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Zepf Center News

What is Recreation Therapy?

Published Monday, September 28, 2015
by Amy Yarnell, Recreation Therapist(M. Ed., CTRS)



Recreation Therapy is defined as “a treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restriction to participation in life situations caused by an illness or disabling condition” (American Therapeutic Recreation Association [ATRA], 2009).  Recreation Therapy is a skilled therapy provided as active treatment (as defined by the Centers for Medicare and Medicaid Services).  Recreation Therapy is recognized as an allied health discipline by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and encompasses trained professionals dedicated to providing outcome-based therapeutic recreation services to all citizens.



The recreational therapy profession can be traced back to the 1850’s when Florence Nightingale proposed that recreation experiences could be drawn upon to improve the human condition.  In 1931 the American Red Cross began hiring recreation hospital workers.  The term “recreational therapy” was first coined by the Menninger brothers who were enthusiastic for the inclusion of recreational therapy as a treatment of persons with mental health disorders.  Since the 1940’s, recreational therapists have served as active members of the interdisciplinary treatment team addressing the psychosocial and physical rehabilitation needs of consumers. 

Recreation Therapists are professionally trained practitioners who:

  • Individually assess each patient/client
  • Design specific therapeutic goals
  • Plan intervention programs
  • Implement safe and effective evidence-based recreational therapy interventions
  • Document interventions provided/chart patient progress
  • Evaluate the effectiveness of intervention programs
  • Manage recreation therapy practice



Recreation Therapy embraces a definition of “health” which includes not only the absence of “illness”, but extends to enhancement of physical, cognitive, emotional, social and leisure development so the individual may participate fully and independently in chosen life pursuits.  The unique feature of recreation therapy that makes it different from other therapies is the use of recreational modalities in the designed intervention strategies.  Although many of the treatment goals that a recreation therapist may work towards are similar to other disciplines on the rehabilitation team, the way the recreation therapist achieves those goals is what distinguishes this unique service.  Incorporating the client’s interest and the client’s family and/or community makes the therapy process meaningful and relevant.  Recreation Therapy is extremely individualized to each person, their past, present and future interests and lifestyle.  The recreation therapist has a unique perspective regarding the social, cognitive, and physical and leisure needs of the client.  Recreation Therapists weave the concept of healthy living into treatment to ensure not only improved functioning, but also to enhance independence and successful involvement in all aspects of life. 

Recreation Therapists have assessed competency in:

  • Foundations of professional practice
  • Recreation and leisure services
  • Individualized patient/client assessment
  • Planning treatment interventions
  • Implementing treatment interventions
  • Evaluating treatment/programs
  • Managing recreational therapy practice
  • Anatomy and physiology
  • Human growth and development (lifecycle)
  • Psychology
  • Abnormal psychology
  • Disabling conditions
  • Counseling
  • Kinesiology
  • Cognitive and educational psychology
  • Group dynamics and leadership
  • First aid and safety
  • Pharmacology
  • Heath care organization and delivery
  • Legal aspects of health care



A qualified recreation therapist is one who is nationally certified as a certified therapeutic recreation specialist (CTRS).  Qualified professionals are certified through the National Council for Therapeutic Recreation Certification (NCTRC) which requires a bachelor degree or higher from an accredited university, a formal 640 hour internship and the passing of a national certification.  In addition, a CTRS must maintain their credential every five years through the NCTRC recertification process.



  • Acute care hospitals
  • Rehabilitation units in acute care hospitals
  • Long-term care facilities or skilled nursing facilities
  • Comprehensive outpatient facilities
  • Inpatient and outpatient mental, behavioral health/psychiatric facilities
  • Addiction/substance abuse rehabilitation facilities
  • Home health care agencies
  • Residential facilities for persons with disabilities
  • Adult day care centers
  • Centers for independent living
  • Public and private school systems
  • Correctional Institutions



  • Behavior modification
  • Cognitive retraining
  • Loss counseling
  • Guided imagery
  • Play/therapy skills
  • Re-motivation
  • Reality orientation
  • Sensory stimulation
  • Stress management
  • Anger management
  • Coping skills
  • Feelings/triggers
  • Relapse prevention
  • Values clarification
  • Biofeedback-based relaxation techniques
  • Family interventions
  • Group interventions
  • Leisure education
  • Re-socialization
  • Reminiscence
  • Social skills training
  • Community integration
  • Wellness training
  • Horticulture
  • Therapeutic exercise
  • Aquatic therapy
  • Expressive arts
  • Adapted sports



Current research indicates a significant number of positive health outcomes resulting from participation in recreation therapy programs. 

Improvement in Cognitive Status – Individuals who participated in various structured recreation therapy interventions achieved the following results:

  • Enhanced attention, memory, and perception
  • Improved organizational skills
  • Increased decision making and problem solving skills
  • Behavior management strategies
  • Increased alertness and awareness of surroundings
  • Reduced confusion and disorientation

Improvement in Physical Health Status - Individuals who participated in various structured recreation therapy interventions achieved the following results:

  • Improvement in physical skill development
  • Increased mobility and muscular strength
  • Increased flexibility, ambulation, and range of motion
  • Increased fine motor skills
  • Improvement in perceptual-motor skills, balance, agility, and athletic skill
  • Improvement in cardiovascular and respiratory functioning
  • Increased strength, endurance, and coordination
  • Decreased pain and stiffness
  • Reduced reliance upon medication and other health care services
  • Reduced secondary disability and associated higher health care costs
  • Reduction in complications related to secondary disability

Improvement in Psychosocial Status - Individuals who participated in various structured recreation therapy interventions achieved the following results:

  • Increased self-efficiency, self-confidence, and acceptance of disability
  • Increased communication, trust and cooperation skills
  • Increased skills at managing stressors, anxiety, and boredom
  • Increased skills in conversation, assertion, and advocating for self
  • Decreased social isolation and increased affiliation with others
  • Increased verbal interaction
  • Lowered levels of depression
  • Enhanced feelings of well being
  • Improved morale and life satisfaction
  • Enhanced perceptions of personal control and competence
  • Increased relaxation
  • Improved body image

Improvement in Life, Recreation and Community Activities - Individuals who participated in various structured recreation therapy interventions achieved the following results:

  • Improvement in community functioning and barrier management
  • Establishment of new life activities for continued growth
  • Improved ability to cope with substance-related stressors
  • Improved decision-making skills
  • Enhanced sober lifestyle and identity
  • Enhanced functional independence for community living
  • Improved ability to structure time
  • Increased quality of discretionary time use



I studied Recreation Therapy and earned my Bachelor’s degree from The University of Toledo.  My Master’s degree is in Therapeutic Arts, also from The University of Toledo.  I have been a CTRS for 20 years and have worked with a variety of populations including long-term care residents, skilled nursing patients in sub-acute rehabilitation facilities, residential homes for memory care/Alzheimer’s, residential facility for developmental disabilities, prison inmates, adult day care center clients, inpatient psych patients, and now outpatient mental health clients at the Zepf Center.  Throughout my career as a Recreation Therapist, I’ve built and managed several Recreation Therapy departments for my former employers.  I am the Wellness Program Coordinator at the Zepf Center and I oversee and track all of the Wellness Programming referrals and groups for youth and adults, as well as facilitating wellness programs that I have designed.  I am also the Clinical Instructor at the Zepf Center for Recreation Therapy interns from The University of Toledo.  Please contact me at ext. 3259 if you have any questions about Zepf Wellness Programs and I would love to assist you.


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