Standards Of Practice For Recreation Therapists And .
Standards of Practice for Recreation Therapists and Recreation Therapy AssistantsA Publication of Therapeutic Recreation OntarioCopyright January 2012Website: www.trontario.orgEmail: trontario@becon.orgAll rights reserved. This is a copyrighted document. No part of this publication may bereproduced without the written permission of the publisher. Additional copies areavailable for purchase from Therapeutic Recreation Ontario through the channels listedabove.
STANDARDS OF PRACTICE FOR RECREATION THERAPISTSAND RECREATION THERAPY ASSISTANTSTABLE OF CONTENTSINTRODUCTION2PHILOSOPHICAL POSITION2TRO'S PHILOSOPHICAL STATEMENT FOR RECREATION THERAPY3DEFINITION OF THERAPEUTIC RECREATION4DEFINITION OF RECREATION THERAPIST4DEFINITION OF RECREATION THERAPY ASSISTANT4PURPOSE OF STANDARDS OF PRACTICE5SCOPE OF SERVICE6STANDARDS OF PRACTICE OVERVIEW71.0 THERAPEUTIC RECREATION ASSESSMENT92.0 THERAPEUTIC RECREATION INTERVENTION PLAN113.0 THERAPEUTIC RECREATION PROGRAM DEVELOPMENT134.0 THERAPEUTIC RECREATION PROGRAM DELIVERY165.0 THERAPEUTIC RECREATION DOCUMENTATION196.0 THERAPEUTIC RECREATION EVALUATION217.0 THERAPEUTIC RECREATION RESEARCH238.0 THERAPEUTIC RECREATION PROFESSIONAL DEVELOPMENT259.0 THERAPEUTIC RECREATION AND COMMUNITY PRACTICE28APPENDIX A - GLOSSARY OF TERMS31APPENDIX B - REFERENCES FOR PHILOSOPHICAL POSITION33APPENDIX C - RESOURCE DOCUMENTS FOR STANDARDS OF PRACTICE34APPENDIX D - LIST OF CONTRIBUTORS36APPENDIX E – STANDARDS PERFORMANCE CHECKLISTS371Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
STANDARDS OF PRACTICE FOR RECREATION THERAPISTSAND RECREATION THERAPY ASSISTANTSINTRODUCTIONThe Standards of Practice for Recreation Therapists and Recreation Therapy Assistantsare designed to serve as a foundation for the practice of therapeutic recreationregardless of setting. This document has been created using the original Standards ofPractice for Therapeutic Recreation (TRO, 2003) document as a foundation. TheStandards of Practice for Recreation Therapists and Recreation Therapy Assistants area dynamic work and will continue to grow and change as the profession evolves.This document represents the work of the Therapeutic Recreation Ontario (TRO) Boardof Directors, along with significant input from its membership. It is our hope that thisdocument will be relevant and useful in encouraging discussion and promotingconsistency in service among therapeutic recreation practitioners.PHILOSOPHICAL POSITIONTherapeutic Recreation Ontario supports a leisure-based philosophy, acknowledgingthe significance of leisure in enhancing the health, independence and well-being ofindividuals. TRO also recognizes rehabilitation theory as providing a fundamentalfoundation for therapeutic recreation service delivery.The leisure-based philosophy endorsed by TRO is based upon the Leisure Ability Model(Peterson & Stumbo, 2000) and is consistent with the therapeutic recreation service andoutcome models (Carter, Van Andel & Robb, 1995).Rehabilitation theory is operationalized through the International Classification ofFunctioning, Disability and Health (ICIDH-2) revised by the World Health Organization(WHO) in 2001. The WHO model acknowledges the impact of environmental andpersonal factors on individuals with an impairment (World Health Organization, 2001).Consistent with the leisure-based philosophy for practice and the WHO definition of“disability”, therapeutic recreation intervention is dependent upon individual clientabilities, needs and interests.2Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
TRO'S PHILOSOPHICAL STATEMENT FOR RECREATION THERAPYThe purpose of Recreation Therapy is to enable all individuals to achieve quality of life,and optimal health through meaningful experiences in recreation and leisure. Webelieve in the inherent capacities of individuals for personal growth, happiness andfreedom. Recreation Therapy is a profession which provides service to, and advocatesfor individuals with physical, mental, social, behavioural or emotional limitations in avariety of settings such as hospitals, long-term care settings, day programs, communitybased programs, and mental health centres. The Recreation Therapy professionrecognizes the right of all citizens to have access to and the freedom to chooserecreation and leisure opportunities regardless of their physical, financial,developmental, emotional, or social challenges OR the barriers imposed on them bysociety at large.The foundation of the Recreation Therapy profession is the establishment of authenticrelationships with the individual receiving services and all other key stakeholders.Utilizing a collaborative approach, Recreation Therapy follows a systematic process ofassessment, goal-setting, program/intervention development, individual and groupfacilitation, documentation, and evaluation. Programs are designed to promoteindependent functioning within the physical, emotional, mental, spiritual, behaviouraland social domains, and to educate individuals about the skills and resources requiredto participate in recreation and leisure. The Recreation Therapy profession utilizesevidence-based practice to create outcome-based interventions suitable to the client’sabilities. As part of its advocacy, Recreation Therapy is committed to educating societyabout the rights and capacities of all citizens to participate in recreation and leisure.3Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
