Timeline of Historic TR Events

Time Line of Historic Events
2.6 million years ago: flaked stones found amoun the fossils of australopithecines indicate they were already exploring the possibilities of hanidcraft, and fashioning simple tools from the pebbles.
35,000 BC: Homo sapiens invent art
10,000 BC: The first evidence of surgical treatment, tephaning
2600 BC: Chinese taught that disease was caused by organic inactivity and used physcial training for the promotion of heatlh
2000-1500 BC: Egyptians describe diversion and recreation as a means of treating the sick.
1700 BC: Code of Hammurabi-Mesopotamia-Summerians included 282 malpractice laws concering surgical procedures.
1000 BC: Ancient persians realized the beneficial effects of physical training and utilized it to fit their youth for military duty.
500 BC -500 AD: Asclepius' Temple and Cult
460 BC: Age of Pericles in Athens
420 BC: The Greeks described diversion and recreation as a means of treating the sick.
400 BC: Socrates and 347 BC Plateo understood the relationship between physical status and mental health.
359 BC: Hippocrates (460-361), the father of modern medicine, recommended that their patients exercise in the gymnasium as a means of recovering from illness.
340 BC: Aristotle felt that the "education of the body must precede that of the intellect."
100 BC- 4 AD: The Roman Ascliepiades advocated massage, therapeutic baths, and exercise for improving diseased conditions. He also recommended activity treatment for patients with mental diseases. This included diversions and entertainment, but only the diversional value was recognized.
477-900: The Dark Ages, the mental and physical influences of play were regarded by the Church to be evil. (The first half of the Middle Ages, until the 10th century).
900-1453: The Middle Ages, the mental and physical influences of play are again recognized after Arabic texts are translated into German.
1454-1605: The Renaissance, the mental and physical influences of play are again recognized after Arabic texts are translated into German.
1537-1543: Vesalius at Padua
1752: Pennsylvania Hospital is established in Philadelphia. Benjamin Franklin was involved indrafting the petition for its establishment. Inmates were provided with light manual labor such as spining and carding wool for activity.
1780: Clement Joseph Tissot publishes the book Gymnastique Medicinale et Churgicale recommending "prescribed craft and recreational activities as therapeutic exercise for the treatment of disabled muscles and joints following disease or injury."
1786: Phillip TInel introduced work treatment in the Bicetra Asylum fpr th INsane near Paris.
1798: Benjamin Rush, M.D., one of the signers of the Declaration of Independence, advocated work as a remedial measure for the treatment of patients in the Pennsylvania Hospital.
1801: Pinel publishes a book Medical Philosophical Treatise on Mental Alienatino, describing the method as 'prescribed physical exercises and manual occupations." It is the first reference in literature to the medically prescribed use of activity for remediation.
1803: Johann Christian Reil suggested the use of exercise and a special hospital gymnasium along with patient participation in dramatic productions and fine arts, in his book Rhapsodies on the Psychic Treatment of the Insane. This is evidence of one of the first uses of psychodrama in the treatment of the insane.
1810: Rush, in an address to the Board of the Pennsylvania Hospital, advised that "certain kins of labor, exercise, and amusements be contrived for them, which should act at the same time, upon their bodies and minds."
1816: Samuel Tuke, an English Quaker, established a Retreat Asylum for the Insane at York, England. He used work or occupation therapy as Pinel did but placed special emphasis on humane treatment or treating of patients as rational beings who have the capability of self-restraint. He called it moral treatment  stating "...of all the modes by which patients may be induced to restrain themselves, regular employment is perhaps the most generally efficacious; and those kinds of employment are doubtless to be preferred which are accompanied by considerable bodily action, that are most agreeable to the patient, and which are most opposite to the illusions of his disease,...every effort should be made to divert the mind of melancholia by bodily exercise, walks, conversations, reading, and other recreations. Those who manage the insane should sedulously endeavor to gain their confidence and esteem, to arrest their attention and fix it on object opposed to their delusions ..and to remember that in the wreck of the intellect the affections not infrequently survive."
