Recreational Therapist Career

Recreational therapists plan, organize, direct, and monitor medically approved recreation programs for patients in hospitals, clinics, and various community settings. These therapists use recreational activities to assist patients with mental, physical, or emotional disabilities to achieve the maximum possible functional independence. Recreational therapists hold almost 24,000 jobs in the United States.

Recreational Therapist Career History

Recreational Therapist CareerThe field of therapy has expanded in the past few decades to include recreational therapy as a form of medical treatment. Its use grew out of the realization that soldiers suffering from battle fatigue, shock, and emotional trauma respond positively to organized recreation and activity programs.

As a result, therapy for people in nursing homes, hospitals, mental institutions, and adult care facilities is no longer limited to physical therapy. Experiments have shown that recovery is aided by recreational activities such as sports, music, art, gardening, dance, drama, field trips, and other pastimes. Elderly people are more healthy and alert when their days are filled with activities, field trips, and social get-togethers. People with disabilities can gain greater self-confidence and awareness of their own abilities when they get involved with sports, crafts, and other activities. People recovering from drug or alcohol addiction can reaffirm their self-worth through directed hobbies, clubs, and sports. The recreational therapist is a health professional who organizes these types of activities and helps patients take an active role in their own recovery.

The Job of Recreational Therapists

Recreational therapists work with people who are mentally, physically, or emotionally disabled. They are professionals who employ leisure activities as a form of treatment, much as other health practitioners use surgery, drugs, nutrition, exercise, or psychotherapy. Recreational therapists strive to minimize patients’ symptoms, restore function, and improve their physical, mental, and emotional well-being. Enhancing the patient’s ability to take part in everyday life is the primary goal of recreational therapy; interesting and rewarding activities are the means for working toward that goal.

Recreational therapists work in a number of different settings, including mental hospitals, psychiatric day hospitals, community mental health centers, nursing homes, adult day care programs, residential facilities for the mentally disabled, school systems, and prisons. They can work as individual staff members, as independent consultants, or as part of a larger therapeutic team. They may get personally involved with patients or direct the work of assistants and support staff.

The recreational therapist first confers with the doctors, psychiatrists, social workers, physical therapists, and other professionals on staff to coordinate their efforts in treatment. The recreational therapist needs to understand the nature of the patient’s ailment, current physical and mental capacities, emotional state, and prospects for recovery. The patient’s family and friends are also consulted to find out the patient’s interests and hobbies. With this information, the recreational therapist then plans an agenda of activities for that person.

To enrich the lives of people in hospitals and other institutions, recreational therapists use imagination and skill in organizing beneficial activities. Sports, games, arts and crafts, movie screenings, field trips, hobby clubs, and dramatics are only a few examples of activities that can enrich the lives of patients. Some therapists specialize in certain areas. Dance/movement therapists plan and conduct dance and body movement exercises to improve patients’ physical and mental well-being. Art therapists work with patients in various art methods, such as drawing, painting, and ceramics, as part of their therapeutic and recovery programs. Therapists may also work with pets and other animals, such as horses. Music therapists design programs for patients that can involve solo or group singing, playing in bands, rhythmic and other creative activities, listening to music, or attending concerts. Even flowers and gardening can prove beneficial to patients, as is proved by the work of horticultural therapists. When the treatment team feels that regular employment would help certain patients, the industrial therapist arranges a productive job for the patient in an actual work environment, one that will have the greatest therapeutic value based on the patient’s needs and abilities. Orientation therapists for the blind work with people who have recently lost their sight, helping them to readjust to daily living and independence through training and exercise. All of these professional therapists plan their programs to meet the needs and capabilities of patients. They also carefully monitor and record each patient’s progress and report it to the other members of the medical team.

As part of their jobs, recreational therapists need to understand their patients and set goals for their progress accordingly. A patient having trouble socializing, for example, may have an interest in playing chess but be overwhelmed by the prospect of actually playing, since that involves interaction with another person. A therapist would proceed slowly, first letting the patient observe a number of games and then assigning a therapeutic assistant to serve as a chess partner for weeks or even months, as long as it takes for the patient to gain enough confidence to seek out other patients for chess partners. The therapist makes a note of the patient’s response, modifies the therapy program accordingly, and lets other professionals know of the results. If a patient responds more enthusiastically to the program, works more cooperatively with others, or becomes more disruptive, the therapist must note these reactions and periodically reevaluate the patient’s activity program.