DEFINITION OF THERAPEUTIC RECREATIONTherapeutic Recreation Ontario endorses the following definition:Therapeutic recreation is a process that utilizes functional intervention, education andrecreation participation to enable persons with physical, cognitive, emotional and/orsocial limitations to acquire and/or maintain the skills, knowledge and behaviours thatwill allow them to enjoy their leisure optimally, function independently with the leastamount of assistance and participate as fully as possible in society. Therapeuticrecreation intervention is provided by trained professionals in clinical and/or communitysettings.DEFINITION OF RECREATION THERAPISTThe Recreation Therapist utilizes recreation to maximize independence and promote anoptimal leisure lifestyle. He/she is responsible for assessments, interventions, andevaluations to promote skill development in the physical, cognitive, affective, social, andspiritual domains, in addition to non-direct client activities.DEFINITION OF RECREATION THERAPY ASSISTANTRecreation Therapy Assistants work under the direction of a Recreation Therapist todeliver recreation therapy services. They assist in the delivery of goal-orientedprograms and services to meet the leisure related needs of clients. It is important thatRecreation Therapy Assistants work alongside the therapist(s) and contribute to thecontinuum of therapeutic services. The two main responsibilities of the RecreationTherapy Assistant include: program development and program delivery as well asprogram observation and reporting, in addition to non-direct client activities. RecreationTherapy Assistants provide input, which will enable the Recreation Therapist to conductassessments, develop intervention plans or evaluate a client’s progress in relation to theintervention plan.4Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
PURPOSE OF STANDARDS OF PRACTICETherapeutic recreation practitioners make judgments and decisions based on guidingprinciples, extensive knowledge, professional skills, and standards of practice.Standards are developed to assist therapeutic recreation practitioners to systematicallyplan, implement, evaluate, and adapt their own work performance according to theseapproved guidelines.By utilizing these Standards of Practice for Recreation Therapists and RecreationTherapy Assistants, therapeutic recreation practitioners will develop supporting data forthe efficacy of therapeutic recreation within their settings.It is incumbent upon each practitioner, be they recreation therapists or recreationtherapy assistants, to follow The Standards of Practice for Recreation Therapists andRecreation Therapy Assistants. Endorsement and adherence to these Standards ofPractice will result in increased consistency among practitioners, which will lead tohigher quality services to clients, and the strengthening of the profession of therapeuticrecreation.5Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
SCOPE OF SERVICECORE VALUESThe following statements reflect the values and beliefs upon which therapeuticrecreation service should be based:a. All aspects of therapeutic recreation service delivery must reflect clientconfidentiality and client self-determination.b. Therapeutic recreation service delivery should involve family and any othersupport networks at all appropriate stages of intervention provided with the client.c. All aspects of therapeutic recreation service delivery must incorporate clientgoals, beliefs, and perspectives.d. Recognition of the need for personalized intervention to address the uniquenessof each individual client.e. Individual client differences require a continuum of care approach to therapeuticrecreation service delivery.f. Optimal client outcomes are directly related to the understanding of social,cultural, attitudinal, and environmental influences on an individual.g. All aspects of therapeutic recreation service delivery should be outcome-orientedand measurable with program decisions reflecting evidence-based practice.h. Recognition of the importance of a team approach for therapeutic recreationservice delivery.i. Recognition of the importance of documentation for effective communication,evaluation, and accountability.j. Evaluation and research are essential for the maintenance and/or improvementof therapeutic recreation services.k. Provision of therapeutic recreation intervention is facilitated for clients in a varietyof service delivery settings.l. Recognition of the importance of community involvement in the inclusion ofclients with and within their community.m. Knowledge of different forms of diversity including ethnicity, poverty, and genderissues.n. All aspects of therapeutic recreation service delivery must be provided in a safemanner taking into account the potential for risk of harm in physical, social,emotional, spiritual, and financial domains.o. All TR practitioners should engage in regular self-reflective practice to accountfor ongoing changes with relationships with the client, the team, and in theworkplace,6Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
