Printer Friendly

Recreational therapists.

Recreational Therapists

Recreational therapists have learned that play can heal. They share with occupational thereapists the view that seemingly ordinary activities can put a disabled person on the road to recovery--or lead to improvement, at any rate. Also known as therapeutic recreation specialists--a job title that draws attention to the fact that theirs is a health profession--they use recreational and leisure activities as a form of treatment, much as other health professionals use surgery, drugs, nutrition, exercise, or psychotherapy.

Although recreational therapists use enjoyable and rewarding activities with their patients, they should not be confused with recreation workers, who organize recreational activities for the sole purpose of enjoyment. The primary goal of the recreation therapist is to enhance the patient's ability to function in everyday life. Apart from sheer enjoyment, the activities they devise provide opportunities for exercise and social participation. Other goals that the therapist might have in mind when planning an activity include relieving anxiety, building confidence, and promoting independence.

Together with the other activity or expressive therapies--art, music, drama, and dance--recreational therapy owes much to the discovery that soldiers suffering from battle fatigue or other emotional traumas responded favorably to organized treatment programs. During World War II, for example, the Veterans Administration organized what were then known as medical recreational activities in its hospitals.

Nature of the Work

The work of recreational therapists differs according to the setting. The activities employed also vary, just as the interests and abilities of the people served do. Therapists might, for example, organize athletic events, dances, craft workshops, concerts, recitals, sing-alongs, poetry readings, movie showings, or field trips. Nevertheless, workers in this occupation do have many duties in common.

In general, recreational therapists assess the patient's ability to function, develop a treatment plan, lead activities, and monitor progress as the plan is carried out. Responsibilities also include directing the support personnel, such as a therapeutic assistant, who may actually conduct the activities recommended by the therapist.

During the initial session with a patient, the recreational therapist might chat for a while with the patient and family, trying to put them at ease before directing the conversation toward the patient's hobbies or other interests. By discovering what kinds of things the patient likes to do, the therapist will be able to increase voluntary involvement and participation.

The therapist also needs information about the patient's physical, mental, and emotional status in order to set realistic goals and recommend suitable activities. To gather this information, the therapist pores over medical records, talks with other members of the staff, and observes the patient's behavior. Having learned what the patient both can do and likes to do, the therapist prepares a list of activities that capitalize on the patient's strengths and interests.

When organizing activities, therapists take the therapeutic requirements of all their patients into account. Once the program has been planned and publicized, the therapist interviews each individual who signs up and may also discuss the upcoming event with the client's physician. Some degree of screening is necessary to be sure that the event is suitable, given the client's condition. For example, an extremely competitive patient who screams and bangs and throws things after losing a game would be dissuaded from signing up for a chess competition.

While patients engage in activities, recreational therapists carefully observe their reactions. The therapist might note, for example, that one patient participates in outdoor activities more enthusiastically than before; another is ready for activities that require teamwork; and still another patient, formerly cooperative, has become combative and disruptive. Observations such as these provide the basis for the therapist's periodic review and modification of each patient's activity program.

Another important part of the recreasional therapist's job is keeping records. Among them are the initial evaluation, memoranda of periodic reviews, reports to the physician, internal staff notes, Medicare records, and discharge evaluations. These records are used to keep track of the patient's condition, document treatment, and monitor progress.

The specifics of the recreational therapist's job vary with the population served and the work setting, such as a hospital, nursing home, or community agency. In a hospital, for example, the recreational therapist usually works as a member of an interdisciplinary team that may include a physician, nurse, clinical psychologist, social worker, and other rehabilitation professionals. Team members evaluate the patient from the perspective of their various specialties and then work together to develop a treatment plan for each patient.

Because nursing home residents are likely to remain in a facility for months or even years, the activities program can make a big difference in the quality of their lives. Without the stimulation of pleasant people and interesting events, the daily routine of a nursing home can become dreary and depressing, and the health of the residents can deteriorate. Group activities usually receive more emphasis in a nursing home than in a hospital. Therapists arrange for activities in the surrounding community as well as in the facility itself.

Transportation to and from the activity site is an important concern for recreational therapists employed in community settings because clients generally live at home with their families or in group residential facilities such as halfway houses. These therapists may also need to devote extra time to arranging for an appropriate activity site and the necessary equipment. Before an activity such as wheelchair basketball can take place, for example, space must be secured and equipment rented; prospective participants interviewed; and clients, staff, and volunteers advised of timetables and logistics.

