Recreational Therapy (RT) to
Live Well With:
Chronic Disability, Disease & Developmental Disorders
To Start Recreational Therapy:
1. Sign up for membership (which includes automatic enrollment in the Lifestyle Foundation Program).
"Leisure should be taken seriously as a vehicle for enhancing wellbeing and adaptation to life with long-term illness."
- - McQuoid J. Finding joy in poor health: The leisure-scapes of chronic illness. Soc Sci Med. 2017 Jun;183:88-96. doi: 10.1016/j.socscimed.2017.04.044. Epub 2017 Apr 26. PMID: 28475903; PMCID: PMC5507015.
FAQ: Recreational Therapy (RT)
to Live Well With: Chronic Conditions
"[S]everal participants described the loss or diminishment of leisure activities to physical impairment. [...] The pleasure and aliveness experienced by engaging in leisure also provides an alternative experience of one’s body that contrasts with the ‘problem body’ defined by illness. It is precisely the voluntary – rather than obligatory – nature of leisure that allows it to have such a positive influence on a person’s outlook on and ability to cope with life with chronic illness."
- McQuoid J. Finding joy in poor health: The leisure-scapes of chronic illness. Soc Sci Med. 2017 Jun;183:88-96. doi: 10.1016/j.socscimed.2017.04.044. Epub 2017 Apr 26. PMID: 28475903; PMCID: PMC5507015.
"[F]or people with chronic illness, putting life ‘on hold’ until good health returns is not an option.
There is an imperative to live well with illness that must be recognised in the framing of chronic illness management. "
- McQuoid J. Finding joy in poor health: The leisure-scapes of chronic illness. Soc Sci Med. 2017 Jun;183:88-96. doi: 10.1016/j.socscimed.2017.04.044. Epub 2017 Apr 26. PMID: 28475903; PMCID: PMC5507015.
"[C]hronic disability has been defined as disability lasting or expected to last at least 90 days[.]"
- Gill TM, Gahbauer EA. Overestimation of Chronic Disability Among Elderly Persons. Arch Intern Med. 2005;165(22):2625–2630. doi:10.1001/archinte.165.22.2625
"Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both."
- U.S. Centers for Disease Control and Prevention
"Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the child's developmental period, may impact day-to-day functioning, and usually last throughout a person's lifetime."
- U.S. Centers for Disease Control and Prevention
"Leisure activities are often key sources of meaning, enjoyment, and sense of purpose.
[...]Inability to perform valued activities, such as leisure, may play a substantial role in how people with chronic illness perceive their health,
above and beyond health status, disease symptoms, and general physical functioning[.]
[...]Rather than disregarding leisure as a dispensable category of activities in everyday life with chronic illness,
leisure should be taken seriously as a vehicle for enhancing wellbeing and adaptation to life with long-term illness."
- McQuoid J. Finding joy in poor health: The leisure-scapes of chronic illness. Soc Sci Med. 2017 Jun;183:88-96. doi: 10.1016/j.socscimed.2017.04.044. Epub 2017 Apr 26. PMID: 28475903; PMCID: PMC5507015.
Recreational Therapy (RT) to Treat
Amyotrophic Lateral Sclerosis (ALS)
" A neurological disability may create additional challenges in assuming family roles. Referral to appropriate interdisciplinary team members may be beneficial to address functional and psychosocial needs.[...R]ecreational therapy services can introduce meaningful leisure activities.
[..]The neurological conditions addressed in this review include relatively static conditions, such as spinal cord injuries (SCI) and disorders, stroke, traumatic brain injuries (TBI), non-traumatic injuries, and congenital disorders (e.g., degenerative ataxias and cerebral palsy). Progressive conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and Parkinson’s disease (PD) are also included."
-Aging with a Neurological DisabilityAuthor(s): Justin Weppner, MD, Patrick Monico, OMS IV, Sara Raiser, MD Originally published: September 20, 2014 Last updated: January 12, 2023
Recreational Therapy (RT) to Treat
Autism Spectrum Disorder (ASD)
"Recreational therapy program, which is more long term and more number of weekly sessions, should be scheduled for children and adolescents with ASD."
- Analysis of Gait Patterns in Individuals with Autism Spectrum Disorder after Recreational Therapy Program at Eskisehir Technical University
"Approximately 85% of children with autism spectrum disorder from the SPARK study receiving standard interventions such as speech-language and occupational therapies.