1817: Thomas Scattergood, a Quaker minister who visited Retreat, brought the principles of "occupationa dn nonrestraint" back to the US, and helped establish the Friends of Asylum for the Insane in Philadelphia.
1818: McLean Asylum opens near Boston under the supervision of Rufus Wyman, M.D. He established, and was probably the first physician in the country to supervise a program of occupational therapy.
1821: Thomas Eddy, New York merchant and member of the Society of Friends, was another visitor impressed by treatment methods at Retreat. He submitted suggestions for the moral management of the insane to the Governors of the Lunatic Asylum of the New York, Hospital. As a result, Bloomingdale Asylum was opened in New York City and began moral management including "occupational therapy.
1840: F. Leuret wrote On the Moral Treatment of Insanity, which recommended diversions and work to prevent the effects of idleness and boredom. He utilized exercise, drama, music, and reading along with manual labor. Nearly synonymous with occupation therapy, it is considered the first book entirely devoted to the subject.
1840: Thomas Stroy Kirkbride, M.D> became superintendent of Pennsylvaniea Hospital, and began a program of mental care that stressed occupation therapy. He said that thte value of occupational therapy cannot be measured in dollars and cents but must be judged in regard to the restoration of comfort to the inmates of the hospital. Crafts, amusements, and hospital occupations were used therapeutically. He helped to organize the Association of Asylum Medical Superintendents, which later became the American Psychiatric Association. Through this association Kirkbride ,influenced its members regarding the value of occupation therapy.
1844: Amaria Brigham, superintendent of Utica State Hospital in New York advocates the therapeutic value of occupying patients. The idea that only the therapeutic value should be considered in selecting the activity was a important advance toward a more scientific use of occupation therapy.
1854: Florence Nightingale provides recreation to casualties of the Crimean War dubbing her the mother of hospital recreation.
1860-1885: Economic pressures felt in all hospitals during and after the Civil War, busy physicians, lack of public interest and insight, and an underestimation of the therapeutic value of occupation as well as "the real returns as compared to the incidental returns or possible economic proceeds from the treatment," all contributed to the sudden decline and de-emphasis of the allied health therapies for more than 25 years.
1880s: The settlement house concept beings in England
1889: Hull House, Chicago, IL, founded by Jane Addams and Ellen Gates Starr  provides community services and recreation to the poor.
1892: Dr Adolf Meyer, a psychiatrist, reported that "the proper use of time in some helpful and gratifying activity appeared to be a fundamental issue in the treatment of the neuropsychiatric patient." He is known for the concept of psychobiology.
1893: The "industrial Home for the Blind" in New York City was established to provide among other things recreation experiences for its clients
1895: Mary Potter Brooks Meyer, a social worker, introduced a systematic type of activity into the wards of a state institution in Worcester, Massachusetts. She was also the first social worker to provide a systematic program to help patients, their families, and the physician.
1905: The "Lighthouse" (Another New York association for the blind) added the donation of theater and concert tickets as part of its services.
1906: National Recreation Association founded, Boston Sand Gardens
1906: Hall received a $1,000 grant from Harvard to assist in the study of the treatment of neurasthenia by progressive and graded manual occupation. He established a workshop in Marblehead, MA, where he used, as a treatment, the crafts of hand-weaving  woodcarving, metalwork, and pottery "because of their universal appeal and the normalizing effect of suitable manual work.

