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.

Monday, November 06, 2006

ICF and RT -- Information from David Howard

David Howard, Ph.D., from Indiana State University, recently sent me the following on the ICF for the RT Blog. I appreciate Professor Howard's work with the ICF and am providing this post from him FYI. Here it is:

Since its inception over a half-century ago, the World Health Organization has worked for the “attainment by all peoples of the highest possible level of health,” defining health as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (World Health Organization, 1946). In 2001, the WHO published the International Classification of Functioning, Disability and Health (ICF) as one part of their Family of International Classifications (the ICD being the other part). The ICF offers us a contemporary framework that conceptualizes health thru a focus on a) body functions and structures, b) activities and participation, and c) contextual factors (environmental and personal). The four primary aims of the ICF are: a) to provide a scientific basis for understanding and studying health and health outcomes, b) to establish a common language for describing health in order to improve communication at all levels of health and society, c) to permit comparison of data across countries, health care disciplines, and health-related services, and d) to provide a systemic coding scheme for heath information systems.

For recreation and leisure professionals, the ICF is a very important conceptual model and classification system – inclusive of information for those involved in therapeutic recreation – whether one’s focus is clinical treatment and rehabilitation work or inclusion, wellness, and or health promotion activities.

Since the release of the ICF, many organizations and health care professions have acted to adopt the language, framework, and classification system of the ICF. In October 2005, the American Therapeutic Recreation Association (ATRA) endorsed the ICF with the following statement:

The concepts and terminology of the ICF are compatible with recreational therapy practice. ATRA supports, the use of ICF language and terminology in recreational therapy practice guidelines, standards of practice, curriculum development, public policy, international relations, and research. ATRA also acknowledges the significance of the use of the ICF classification and coding system as a vehicle to clarify and enhance practice and research in recreational therapy.

For each of the past twelve years, the North American Collaborating Center (NACC) Conference meetings on the ICF has been held, co-sponsored by the Centers for Disease Control and Prevention in the United States and the Canadian Institute for Health Information in Canada. Therapeutic recreation professionals have attended the past four of these conferences, with the next conference being held June 2007 in Niagara Falls, NY. Information about the next NACC conference can be found via the Center for International Rehabilitation Research Information and Exchange (CIRRIE) website. ATRA continues to work with the American Psychological Association in a multi-disciplinary effort to publish a manual for the application of the ICF for health professionals. Other professional organizations that have played primary roles in the creation of this manual include the American Speech Language Hearing Association, the American Occupational Therapy Association, the National Association of Social Workers, and the American Physical Therapy Association.

No less important, the ICF has a role in inclusion, health promotion, and wellness efforts for all members of society, including people with disabilities. An example of this is Healthy People 2010, the nations’ health agenda which has two goals: a) increasing quality and years of healthy life and b) eliminating health disparities. Within HP2010 are twenty-eight focus areas, including cancer (Ch. 3), educational and community-based programs (Ch. 7), mental health and mental disorders (Ch. 18), physical activity and fitness (Ch. 22), and substance abuse (Ch. 26). Salient to most therapeutic recreation specialists, Chapter 6, labeled Disability and Secondary Conditions is conceptually grounded on the ICF, and the ICF may have an even prominent role in the development of Healthy People 2020 within the next few years.

Hopefully, the reader will take advantage of the many opportunities to further educate themselves about the ICF and its potential role in practice, research, and policy-making endeavors.

Links the reader may find useful in learning more about the ICF include:

HP2010 (
Healthier US (


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