Although recreational therapy (RT) is considered to be a valuable service for individuals with acquired brain injury (ABI), longitudinal studies are needed to validate its functional utility. Objective: To identify longitudinal relationships among the number of RT services, neuropsychological impairments, community integration, and quality of life for individuals with significant ABI. Methods: The sample included 71 individuals with moderate/severe ABI in an inpatient rehabilitation program who received RT services and completed predictor and outcome measures during inpatient rehabilitation (n = 71) and at 6 months post-discharge (n = 33). Measures included the number of RT services offered and indices of ABI-related neuropsychological impairments, community integration, and environmental quality of life. Results: Pearson correlations and multiple regressions indicated that (1) more RT services are offered to people with less successful community integration (as expected); and (2) more RT services and better community integration (but not neuropsychological impairments) are associated with better environmental quality of life. Conclusion: RT services promote long-term community integration and quality of life in individuals with ABI.
This paper explores the impact that recreational therapy interventions had on the social-emotional growth of middle schoolers during a 5-week summer school program. Five subscales—Interpersonal Strength, Family Involvement, Intrapersonal Strength, School Functioning, and Affective Strength—were analyzed through pre- and post-tests assessments. While overall changes were not statistically significant, the Interpersonal Strength subscale showed a notable increase in mean scores, with two items demonstrating significant improvement (p < .05), suggesting gains in emotional regulation and accountability. Other subscales remained stable or showed mixed results. The findings highlight the potential of targeted interventions to support specific aspects of social-emotional growth and underscore the need for further research with larger sample sizes and more extensive program components.
Recreational therapists work in a broad field with numerous service settings for individuals with disabilities. Students' learning may be enhanced by providing opportunities during class time to implement services for more unfamiliar populations. Therefore, the purpose of this study was to investigate students' reflections from a class time fieldwork experience (CTFE) in a recreational therapy (RT) class with adolescents who engage in health-risk behaviors. A retrospective, qualitative content analysis of 111 RT students' perspectives was used for this study, and two main themes emerged: exposure to an unfamiliar community population and identifying personal biases and judgments. Implications are identified for RT educators and practitioners to apply these findings to future CTFEs, internships, and employment opportunities.
Nature-based interventions (NBIs) present a promising but underexplored approach in recreational therapy for improving the quality of life in individuals with eating disorders (EDs). Due to limited research, this scoping review focuses on strategies and techniques for implementing NBIs, including wilderness therapy, horticultural therapy, forest bathing, and adventure therapy. Based on theoretical frameworks such as the Biophilia Hypothesis, Attention Restoration Theory, and Stress Reduction Theory, this review suggests ways nature-based experiences may promote emotional regulation, mindfulness, self-efficacy, and social well-being. However, several practical and individual challenges must be addressed, including limited access to natural spaces, financial and logistical constraints, psychological resistance, and the need for culturally sensitive approaches. Additionally, the lack of standardized evaluation methods makes it difficult to measure the effectiveness of NBIs in ED recovery. Given these challenges, this paper offers recommendations for recreational therapists to adapt and integrate NBIs into treatment, emphasizing creative solutions and individualized approaches. By exploring the possibilities of NBI with people who have EDs, this paper contributes to the growing conversation on using nature-based strategies to enhance therapeutic outcomes.
Blue care, a therapeutic approach utilizing natural aquatic environments, has emerged as a promising nature-based intervention (NBI) to enhance well-being. This literature review explored the concept of blue care as well as its relevance to recreational therapy (RT) practices. Supported by Ulrich's Stress Reduction Theory, this review discusses the restorative effects of water that support physical, emotional, and psychological health. Studies demonstrated that proximity to and engagement with blue spaces was associated with increased physical activity, improved mood, reduced symptoms of anxiety and depression, enhanced body image, and greater life satisfaction. These benefits were observed across diverse populations including children, older adults, and veterans. Interventions ranged from direct immersion activities, such as swimming and surfing, to passive methods, such as viewing aquatic environments or practicing guided imagery.
Objective: To explore professional perspectives on the role of leisure in mental health recovery, as understood by a mental health nurse, an occupational therapist, and a recreational therapist. Methods: An autoethnographic dialogue was conducted using four guiding questions to prompt reflection on the therapeutic use of leisure, professional roles, and interprofessional boundaries. Results: The dialogue revealed overlapping values and distinct disciplinary frameworks. While all professions recognized the value of leisure in promoting recovery, challenges emerged around role clarity, hierarchy, and the integration of leisure into practice. Conclusion: Leisure is a shared, yet underutilized, therapeutic medium in mental health settings. Enhancing collaboration across disciplines and addressing systemic barriers could support broader, more effective use of leisure in recovery-oriented care.