1908: A. M. Forster opened Eudwood Farm in Towson, MD. The International Congress on TB awarded him their Gold Medal for progressive treatment of tuberculosis patients using activity therapy. He based his work on American philosopher William James' Tough Minded concept.
1909: The first known course in professional recreation is taught at an institution of higher learning

1913: The American Journal of Insanity details how one hospital chartered a train and took 500 patients on a picnic for curative and restorative benefits.
1914: The Jewish Guild for the Blind cites as one of its original purposes the provision of a recreation center.
1915: The director of the Vineland Institute (New Jersey) publishes an account of the use of games and play to help develop self-control, coordination, and manner in the mentally retarded
1919: The American Red Cross formally organizes a division of recreation in hospitals (by 1930 there are 117 full-time Red Cross hospital recreation workers)
1919: The first "manual concerned with recreation and illness was published, Hospital and Bedside Games.
1919: The St. Loui School for Reconstruction Aides changes its name to the St. Louis School of Recreational and Occupational Therapy. Both 3-year and 4-year bachelor of science degrees are offered.
1926: The first formal training school devoted solely to the trainging of professional recreation personnel is established and called the National Recreation Association's Leadership Trainging School
1931: New York University offers the first university curriculum in recreation.
1932: The White House Conference on Child Health and Protection acknowledged the need for recreation as one element essential in supplementing social reform.
1932: The use of recreation in chronic psychiatric settings is published in the text Emotion and Sport.
1932: One of the very first experimental design projects regarding recreation is completed at the Lincoln State School and Colony in Illinois  The results indicate that responses of retarded children can be significantly improved through the use of play activities.
1933: The book psychoanalytic Theory of Play extends the case for recreation as a part of the psychoanalytic school of psychology.
1936: First recreational therapy text is written by Dr. William Rush Davis Jr titled Principles and Practice  of Recreation Therapy with the Mentally Ill.
1938: The term therapeutc recreation first appears in federal legislation as part of the creation of the Words Progress Administraion (WPA)
1944: The first Community Center entirely devoted to serving older adults was started by the New York City Department of Welfare.
1950: The University of Minnesota offers the first universtiy curriculum dedicated solely to therapeutic recreation.
1950's: Three Therapeutic Recreation Associations in existence.
1953: A study by the Standards and Training Commitee of the Hospital Recreation Section of the American Recreation Society reported six colleges and universities with graduate or undergraduate degrees in hospital recreation.
1954: Publication of Recreation in Treatment Centers, an annual collection of therapeutic recreation research, is begun by the Hospital Recreation Section of the American Recreation  Society and is published until 1969.
1955: One of the earliest university textbooks available is printed: Recreation for the Handicapped by Valerie Hunt.
1957: A quarterly journal, Recreation for the Ill and Handicapped, is developed by the National Association of Recreational Therapists and is published until 1967.
1958: The National Recreation Association commissioned a study that involved more than 6,000 hospitals/institutions as the first major cataloging of personnel, clients, and content served in therapeutic recreation programming
1959: Recreation in Total Rehabilitation by Rathbone and Lucas provided one of the first comprehensive technical manuals on provision of therapeutic recreation services.
1961: The National Recreation Asociation sponsored a therapeutic recreation curriculum development conference, the first nationally organized effort to identify general competencies needed by recreation personnel in hospital settings.
1963: The Rehabilitation Services Administration of the U.S. Department of Health, Education and Welfar provided funds to selected colleges and universitites for graduate study in therapeutic recreation
1965: The first organized attempt to develop uniform standards of practice for the delivery of therapeutic recreation get underway via CAHR.
1967: NTRS begines the publication of the Therapeutic Recreation Journal (TRJ) as a replacement  journal for Recreation for the Ill and Handicapped (publication of TRJ continues thorough to the present day).
1968: A national Recreation Education Accreditation Project (begun originally in 1963) published TR emphasis criteria for both undergraduate and graduate levels of study.
1969: A national study identified 28 undergraduate and 26 graduate programs in therapeutic recreation.
1970: NTRS begins the publication of the Therapeutic Recreation Annual as a replacement for Recreation in Treatment Centers (however the TR Anuual survives only through five volumes and leaves the TRJ as the only professional journal published by NTRS.)
1970: A small flurry of new academic texbooks begins as curricula diversify with such works by Frye and Peters (1972), Kraus (1973), Stein and Sessoms (1973), Avedon (1974), Shivers and Fait (1975), O'Morrow and Reynolds (1976), Gunn and Peterson (1978), and Kaplan (1979).
1972: Frye and Peters (1972) report that one third of all studies withing therapeutic recreation had been completed since 1963.
1973: Martin (1973) reported that betwen 1965 and 1973 a total of 210 research studies appeared either in professional journals or conference and symposia proceedings.
1975: The first standards for the accreditation of recreation curricula in colleges and universities are implemented by the National Recreation and Park Association in concert with the American Association of Leisure and Recreation. The first standards for therapeutic recreation are accepted by this body in
1978: Standards of practice for the delivery of therapeutic recreation in community-based programs are printed by NTRS.
1979: Standards of practice in ten specialized areas of clinical and residential service settings are formalized by NTRS.
1979: A national study identified a total of 116 undergraduate therapeutic recration programs and another 34 master's degree programs.
1980: NTRS begins a dialogue with both the Joint Commission on Accreditation of Hospitals (JCAH) and the Commission on Accreditation of Rehabilitation Facilities (CARF) to see that standards of practice intended to protect the consumer become part of the standard review process of accreditation of facilities. Eventually, both bodies adopt key element of the NTRS standards (JCAH in 1981 and CARF in 1982).
