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Your UCP: National August 25, 2003
Sports & Leisure

Recreation & Leisure

Therapeutic Recreation Services

Woman who uses a wheelchair participating in a relay race.  There is a person pushing her wheelchair.

Therapeutic Recreation Services
Kristin Ruprecht, MS, CTRS

The therapeutic recreation specialist (TRS) is an important ally for people with disabilities working toward successful integration into the community. 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, says, "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, there are many reasons for a patient to consider treatment at a rehabilitation center that employs a TRS.

The TRS begins by conducting an assessment to identify patients' past leisure interests. Next, with input from the patient, the TRS will create a plan of treatment that includes goals as well as steps to accomplish those goals. The patient and TRS then work together individually and in group sessions to prepare the patient for community integration. Within these individual and group sessions, they may work on adaptations to leisure interests and community integration skills for continual enjoyment and future participation in recreation.

Sam Andrews, Director of Therapeutic Recreation at Craig Hospital in Denver, says 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 illnesses, 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.

A woman who uses a wheelchair participating in a relay race.  The woman is passing the baton in the form of a hoola hoop.

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. For example, Illinois 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 also are identified and pursued. 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 be found. Any child with an Individualized Education Plan (IEP) may be provided a TRS as part of his or 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
TRS may obtain a degree in Therapeutic Recreation or Recreation with an option in TR. 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.

People who use  wheelchairs preparing to play golf.

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 such as specified coursework and an internship and acquired specific skills during the internship. The 200-question exam is offered two or three times per year in various locations. Once the applicant has passed the exam, he or she is given the title of 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 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 Web site, listed below. Once on the NRPA Web site, click on Branches, NTRS, Leadership, and then Board.

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

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

National TheratRS
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
Kristin Ruprecht is the Resource Assistant at the National Center on Accessibility and recently completed her master's degree in Therapeutic Recreation at Indiana University. She has interned as an undergraduate at Sister Kenny Institute in Minneapolis, and as a graduate student at Hook Rehabilitation Center in Indianapolis.

The information provided here is offered as a service only. The National Center on Physical Activity and Disability, University of Illinois at Chicago, the National Center on Accessibility, and the Rehabilitation Institute of Chicago do not formally recommend or endorse the equipment listed. As with any products or services, consumers should investigate and determine on their own which equipment best fits their needs and budget.

Source: NCPAD

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