In contrast, only 32%–13% of children with autism spectrum disorder received movement therapies such as physical and recreational therapies, respectively.[...]
While movement therapies (occupational therapy, physical therapy, recreational therapy) increased with increasing motor risk and severity, there continued to be large disparities in physical therapy (37%–55%) and recreational therapy (15%–19%) compared to occupational therapy (85%–92%) across various settings indicating clear unmet needs for specific motor services given that 88.3% of this sample of children with autism spectrum disorder is at risk for motor difficulties/Developmental Coordination Disorder. [...]
These findings explain the paucity of physical therapy/recreational therapy and physical activity programs for individuals with autism spectrum disorder and the need for movement experts to receive appropriate access and training to work with individuals with autism spectrum disorder."
-Bhat, A. N. (2024). Fewer children with autism spectrum disorder with motor challenges receive physical and recreational therapies compared to standard therapies: A SPARK data set analysis. Autism, 28(5), 1161-1174. https://doi.org/10.1177/13623613231193196
"The purpose of this research was to examine effects of a therapeutic recreation (TR) program designed to increase executive function (EF), social skills, adaptive behaviours and well-being of adults with autism spectrum disorder (ASD) and intellectual disability (ID).
Findings provide support for inclusion of EF [executive function] enrichment as a way to enhance effects of TR interventions for adults with ASD and ID.[...]
In addition to TR-EF program primary effects on EF, there were indirect benefits on adaptive behaviours, personal well-being and social skills."
- García-Villamisar, D., Dattilo, J., and Muela, C. (2017) Effects of therapeutic recreation on adults with ASD and ID: a preliminary randomized control trial. Journal of Intellectual Disability Research, 61: 325–340. doi: 10.1111/jir.12320.
"The main characteristics of autism spectrum disorder (ASD; i.e. Asperger syndrome, autistic disorder or pervasive developmental disorder–not otherwise specified) are qualitative impairment of social interaction, qualitative impairments in communication and restricted and repetitive stereotyped patterns of behaviour, interests and activities[.] [...]
Individuals with ASDs also seem to be vulnerable to a number of psychiatric and neurological disorders, such as depression, obsessive-compulsive disorder, attention deficit disorder, developmental coordination disorder, epilepsy, sleep disturbances and anxiety[.] [...]
Moreover, hyper- or hyposensitivity to pain, touch, movement, sound, smell and light is often reported[.]
In adults with ASDs and intellectual disability, quality of life has been positively associated with engagement in regular recreational activities[.][...]Furthermore, for children with ASDs, recreational activity has been shown to be equally influential as cognitive behavioural therapy (CBT) in reducing anxiety[.][...]
This study addressed the shortage of treatment options for adults with ASDs, showing that group CBT and group recreational activity interventions are beneficial treatment options. "
-Hesselmark, E., Plenty, S., & Bejerot, S. (2014). Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: A preliminary randomized controlled trial. Autism, 18(6), 672-683. https://doi.org/10.1177/1362361313493681
Educational Video,
BF&M No Limits sailing programme - Kuhn's story
BF&M launched the No Limits sailing programme in association with
the America's Cup Endeavour programme and BASE to offer sailing as a form of recreational therapy to children on the autism spectrum
(from BF&M group of companies operate in Bermuda and throughput the Caribbean):
Educational Video,
A Life-Changing Therapy For Children With Autism At The Child Study Center
(from Yale Medicine):
Oncology Recreational Therapy (RT) for
Cancer Rehabilitation
The National Cancer Institute defines Recreational Therapy (RT) as,
"A type of therapy that uses activities to help meet the physical and emotional needs of patients with an illness or disability and help them develop skills for daily living."
" Results from the current study suggest that recreation therapy can provide positive therapeutic benefits when included in the Cancer treatment process."
-Mazza, J. K. (2015). The Role of Recreation Therapy Protocols in Cancer Treatment and Survivor Quality of Life [Master's thesis, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1449697703
"Cancer rehabilitation is a rapidly emerging subspecialty of rehabilitation medicine whose primary focus is the evaluation and treatment of functional disorders in cancer patients and survivors.
These disorders can result directly or indirectly from cancer, or from cancer treatments such as surgery, chemotherapy, and radiation.
[...]The optimal cancer rehabilitation team includes physiatry, nursing, physical and occupational therapy, speech and language pathology, recreational therapy, nutritionists, social workers, psychologists, orthotists, and prosthetists, among others."