1980's Clinical specialization of textbooks refines as new titles based on specific populations and models of service appear.
1982: The NTRS membership and board of directors formally adopt a national philosophical position statement as a declaration to the public of the mission of NTRS. It should be noted, however, that this adoption was not without controversy. Both a very low membership voting turnout and the very divided results of balloting (four different positions were voted on) contributed to post-decision derisiveness withing the profession.
1984: ATRA is established in a smoke filled room
1984: Emilie Adams, a future TRS is born.
1984: A national survey by the Society of Park and Recreation Educators catalogs a total of 98 undergraduate and 55 graduate programs of study in therapeutic recreation, across a total of 260 responding institutions.
1986: The Jounral of Expanding Horizons in Therapeutic Recreation is begun by the University of Missouri as the second contemporary referred journal (TRJ being the first) dedicated exclusively to therapeutic recreation.
1987: The National Council on Post-secondary Accreditation formally recognizes the NRPA?AALR accreditation of educational standards and programs; a kind of national "good housekeeping seal of approval" is thus extended. This event represents a landmark legitimization of the quality of postsecondary curricula in therapeutic recreation.
1988: DRF's new standards recognize the CTRS credential for the first time. Subsequently, demands on the national job market for CTRS's increase 120 percent over the next calendar year.
1988: In a move the "rankles" many educators, the NCTRC sets forth content coursework guidelines for the review of certification eligibility of professionals. Specific course titles and content are deemed appropriate or inappropriate for both TR and general recreation/leisure studies courses. Many university and college programs are forced to re-title and re-think their content offerings in order for their graduates to be certification eligible (these standards were revised and further sharpened in 1993).
1990: The NTRS membership and board of directors formally adopt "Standards for Practice" toward the goal of ensuring unified delivery of the service motive acress practitioners and service settings.
1990: The Annual in Therapeutic Recreation is published as a joint venture between the University of Missouri, the American Therapeutic Recreation Association, and the American Association of Leisure and Recreation. The Journal of Expanding Horizons closes after just thee volumes: however, its editorial mission is refined and forms the cornerstone for the new Annual. After 2 years the Annual becomes the the sole responsibility of ATRA.
1991: ATRA membership and board of directors publish their version of "Standards of Practice." The document includes 12 points and requires, among other points, the credentialing of all ATA members through the National Council for Therapeutic Recreation Certification (NCTRC) and pledges to uphold confidentiality of clients to practice individualized treatment planning, and to adhere to the ATRA code of ethics.
1991: A notional conference on TR research and benefits is hosted by Temple University, funded by the National Institute on Disability and Rehabilitation Research.  A summary monograph is published in which a typology of six global "benefit" to therapeutic recreation is validated. The review of research covers over 135 studies from 1973 to 1990, across 30 interdisciplinary journals, and represents the most exhaustive meta-analysis of research in therapeutic recreation in the history of the profession.
1992: The Joint Commission for the Accreditation of Health Care Organizations (JCAHCO) recognizes recreational therapy within its standards as a formal rehabilitation therapy. These standards actually recognized recreational therapy along with its sister therapies: occupational, physical, and speed therapy (all members of the newly organized National Coalition of ARTs Therapies).
1995: The Comprehensive Accreditation Manual for Hospitals (CAMH), published by the JCAHCO, defines for the first time recreational therapist, qualified and recreational therapy assistant/technical...qualified. The development and adoption of these definitions were a joint venture by both ATRA and NCTRS.
1995: ATRA launches its first Annual Research Institute and commits a portion of its national conference to highlighting research demonstration thereafter.
1995: ATRA sets a focus on higher education and curriculum reform in therapeutic recreation as a 3-day focus for its national midyear conference. A national panel and 65 participants debate the indicators of TR coursework content, patterns, and needs and establish a set of reform and developmental priorities for curriculum planners.
1998: A notional study of TR experts establishes the "top five  research priorities. The study represents a significant extension of the 1991 Temple study and provides a national focus and perspective for collaborative areas of work previously lacking in the literature. The top five areas include community integration  recidivism, independent functioning, length of stay and health functioning.
1999: The ATRA Standards of Practice Committee completes a revision of their 1991 publication, including new "Standards for TR Assistants." Companion document including a "Patient's Bill of Rights" and "Patient Satisfaction Scales" are also completed.
1999: The NCTRC targets long-term care facilities as a priority for promotion of the CTRS credential. An education campaign is launched nationwide by mailing packets to over 2,400 health care providers in an attempt to improve services to consumers and the TR profession.
1999: A national crises in higher education is recognized by two different studies. Riley and Heyne (1999) report 21 universities searching for new TR faculty in a year that only 3 new PhD's are produced nationwide. Austin, Compton, and Young (1999) publish a national survey that projects a need for some 64 new PhD's over the next 3 years, a goal that cannot possibly be met by the few Ph.D-granting institutions left.
2009: Utah recreation practice act R156-81
2011: Emilie Adams discovers the field of Therapeutic Recreation
2012: Recreation Therapy Practice Act is renewed and revised in the state of Utah. New CEU requirements come into place.
2014: Emilie Adams completes an internship in Therapeutic Recreation, passes the certification, graduates and become a licensed MTRS.

