Recreational Therapy FAQs
Michael Coluccio has worked as a certified recreational therapist and healthcare administrator for over 30 years. He has a master’s degree in therapeutic recreation and a master's degree in healthcare administration. He is the Executive Director of the Right at Home office in Brooklyn, New York. Michael answers 10 common questions about recreational therapists who plan, execute and evaluate recreation-based health interventions for individuals.
1. What is recreational therapy?
Recreational therapy, also known as therapeutic recreation, is therapy based on engagement in recreational activities (e.g. sports or music) especially to enhance the function, independence, and well-being of individuals affected with a disabling condition. The savvy recreation therapist will utilize multiple "domains" for stimulation and success in implementation with the client.
2. What activities are part of recreational therapy?
A good recreational therapy program provides activities for the client that cover the physical, spiritual, artistic, intellectual, social and sensory domains. The artistic domain, or creative arts, could involve crafts, music, drama and games. The physical domain could include sports or activities such as exercise, yoga or dance. The spiritual is not just formal religion but anything that deals with self-awareness, meditation and inner peace and can include religious participation or communing with nature. The cognitive or intellectual domain can involve crossword puzzles, word searches, trivia games or even current-event discussions.
Another domain is sensory stimulation or sensory awareness where the client's senses are engaged purposefully to elicit a response or reaction. These senses include the visual, auditory, olfactory (smell), gustatory (taste) and tactile. For someone who needs to be engaged on the sensory level, I use the example of an orange. An orange has a certain size, a certain texture and a certain visual appeal. If you cut open the orange, it has a fragrance. Once the orange is cut open and you squeeze it, you can put a drop of juice onto the client’s lip for the gustatory—you engage almost all the senses with one item. The most successful therapeutic recreation program with the greatest outcome is where the client experiences sensations across a diversity of domains.
3. Who can benefit from a recreational therapist?
Recreational therapy is for people of any age—as young as infancy and as old as the end of life. Anybody at any age will benefit from a recreational therapist who has the experience required and utilizes the best modalities to achieve the best results with each client.
4. Do recreational therapists work with other health providers?
Most definitely. Recreational therapy is connected to physical and occupational therapy in several ways. Physical and occupational therapies tend to deal with restorative rehab including walking, transferring, dressing, taking a shower—helping clients get to a functional level of restoration, for example, after a stroke or an accident. Once a rehab therapist has determined the client has reached a plateau, the client works on maintenance rehab. Recreational therapy can be considered both a maintenance therapy, in which the person works on maintaining their functional skills, and a "restorative" therapy, where the client learns new adaptable techniques in which to engage in activity pursuits.
5. How does recreational therapy differ from activity participation?
You can have experiences in recreation that encompass more of the social domain in activities, such as arts and crafts and bingo, or birthday parties or socials. These are events that an activity professional or coordinator will put together for the overall benefit of everyone. With recreational therapy, we get to know each of our clients more on an individual basis during an intake session, and then we look at the needs of each individual in order to design a therapeutic leisure intervention. The whole therapeutic approach takes into account that person’s illness or disability, and we try to elevate the client's participation based on adaptation as required. We also work with a client when a physician writes a prescription for recreational therapy.
Many recreational therapists study for a bachelor’s or master’s degree in recreation therapy, like I did, and take courses such as kinesiology, physiology, psychology and medical terminology. To be a recreational therapist, you have to understand the disease process and the rehabilitation process, whereas an activity professional does not. Some facilities may have an activity director or activity professional, and there’s nothing wrong with that—they just can’t call their programs recreational therapy.
6. What fitness level is required for recreational therapy?
Anybody at any skill level can be engaged and receive the services of a recreational therapist. It’s a wonderful field because, unlike other therapies, which can deny services to someone they feel will not benefit from them, with recreation therapy, you can never really deny somebody the opportunity to participate in a recreation experience. We are responsible in our field for engaging in programming for all people of all function levels. In physical therapy, you may need to be able to stand and walk 50 feet, but if you are sitting there and can’t walk 3 feet, you can still participate in recreational therapy.
7. Does health insurance cover the costs of recreational therapy?
Medicare covers therapeutic recreation for certain conditions. Some health insurance policies will also cover recreational therapy. An individual’s healthcare provider and insurance company can provide details about cost and how to get a therapy referral. It is important to remember that only a prescription for recreational therapy would be considered for reimbursement, which doesn't occur all the time.
8. Where does a recreational therapist work?
Recreational therapists can work anywhere from an acute care facility or a health club to a home or community recreation center. Therapeutic recreation can be done with a large group, small group, one person to two people (called a dyad), or one to one.
9. Are recreational therapists licensed and credentialed?
Many recreational therapists are credentialed, and currently, only four states require licensure for recreational therapy: New Hampshire, North Carolina, Oklahoma and Utah. Over the years, recreation services have gone from participation in just any activity to pass the time to a therapeutic approach, which has led to the whole field being stricter with their criteria for credentialing. To be certified in recreational therapy, there are two main national accreditation organizations: the National Council for Therapeutic Recreation Certification (NCTRC) and the American Therapeutic Recreation Association (ATRA).
10. How do I find a recreational therapist in my community?
Contact one of the national organizations, whether it’s ATRA in Virginia or NCTRC in New York, and ask which facilities are near you in your state that employ the use of a certified therapeutic recreation specialist. Call ATRA at (703) 234-4140, or call NCTRC at (845) 639-1439 or email them at nctrc@NCTRC.org. Your healthcare provider may also be able to refer you to local therapists.
About the Author
An award-winning journalist who has documented stories in nearly 20 countries, Beth Lueders is an author, writer and speaker who frequently reports on diverse topics, including aging and health issues for both U.S. and international corporations.