Recreational Therapy (RT) for
Cerebral Palsy (CP)
"Recreation therapy makes use of activity-based interventions that are rooted in functional performance, communication, behavior, adaptation and modification to physical conditions and cognitive processes.[...] recreation therapy also has another purpose – to enhance the ability of a child with Cerebral Palsy to plan, strategize and perform tasks in an effort to achieve improved physical functioning and encourage emotional well-being by facilitating inclusion into activities they benefit by and enjoy. "
" Unlike traditional treatments and therapies, therapeutic recreation uses leisure as a way to maximize a person's overall health, well-being, and quality of life. For children with Cerebral Palsy, therapeutic recreation has many physical, social, and emotional benefits. Therapeutic recreation programs are designed to facilitate patients' physical and emotional well-being by providing activities that help improve cognitive, social and motor functioning. Therapeutic recreation modalities used to target Cerebral Palsy improve strength, posture stability, gross and fine motor skills, etc. in addition to improving social and emotional health. In conclusion, children with Cerebral Palsy who participate in therapeutic recreation programs greatly benefit physically, socially, and emotionally. "
-Todd Farmer, Langston University Chelsey Watson, Langston University (2019). An Analysis of the Benefits of Therapeutic Recreation for Children with Cerebral Palsy, Kentucky SHAPE Journal Vol. 57 No. 1
Educational Video,
Living with Cerebral Palsy What is Oncology Recreation Therapy?
Recreational Therapy (RT) to Treat
Chronic Pain
"The International Association for the Study of Pain (IASP) defined pain as “… an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Note: Pain is always subjective.” (Merskey, 1979, p. 250). Pain has been categorized as acute, recurrent, or chronic pain (Kuttner, 2010). Acute pain is sudden, alerting the individual to potential tissue damage such as placing one’s hand on a hot stove. It generally is short term and can range from mild to severe. Recurrent pain has episodes of pain alternating with recovery (absence of pain); examples include headaches or abdominal pain. Chronic pain is defined as pain that endures beyond six months and serves no protective purpose. Kuttner (2010) states chronic pain “persists often due to physiological and chemical changes to nerve fibers, which alter the way pain works” (p. 17). "
- Therapeutic Recreation Journal; Pain Management in Recreation Therapy Practice, https://doi.org/10.18666/TRJ-2019-V53-I1-8912
"Chronic pain in adolescents is a multidimensional, biopsychosocial disorder with an unpleasant sensory and emotional experience that persists or recurs over time and can be associated with or without tissue damage. The management of chronic pain requires an interdisciplinary, comprehensive approach that includes CBT as a primary psychological intervention[.]"
- Tamara K. Zagustin, The Role of Cognitive Behavioral Therapy for Chronic Pain in Adolescents, PM&R, Volume 5, Issue 8, 2013, Pages 697-704, ISSN 1934-1482, https://doi.org/10.1016/j.pmrj.2013.05.009. (https://www.sciencedirect.com/science/article/pii/S1934148213002827)
"The National Center for Complementary and Integrative Health (2017) states the most common reason for individuals seeking medical care is pain (https://nccih.nih. gov/health/pain). [...] In the United States, chronic pain is viewed as the most pervasive, expensive, and debilitating medical condition. To understand its scope, more individuals are affected by chronic pain than those with heart disease, diabetes, and cancer combined (Gereau et al., 2014)."
- Therapeutic Recreation Journal; Pain Management in Recreation Therapy Practice, https://doi.org/10.18666/TRJ-2019-V53-I1-8912
A study "reviewed a large sample of chronic low back-pain patients from admission to a multi-disciplinary program through to initial and long-term follow-up over a period of six months to five years following treatment. The therapeutic techniques used on the program included biofeedback, attribution-based psychotherapy, patient-controlled medication reduction, physical reconditioning, vocational counseling, educational presentations, pool and recreational therapy, and assertiveness training. Favorable outcomes were achieved by many of the respondents, and in several of the measures a good degree of stability was observed over the follow-up period[.]"
- Shirley Pearce, Anne-Lise McDonald, in Comprehensive Clinical Psychology, 1998.
"[T]he 2001 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards on pain management [...] document indicated PM is the obligation of all disciplines[.] Over time, the concept of pain has broadened from an initial one-dimensional definition to a multidimensional definition. Kumar and Elavarasi (2016) identified the dimensions of pain as cognitive, emotional, and sensory (p. 87). The Institute of Medicine (IOM, 2011) emphasized that the IASP definition acknowledged pain was more than just a physical or biological event. This definition is holistic, considers the emotional and psychosocial aspects of pain, and recognizes that pain has multidimensional properties. There are many aspects to consider regarding pain, including intensity, duration, nature, location of pain, its impact on QOL and mood (IOM, 2011)."
