What does a Therapeutic Recreation Specialist do?

A therapeutic recreation specialist works with patients who have mental, physical, or emotional difficulties. Through a carefully planned series of exercises and activities, a therapist works to restore independence and self-management to clients. The therapeutic recreation specialist works with clients in hospitals, rehabilitation centers, mental health centers, and in private practice. Most clients come through referral from a psychiatrist or social worker.

There are four main functions performed by a therapeutic recreation specialist: evaluation, plan development, implementation, and documentation. In order to become a therapeutic recreation specialist, a university degree in recreation therapy or physical therapy is usually required. Certification from the National Council for Therapeutic Recreation Certification (NCTRC) is required by most employers.

Most therapeutic recreation specialists are part of a medical services team. The first meeting with a new client involves a review of the patient history, discussion with the primary care physician of the issues that need to be addressed, and a brief meeting with the client. A recreation specialist reviews patient interests, hobbies or skills, and builds on those items to develop a therapy program. For example, a therapist might teach a stroke victim with partial paralysis fishing. The activity can be completed with the functional side and then expanded to the side affected with the paralysis.

At the start of the program, the therapist will conduct a series of diagnostic tests to measure level of mobility, strength, and interest. This information is used to form a baseline to measure growth. The items measured depend on the patient and his concerns.

For example, a patient struggling with severe depression may be very quiet, responding in single word answers. A patient with motor control issues may not be able to move forward in a straight line. The measure of progress is based on each patient's individual achievements over a specific period of time.

The treatment plan is developed to meet specific skill levels and targets. Multiple activities can be used to engage the client, introduce variety, and focus on different muscular groups. Alternating between individual and group activities adds to the variety and aids in the recovery process.

The approach used to implement the treatment plan varies, depending on the client's issues, level of family support, and interpersonal skills. Many therapists use a very low-key approach, with an invitation to join an ongoing activity with a family member or group of other patients. Some therapists provide a detailed plan to the support staff, but do not share it with the patient. The level of participation, success, and failure of different options and techniques must be documented and discussed with the patient’s treatment team. This type of review measures the effectiveness of the therapy.