This pilot study explored the impact of a 6-week virtual reality (VR) gaming intervention on executive functioning among adults with intellectual and/or developmental disabilities (IDDs). Using a randomized waitlist control design, nine participants completed biweekly sessions playing the Beat Saber VR game, with assessments conducted via the Behavior Rating Inventory of Executive Function-Adult Version at multiple time points. Repeated measures analysis of variance revealed statistically significant improvements in overall executive functioning, working memory, and planning/organization skills. While between-group differences were not statistically significant, clinically meaningful trends favored the intervention group. These findings support the potential of VR as a recreational therapy intervention to enhance executive functioning in adults with IDD. Results support the need for further research to establish VR as an evidence-based recreational therapy practice, especially for enhancing cognitive skills among individuals with IDD.
Rationale: Recreational therapy (RT) services are offered to improve the health, functioning, and particularly the community integration of individuals with acquired brain injury (ABI) but can also be of benefit to caregivers. However, longitudinal studies are needed to demonstrate these beneficial relationships. Methods: Participants included 40 caregivers of individuals with ABI who were engaged in inpatient rehabilitation. Data were collected during inpatient rehabilitation (time 1; n = 40) and at 6 months post-discharge (time 2; n = 16). Predictor variables included patient neuropsychological complaints (neurobehavioral symptom inventory), patient community integration (community integration questionnaire), and number of RT services offered. The outcome was caregiver functioning (caregiver burden inventory). Results: (1) Increased RT services are associated with worse patient-related neuropsychological complaints and community integration; (2) increased patient neuropsychological complaints are associated with worse caregiver functioning, particularly after discharge; but (3) better patient community integration is associated with better caregiver functioning after discharge. Conclusions: The results suggest that better community integration, ie, a primary focus of RT, of individuals with ABI is associated with better long-term functioning for their caregivers. Previous research and the current results support the use of RT services to improve the community integration of individuals with TBI, as well as the overall functioning of their caregivers.
As the United States (US) population continues to age rapidly, healthcare professionals—including recreation therapists (RTs)—must be prepared to meet the complex needs of older adults. Despite the high percentage of certified therapeutic recreation specialists working with geriatric populations, gerontology-focused education is not currently required for certification. This quantitative study surveyed 410 RTs across the US and Canada to examine whether the completion of a university-level gerontology course influenced perceptions of aging. Using the Expectations Regarding Aging-12 survey, the study found that participants who had completed a 3-credit gerontology course reported significantly more positive perceptions of aging (mean = 71.38) than those who had not (mean = 69.67), with results reaching statistical significance (t(204) = 2.24, p = .026). While the effect size was small, findings suggest that gerontology coursework may positively shape RTs’ attitudes toward aging. The study underscores the need for the National Council for Therapeutic Recreation Certification to consider incorporating gerontology-specific competencies into certification requirements. Doing so could help reduce ageism in care settings and enhance therapeutic outcomes for the growing population of older adults.
Purpose: This single-case study examined whether a structured, once-weekly recreational therapy (RT) program could facilitate and maintain improvements in a 58-year-old male diagnosed with a cerebrovascular accident resulting in left hemiparesis post-stroke. Methods: This 16-week intervention involved weekly 60-minute sessions, with measurements conducted at baseline, 8 weeks, 16 weeks, and 3-month follow-up. Each session included a warm-up, muscular strength exercises, balance and postural control training, recreational boxing, and functional movement tasks. Gait parameters (step velocity, step length, and cadence) were assessed via the GAITRite® walkway system, postural sway via the BioSway™ balance system, and perceived fall risk via the Short Falls Efficacy Scale-International. Results: At 16 weeks, step velocity (+94.6 percent), step length R (+50.8 percent), and cadence (+25.4 percent) showed significant improvements, with partial regression observed at follow-up. Balance (–16.6 percent) and fall risk perception (–18.7 percent) initially improved but worsened post-intervention. Effect sizes confirmed strong impacts on gait function (d > 2.4), while balance and fall risk perception showed moderate effects (d ≈ –1.7). Tau-U analysis supported strong intervention effects for step velocity (0.89) and step length R (0.85), reinforcing the therapy’s efficacy but highlighting the need for continued intervention. Conclusion: A once-weekly structured RT program significantly improved gait parameters and balance-related outcomes in a post-stroke individual. However, partial regression post-intervention suggests that continued therapy is necessary to sustain long-term benefits. These findings highlight the potential benefits of low-frequency RT in post-stroke rehabilitation while emphasizing the need for ongoing intervention strategies to maintain functional improvements.