Related Fields

Similar fields of study/Professions

Addiction Counseling: Addiction counseling programs prepare students to work as counselors with people who have alcohol, substance abuse, or gambling addictions. Students learn to assess problems and set up treatment plans. They learn methods for early intervention and prevention.

Art Therapy: Art therapy programs teach students how to use art to promote the physical, mental, and emotional health of patients. Students learn drawing, painting, and other forms of art. They also learn psychology and counseling techniques.

Community Services: Community services programs prepare people to connect individuals with health care and social services. Students learn to plan, manage, or implement service programs. They also learn to make referrals to services.

Dance Therapy: Dance therapists use movement as a medium to work with clients. It is a non-verbal means of expression employed with both individuals and groups. Although not found exclusively in psychiatric treatment programs, it is most commonly used with people experiencing problems in mental health. 

Human Services: Human services programs prepare people to work for organizations that serve people in need. Students learn the theories, principles, and practice of providing services. They also learn how to counsel and refer clients to related services.

Medical Doctors: Medical doctors (M.D.'s) use surgery, drugs, and other methods of medical care to prevent and alleviate disease. There are over 30 different specializations of medical doctors. Examples of these are psychiatrists (who specialize in mental and emotional disorders), pediatricians (who specialize in the care and treatment of children), and neurologists (who deal with diseases of the nervous system). 

Mental Health Counseling: Mental health counseling programs prepare people to help patients with personal problems, conflicts, or emotional crises. Students learn to guide patients to improved mental health. Students also learn counseling and interviewing skills. In addition, they learn observation and testing methods.

Music Therapy: Music therapy programs prepare people to encourage healing in patients through music. Students learn music theory and performance. They learn diagnosis and therapy. In addition, they learn how to counsel patients.

Nursing: Registered nurses (R.N.'s) have responsibility for giving nursing care to patients, carrying out physicians' orders, and supervising other nursing personnel such as licensed practical nurses(L.P.N.'s) nurses aides, orderlies, and attendants. 