- Shirley Pearce, Anne-Lise McDonald, in Comprehensive Clinical Psychology, 1998.
"This study shows that frequency, duration, and intensity of recreational exercise are all associated with a lower prevalence of chronic pain, and that the associations are stronger for older subjects, especially for women. "
- International Association for the Study of Pain, Associations between recreational exercise and chronic pain in the general population: Evidence from the HUNT 3 study, PAIN 152 (2011) 2241–2247
"Pain anxiety and dysfunction are among the most prevalent complications of burns, impacting the quality of life (QOL) of patients with burn injuries. As a nonpharmaceutical approach, recreational therapy can be effective in reducing the complications of burns. "
- Razieh Froutan, Abolfazl Saberi, Ali Ahmadabadi, Seyed Reza Mazlom, The Effect of a Recreational Therapy Program on the Pain Anxiety and Quality of Life of Patients With Burn Injuries: A Randomized Clinical Trial, Journal of Burn Care & Research, Volume 43, Issue 2, March/April 2022, Pages 381–388, https://doi.org/10.1093/jbcr/irab153
"The top 10 RT interventions to manage pain included music, relaxation, deep breathing, exercise, distraction, coping skills, stress management, guided imagery, yoga, and play[.]"
-Therapeutic Recreation Journal, Pain Management in Recreation Therapy Practice, https://doi.org/10.18666/TRJ-2019-V53-I1-8912
Educational Video,
Cognitive Behavioral Therapy for Chronic Pain
(from Veterans Health Administration):
Educational Video,
Chronic Pain Sufferers Finding Relief In Aquatic Therapy
(from WCCO CBS Minnesota):
Recreational Therapy (RT) to Treat
Dementia
(Alzheimer's Disease, Lewy body dementia)
"The findings suggested that participation in therapeutic recreation (TR) programming was important for a number of reasons. In addition to experiencing feelings of enjoyment, engagement and meaning, of primary importance was the relationship development between resident and practitioner."
- LeDrew, Danielle (2007) The value of recreation therapy for individuals living with dementia. Masters thesis, Memorial University of Newfoundland (Canada).
"Over six weeks, the resident participated in 40- to 60-minute therapeutic gardening sessions three to four times per week to improve mood, decrease behavioral disturbances, and improve acclimation to the facility. By discharge, the resident met each treatment goal and significantly decreased symptoms of depression and anxiety as measured by the Geriatric Depression Scale (GDS) and Beck Anxiety Inventory (BAI)."
-Therapeutic Recreation Journal, Recreational Therapy for Dementia-Related Symptoms in a Long-Term Care Setting
Educational Video,
Music and memory
(from WJLA, the local ABC affiliate for the greater Washington DC area, USA):
Educational Video,
Pauline Plewinski, Diversional Therapy Apprentice at Alzheimers Northland, Whangarei, New Zealand
(from Careerforce is a business division of Te Pūkenga – New Zealand Institute of Skills and Technology):
Recreational Therapy (RT) to Treat
Diabetes
"Therapeutic Recreation programmes have been shown to have positive benefits for control of diabetes and its complications."
- Middleton, R., Moxham, L., & Parrish, D. (2018). Motivation to engage in therapeutic recreation programmes for older people with diabetes. World Leisure Journal, 60(2), 94–110. https://doi.org/10.1080/16078055.2018.1456481
"Patient education is an important aspect of care to young diabetic children. The use of playthings and recreational activities is an effective way to help children develop harmoniously by integrating the paradox of having to become compliant with treatment and medication while becoming autonomous in life."
-Julie Pélicand, Rémi Gagnayre, Brigitte Sandrin-Berthon, Isabelle Aujoulat, A therapeutic education programme for diabetic children: recreational, creative methods, and use of puppets, Patient Education and Counseling, Volume 60, Issue 2, 2006, Pages 152-163, ISSN 0738-3991, https://doi.org/10.1016/j.pec.2004.12.007 (https://www.sciencedirect.com/science/article/pii/S0738399104004124)
"Systemically structured leisure counseling, provided by a recreational therapist (RT) early in the disease process, aimed at identifying, exploring, and enhancing the experience of such personal meanings in [leisure-time physical activity] LTPA may prove helpful in diabetes management."