Objectives: Examine the effectiveness of a coupled HydroWorx Aquatic Treadmill and virtual trail walking (HAT-TW) program for pain, physical functioning (aim 1), and physical activity enjoyment (aim 2) in older adults with osteoarthritis. Design: Pre-experimental case study. Setting: Hydrotherapy lab in North Carolina. Participants: Three community-dwelling older adults (aged 76-83; standard deviation = 4.04). Intervention: 4-Week (12 sessions/60-minutes/sessions) HAT-TW program. Main outcome measures: Pain, physical function (aim 1), and physical activity enjoyment and leisure satisfaction (aim 2). Results: Participants demonstrated reduced pain and pain interference, and increased physical function, at pre- and post-test. High scores on physical activity enjoyment and leisure satisfaction were observed. Conclusion: These preliminary findings show the utility of the HAT-TW dual-component program. Future research should examine outcomes of this dual-component program in a larger sample.
The disciplines of recreational therapy, exercise physiology, and athletic training work with adaptive sport athletes in various capacities, but practice recommendations for this interprofessional work are not yet established. Therefore, the aim of this study was to propose practice recommendations for these three disciplines working in adaptive sports. This qualitative research used focus group interviews with participants from the three disciplines. Findings included two themes for practice recommendations for all disciplines (interprofessional collaboration and holistic athlete care) and three additional, discipline-specific themes [recreational therapy as disability specialists using the assessment, planning, implementation, evaluation, and documentation process, exercise physiologists as training as challenging, safe, and empowering, and athletic training as emergency action plan]. Discussions of implications for interprofessional work in adaptive sport and future research directions are further presented.
Riding or being around horses is one form of therapeutic recreation. For safety, helmets are required by most practitioners, if not strongly encouraged. Yet, current helmet designs for equine activities remain largely inaccessible and noninclusive, raising significant safety concerns within equine-assisted services (EASs). This study examines the experiences of EAS providers (N = 201) in fitting helmets for clients, many of whom have diverse access needs. A secondary analysis of deidentified survey responses was conducted. Findings demonstrate systemic barriers related to helmet sizing, fit, and compatibility with hairstyles and assistive technologies, such as cochlear implants. These challenges underscore the need for an inclusive helmet design that addresses bodily diversity. Drawing on the Adaptive Synergy framework, adaptive technologies from other sports may offer timely and novel pathways for decreasing barriers and increasing accessibility. Furthermore, companies are encouraged to include those lacking access to the industry in the conversation to gain user involvement, which may increase innovation, accessibility, and end-user engagement. Through the intersection of design, access, and autonomy, this research contributes to broader debates about how exclusionary practices in safety equipment perpetuate marginalization and stigmatization of disabled persons within sport and therapeutic recreation.
Adolescents with intellectual disabilities (IDs) have lower physical activity (PA) levels, higher body mass index (BMI), and a higher risk of chronic diseases such as diabetes and cardiovascular disease. Specific programming focusing on adaptations, teamwork, and motivation has been found to promote PA in adolescents with IDs. Recreational therapy provides unique PA programming, focusing on physical components, while also including social, cognitive, and emotional functioning skills. Purpose: To examine the effects of a recreational therapy-based PA intervention on cholesterol levels, glucose, weight, BMI, flexibility, upper and lower body strength, and aerobic endurance in adolescents diagnosed with ID. Methods: Adolescents (n = 21) attending a psychiatric rehabilitation treatment facility participated in a 30-minute recreational therapy-based PA intervention 3 days per week for 8 weeks. Pre- and post-assessments included waist circumference, weight, blood sample (low-density lipoprotein [LDL] and high-density lipoprotein levels, glucose), strength (hand grip and 10 rep timed chair stands), aerobic endurance (6-minute walk test), and flexibility (sit and reach). Demographics were assessed using mean and standard deviation (mean ± SD). Comparisons between pre- and post-assessments were assessed using dependent t-tests. The Shapiro–Wilk test was used to check for normality in data. SPSS (v.27) was used for statistical analysis. Results: Participants (age 15.76 ± 2.81 years, m = 15, f = 6) demonstrated a significant decrease in their LDL scores between pre- and post-tests (pre: 91.85 ± 20.61 mg/dL; post: 85.40 ± 22.58 mg/dL), with a medium effect size (p = 0.014, d = 0.60). Timed chair stands decreased in time (pre: 37 ± 16.76 seconds; post: 32.22 ± 10.57 seconds) and showed a trend toward significance (p = 0.055) with a small effect size (d = 0.47). Conclusion: Based on evidence, it can be suggested that participation in recreational therapy-based PA is beneficial for individuals with IDs. Professionals who encourage a combination of individual and game-based PA in individuals with IDs may see improved health outcomes.
