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 NCPAD Monographs
National Center on Physical Activity & Disability (NCPAD)
   Therapeutic Recreation Services

by Kristin Ruprecht, MS, CTRS

This is a photo of a program participant "jumping through the hoop" as part of a relay race.
The therapeutic recreation specialist (TRS) is an important ally for people with disabilities for successful integration in the community. Photo courtesy of Bradford Woods.
Therapeutic recreation (TR), also known as Recreation Therapy, is the provision of recreation and leisure services to people with disabilities or illnesses. David Austin, Professor and Graduate Coordinator of Therapeutic Recreation at Indiana University, states, "TR is a purposeful intervention that uses recreation to bring about health restoration…(and) has the potential to enhance health or produce high level wellness." Therapeutic recreation specialists provide recreation to meet the physical, cognitive, emotional and social needs of people they serve. Connecting with a therapeutic recreation specialist not only increases awareness of the endless recreation possibilities available for people with disabilities through education and the use of adaptive equipment, but also bridges the gap between successful community integration and the person with a disability.

Where to Find a TRS:

Hospital/Rehabilitation Facilities
Patients in hospital facilities and especially on rehabilitation units have the unique opportunity to work with a TRS. After sustaining an injury or illness, a patient should consider treatment at a rehabilitation center that employs a TRS for many reasons. The TRS identifies past leisure interests with patients by conducting an assessment. Next, a plan of treatment will be created with input from the patient that includes goals and steps to accomplish those goals. The patient and TRS then work together individually and group sessions to prepare the patient for community integration. Within these individual and groups sessions, adaptations to leisure interests and community integration skills may be worked on for continual enjoyment and future participation in recreation. Sam Andrews, Director of Therapeutic Recreation at Craig Hospital in Denver, CO, states that TRSs "provide skill training in adaptive techniques and the use of adaptive equipment…cognitive stimulation, and community integration activities" in regards to leisure participation. TRSs may also educate patients regarding personal, attitudinal, and community barriers that may prevent them from fully participating in leisure, and assist in creating solutions for these barriers.

Psychiatric/Mental Health Programs
Another setting where patients may encounter TRSs are in psychiatric or mental health programs. A TRS conducts assessments on each patient, and determines the appropriate path of treatment. Treatment may consist of leisure interest inventories, stress management techniques, and social skills training. TRSs may also teach time management skills to chronically ill patients who may not have the capacity to hold a job due to their illness, and thus, have more time for leisure. In drug and alcohol treatment centers, the TRS is invaluable for teaching and broadening leisure interests to substitute recreation for harmful addictions.

Residential/Group Home Facilities
In long-term care or group home facilities, the TRS is responsible for increasing the quality of life through recreation activities. Again, assessments are conducted with each resident to determine their leisure interests preferences. Through recreation, independence is furthered when residents choose the event and type of leisure participation (group or solitary). An active lifestyle is important for maintaining optimum physical, cognitive, emotional, and social functioning.

City/County Parks Department
A person with a disability may find a TRS employed at a city/county park and recreation department that creates and runs accessible sports and arts programs. The TRS would be responsible for assessing community leisure needs, creating the necessary programs, adapting the activity and providing adaptive equipment for people with disabilities; this enables full participation for people of all abilities. Many states have created specific programs to serve the needs of people with disabilities. Illinois is one such state that created organizations called Special Recreation Associations (SRAs). Several of these associations exist within the state to better serve people with disabilities. With a TRS on staff, year-round recreation programs may include a spectrum of leisure interests including cultural, sport, social, physical, outdoor, and special event activities. Seasonal program guides are available through the city/county recreation departments that describe the program, provide information regarding location, cost and instructor.

Correctional Facilities
Another population served by TRSs is persons in correctional facilities. Clients attend sessions with the TRS and are taught recreation skills in hopes of eliminating prior inappropriate leisure behaviors. Leisure interests are identified and pursued, also. The TRS also provides recreation activities to promote socialization and necessary social skills for successful integration into the community.

School Districts
School districts are a groundbreaking area where TRSs can also be found. Any child with an Individualized Education Plan (IEP) may be provided a TRS as part of his/her treatment. An assessment of the child's needs and strengths is completed, and a plan of treatment is created. The TRS and child may work on increasing social and recreation skills while in the school setting, which furthers the inclusion process for that particular child. This also creates understanding among the child's peers.

Degree Requirements and Credentials

This is a photo of program participants taking to recreational therapy.
A TRS may obtain a degree in Therapeutic Recreation, or Recreation with an option in TR. Photo courtesy of Bradford Woods.
Currently, universities offering four-year degree programs in TR can be found in 40 U.S. states. Degree requirements include a 360-hour internship under the supervision of a certified TRS. Courses taken outside of the major usually include but are not limited to: anatomy and physiology; psychology; and medical terminology. Once degree requirements are completed, the TRS may opt to sit for a national certification exam. The National Council for Therapeutic Recreation Certification requires an application process to determine if the candidate has met certain requirements - specified coursework, the internship - and acquired specific skills during the internship. The 200-question exam is offered 2-3 times per year in various locations. Once the applicant has passed the exam, he/she is given the Certified Therapeutic Recreation Specialist (CTRS). A CTRS has the authority to treat any patient, including those requested by doctor's orders.

Professional Organizations
There are two national organizations strictly devoted to TR and the issues it faces. The American Therapeutic Recreation Association (ATRA) and the National Therapeutic Recreation Society (NTRS), a branch of the National Recreation and Park Association, support advancement of the profession and encourage professional development of their members. Many states in kind have ATRA and NTRS chapters, which advocate for the profession on the state and local levels. NTRS provides the ability to contact board members and regional directors regarding questions via their website, listed below. Once on the NRPA website, click on Branches, NTRS, Leadership, and then Board.

For more information, you may call or visit the website of the following organizations:

American Therapeutic Recreation Association
1414 Prince St. Suite 204
Alexandria, VA 22314
(703) 683-9420

National Therapeutic Recreation Society
22377 Belmont Ridge Road
Ashburn, VA 20148
(703) 858-0784

National Council Therapeutic Recreation Certification
7 Elmwood Drive
New City, NY 10956
(845) 639-1439

About the Author
Currently, Kristin Ruprecht is the Resource Assistant at the National Center on Accessibility and recently completed her Masters in Therapeutic Recreation at Indiana University. She holds a Bachelors degree in Therapeutic Recreation from the University of Wisconsin-La Crosse, interned as an undergraduate at Sister Kenny Institute in Minneapolis, and as a graduate student at Hook Rehabilitation Center in Indianapolis.

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