Occupation Therapy: Occupational therapists (OTs) help people who have mental, physical, or developmental disabilities. When they get new patients, therapists read their medical charts to learn about their disabilities and develop a treatment plan.

Physical Therapy: Physical therapy programs prepare people to work with patients who have physical pain or limitations. Students learn to promote the healthy movement of the human body. They also learn to use exercises and massage to promote healing.

Play Therapy: Play therapy is a form of psychotherapy that uses play activities and toys with children to permit the expression of and working through emotional conflicts. Symbolic play is seen as a means for the child to surface problems so that they can be dealt with. 

Psychology: Psychologists usually hold Ph.D. or Psy.D. degrees in psychology. They engage in psychological testing, diagnosis, counseling, and other therapies.


Social Work: Social work programs prepare people to counsel disadvantaged groups and individuals. Students learn about counseling methods and how to manage casework. They also learn when to make referrals to other services.

Vocational Rehabilitation Counseling: Vocational rehabilitation counselors (often referred to as "voc rehab" counselors) are concerned with work or career counseling of clients in treatment and rehabilitation programs. They assess client vocational interests and potentials and attempt to find appropriate training or placements to meet clients' abilities.

Source: http://www.iseek.org/education/fieldOfStudy?tab=5&id=361308

Fletcher Allen Health Care Philosophy of TR

It is the philosophy of the Therapeutic Recreation program that leisure and recreation are inherent aspects of the human experience. Therapeutic recreation is a process of utilizing recreation activities for intervention in physical, emotional, and/or social behavior to bring about a change which promotes the growth and development of the individual.

Philosophy of Treatment of Care at Heritage School

"Heritage approaches the treatment and care of adolescents from the point of view that the most crucial issues for them are safety, relationships, and the development of emotional attachments. Our approach is to build on the positive aspects of supportive relationships and to provide nurture and security together with clinical assistance and structured care. Our successful history has shown that this philosophy of treatment gives troubled teens the skills and attitudes they need to regain control of their lives." – Jerry Spanos, Founder Heritage School, Provo, UT.

Continuum of Recreational Therapy Services at Heritage Schools:

Treatment

Helps process new information learned during group challenges, recreational, play, and leisure experiences. Improves functional skills for involvement in more meaningful leisure experiences. Introduces personal and group challenges. Promotes positive relationships with others.

Leisure Education

Provides students the opportunity to attain new skills, knowledge, and attitudes toward best ways to spend leisure time.

Recreation Participation

Allows students to explore new recreation interests through on and off campus activities. This will provide community resources for free time leisure experiences.

NTRS Philosophical Statement

 Leisure, including recreation and play, are inherent aspects of the human experience.  The importance of appropriate leisure involvement has been documented throughout history.  More recently, research has addressed the value of liesure involvement in human development, in social and family relationships, and, in generals, as an important aspect of the quality of life.  Some human beings have disabilities, illnesses, or social conditions which limit their full participation in the normative social structure of society.  These individuals with limitations have the same human rights to, and needs for, leisure involvement.

            The purpose of therapeutic recreation is to facilitate the development, maintenance and expression of an appropriate leisure lifestyle for individuals with physical, mental, emotional, or social limitations.  Accordingly, this purpose is accomplished through the provision of professional programs and services which assist the client in eliminating barriers to leisure, developing leisure skills and attitudes, and optimizing leisure involvement.  Therapeutic recreation professionals use these principles to enhance clients’ leisure involvement.  Therapeutic recreation professionals use these principles to enhance clients’ leisure ability in recognition of the importance and value of leisure in the human experience.

            Three specific areas of professional services re employed to provide this comprehensive leisure ability approach toward enabling appropriate leisure lifestyles: therapy, leisure education, and recreation participation.  While these three areas of service have unique purposes in relation to client need, they each employ similar delivery processes using assessment or identification of client need, development of a related program strategy, and monitoring and evaluating client outcomes.  The decision as to where and when each of the three service areas would be provided is based on the assessment of client needs and the service mandate of the sponsoring agency.  The selection of appropriate service areas is contingent on recognition that different clients have differing needs related to leisure involvement in view of their personal life situation.