Responsibilities and elements of the job can vary, depending on the setting in which the recreational therapist works. In nursing homes, the therapist often groups residents according to common or shared interests and ability levels and then plans field trips, parties, entertainment, and other group activities. The therapist documents residents’ responses to the activities and continually searches for ways of heightening residents’ enjoyment of recreational and leisure activities, not just in the facility but in the surrounding community as well. Because nursing home residents are likely to remain in the facility for months or even years, the activities program makes a big difference in the quality of their lives. Without the stimulation of interesting events to look forward to and participate in, the daily routine of a nursing home can become monotonous and depressing, and some residents are apt to deteriorate both mentally and physically. In some nursing homes, recreational therapists direct the activities program. In others, activities coordinators plan and carry out the program under the part-time supervision of a consultant who is either a recreational or occupational therapist.

The therapist in a community center might work in a day-care program for the elderly or in a program for mentally disabled adults operated by a county recreation department. No matter what the disability, recreational therapists in community settings face the added logistical challenge of arranging transportation and escort services, if necessary, for prospective participants. Coordinating transportation is less of a problem in hospitals and nursing homes, where the patients all live under one roof. Developing therapeutic recreation programs in community settings requires a large measure of organizational ability, flexibility, and ingenuity.

Recreational Therapist Career Requirements

High School

You can prepare for a career as a recreational therapist by taking your high school’s college preparatory program. Naturally, this should include science classes, such as biology and chemistry, as well as mathematics and history classes. You can begin to gain an understanding of human behavior by taking psychology and sociology classes. For exposure to a variety of recreation specialties, take physical education, art, music, and drama classes. Verbal and written communication skills are essential for this work, so take English and speech classes. This job will require you to write reports, so computer science skills are also essential.

Postsecondary Training

Approximately 150 recreational therapy programs, which offer degrees ranging from the associate to the doctoral level, are currently available in the United States. While associate degrees in recreational therapy exist, such a degree will allow you only to work at the paraprofessional level. To be eligible for an entry-level professional position as a recreational therapist, you will need a bachelor’s degree. Acceptable majors are recreational therapy, therapeutic recreation, and recreation with a concentration in therapeutic recreation. A typical four year bachelor’s degree program includes courses in both natural science (such as biology, behavioral science, and human anatomy) and social science (such as psychology and sociology). Courses more specific to the profession include programming for special populations; rehabilitative techniques including self-help skills, mobility, signing for the deaf, and orientation for the blind; medical equipment; current treatment approaches; legal issues; and professional ethics. In addition, you will need to complete a supervised internship or field placement lasting a minimum of 480 hours.

Continuing education is increasingly becoming a requirement for professionals in this field. Many therapists attend conferences and seminars and take additional university courses. A number of professional organizations (for example, the National Therapeutic Recreation Society, the American Therapeutic Recreation Association, and the American Alliance for Health, Physical Education, Recreation, and Dance) offer continuing education opportunities. Those with degrees in related fields can enter the profession by earning master’s degrees in therapeutic recreation. Advanced degrees are recommended for those seeking advancement to supervisory, administrative, and teaching positions. These requirements will become more strict as more professionals enter the field.

Certification or Licensing

A number of states regulate the profession of therapeutic recreation. Licensing is required in some states; professional certification (or eligibility for certification) is required in others; titling is regulated in some states and at some facilities. In other states, many hospitals and other employers require recreational therapists to be certified. Certification is recommended for recreational therapists as a way to show professional accomplishment. It is available through the National Council for Therapeutic Recreation Certification. To receive certification you must meet eligibility requirements, including education and experience, as well as pass an exam. You are then given the title of certified therapeutic recreation specialist (CTRS). Because of the variety of certification and licensing requirements, you must check with both your state and your employer for specific information on your situation.

Other Requirements

To be a successful recreational therapist, you must enjoy and be enthusiastic about the activities in which you involve your clients. You will also need patience and a positive attitude. Since this is people-oriented work, therapists must be able to relate to many different people in a variety of settings. They must be able to deal assertively and politely with other health care workers, such as doctors and nurses, as well as with the clients themselves and their families. In addition, successful therapists must be creative and have strong communication skills in order to develop and explain activities to patients.

