Purpose, passion, progress: celebrating 40 years of NTRS.

It's 1966. Gasoline is selling for 32 cents a gallon and a U.S. postage stamp cost a nickel. In the midst of protests of the Vietnam War and civil rights unrest in many cities, Star Trek debuts, disposable diapers hit the scene, mini skirts are "hip" and many of us are California Dreamin' in our Yellow Submarine. Amid this backdrop, the National Therapeutic Recreation Society (NTRS) emerged as a branch of NRPA.

2006 marks the 40th birthday of NTRS. The merger in 1965, which formed NRPA, included two groups concerned with therapeutic recreation (TR)--the National Association of Recreational Therapists (NART) and the Hospital Recreation Section of the American Recreation Society (ARS-HRS). These organizations put aside their philosophical differences--and voted to merge. These early therapeutic recreation specialists shared a common concern with the inhumane treatment of individuals with disabilities and the right of these individuals to participate in the full gamut of recreation and leisure experiences.

NTRS has been a major catalyst and participant in many of the professional milestones of TR's history. Such milestones illuminate the phenomenal growth and development of the field and its emergence as a recognized and important service. In the mid-sixties though, TR was not widely known.

Nancy Taback was a high school student in 1966 and her story is typical of many who were discovering the field at that time. Taback's story--developmental exposure to persons with disabilities, a passion for activity leadership, and a lifelong service commitment--characterize the experience of many who have found their calling in TR.

"In 1965 I babysat for a family who had a child with Down syndrome and I had a connection with him that his mother recognized in the first visit," she recounts. The mother told her that she thought her child had a developmental disability and that perhaps Taback should consider working with children with disabilities when she got older. This motivated her. She says, "I spent my senior year in high school volunteering at the St. Louis State School and Hospital, playing with the residents." After entering the University of Missouri in 1968, Taback says she met Dr. Ethel Scott and was introduced to Therapeutic Recreation, an association that she says caused her to be proud. "After 34 years in the field, I'm still proud!"

TR in the late 1960s focused on persons, not prescriptions. Are participants having fun? Are they participating in the same types of activities as their peers without disabilities? These were the commonly identified concerns in reviewing program materials of the time.

The ensuing decades witnessed historical legislation concerning public access, education, jobs and living arrangements for persons with disabilities. Budgets supporting people with disabilities grew and were then "reconciled." The 2006-2007 edition of the U.S. Department of Labor's Occupational Outlook Handbook reported that the majority of today's therapeutic recreation specialists work in nursing homes and hospitals. Others work in state and local government agencies and in community-based programs for older adults, including assisted-living facilities.

The rest of the field works primarily in residential mental retardation, mental health and substance abuse facilities; individual and family services; federal government agencies; educational services; and outpatient care centers. A small but growing number of therapists are self-employed, generally contracting with long-term care facilities or community agencies to develop and oversee programs.

The National Council for Therapeutic Recreation Certification (NCTRC) reported that hospitals continue to represent the largest employment setting with 42 percent of all therapists working in hospitals. The Council reported that there are 38,000 TR professionals in the U.S., with the majority (61 percent) providing services to adults who are older or who have psychiatric diagnoses.

Newer populations being served today include persons who have HIV/AIDS, who are homeless, who are living with a chronic illness or disease, or who have a terminal condition. And, as veterans returning from World Wars I and II boosted the development of TR in the rehabilitation arena, the men and women returning from the ongoing conflicts in Iraq and Afghanistan are also shaping TR discourse and practice.

TR specialists may use a variety of recreation and leisure modalities including arts and crafts, animals, sports, games, dance and movement, drama, music and community outings. Therapists may also hold specialized certifications, for example, in, aquatic therapy, adventure programming, or crisis intervention, and work in these areas.

Therapists are likely to work as part of an interdisciplinary or transdisciplinary team, sometimes collaborating to provide interventions alongside their peers from other disciplines. These activities may be provided in small groups or individually. Increasingly, family members are involved in TR interventions. Unfortunately, TR caseloads remain high in most situations. While they vary considerably depending on population and setting characteristics, caseloads can range from as few as 10 to as many as 200.