            The purpose of the therapy service area within therapeutic recreation is to improve functional behaviors.  Some clients may require treatment or remediation of a functional behavior as a necessary prerequisite to enable their involvement in meaningful leisure experiences. Therapy, therefore, is viewed as not appropriate when clients have functional limitations that relate to, or inhibit, their potential leisure involvement.  This distinction enables the therapeutic recreate to decide when therapy service is appropriate, as well as to identify the types of behaviors that are most appropriate to address within the therapeutic recreation domain of expertise and authority.  In settings where a comprehensive treatment team approach is used, therapy focuses on team identified treatment goals, s well as addressing unique aspects of leisure related functional behaviors. This approach places therapeutic recreation as an integral and cooperative member of the comprehensive treatment team, while linking its primary focus to eventual leisure ability.

            The purpose of the leisure education service area is to provide opportunities for the acquisition of skills, knowledge, and attitudes related to leisure involvement.  For some clients, acquiring leisure skills, knowledge, and attitudes are priority needs.  It appears that the majority of clients in residential treatment, and community settings need leisure education services in order to initiate and engage in leisure experiences.  It is the absence of leisure learning opportunities and socialization into leisure that blocks or inhibits these individuals from participation in leisure experiences.  Here, leisure education services would be employed to provide the client with leisure skills, enhance the client’s attitudes concerning the value and importance of leisure, as well as learning about opportunities and resources for leisure involvement. Thus, leisure education programs provide the opportunity for the development of leisure behaviors and skills.

            The purpose of the recreation participation area of therapeutic recreation services is to provide opportunities which allow voluntary client involvement in recreation interests and activities.  Human beings, despite disability, illness or other limiting conditions, and regardless of place of residence, are entitled to recreation opportunities.  The justification for specialized recreation participation programs is based on the client’s need for assistance and/or adapted recreation equipment, limitations imposed by restrictive treatment or residential environment, or the absence of appropriate community recreation opportunities.  In therapeutic recreation services, the need for recreation participation is acknowledged and given appropriate emphasis in recognition of the intent of the leisure ability concept.

            These three service areas of therapeutic recreation represent a continuum of care, including therapy, leisure education, and the provision of special recreation participation opportunities.  This comprehensive leisure ability approach uses the need of the client to give direction to program service selection.  In some situations, the client may need programs from all three service areas. IN other situations, the client may require only one or two of the service areas.

            Equally important is the concern of generalizing therapeutic recreation service across diverse service deliver settings.  The leisure ability approach of therapeutic recreation provides appropriate program direction regardless of type of setting type of client served.  A professional working in a treatment setting can see the extension of the leisure ability approach toward client needs withing the community environment.  Likewise, those within the community can view therapeutic recreation services within a perspective of previous services received or possible future needs.

            All human beings, including those individuals with disabilities, illnesses, or limiting conditions, have a right to, and a need for, leisure involvement as necessary aspect of the human experience. The purpose of therapeutic recreation services is to facilitate the development, maintenance, and expression of an appropriate leisure lifestyle for individuals with limitations through the provision of therapy, leisure education and recreation participation services. 

NTRS Definition of TR

Practiced in clinical, residential, and community settings, the profession of therapeutic recreation uses treatment, education, and recreation services to help people with illness, disabilities, and other conditions to develop and use their leisure in ways that enhance their health, independence, and well-being.

ATRA Definition of TR

Therapeutic recreation is the individualized, goal oriented process of delivering treatment, educational, and/or preventative interventions uniquely based in recreation activity concepts. These interventions are intended to restore remediate, or rehabilitate. The primary purpose is to contribute to outcomes associated with the improvement or maintenance of health status and functional capacities in order to facilitate disease preventions and quality of life of persons with demonstrated need. Therapeutic Recreation may be delivered in any setting deemed appropriate for human and health care services, and by persons who are certified and/or licensed.

