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Recreational therapists work with people who are mentally, physically, or emotionally disabled. They are professionals who employ leisure activities as a form of treatment, much as other health practitioners use surgery, drugs, nutrition, exercise, or psychotherapy. Recreational therapists strive to minimize patients' symptoms, restore function, and improve their physical, mental, and emotional well-being. Enhancing the patient's ability to take part in everyday life is the primary goal of recreational therapy; interesting and rewarding activities are the means for working toward that goal.
Recreational therapists work in a number of different settings, including mental hospitals, psychiatric day hospitals, community mental health centers, nursing homes, adult day care programs, residential facilities for the mentally disabled, school systems, and prisons. They can work as individual staff members, as independent consultants, or as part of a larger therapeutic team. They may get personally involved with patients or direct the work of assistants and support staff.
The recreational therapist first confers with the doctors, psychiatrists, social workers, physical therapists, occupational therapists, and other professionals on staff to coordinate their efforts in treatment. The recreational therapist needs to understand the nature of the patient's ailment, current physical and mental capacities, emotional state, and prospects for recovery. The patient's family and friends are also consulted to find out the patient's interests and hobbies. With this information, the recreational therapist then plans an agenda of activities for that person.
To enrich the lives of people in hospitals and other institutions, recreational therapists use imagination and skill in organizing beneficial activities. Sports, games, arts and crafts, movie screenings, field trips, hobby clubs, and dramatics are only a few examples of activities that can enrich the lives of patients. Some therapists specialize in certain areas. Dance/movement therapists plan and conduct dance and body movement exercises to improve patients' physical and mental well-being. Art therapists work with patients in various art methods, such as drawing, painting, and ceramics, as part of their therapeutic and recovery programs. Therapists may also help patients by having them spend time with pets and other animals, such as horses. Music therapists design programs for patients that can involve solo or group singing, playing in bands, rhythmic and other creative activities, listening to music, or attending concerts. Even flowers and gardening can prove beneficial to patients, as is proved by the work of horticultural therapists. When a treatment team feels that regular employment would help certain patients, an industrial therapist arranges a productive job for the patient in an actual work environment, one that will have the greatest therapeutic value based on the patient's needs and abilities. Orientation therapists for the blind work with people who have recently lost their sight, helping them to readjust to daily living and independence through training and exercise. All of these professional therapists plan their programs to meet the needs and capabilities of patients. They also carefully monitor and record each patient's progress and report it to the other members of the medical team.
As part of their jobs, recreational therapists need to understand their patients and set goals for their progress accordingly. A patient having trouble socializing, for example, may have an interest in playing chess but be overwhelmed by the prospect of actually playing, since that involves interaction with another person. A therapist would proceed slowly, first letting the patient observe a number of games and then assigning a therapeutic assistant to serve as a chess partner for weeks or even months, as long as it takes for the patient to gain enough confidence to seek out other patients for chess partners. The therapist makes a note of the patient's response, modifies the therapy program accordingly, and shares the results with other professionals on the team. If a patient responds more enthusiastically to the program, works more cooperatively with others, or becomes more disruptive, the therapist must note these reactions and periodically reevaluate the patient's activity program.
Responsibilities and elements of the job can vary, depending on the setting in which the recreational therapist works. In nursing homes, the therapist often groups residents according to common or shared interests and ability levels and then plans field trips, parties, entertainment, and other group activities. The therapist documents residents' responses to the activities and continually searches for ways of heightening residents' enjoyment of recreational and leisure activities, not just in the facility but in the surrounding community as well. Because nursing home residents are likely to remain in the facility for months or even years, the activities program makes a big difference in the quality of their lives. Without the stimulation of interesting events to look forward to and participate in, the daily routine of a nursing home can become monotonous and depressing, and some residents are apt to deteriorate both mentally and physically. In some nursing homes, recreational therapists direct the activities program. In others, activities coordinators plan and carry out the program under the part-time supervision of a consultant who is either a recreational or occupational therapist.
The therapist in a community center might work in a day-care program for the elderly or in a program for mentally disabled adults operated by a county recreation department. No matter what the disability, recreational therapists in community settings face the added logistical challenge of arranging transportation and escort services, if necessary, for prospective participants. Coordinating transportation is less of a problem in hospitals and nursing homes, where the patients all live under one roof. Developing therapeutic recreation programs in community settings requires a large measure of organizational ability, flexibility, and ingenuity.