Allied Health Profession of the Month - July 2004
The Recreational Therapy Professional


A recreational therapist utilizes a wide range of interventions (Word .doc) and techniques to improve the physical, cognitive, emotional, social and leisure needs of their clients. A recreational therapist works with the client, their family members and others significant to the improvement of their health condition. Recreational therapists assist clients to develop skills, knowledge and behaviors for daily living and community involvement. The goal of recreational therapy is to restore, remediate or rehabilitate in order to improve functioning and independence as well as reduce or eliminate the effects of illness or disability.


What clients do Recreational Therapists serve and where can you find Recreational Therapists working?

Recreational Therapists may work with a wide range of individuals requiring health services including geriatric, mental health, addictions, general medicine, physical medicine and rehabilitation, developmental disabilities and pediatric clients.

Most recreational therapists are employed by health care agencies and work in traditional inpatient hospitals or health facilities but an increasing number are being hired in residential facilities, community mental health centers, adult day care programs, substance abuse centers, hospice care, community centers and in school systems. There is a growing trend for recreational therapists to work in private practice providing services in the home and community as well.

Settings which employ Recreational Therapists

Acute care hospitals

Free standing rehabilitation hospitals

Rehabilitation units in acute care hospitals

Long-term care facilities or skilled nursing facilities

Comprehensive outpatient facilities

Inpatient and outpatient mental, behavioral health/psychiatric facilities

Addiction/substance abuse rehabilitation facilities

Home health care agencies

Residential facilities for persons with disabilities

Adult day care centers

Centers for independent living

Public and private school systems

Non-profit disability related/recreational agencies



How are Recreational Therapy services different from other therapies?

Recreational therapy embraces a definition of "health" which includes not only the absence of "illness", but extends to enhancement of physical, cognitive, emotional, social and leisure development so the individual may participate fully and independently in chosen life pursuits. The unique feature of recreational therapy that makes it different from other therapies is the use of recreational modalities in the designed intervention strategies. Although many of the treatment goals that a recreational therapist may work towards are similar to other disciplines on the rehabilitation team, the way a recreational therapist achieves those goals is what distinguishes this unique service. Incorporating client's interests, and the client's family and/or community makes the therapy process meaningful and relevant. Recreational therapy is extremely individualized to each person, their past, present and future interests and lifestyle. The recreational therapist has a unique perspective regarding the social, cognitive, physical, and leisure needs of the patient. Recreational therapists weave the concept of healthy living into treatment to ensure not only improved functioning, but also to enhance independence and successful involvement in all aspects of life.

How are Recreational Therapy services recognized?

Recreational therapy is defined by the American Therapeutic Recreation Association (ATRA) as a health care and human service discipline that delivers treatment services designed to restore, remediate and/or rehabilitate functional capabilities for persons with injuries, chronic illnesses and all types of disabling conditions (ATRA 1986). Recreational therapists are standard treatment team members in rehabilitation services. Recreational therapy is listed as a rehabilitation therapy service in the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards. In addition, recreational therapists are designated as treatment team members (based upon need) in the acute brain injury, the post-acute brain injury, and the inpatient rehabilitation standards of the Commission on Accreditation of Rehabilitation Facilities (CARF). The Centers for Medicare and Medicaid Services (CMS) includes recreational therapy in the mix of treatment and rehabilitation services used to determine federal compliance in skilled nursing, rehabilitation (physical and psychiatric) and long-term care facilities. Therapeutic Recreation is specifically indicated as a Related Service under the Individuals with Disabilities Education Act. A few states regulate this profession through licensure, certification, registration or regulation of titles. The National Council for Therapeutic Recreation Certification (NCTRC) provides national certification of recreational therapists, see credentials below.

What are the outcomes of Recreational Therapy?