Other Definitions of TR

"Therapeutic recreation is the provision of purposeful intervention designed to help clients grow and to assist them to prevent or relieve problems through recreation and leisure" (Austin).

"Therapeutic recreation i purposeful intervention designed to improve the client's quality of life through recreation and leisure" (Iso-Ahola).

"Therapeutic recreation refers to the specialized application of recreation and experiential activities or interventions that assist in maintaining or improving the health status, functional capacities, and ultimately the quality of life of persons with special needs" (Carter, Van Andel, & Robb).

Personal Philosophy of TR

Personal Philosophy

My favorite definition: Therapeutic recreation is a holistic process which purposively uses recreation of all kinds to bring about a positive change emotionally, spiritually, socially, physically, intellectually, in an effort to maintain and improve quality of life.
My philosophy. My philosophy of therapeutic recreation is a combination of the health protection model and the leisure ability model, based on the Dr. Zabriskie model (see Figure 1). 

 Treatment. In this area the purpose of therapeutic recreation is to improve functional behavior. The role of the TRS is that of therapist.  The skilled TRS uses recreation to improve physical and/or mental functioning, or address problem habits and behaviors. At this stage in treatment the patient's perceived freedom is low.  The patient requires support and guidance at every step.  
Example. For example, a individuals who have suffered  a CVA typically experience loss of mobility on one side of their body.  A TRS might teach a stroke victim with partial paralysis fishing. They would begin with their strong side, and expand to the side affected with paralysis. As the activity continues the patient could experience increased fine motor skill ability, increased gross motor skill ability, and increased strength depending on the weight of the fish they reeled in. 
 Leisure Education. During Leisure Education the TRS acts as a counselor. The client learns new skills and becomes better equipped to overcome barriers. People often get into trouble or suffer mentally and emotionally because of leisure boredom. This area involves helping teach new skills or choices. Leisure education includes exposing clients to recreation options, providing training in how to participate, and building their skill sets of specific leisure activities. The client's perceived freedom is greater in leisure education than in treatment, and the TRS is there for support and guidance.  
Example. An individual who recently suffered a spinal cord injury rendering her paralyzed from the waist down will probably not be able to participate in leisure activities the way they did prior to their injury.  If the client had been an avid triathlete prior to her accident, a TRS would help the client locate a place to purchase a hand-cycle, teach them how to get in and out of the pool, spend time with them in the pool while they learn how to swim again. Ultimately the TRS helps the client adapt the activities they love so they can still participate. 
 Recreation Participation. This area focuses on recreating. The patients now know about different options and are putting it to use. At this point, the recreational therapist acts only as a resource. The patient doesn’t need the TRS watching over them every step of the way and are used as a support system.  Perceived freedom is high. The patient sees themselves as able to make their own decisions with their new found freedom of choice.
 There is room for overlap in the model, and often the objectives are interchangeable. A TRS may start clients anywhere on the chart and work in any direction.  It is possible all three things are going on at once.  For example, an RT may take a group of adolescent skiing, with the purpose of participating in recreation, at this point the role of the RT is that of a facilitator.  Yet, some individuals have never skied before and they gain new skills (leisure education), as the RT acts as a resource.  One of the adolescents is sufferring from depression, anxiety, and opposition defiant disorder.   The RT may begin to process the individuals experience skiing, comparing it to other life situations that induce anxiety, where the individual is likely to act defiantly, by having the individual decipher ways oand being able to succeed in those areas, a process which falls under improved functioning.
Therapeutic Recreation Specialists (TRS) should facilitate appropriate, accessible, enjoyable activities for their clients, which increase perceptions of freedom and ultimately quality of life.  Activities should be person centered and should meet one of the following  objectives: (a) improve functioning, (b) increasing skills and ability, or (c) participating.  Throughout all activities the TRS should be flexible, creative, and adaptable, changing activities as needed to be sure the activities are best meeting the needs of the clients.  The TRS should also be willing change their role as needed between that of a (a) therapist, (b) councilor, and (c) resource.  No matter which role the TRS is taking the practitioner should always view all clients with unconditional positive regard.