Leisure education (LE) is frequently provided in recreational therapy (RT) practice and can be offered to a diverse clientele. This study aimed to evaluate a new LE program for law enforcement officers that was developed based on the leisure education content model (LECM) and incorporated leisure experiences in parks to address stress and well-being. Specifically, the purpose of this study was to evaluate (a) the extent to which the program met its stated objectives, (b) the program’s alignment with the four key elements of the LECM, and (c) the perceived value of the program to participants. Participants (N = 10) were offered a series of six LE sessions at their place of employment and supplemented sessions with independent experiences in parks. Findings indicate 89.25 percent agreement that session learning objectives were met, 78.22 percent agreement that session content aligned with the LECM components, and 93.55 percent agreement that sessions had value to the participants. Suggestions for program improvement and implications for the profession are discussed, including possibilities to expand RT services to new populations.
For more than a decade, the profession has finally been housed in one sole professional organization, the American Therapeutic Recreation Association (ATRA), begging the question: How have we achieved unification? This article addresses this question by looking into our history to illuminate the events that have occurred and shaped ATRA, with the goal of understanding how today’s professional membership organization came into being, and how it defines itself, stipulates its mission and goals, and represents the profession.
This program evaluation was part of a broader research study that aimed to evaluate a new recreational therapy (RT) program focused on developing resiliency and self-efficacy in college students through a combination of rock climbing, mindfulness, and reflective journaling activities. RT programming was imbedded in an introductory college rock climbing course offered over three consecutive days, and participants experienced significant increases in resiliency and self-efficacy post-program. Given the multifaceted structure of the intervention, this program evaluation aimed to (a) clarify the role of specific program elements by assessing the RT program’s alignment with its 12 intended objectives and (b) determine the program’s appropriateness for its intended clientele by assessing perceived value to college students. Evaluation surveys revealed that 11 of the 12 objectives (91.67 percent) were met based on established thresholds for participant feedback, indicating that the program content and activities were well aligned with the intended objectives. Additionally, all of the participants (N = 12) either agreed (n = 4) or strongly agreed (n = 8) that the program had value to them.
Purpose: This study aimed to determine the feasibility and potential impact of adaptive therapeutic climbing (TC) program as an intervention to improve both psychosocial health and hand function of children with congenital upper limb differences (CULDs). Methods: Participants completed 6 weeks of 1-hour group adaptive TC sessions with pre- and post-participation functional tests of active and passive range of motion (ROM) and manual muscle testing as well as evaluations for psychosocial impact using the Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, Perceived Life Satisfaction Scale, and Patient-Reported Outcomes Measurement Information System short forms. Feasibility outcomes of the program were also evaluated. Results: Although seven children began the study, three children dropped out due to socioeconomic hardship related to attendance. Of the four that completed the study, two participants with symbrachydactyly (complete absence of one hand) demonstrated improvement in contralateral tip pinch and bilateral shoulder ROM. Active and passive ROM for shoulder flexion and abduction improved in all children by at least 20° bilaterally. Overall, mean psychosocial scores were similar among study participants and healthy peers. Participants consistently attempted more climbs and some even higher grade routes. Conclusion: Adaptive TC programs are likely impactful and safe for children with CULD and may improve function and flexibility of affected and unaffected limbs. Obstacles preventing attendance affected families of lower socioeconomic status.
Clinical supervision improves patient care, performance, and safety in recreational therapy (RT) but is mostly limited to internships. A consistent and frequent supervisory process is needed throughout the professional life of RT clinicians to improve clinical practice and increase the fidelity of supervision. In this paper, the authors emphasize the importance of clinical supervision and provide an overview of it, accentuate the need for a consistent approach to it within the field of RT, provide input from other professionals who have actively engaged in producing knowledge on this subject matter, and evaluate the possible application of clinical supervision into RT.