Current research indicates a significant number of positive health outcomes resulting from participation in recreational therapy programs. Evidence based outcomes are critical to the viability of Recreational Therapy as a health care provider. For specific health outcomes as a result of Recreational Therapy interventions refer to the links below:

Improvement in Physical Health Status (Word .doc)
Improvement in Psychosocial Status (Word .doc)
Improvement in Cognitive Status (Word .doc)
Improvement in Life, Recreation and Community Activities (Word .doc)
A Guide to Recreational Therapy Outcomes
Recreational Therapy: A Viable Option in Health and Rehabilitation Services - Treatment To Prevention (.Pdf file)

Consumers, administrators, and health care providers are challenged to make informed choices regarding a wide array of treatment options and interventions available in today's health care market. With an emphasis on quality, treatment, prevention, efficacy, efficiency, and customer satisfaction, it is critical that selected intervention strategies utilize approaches that not only address a wide array of health outcomes but also reflect best practices in providing a continuum of care from treatment to prevention.

What are a Recreational Therapist's Education, Qualifications, & Credentials?

A qualified recreational therapist is one who is nationally certified as a certified therapeutic recreation specialist (CTRS), usually referred to as recreational therapists. Qualified professionals are certified through the National Council for Therapeutic Recreation Certification (NCTRC), which requires a bachelors degree or higher from an accredited university, a formal internship and the passing of a national certification examination. In addition, a CTRS must maintain their credential every five years through the NCTRC recertification process.

Academic programs in therapeutic recreation or recreational therapy emphasize course work in the physical, biological, and behavioral sciences and recreation and leisure theory. They also require an internship under the supervision of a Certified Therapeutic Recreation Specialist. ATRA maintains a comprehensive list of Therapeutic Recreation curriculum programs in the United States,

How can I get Recreational Therapy services?

Many health care facilities have a therapy referral process in place, and include recreational therapy as part of their standard referral process for other ordered therapies and services. Once the referral for recreational therapy is made, usually by the physician or health care professional responsible for the client's care an assessment should be completed by the CTRS. On many inpatient program units a standard order is provided for each new resident "to evaluate for recreational therapy services". Clients from outpatient, home health or community programs may also be appropriate for recreational therapy, and the referral is done on a case-by-case basis.

 Recreational Therapy Order/Referral Form

How did Recreational Therapy develop?

The recreational therapy profession can be traced back to the 1850's when Florence Nightingale proposed that recreation experiences could be drawn upon to improve the human condition. In 1931 the American Red Cross began hiring recreation hospital workers. The term "recreational therapy" was first coined by the Menninger brothers who were enthusiastic for the inclusion of recreational therapy as a treatment of persons with mental health disorders. Since the 1940's, recreational therapists have served as active members of the interdisciplinary treatment team addressing the psychosocial and physical rehabilitation needs of the consumer.

For more history,

Where is Recreational Therapy headed in the future?

According to the US Department of Labor, "The rapidly growing number of older adults is expected to spur job growth for recreational therapy professionals and paraprofessionals in assisted-living facilities, adult daycare programs, and other social assistance agencies. Continued growth also is expected in community residential care facilities, as was daycare programs for individuals with disabilities."

Individuals with disabling conditions represent a large and growing sector of the population that needs health care services. Over 54 million Americans have been identified as having a disability. By some estimates, the disability community comprises nearly one-fifth of the American population. According to the National Organization on Disability, individuals with disabling conditions spend significantly less time outside the home, socializing and going out, than individuals without disabilities. They tend to feel more isolated, and participate in fewer community activities than their non-disabled counterparts. The need for recreational therapy services is evident. Opportunities to provide recreational therapy services will continue to be an important factor in the health care of individuals with disabilities.

The older population—persons 65 years or older—numbered 35.6 million in 2002. They represented 12.3% of the U.S. population, about one in every eight Americans. By 2030, there will be about 71.5 million older persons, more than twice their number in 2002. (Administration on Aging, The promotion of pro-active health and wellness programs has recently become a focus of the health care industry. Older adults want to remain healthy and independent at home in their communities. Society wants to minimize the health care and economic costs associated with an increasing older population. As a result, health promotion and disease prevention activities and programs are an increasing priority for older adults, their families, and the health care system. Recreational therapists can and will play a vital role in these type of programs and services. This is a wonderful opportunity for certified therapeutic recreation specialists to provide a service that not only improves the quality of life for older adults but also has a positive financial impact on facilities.