Exploring Recreational Therapist Career

If you are interested in recreational therapy, you can find part-time or summer work as a sports coach or referee, park supervisor, or camp counselor. Volunteer work in a nursing home, hospital, or care facility for disabled adults is also a good way to learn about the daily realities of institutional living. These types of facilities are always looking for volunteers to work with and visit patients. Working with people with physical, mental, or emotional disabilities can be stressful, and volunteer work is a good way for you to test whether you can handle this kind of stress.


Recreational therapists hold almost 24,000 jobs, according to the U.S. Department of Labor. About one-third of these jobs are in nursing and personal care facilities and one-third are in hospitals. Other employers include residential facilities, adult day care centers, and substance abuse centers, and some therapists are self-employed. Employment opportunities also exist in long-term rehabilitation, home health care, correctional facilities, psychiatric facilities, and transitional programs.

Starting Out

There are many methods for finding out about available jobs in recreational therapy. A good place to start is the job notices and want ads printed in the local newspapers, bulletins from state park and recreation societies, and publications of the professional associations previously mentioned. State employment agencies and human service departments will know of job openings in state hospitals. College placement offices might also be able to put new recreational therapy graduates in touch with prospective employers. Internship programs are sometimes available, offering good opportunities to find potential full-time jobs.

Recent graduates should also make appointments to meet potential employers personally. Most colleges and universities offer career counseling services. Most employers will make themselves available to discuss their programs and the possibility of hiring extra staff. They may also guide new graduates to other institutions currently hiring therapists. Joining professional associations, both state and national, and attending conferences are good ways to meet potential employers and colleagues.


Newly graduated recreational therapists generally begin as staff therapists. Advancement is chiefly to supervisory or administrative positions, usually after some years of experience and continuing education. Some therapists teach, conduct research, or do consulting work on a contract basis; a graduate degree is essential for moving into these areas.

Many therapists continue their education but prefer to continue working with patients. For variety, they may choose to work with new groups of people or get a job in a new setting, such as moving from a retirement home to a facility for the disabled. Some may also move to a related field, such as special education, or sales positions involving products and services related to recreational therapy.


Salaries of recreational therapists vary according to educational background, experience, certification, and region of the country. Recreational therapists had median earnings of $32,900 in 2004, according to the U.S. Department of Labor. The lowest paid 10 percent earned less than $20,130 a year, while the highest paid 10 percent earned more than $51,800 annually. Employment setting is also an important factor in determining salary. Recreational therapists employed by personal care agencies and nursing facilities earned median incomes of $28,130. Those in management positions command higher salaries. Supervisors report top salaries of $50,000 per year; administrators reported maximum earnings of $65,000 annually; and some consultants and educators reported even higher earnings.

Therapists employed at hospitals, clinics, and other facilities generally enjoy a full benefits package, including health insurance and vacation, holiday, and sick pay. Consultants and self-employed therapists must provide their own benefits.

Work Environment

Working conditions vary, but recreational therapists generally work in a ward, a specially equipped activity room, or at a nursing home. In a community setting, recreational therapists may interview subjects and plan activities in an office, but they might work in a gymnasium, swimming pool, playground, or outdoors on a nature walk when leading activities. Therapists may also work on horse ranches, farms, and other outdoor facilities catering to people with disabilities.

The job may be physically tiring because therapists are often on their feet all day and may have to lift and carry equipment. Recreational therapists generally work a standard 40-hour week, although weekend and evening hours may be required. Supervisors may have to work overtime, depending on their workload.

Recreational Therapist Career Outlook

The U.S. Department of Labor predicts that employment for recreational therapists will grow more slowly than the average occupation through 2014. Employment in nursing homes will grow slightly faster than in other areas. Fast employment growth is expected in assisted living, outpatient physical and psychiatric rehabilitation, and services for people with disabilities. Increased life expectancies for the elderly and for people with developmental disabilities such as Down’s Syndrome will create opportunities for recreational therapists. The incidence of alcohol and drug dependency problems is also growing, creating a demand for qualified therapists to work in short-term alcohol and drug abuse clinics.

Most openings for recreational therapists will be in health care and assisted living facilities because of the increasing numbers and greater longevity of the elderly. There is also greater public pressure to regulate and improve the quality of life in retirement centers, which may mean more jobs and increased scrutiny of recreational therapists.

Growth in hospital jobs is not expected to be great. Many of the new jobs created will be in hospital-based adult day care programs or in units offering short-term mental health services. Because of economic and social factors, no growth is expected in public mental hospitals. Many of the programs and services formerly offered there are being shifted to community residential facilities for the disabled. Community programs for special populations are expected to expand significantly.

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