TR and the Internet.

The Internet is a patchwork of networks connecting millions of computers across the world, reducing distances between countries, and bringing people and ideas together. Consider the astronomical growth of the Internet and its numerous applications (Mantovani, 1995). Through the graphical interface of the World Wide Web (WWW), Internet users can find information for nearly anything imaginable, from the most common to the most absurd. Many companies are starting to put their businesses on the WWW. For some it's away to attract customers, for others, it's their only contact with customers and all transactions are done on-line. Many of these sites are health care related.

It is surmised that within 10 years, patients may be able to enter virtual reality clinics through the Internet for diagnoses (National Underwriter Property and Casualty, 1996). Already, Internet users can retrieve information on first aid treatment. Through question and answer programs, individuals can care for minor illnesses and injuries in their home and consumers can retrieve a list of various treatment choices for specific physical illnesses, including associated medications and their side effects and probable outcomes from the different forms of treatment. On-line healthcare professionals are helping patients get second opinions at a fraction of the cost, without visiting a physician's office.

The purpose of this article is to demonstrate that the Internet is an important tool for the future of therapeutic recreation (TR). It will explain that the Internet is a new community, expanding many horizons, that TR specialists need to recognize and research. Finally, this paper will illustrate potential future trends in the healthcare industry and how these, as applied to TR, can be activated on the Internet.

The Internet as a Community

Webster (1988) defines community as "a body of people living near one another and in social relationship." Although Internet users do not necessarily live close to each other, the system of connected networks has brought them together from all ends of the Earth to create an online community or relationship. The Internet is a means to build a community where lay-people are able to confidently approach experts and have their questions answered. It is a place where all people can exchange information and ideas, collaborate and accomplish projects, learn new concepts or complete academic courses, train for promotions, receive and give direct customer support, exchange goods and services, and much more. How curious that this place cannot be found on a map; yet, it contains many public libraries, organized activities, social clubs, and learning centers much as traditional communities do.

Why is the Internet important to therapeutic recreation? As a community, the Internet is more than just a form of telecommunication. If therapeutic recreation specialists are to become part of the future of health care, they need to understand the Internet and all that it can do. The Internet is an excellent forum in which TR professionals can advocate for themselves, demonstrate their contributions to the healthcare industry, and show consumers the reasons behind the costs for services. The Internet community contains a plethora of professionals and lay-people that select exactly what they want to learn more about and to whom TR professionals may need to direct their attention.

Using the Internet for Therapeutic Recreation

There are a few Web pages established for TR on the WWW. They are mainly sources of information for TR professionals and students. These pages also serve to advocate for TR by attracting "Web Surfers" who encounter the pages. However, TR specialists need to take advantage of the Internet's constantly expanding population and create more interactive environments which would attract people to the sites. Is therapeutic recreation prepared for this? To answer this question, TR specialists need to brainstorm and ask themselves what people need to know about therapeutic recreation to ensure and enhance its viability in the healthcare arena. In order to strengthen the brainstorming process, TR specialists need to be aware of potential healthcare trends.

Landrum, Schmidt and McLean (1995) state that the future of healthcare is going to be consumer-driven, outcome-oriented, and concentrated on the most effective and efficient treatments available. Therapeutic recreation specialists need to use the above information as they clearly define themselves, demonstrate the outcomes of their services and justify the costs of these services. If the future of healthcare is going to be consumer-driven, then TR specialists need to advocate to the consumers (Landrum, Schmidt and McLean, 1995). Through more interactive environments on the Internet, TR specialists may be able to attract consumers to their sites and teach the value and benefits of the profession including its various levels of services in prevention, treatment, education, and participation.

Therapeutic recreation specialists need to establish firm outcome-based treatments (Landrum, Schmidt and McLean, 1995). Consumers may want to know what results are expected prior to purchasing specific treatment. To cater to a variety of clients, these outcomes will have to be expressed in lay terms. For instance, an assessment instrument, such as the Leisure Competency Measure, as explained by the Therapeutic Recreation Network of Austin (unpublished), could be used to demonstrate levels of leisure independence and gauge a client's progress. The levels are expressed numerically from one--totally dependent--to seven--being independent. These levels could be thoroughly explained on the Internet. In addition, specific areas for conferencing on topics related to these levels, could be established to further support clients.

This would also increase accountability for TR specialists since clients could follow their progression throughout the treatment.

In order to be considered effective and efficient, healthcare services will need to be able to adapt to all settings. The portability of TR makes it extremely efficient. Adding to this, once a client has been returned to the lowest cost setting, the home, he or she can continue to work with the TR specialist through the Internet. This would limit the need for house calls, reduce time spent directly with clients, and in turn, reduce expenses for clients.

Where To Go From Here

The benefits of communication between professionals is clear. The Internet allows for easy and low-cost direct communication between healthcare and other specialists. TR specialists could discuss new cases and applied activities or interact to help with research applications in the field (Young and Milosevic, 1996). The concern is the application of TR processes and procedures on the Internet with its clients. Is the Internet limited to providing information for prevention and recognition of illnesses and injuries for TR?

Can therapeutic recreation treatment be completed through the Internet for any or all illnesses or injuries? Research is needed to answer these questions.

The Internet community is vast and makes available an immeasurable opportunity for advocacy with other healthcare professionals. Therapeutic recreation specialists should prepare for the future and realize that the Internet will likely be a part of it.