective development and functioning; and the application of therapeutic activities are essential in adapting activities to individual needs.

Educational Programs

Length. A bachelor’s degree or higher with a major in recreational therapy or therapeutic recreation or recreation with a specialization in recreational therapy or therapeutic recreation is required for national certification. Specific requirements can be obtained from the National Council for Therapeutic Recreation Certification (see www.nctrc.org)

Curriculum. In addition to recreational therapy courses in aspects of clinical practice (assessment, planning, implementing, and evaluating recreational therapy services), foundations of professional practice, management of recreational therapy practice, modality/interventions skills, and recreation and leisure services, students study human anatomy and physiology, human growth and development, psychology, abnormal psychology, and human services supportive coursework. These content areas are required by the National Council for Therapeutic Recreation Certification. In addition, the CAAHEP accredited requires kinesiology and educational psychology. Additional content areas studied for the degree may also include motor skill learning, counseling, group dynamics and leadership, first aid and safety, pharmacology, health care organization and delivery, and legal aspects of health care. In addition, an internship under the supervision of a certified therapeutic recreation specialist or a licensed recreational therapist (who has held the credential at least one year prior to supervising the intern) is required. Refer to the NCTRC website to review curriculum standards changes, effective January 1, 2012 and 2013. (www.nctrc.org)

Certification/Registration

Some states regulate the recreational therapy profession through licensure, certification, or registration of titles. Licensure is required in New Hampshire, North Carolina, Oklahoma, and Utah. These states require individuals to make application to their state boards and meet designated competencies in order to provide safe and effective consumer services. Washington requires state registration and California requires state certification. For more information on state licensure requirements, contact:

Office of Licensed Allied Health Professionals
New Hampshire
(603) 271-8389
Website: www.nh.gov/alliedhealth

North Carolina Board of Recreational Therapy Licensure
(336) 212-1133
Website: www.ncbrtl.org

Oklahoma Board of Medical Licensure and Supervision
(405) 848-6841
Website: www.okmedicalboard.org

Utah Division of Occupational and Professional Licensure
(801) 530-6628
Website: www.dopl.utah.gov

National certification is available through the National Council for Therapeutic Recreation Certification (NCTRC), which awards the title of Certified Therapeutic Recreation Specialist (CTRS).

National Council for Therapeutic Recreation Certification
7 Elmwood Drive
New City, NY 10956
(845) 639-1439
E-mail: nctrc@nctrc.org
Website: www.nctrc.org

Commission on Accreditation

of Allied Health Education Programs