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Recreational Therapists

Significant Points
  • Overall employment of recreational therapists is expected to grow more slowly than the average for all occupations, but employment of therapists who work in community care facilities for the elderly and in residential mental retardation, mental health, and substance abuse facilities should grow faster than the average.
  • Opportunities should be best for persons with a bachelor’s degree in therapeutic recreation, or in recreation with a concentration in therapeutic recreation.
  • 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 to 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 treat 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, as well as reduce or eliminate the effects of their illness or disability. In addition, therapists help integrate people with disabilities into the community by teaching them how to use community resources and recreational activities. Recreational therapists should not be confused with 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 related to illnesses and disabilities.

    Recreational therapists assess clients on the basis of information the therapists learn from standardized assessments, observations, medical records, 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, clients who are isolated from others or who have limited social skills may be encouraged to play games with others, and right-handed persons with right-side paralysis may be instructed in how to adapt to using 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 individual as well as team activities. In addition, 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 programs for older adults and people with disabilities. Included in the last group are programs and facilities such as 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. Although most therapists are employed in other areas, those who work in schools help counselors, teachers, and parents address the special needs of students, including easing disabled students’ transition into adult life.

    Working Conditions

    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 instruct the clients regarding the accessibility of public transportation and other public areas, such as parks, playgrounds, swimming pools, restaurants, and theaters.

    Therapists often lift and carry equipment, as well as lead recreational activities. 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 in therapeutic recreation, or in recreation with a concentration in therapeutic recreation, is the usual requirement for entry-level positions. Persons may qualify for paraprofessional positions with an associate degree in therapeutic recreation or a health care related field. 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 150 programs prepare students to become recreational therapists. Most offer bachelor’s degrees, although some also offer associate, master’s, or doctoral degrees. 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.

    Although certification is usually voluntary, most employers prefer to hire candidates who are certified therapeutic recreation specialists. The National Council for Therapeutic Recreation Certification is the certificatory agency. To become certified, specialists must have a bachelor’s degree, pass a written certification examination, and complete an internship of at least 480 hours. Additional requirements apply in order to maintain certification and to recertify. Some States require licensure or certification to practice recreational therapy.

    Recreational therapists should be comfortable working with persons who are ill or who have disabilities. 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.

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


    Recreational therapists held about 24,000 jobs in 2004. About 6 out of 10 were in nursing 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 through the year 2014. 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. Employment is expected to decline, however, in hospitals as services shift to outpatient settings and employers emphasize cost containment. Fast employment growth is expected in the residential and outpatient settings that serve disabled persons, the elderly, or those diagnosed with mental retardation, mental illness, or substance abuse problems. Among these settings are community care facilities for the elderly (including assisted-living facilities); residential mental retardation, mental health, and substance abuse facilities; and facilities that provide individual and family services (such as day care centers for disabled persons and the elderly). Opportunities should be best for persons with a bachelor’s degree in therapeutic recreation or in recreation with an option in therapeutic recreation. Opportunities also should be good for therapists who hold specialized certifications, for example, in, aquatic therapy, meditation, or crisis intervention.

    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.

    The rapidly growing number of older adults is expected to spur job growth for recreational therapy professionals and paraprofessionals in assisted-living facilities, adult day care programs, and other social assistance agencies. Continued growth also is expected in community residential care facilities, as well as in day care programs for individuals with disabilities.


    Median annual earnings of recreational therapists were $32,900 in May 2004. The middle 50 percent earned between $25,520 and $42,130. The lowest 10 percent earned less than $20,130, and the highest 10 percent earned more than $51,800. In May 2004, median annual earnings for recreational therapists were $28,130 in nursing care facilities.

    Related Occupations

    Recreational therapists primarily design activities to help people with disabilities lead more fulfilling and independent lives. Other workers who have similar jobs are occupational therapists, physical therapists, recreation workers, and rehabilitation counselors.

    Sources of Additional Information

    For information on how to order materials describing careers and academic programs in recreational therapy, contact:

    Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07 Edition,

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