Additionally, TR professionals in both practice and research settings are being challenged to verify appropriate and quality services that can be empirically linked to outcomes valued by recipients of services, persons or entities who help to pay for services, and society. A demand has evolved, driven by consumers, accrediting bodies, and third-party payers alike to produce data-based outcomes that can be linked to the content and process of TR practice. These outcomes serve to verify the purposes of TR interventions and the achievement of these purposes.

NTRS at 40 is focusing much activity in the area of public policy and inclusion so that the health and life quality of persons with disabilities may be achieved and maintained more readily. In the public policy arena, recent efforts have been directed to defending and enhancing provisions in legislation important to our consumers such as the Individuals with Disabilities Education Act and the Americans with Disabilities Act. Regarding inclusion, NTRS and NRPA are collaborating to establish a National Inclusion Center (NIC). The NIC will address a range of issues relative to the inclusion of persons with disabilities in park and recreation opportunities. Currently, NTRS is developing NIC's scope of services, creating budgets, preparing public information, collaborating with like-minded organizations and meeting with legislators to help influence funding and political support for NIC.

So what is TR's future? Forty years ago, TR professionals, just like you, may have asked the same question. Through the years, TR professionals with passion and vision have responded to this question. While no correct answer will be provided, the challenge is for you to address the question--where will TR be in 2046?

At a recent conference of TR professionals hosted in the southwest, a convenience sample of 30 participants responded to a questionnaire about the future of TR. The questionnaire used a mixed open-ended and closed question format. Respondents, the majority of whom were women (70 percent or 21), ranged in age from 24 to 67 years old and represented a variety of populations and settings such as children, youth, adults and older adults, as well as rehabilitation and psychiatric facilities, long term care, and adult day care centers. While the survey process was admittedly informal and limited, responses provide interesting food for thought concerning the next 40 years of TR.

Participants' responses clearly indicated many of those practicing TR today would not be doing so in 2046. Most would be retired and hoped to have the benefits of TR to enhance their quality of life, assist with functioning to remain as independent as possible, and to keep mentally, socially, emotionally and physically fit. More than 75 percent (23) of the 30 respondents felt TR services would be important and needed in the future, and most believed that they would be delivered differently than they are today.

The majority (80 percent--24) of the respondents thought TR would be especially beneficial to older adults. Some respondents (15 percent--5) saw a role for TR professionals with continuing changes in family composition. Specifically, they commented on how TR professionals serve and support blended (e.g., previous marriages, grandparents raising children, adopted and biological children, older parents, and bi-racial and ethnic) families. About 38 percent (11) of the respondents saw TR professionals shifting to disease prevention and health promotion focuses.

Web-based programs and services were seen as major delivery systems for TR in the future. Several illustrations that were shared included assessments completed on-line and leisure resources exchanged through web interactions. Leisure education and counseling may be provided individually; however, not necessarily face-to-face. Computer games, relationships and supports were briefly discussed by more than 50 percent of the respondents as mechanisms through which TR might be delivered in coming years. A majority (73 percent--22) of the respondents thought a vast amount of documentation would be handled using technology.

When specifically asked, "Will TR as we know it exist in 2046?," an overwhelming 77 percent (23) said no. At the same time, however, 93 percent (28) indicated the outcomes of TR will remain very important in 2046.

As the future is anticipated, what can be gained from knowledge of the past 40 years of NTRS and the contributions of NTRS members to the growth of TR? It appears that if TR professionals will remain true to their roots, are willing to reflect on their practice, consider alternative settings of service delivery, remain open to new challenges, expand their research base and continue to explore the role of technology, TR practice will continue to serve the needs of its consumers. TR professionals in 2046 will be wondering, "What will be the future of therapeutic recreation in 2086?"

As aptly stated by Terry Robertson, recent NTRS president, for 40 years NTRS members have been helping persons with disabilities regain functioning; improve specific skills; and explore and understand themselves, their worth, and their ability to contribute to their community. "Forty years of trying to do the best we can for our friends, our neighbors, even strangers. Forty years of advocating, 40 years of caring, sharing, and defending," he said. Forty years of purpose, passion and progress. Here's to the next 40!--written by Barbara Wilhite, Ed.D., CTRS, Jean Keller, Ed.D., CTRS, and Jeff Witman, Ed.D., CTRS