STANDARDS OF PRACTICE OVERVIEW1.0THERAPEUTIC RECREATION ASSESSMENT - Utilizes an individualized andsystematic process to determine individual strengths, needs, and interests ofclients to establish the priorities and direction of therapeutic recreationintervention.2.0THERAPEUTIC RECREATION INTERVENTION PLAN - Outlines specificstrategies and modalities based on assessment results. The individualized planis achieved via a collaborative approach including the client and supportnetworks to attain a client-centred and outcome-oriented process.3.0THERAPEUTIC RECREATION PROGRAM DEVELOPMENT - Creates aframework for each program addressing the needs and interests of clients withinthe context of their environment. It is a systematic process based on theintervention plan. Individual and group program outlines should include purpose,rationale, description, target population, goals, outcomes, evaluationmechanisms, and resource requirements.4.0THERAPEUTIC RECREATION PROGRAM DELIVERY - Encompasses theprovision of outcome-oriented programs in a variety of service delivery settingsthat reflect a continuum of care model. A therapeutic recreation practitioner’saction is determined by the intervention plan and can be offered on an individualand/or group basis.5.0THERAPEUTIC RECREATION DOCUMENTATION - Is the comprehensivecollection of information related to every aspect of therapeutic recreationintervention. This can include a variety of methods (written, verbal, electronic,etc.) and the steps of an initial screening, assessment report, progress report,discharge report, case review, and/or intervention notes. Documentation providesa basis for professional accountability.6.0THERAPEUTIC RECREATION EVALUATION - Involves a thorough review oftherapeutic recreation assessment, intervention plan, program development, andprogram delivery to illustrate and ensure the efficacy of therapeutic recreationservices.7.0THERAPEUTIC RECREATION RESEARCH - Demonstrates the benefits of aplanned systematic analysis of the components that comprise therapeuticrecreation services. Work in this area illustrates professional efficacy whilecontributing to the growth of therapeutic recreation as a whole.8.0THERAPEUTIC RECREATION PROFESSIONAL DEVELOPMENT - Acommitment to ongoing involvement in upgrading personal and professionalknowledge related to therapeutic recreation.7Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
9.0THERAPEUTIC RECREATION AND COMMUNITY PRACTICE - The obligationto create opportunity for community involvement for clients in a variety of servicedelivery settings.8Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
1.0 Therapeutic Recreation Assessment1.1The purpose of therapeutic recreation assessment is to:1.1.1 determine the individual strengths, needs, and interests of the client utilizing asystematic process1.1.2 establish therapeutic direction and priorities1.1.3 validate intervention plans1.2Guiding Principles1.2.1 therapeutic recreation intervention should be based on assessment results1.2.2 client beliefs and perspectives must be reflected and incorporated in theassessment process1.2.3 appropriate assessment tools must be used to gather data1.2.4 the input of other relevant support networks should be used to assist in thetherapeutic recreation assessment process1.2.5 assessment results can be utilized to provide a baseline for evaluating clientprogressRole of Recreation Therapist1.3 Therapist Knowledge – a recreation therapist will have knowledge of:1.3.1 the range of information that may be relevant for therapeutic recreationassessment1.3.2 techniques and tools used to gather appropriate therapeutic recreationassessment information1.3.3 the elements of a continuum model of care as they relate to a comprehensivetherapeutic recreation assessment including:i)functional assessment - cognitive, emotional, physical, social, spiritualii)leisure assessment - awareness, attitude, barriers, skillsiii)leisure interests and participation patterns1.3.4 available standardized therapeutic recreation assessment tools1.3.5 the value of the input of support networks throughout the therapeutic recreationassessment process1.3.6 how the data derived from assessment can be directly incorporated into both theindividual intervention plan and the inter-professional care plan1.3.7 the potential for risk of harm if assessments are inappropriate, incorrect,misinterpreted, or no assessment is given9Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
