Name:
Location: Indiana, United States

I became a Professor Emeritus after serving 29 years as a recreational therapy faculty member at Indiana University. I'm a long-time Hoosier, having grown up in Hanover, Indiana. My RT practitioner work was in psych/mental health. After completing my Ph.D. at the University of Illinois, my first faculty position was at the University of North Texas. RT has been a wonderful profession for me as I have had the opportunity to serve as an author and national leader.

Friday, June 09, 2006

Time for Profession to Adopt RT Term!

In the book, Conceptual Foundations for Therapeutic Recreation published by Venture Publishing in 2002, I wrote the following:

"The time has come to restructure the system of education based on a clear definition of the therapeutic recreation profession. This reform needs to rest on boundaries that distinguish special and inclusive recreation from therapeutic recreation. It may also be time to adopt the term recreation therapy to more clearly represent the clinical approach that uses recreation as an intervention and follows the systematic process of assessment, planning, implementation, and evaluation. If therapeutic recreation curricula do not take this step, therapeutic recreation will remain "lost in familiar places" (Dumas, 1994), and doomed to the long tradition of basing curricula on a definition lacking clear boundaries" (p. 210).

We need a clear demarcation between inclusive recreation (i.e., provision of normal recreation services for persons with disabilities) and recreation therapy (i.e., using interventions to bring about higher levels of health and wellness). A definitive separation between inclusive recreation and RT can lead to advances for both. In my chapter in Conceptual Foundations for Therapeutic Recreation I elaborate on this position of making a clear separation between inclusive recreation and recreation therapy in order to have a foundation for curricula.

Obviously, what we call ourselves makes a difference beyond university curricular concerns. Employing the term recreation therapy would make a large difference in clearly defining ourselves to others -- who today are confused as to whether we are recreators or therapists.

With this post, I would like to raise the issue as to whether it is now time to drop the term therapeutic recreation and adopt the term recreation theapy. In doing research on the history of ATRA I was surprised to learn that several nationally prominent leaders have stated that they believe ATRA made a mistake in not becoming ARTA in 1984. Does our profession wish to compound that mistake by not correcting it now?

5 Comments:

Blogger Sharon N CTRS said...

This comment has been removed by a blog administrator.

9:28 AM  
Blogger Sharon N CTRS said...

After just having gone through the process of securing licensure for recreational therapists in the state of NH, I have to agree that the time has come for our profession to truly clarify how we define ourselves and our profession. During the legislative hearings in both the NH House and Senate, there were questions regarding the broad term of therapeutic recreation compared to recreation therapy. I agree that our profession needs to distinguish special recreation services from recreation therapy.

I believe that the debate is not about TR and RT as much as it is really centered on the difference between inclusive recreation and recreation therapy. These are just some of my thoughts for the moment.

I further believe that our model for practice truly stands within the realm of health promotion and prevention and also is more in line with the World Health Organization's International Classification of Function (ICF). We need to move away from a framework that emphasizes disease and disability and move closer in the direction of health and well being.

9:33 AM  
Blogger Sharon N CTRS said...

After just having gone through the process of securing licensure for recreational therapists in the state of NH, I have to agree that the time has come for our profession to truly clarify how we define ourselves and our profession. During the legislative hearings in both the NH House and Senate, there were questions regarding the broad term of therapeutic recreation compared to recreation therapy. I agree that our profession needs to distinguish special recreation services from recreation therapy.

I believe that the debate is not about TR and RT as much as it is really centered on the difference between inclusive recreation and recreation therapy. These are just some of my thoughts for the moment.

I further believe that our model for practice truly stands within the realm of health promotion and prevention and also is more in line with the World Health Organization's International Classification of Function (ICF). We need to move away from a framework that emphasizes disease and disability and move closer in the direction of health and well being.

9:41 AM  
Blogger Ray West said...

I agree we need to better distinguish between inclusive recreation and recreational therapy (note the use of the term recreational, which I believe to be the gramatically and professionally correct term). I also think we need to continue to distinguish between therapeutic recreation and recreational therapy. There are some therapeutic recreation services/activities (e.g. therapeutic horseback riding, etc.) that are more than just inclusive recreation (e.g. are goal directed, follow the TR process, have outcomes that improve functioning and independence, etc.), but can't meet the definitions of treatment that agencies like CMS use. The ATRA definition distinguishes between RT and TR and describes the purpose of recreational therapy as "treatment". All of therapeutic recreation does not meet the definition of "treatment" as defined by those external to the RT/TR profession. It is necessary that RT is seen as producing evidenced-based treatment outcomes on a consistent and predictable basis if RT is to continue to be provided in health care settings (community and institutional). If we don't understand and relate to the service systems (e.g. health care, public education, public recreation, etc.) we can limit our scope of practice by using the wrong terminology to describe our service. I am not referring to a philosophical construct, but a definition of service that describes outcomes consistent with the service system.

I also think that right now we have a far greater problem than just terminology and it is academic preparation. If you look at the TREC reports and other literature about academic preparation they describe that there is little consistency of academic preparation except at the minimal levels of courses required to sit for the NCTRC exam. We, as a profession, claim to understand health and human functioning and to be behaviorally science oriented, but we don't consistently prepare those entering the profession to understand anatomy and physiology (basic structure and function) at a level minimally comparable to other heath care professions, we also don't consistently prepare those entering the profession to understand elements of movement (kinesiology or biomechanics), understand motor or cognitive learning, understand how drugs and medications affect functioning, understand how to establish effective helping relationships and many other competencies described in the ATRA publication Guidelines for Competency Assessment and Curriculum Planning in Therapeutic Recreation. While we have these limitations in competencies we are still working with patients trying to improve functioning and reach treatment outcomes in the very areas where we lack competencies (e.g. cognitive functioning, physical functioning, etc.). Is the balance between the potential to help and not harm tipped in the wrong direction? We have told those external to the profession, including consumers and policy makers, that we are competent health care professionals who consistently produce evidenced-based outcomes and yet our competencies continue to limit the outcomes we provide and the consistency by which we reach the outcomes. We have struggled our entire professional history with "philosophical" orientations to service and terminology and this has limited our focus on preparing the most competent providers. I am concerned that since PT and OT have moved to graduate level preparation for entry into the profession, RT/TR academic programs will become a feeder program for PT and OT graduate level programs. Once PT's and OT's have an undergraduate degree in RT/TR and understand what we have done in service provision they will incorporate it into PT and OT practice and there won't be a need for RT/TR practice.

I think it is important to contemplate and discuss professional concerns (e.g. philosophical orientations, terminology, etc.), but if improving competency to practice and consistently reaching outcomes valued by stakeholders isn't our first priority we are not as patient/client centered as we claim to be and should be.

12:30 PM  
Blogger Ray West said...

This comment has been removed by a blog administrator.

12:44 PM  

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