Working Conditions

Working conditions vary according to the employment setting, although recreational therapists generally work in well-light, well-ventilated offices when interviewing clients or planning events. When leading activities, the therapist might be in a gymnasium, outdoors on a nature walk, or in a swimming pool.

In a clinical setting, recreational therapists might work on a ward or in a spacious activity center. In a nursing home, the therapist might work in a room equipped with arts and crafts materials. Therapists in community settings are likely to be in a several different places during the course of a day or a week.

The job may be physically tiring because therapists often are on their feet all day. Recreational therapists generally work a standard 40-hour week, although weekend and evening hours are occasionally required. Therapists holding supervisory positions may be required to work overtime.


Recreational therapists held about 17,000 jobs in 1984. Many of the jobs were in rehabilitation, psychiatric, and other specialty hospitals. Recreational therapists are often members of the activities or therapy department, along with other therapists and their assistants from several disciplines, such as occupational, music, dance, and art therapy. Other employers include general hospitals, nursing homes, community mental health centers, adult day care programs, school systems, prisons, residential facilities for the mentally retarded, and community programs for the disabled.

A small number of therapists are self-employed; for the most part, they provide services on a contract basis. A self-employed therapist might develop and oversee activities programs for several small nursing homes or community programs or act as a consultant dealing with special issues for a larger program.

Qualifications and Advancement

Hiring requirements are changing. Increasingly, formal preparation--a degree either in recreation with an emphasis on therapeutic recreation or in therapeutic recreation itself--is expected. An associate degree satisfies hiring requirements in many nursing homes, while a bachelor's degree is ordinarily necessary in community and clinical settings. A graduate degree is generally required for teaching, research, and administrative positions in this field. Individuals without any academic preparation are more likely to be hired as therapeutic assistants than as therapists.

Many employers prefer to hire certified recreational therapists. Certification is available through the National Council for Therapeutic Recreation Certification (NCTRC), which awards credentials for therapeutic recreation specialists and therapeutic recreation assistants. Requirements for certification include graduation from an accredited academic program, completion of an internship, and 2 years of experience.

Three States--Georgia, Maryland, and Utah--regulate the practice of recreational therapy. Georgia and Utah have licensure requirements, while Maryland requires recreational therapists in long-term care facilities to be certified or eligible for certification.

More than 160 accredited programs in recreational therapy are offered at the college or university level. Most of these are bachelor's degree programs, although some are associate or master's degree programs. There are a few doctoral programs in therapeutic recreation.

Academic programs in therapeutic recreation emphasize coursework in the physical, biological, and behavioral sciences. Courses in human anatomy and physiology put disabling and handicapping conditions into context. In the realm of professional practice, courses deal with programming for special populations; assessment and referral procedures; assistive, or helping, techniques including self-help skills, signing, and orientation and mobility; adaptive devices and medical equipment; current treatment approaches; legal issues in delivering services to special populations; and professional ethics. Accredited programs require 360 hours of internship under the supervision of a certified therapeutic recreation specialist.

People considering this career must be able to work with people of all kinds and all ages who have temperaments and personalities as varied as their illnesses and disabilities. A warm, friendly personality that inspires both trust and respect is needed to gain patients' confidence. Patience, organizational ability, ingenuity, and imagination in adapting activities to individual needs are also necessary; and a sense of humor helps a great deal.

Newly graduated recreational therapists generally begin as staff therapists. Advancement is chiefly to supervisory or administrative positions.

Job Outlook

The employment of recreational therapists is expected to grow faster than the average for all occupations through the mid-1990's due to anticipated growth of rehabilitation services and long-term care facilities.

Future changes in the size and age structure of the population mean that there will be many more disabled people in 1995 than there are today. Substantial growth is expected for the population age 85 and above, an age group that suffers a very high incidence of disabling conditions. In addition, better health care now enables people with developmental disabilities such as Down's syndrome to live longer than they used to, so the number of mentally retarded people is expected to grow. Significant growth is also projected for the mentally ill, in part because of the very large number of young adults who have reached the age of peak risk for schizophrenia and other chronic mental illnesses.