1.4Therapist Competencies – a recreation therapist will have the ability to:1.4.1 identify information necessary to be collected during therapeutic recreationassessment1.4.2 select appropriate assessment tools based on client profile and agency mandate1.4.3 use appropriate interview and observational techniques when administering theselected assessment tools1.4.4 accurately analyze and interpret results of the assessment tools administered1.4.5 communicate therapeutic recreation assessment results with the client, theclient’s family members, professional team members, and other key supportnetworks1.4.6 apply assessment findings to the therapeutic recreation intervention planRole of Recreation Therapy Assistant1.5Assistant Knowledge – a recreation therapy assistant will have knowledgeof:1.5.1 purposes/ rationale of assessment1.5.2 methods used by recreation therapists to gather pertinent leisure informationabout a client1.5.3 terminology used in therapeutic recreation assessments1.5.4 the potential for risk of harm if assessments are inappropriate, incorrect,misinterpreted, or no assessment is given1.6Assistant Competencies – a recreation therapy assistant will have theability to:1.6.1 use appropriate observational techniques throughout interventions and reportpertinent leisure related information to the recreation therapist1.6.2 receive regular feedback from the client and/or caregiver(s) and report thisinformation to the recreation therapist in a timely manner10Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
2.0 Therapeutic Recreation Intervention Plan2.1The purpose of the therapeutic recreation intervention plan is to:2.1.1 outline relevant strategies and interventions that will assist the client in achievingthe identified goals2.1.2 use a collaborative approach including the client and support networks todevelop an individualized plan that is outcome-oriented and client-centred2.1.3 reflect a continuum model of care2.2Guiding Principles2.2.1 assessment data is essential to the development of the intervention plan2.2.2 client input directs the development of the intervention plan2.2.3 client differences necessitate the development of individualized interventionplans2.2.4 intervention plans should be outcome-oriented and goal attainment should bequantifiable2.2.5 optimal client outcomes are directly related to client profile (diagnosis impact)and external diversity considerations (cultural, economic, geographic, etc.)2.2.6 the input of relevant support networks is pertinent in the development of atherapeutic recreation intervention planRole of Recreation Therapist2.3Therapist Knowledge – a recreation therapist will have knowledge of:2.3.1 therapeutic recreation models and their associated purposes, interventions, andoutcomes2.3.2 various therapeutic recreation modalities and their associated benefits2.3.3 developing and monitoring effective client goals and behavioural outcomes2.3.4 the diagnostic impact (i.e. abilities, limitations, and/or contraindications) andexternal diversity considerations (cultural, economic, geographic, etc.) upontherapeutic recreation intervention and outcomes the importance supportnetworks have in the development of therapeutic recreation intervention plans2.3.5 the potential for risk of harm by not meeting minimum level of knowledge, skills,and abilities required to develop client-centred interventions plans11Standards of Practice for Recreation Therapists and Recreation Therapy Assistants Therapeutic Recreation Ontario (2012)
2.4Therapist Competencies – a recreation therapist will have the ability to:2.4.1 develop a relevant intervention plan based on an established therapeuticrecreation theoretical model2.4.2 create client-centred goals based on assessment data and individual learningpreferences2.4.3 identify measurable outcomes, which relate to client goals2.4.4 select appropriate therapeutic recreation interventions that will facilitate goalattainment2.4.5 develop outcomes that take into account client profile (diagnosis impact, risk ofharm) and external diversity considerations (cultural, economic, geographic, etc.)2.4.6 utilize a collaborative model with support networks when establishing thetherapeutic recreation intervention pla
The Standards of Practice for Recreation Therapists and Recreation Therapy Assistants are designed to serve as a foundation for the practice of therapeutic recreation regardless of setting. This document has been created using the original Standards of Practice for Therapeutic Recreation(TRO, 2003) document as a foundation.
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