- Heather R. Porter, John Shank, Yoshitaka Iwasaki, Promoting a Collaborative Approach With Recreational Therapy to Improve Physical Activity Engagement in Type 2 Diabetes, Therapeutic Recreation Journal, Vol. XLVI, No. 3, pp. 202-217, 2012
Educational Video
Our Diabetes Management Program helps our patients to manage their diabetes, remove any barriers and educate themselves
at https://www.facebook.com/watch/?v=469382691286379,
(from Weisman Children’s, a leading pediatric rehabilitation provider in Southern New Jersey, USA):
Recreational Therapy (RT) to Treat
Paraplegia and Tetraplegia (Quadriplegia)
"Greater participation in [Therapeutic Recreation] TR-led leisure skill and community activities during rehabilitation is a positive predictor of multiple outcomes at rehabilitation discharge and the 1-year injury anniversary demonstrating that TR activities are associated with a return to a productive and healthy life after SCI."
-Cahow C, Gassaway J, Rider C, Joyce JP, Bogenschutz A, Edens K, Kreider SE, Whiteneck G. Relationship of therapeutic recreation inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCIRehab project. J Spinal Cord Med. 2012 Nov;35(6):547-64. doi: 10.1179/2045772312Y.0000000066. Erratum in: J Spinal Cord Med. 2013 Mar;36(2):172. Bogenshutz, Andrew [corrected to Bogenschutz, Andrew]. PMID: 23318036; PMCID: PMC3522896.
Educational Video,
Courage Kenny Rehabilitation Institute: An Update on Alex
(from Allina Health Courage Kenny Rehabilitation Institute in Minneapolis, United States):
Recreational Therapy (RT) to Treat
Sleep Disorders
(Hypersomnia, Insomnia, Narcolepsy, Restless Legs Syndrome, and Sleep Apnea)
"Sleep is an uncontrollable and involuntary process; efforts to control insomnia paradoxically can lead to increased anxiety and stress surrounding sleep, which in turn worsens the insomnia and perpetuates the cycle of sleeplessness[.][...] ACT does not encourage patients to avoid thoughts, feelings, or physical sensations but allows patients to experience them as they are[.] [...]The acceptance of insomnia reduces the severity of the patient’s symptoms and, paradoxically, can lead to a higher level of sleepiness [...]ACT had a significant effect on primary insomnia and secondary symptoms, especially anxiety related to insomnia."
- Shin JW, Kim S, Shin YJ, Park B, Park S. Comparison of Acceptance and Commitment Therapy (ACT) and Cognitive Behavior Therapy (CBT) for Chronic Insomnia: A Pilot Randomized Controlled Trial. Nat Sci Sleep. 2023 Jul 5;15:523-531. doi: 10.2147/NSS.S409981. PMID: 37431325; PMCID: PMC10329838.
"Pain anxiety and dysfunction are among the most prevalent complications of burns, impacting the quality of life (QOL) of patients with burn injuries. As a nonpharmaceutical approach, recreational therapy can be effective in reducing the complications of burns. "
- Razieh Froutan, Abolfazl Saberi, Ali Ahmadabadi, Seyed Reza Mazlom, The Effect of a Recreational Therapy Program on the Pain Anxiety and Quality of Life of Patients With Burn Injuries: A Randomized Clinical Trial, Journal of Burn Care & Research, Volume 43, Issue 2, March/April 2022, Pages 381–388, https://doi.org/10.1093/jbcr/irab153
"The top 10 RT interventions to manage pain included music, relaxation, deep breathing, exercise, distraction, coping skills, stress management, guided imagery, yoga, and play[.]"
-Therapeutic Recreation Journal, Pain Management in Recreation Therapy Practice, https://doi.org/10.18666/TRJ-2019-V53-I1-8912
Educational Video,
Cognitive Behavioral Therapy for Insomnia
(from American College of Physicians (ACP))
Educational Video,
Recreational Therapist: Elizabeth Terry’s Story With Narcolepsy - Rising Voices Ep. 9
(from Project Sleep):
All New Members are Enrolled in our Lifestyle Foundation Program
The program is 2-6 months (based on client goals and plan) and is paid via monthly membership subscription.
Members may pause or cancel membership subscription at any time
(cancellation effective at the conclusion of their current prepaid month).