Public and private response to the needs of older people is expected to spur rapid employment growth in nursing homes, retirement and life care communities, adult day care programs, and social service agencies. In the areas of mental health and mental retardation, widespread support for deinstitutionalizing residents of large public facilities is expected to create strong and sustained pressure at State and local levels for community residences and programs for the physically and mentally disabled.

Many recreational therapists now work in psychiatric, rehabilitation, and other long-term hospitals. Employment in these hospitals is expected to grow very little, overall; and most job openings will be generated by the need to replace experienced workers who transfer to other occupations or stop working.

Slow growth in the hospital sector will be more than offset, however, by burgeoning demand for recreational therapists in nursing homes, community programs, and residental facilities for people with handicapping conditions. Job prospects for recreational therapists in private psychiatric facilities should also be favorable, although it is important to bear in mind that this specialty sector is small.

Nursing homes are expected to provide 1 job in 4 by the mid-1990's. Growth could be even more rapid than currently anticipated, depending on future developments in nursing home staffing. A broad-based effort to improve the quality of care in nursing homes would undoubtedly lead to additional jobs for recreational therapists, since there is general agreement that well-designed activities programs promote residents' physical and mental health.

Community programs for special populations are also expected to expand significantly in the years ahead, spurring demand for recreational therapists. Locating a job may require persistence, however, in view of the small scale and developmental nature of community-based programs. Internships may prove especially valuable to students interested in community practice. In recreational therapy, as in other human service fields, internships and volunteer work provide contacts that may prove invaluable in finding a job.

Job prospects are expected to be favorable for graduates of accredited programs in therapeutic recreation. Currently, there are reports of a shortage of qualified recreational therapists in some areas, rural areas in particular. In metropolitan areas and localities where training programs abound, competition for jobs is keener.


Salaries of recreational therapists vary according to employment setting, educational background, work experience, and region of the country. Starting salaries for recreational therapists in institutions and programs funded by State mental health or mental retardation agencies ranged from about $14,500 to $19,500 a year in 1985, according to a survey by the National Therapeutic Recreation Society. The starting salary for therapeutic recreation specialists in Veterans Administration facilities was $17,824 a year in 1985.

Recreational therapists in hospitals had average salaries of $17,000 a year in 1985, according to a survey conducted by the University of Texas Medical Branch. Top salaries of experienced recreational therapists averaged $23,400 a year.

Related Occupations

Recreational therapists design activities to help people with disabilities lead more fulfilling and independent lives. Other workers who have similar jobs are orientation therapists for the blind, art therapists, drama therapists, dance therapists, music therapists, occupational therapists, and rehabilitation counselors.

Sources of Additional Information

For information about careers in recreational therapy, contact

National Therapeutic Recreation Society

3101 Park Center Drive

Alexandria, Virginia 22302.

Certification information may be obtained from

National Council for Therapeutic Recreation Certification

P.O. Box 16126

Alexandria, Virginia 22302.

Academic programs in therapeutic recreation are listed in the National Recreation and Park Association's Directory of College/University Programs in Recreation, Leisure Services and Resources. Price and ordering information for the latest edition is available from

National Recreation and Park Association

3101 Park Center Drive

Alexandria, Virginia 22302.

The American Association of Health, Physical Education, Recreation, and Dance also publishes a directory that lists academic programs in therapeutic recreation. Price and ordering information for the latest edition is available from

American Association of Health, Physical Education, Recreation, and Dance

P.O. Box 704

Waldorf, Maryland 20601.

For a pamphlet on careers in mental health, write

Public Inquiries

National Institute of Mental Health

5600 Fishers Lane

Rockville, Maryland 20857.

For a pamphlet on careers in nursing homes, write

American Health Care Association

1200 15th Street NW

Washington, D.C. 20005.

Information about employment opportunities in Veterans Administration medical centers is available from local Veterans Administration medical centers.
COPYRIGHT 1985 U.S. Government Printing Office
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1985 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:training and employment
Author:Gamliel, Sandra
Publication:Occupational Outlook Quarterly
Date:Dec 22, 1985
Previous Article:Farm operators and managers.
Next Article:Computer training and the workplace: a little goes a long way.

Terms of use | Copyright © 2016 Farlex, Inc. | Feedback | For webmasters