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From:
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Bureau of Labor Statistics
Occupational Outlook Handbook

Recreational Therapists

Significant Points

• Recreational therapists will experience competition for jobs.
• A bachelor’s degree in therapeutic recreation is the usual requirement for entry-level positions.
• Recreational therapists should be comfortable working with persons who are ill or who have disabilities.

Nature of the Work

Recreational therapists, also referred to as therapeutic recreation specialists, provide treatment services and recreation activities for individuals with disabilities or illnesses. Using a variety of techniques, including arts and crafts, animals, sports, games, dance and movement, drama, music, and community outings, therapists improve and maintain the physical, mental, and emotional well-being of their clients. Therapists help individuals reduce depression, stress, and anxiety; recover basic motor functioning and reasoning abilities; build confidence; and socialize effectively so that they can enjoy greater independence and reduce or eliminate the effects of their illness or disability. In addition, therapists help people with disabilities integrate into the community by teaching them how to use community resources and recreational activities. Recreational therapists are different from recreation workers, who organize recreational activities primarily for enjoyment.

In acute health care settings, such as hospitals and rehabilitation centers, recreational therapists treat and rehabilitate individuals with specific health conditions, usually in conjunction or collaboration with physicians, nurses, psychologists, social workers, and physical and occupational therapists. In long-term and residential care facilities, recreational therapists use leisure activities—especially structured group programs—to improve and maintain their clients’ general health and well-being. They also may provide interventions to prevent the client from suffering further medical problems and complications. Recreational therapists assess clients using information from observations, medical records, standardized assessments, the medical staff, the clients’ families, and the clients themselves. They then develop and carry out therapeutic interventions consistent with the clients’ needs and interests. For example, they may encourage clients who are isolated from others or who have limited social skills to play games with others, and they may teach right-handed people with right-side paralysis how to use their unaffected left side to throw a ball or swing a racket. Recreational therapists may instruct patients in relaxation techniques to reduce stress and tension, stretching and limbering exercises, proper body mechanics for participation in recreational activities, pacing and energy conservation techniques, and team activities. As they work, therapists observe and document a patient’s participation, reactions, and progress. Community-based recreational therapists may work in park and recreation departments, special-education programs for school districts, or assisted-living, adult day care, and substance abuse rehabilitation centers. In these programs, therapists use interventions to develop specific skills, while providing opportunities for exercise, mental stimulation, creativity, and fun. Those few who work in schools help counselors, teachers, and parents address the special needs of students, including easing disabled students’ transition into adult life. Work environment. Recreational therapists provide services in special activity rooms but also plan activities and prepare documentation in offices. When working with clients during community integration programs, they may travel locally to teach clients how to use public transportation and other public areas, such as parks, playgrounds, swimming pools, restaurants, and theaters. Therapists often lift and carry equipment. Recreational therapists generally work a 40-hour week that may include some evenings, weekends, and holidays.

Training, Other Qualifications, and Advancement

A bachelor’s degree with a major or concentration in therapeutic recreation is the usual requirement for entry-level positions. Some States regulate recreational therapists, but requirements vary.

Education and training. Most entry-level recreational therapists need a bachelor’s degree in therapeutic recreation, or in recreation with a concentration in therapeutic recreation. People may qualify for paraprofessional positions with an associate degree in therapeutic recreation or another subject related to health care. An associate degree in recreational therapy; training in art, drama, or music therapy; or qualifying work experience may be sufficient for activity director positions in nursing homes.

Approximately 130 academic programs prepare students to become recreational therapists. Most offer bachelor’s degrees, although some also offer associate, master’s, or doctoral degrees. Therapeutic recreation programs include courses in assessment, treatment and program planning, intervention design, and evaluation. Students also study human anatomy, physiology, abnormal psychology, medical and psychiatric terminology, characteristics of illnesses and disabilities, professional ethics, and the use of assistive devices and technology.

Licensure. Some States regulate recreational therapists through licensure, registration, or regulation of titles. Requirements vary by State. In 2006, North Carolina, Utah, and New Hampshire required licensure to practice as a recreational therapist.

Certification and other qualifications. Although certification is usually voluntary, most employers prefer to hire candidates who are certified therapeutic recreation specialists. In 2006, about 3 out of 4 recreational therapists worked in a clinical setting, which often requires certification by the National Council for Therapeutic Recreation Certification. The council offers the Certified Therapeutic Recreation Specialist credential to candidates who have a bachelor’s or graduate degree from an accredited educational institution, pass a written certification examination, and complete a supervised internship of at least 480 hours. Therapists must meet additional requirements to maintain certification.

Therapists can also earn certifications in specific areas, such as art therapy and aquatic therapy.

Recreational therapists must be comfortable working with people who are ill or disabled. Therapists must be patient, tactful, and persuasive when working with people who have a variety of special needs. Ingenuity, a sense of humor, and imagination are needed to adapt activities to individual needs, and good physical coordination is necessary to demonstrate or participate in recreational activities.

Advancement. Therapists may advance to supervisory or administrative positions. Some teach, conduct research, or consult for health or social services agencies.

Employment

Recreational therapists held about 25,000 jobs in 2006. About 70 percent were in nursing and residential care facilities and hospitals. Others worked in State and local government agencies and in community care facilities for the elderly, including assisted-living facilities. The rest worked primarily in residential mental retardation, mental health, and substance abuse facilities; individual and family services; Federal Government agencies; educational services; and outpatient care centers. Only a small number of therapists were self-employed, generally contracting with long-term care facilities or community agencies to develop and oversee programs.

Job Outlook

Overall employment of recreational therapists is expected to grow more slowly than the average for all occupations. Competition for jobs is expected.

Employment change. Employment of recreational therapists is expected to increase 4 percent from 2006 to 2016, slower than the average for all occupations. Employment of recreational therapists will grow to meet the therapy needs of the increasing number of older adults. In nursing care facilities—the largest industry employing recreational therapists—employment will grow slightly faster than the occupation as a whole as the number of older adults continues to grow. Fast employment growth is expected in the residential and outpatient settings that serve people who are physically disabled, cognitively disabled, or elderly or who have mental illness or substance abuse problems. Employment is expected to decline in hospitals, however, as services shift to outpatient settings and employers emphasize cost containment.

Health care facilities will support a growing number of jobs in adult day care and outpatient programs offering short-term mental health and alcohol or drug abuse services. Rehabilitation, home health care, and transitional programs will provide additional jobs.

Job prospects. Recreational therapists will experience competition for jobs. Job opportunities should be best for people with a bachelor’s degree in therapeutic recreation or in recreation with courses in therapeutic recreation. Opportunities also should be good for therapists who hold specialized certifications such as aquatic therapy, meditation, or crisis intervention. Recreational therapists might experience more competition for jobs in certain regions of the country.

Earnings

Median annual earnings of recreational therapists were $34,990 in May 2006. The middle 50 percent earned between $26,780 and $44,850. The lowest 10 percent earned less than $20,880, and the highest 10 percent earned more than $55,530. Median annual earnings in the industries employing the largest numbers of recreational therapists in May 2006 were:

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Recreational Therapists, on the Internet at http://www.bls.gov/oco/ocos082.htm.