THERAPEUTIC RECREATION/RECREATIONAL THERAPY

Nature of the Work*

Recreational therapists provide treatment services and recreation activities to individuals with illnesses or disabling conditions. They use a variety of techniques to treat or maintain the physical, mental, and emotional well-being of clients. Treatments may include the use of arts and crafts, animals, sports, games, dance and movement, drama, music, and community outings. Therapists help individuals reduce depression, stress, and anxiety. They help individuals recover their basic motor functioning and reasoning abilities, build confidence, and socialize more effectively to allow them to be more independent, as well as reduce or eliminate the effects of illness or disability. Their focus is to help integrate people with disabilities into the community by helping them use community resources and recreational activities. Recreational therapists should not be confused with recreation workers, who organize recreational activities primarily for enjoyment.

In acute health care settings, such as hospitals and rehabilitation centers, recreational therapists treat and rehabilitate individuals with specific health conditions, usually in conjunction or collaboration with physicians, nurses, psychologists, social workers, and physical and occupational therapists. In long-term care facilities and residential facilities, they use leisure activities—especially structured group programs—to maintain general health and well-being. They may also treat clients and provide interventions to prevent further medical problems and secondary complications related to illness and disabilities. In these settings they may be called activity directors or therapeutic recreation specialists.

Recreational therapists assess clients based on information from standardized assessments, observations, medical records, medical staff, family, and clients themselves. They then develop and carry out therapeutic interventions consistent with patient needs and interests. For instance, clients isolated from others may be encouraged to play games with others, a right-handed person with a right-side paralysis may be instructed in adaptation and compensatory strategies to use his or her non-affected left side to throw a ball or swing a racket. Recreational therapists may instruct patients in relaxation techniques to reduce stress and tension, in correct stretching and limbering exercises, in proper body mechanics for participation in recreation activities, in pacing and energy conservation techniques, and in individual as well as team activities.

Community based recreational therapists work in park and recreation departments, special education programs for school districts, or programs for older adults and people with disabilities. In these programs, therapists help clients develop leisure activities and provide them with opportunities for exercise, mental stimulation, creativity, and fun.

In schools, recreational therapists help counselors, parents, and special education teachers address the special needs of students. They are especially important in helping to ease the transition phase into adult life for the disabled. The transition phase extends from age 14 until high school graduation. Recreational therapists provide assistance in teaching the student about recreational activities and how to use community resources. The primary responsibility for these therapists is to integrate students into the community.

Recreational therapists observe and record patients' participation, reactions, and progress. These records are used by the medical staff and others, to monitor progress, to justify changes or end treatment, and for billing.

Working Conditions*

Recreational therapists provide services in special activity rooms, but also must plan events and keep records in offices. When working with clients during community integration programs, they may travel locally to instruct clients on the accessibility of public transportation and other public areas, such as parks, playgrounds, swimming pools, restaurants, and theaters.

Therapists often lift and carry equipment as well as lead recreational activities. Recreational therapists generally work a 40-hour week, which may include some evenings, weekends, and holidays.

Employment*

Recreational therapists held about 39,000 jobs in 1998. About 38 percent of salaried jobs for therapists were in hospitals and 26 percent were in nursing homes. Others worked in residential facilities, community mental health centers, adult day care programs, correctional facilities, community programs for people with disabilities, and substance abuse centers. About 1 out of 3 therapists was self-employed, generally contracting with long-term care facilities or community agencies to develop and oversee programs.

Training, Other Qualifications, and Advancement*

A bachelor's degree in therapeutic recreation (or in recreation with an option in therapeutic recreation) is the usual requirement for entry-level positions. Persons may qualify for paraprofessional positions with an associate degree in recreational therapy or a health care related field. An associates degree in recreational therapy; training in art, drama, or music therapy; or qualifying work experience may also be sufficient for activity director positions in nursing homes.

Most employers prefer to hire candidates who are certified therapeutic recreation specialists (CTRS). The National Council for Therapeutic Recreation Certification (NCTRC) certifies therapeutic recreation specialists. To become certified, specialists must have a bachelor's degree, pass a written certification examination, and complete an internship of at least 360 hours under the supervision of a certified therapeutic recreation specialist. A few colleges or agencies may require 600 hours of internship.

There are about 150 programs that prepare recreational therapists. Most offer bachelors degrees, although some offer associates, masters, or doctoral degrees. As of 1998, there were fewer than 43 recreation programs with options in therapeutic recreation that were accredited by the National Council on Accreditation.

In addition to therapeutic recreation course work in assessment, treatment and program planning, and intervention design and evaluation, students study human anatomy, physiology, abnormal psychology, medical and psychiatric terminology, and characteristics of illnesses and disabilities. Courses cover professional ethics, assessment and referral procedures, interdisciplinary teamwork, management, and the use of assistive devices and technology.

Recreational therapists should be comfortable working with persons who are ill or have disabilities. [SK1]Therapists must be patient, tactful, and persuasive when working with people who have a variety of special needs. Ingenuity, a good sense of humor, and a strong imagination are needed to adapt activities to individual needs, and good physical coordination is necessary to demonstrate or participate in recreational events.

Therapists can advance to supervisory or administrative positions. Some teach, conduct research, or perform contract consulting work.

Job Outlook*

Employment of recreational therapists is expected to grow as fast as the average for all occupations through the year 2008, because of anticipated expansion in long-term care, physical and psychiatric rehabilitation, and services for people with disabilities. However, the total number of job openings will be relatively low, because the occupation is small. Opportunities should be best for persons with a bachelor’s degree in therapeutic recreation or in recreation with an option in therapeutic recreation.

Health care facilities will provide a large number of recreational therapy jobs through the year 2006. A growing number of these will be in hospital-based adult day care and outpatient programs, or in units offering short-term mental health and alcohol or drug abuse services. Long-term rehabilitation, home-health care, transitional programs, and psychiatric facilities will provide additional jobs.

The rapidly growing number of older adults is expected to spur job growth for activity directors and recreational therapy paraprofessionals in nursing homes, assisted living facilities, adult day care programs, and social service agencies. Continued growth is expected in community residential facilities as well as day care programs for individuals with disabilities.

Earnings*

Median annual earnings of recreational therapists were $27,760 in 1998.The middle 50 percent earned between $21,580 and $35,000 a year. The lowest 10 percent earned less than $16,380 and the highest 10 percent earned more than $42,440 a year. Median annual earnings for recreational therapists in 1997 were $29,700 in hospitals and $21,900 in nursing and personal care facilities.

Sources of Additional Information*

For information on how to order materials describing careers and academic programs in recreational therapy, write to:

• American Therapeutic Recreation Association, P.O. Box 15215, Hattiesburg, MS 39402-5215.
• National Therapeutic Recreation Society, 22377 Belmont Ridge Rd., Ashburn, VA 20148.

Certification information may be obtained from:

• National Council for Therapeutic Recreation Certification, P.O. Box 479, Thiells, NY 10984-0479.

Campus Contact(s)

Betty Hoff, Professor of Health and Physical Education
Brian Solberg, Athletic Trainer

* U.S. Bureau of Labor Statistics, 2000-01 Occupational Outlook Handbook.