Transcript No Slide Title

Identifying the Strengths and Areas of Needed Improvement in Therapeutic Recreation
Eden Fisher CTRS, Lindsay Dame, Dr. Michelle Gerken CTRS, Dr. Jon McChesney & Dr. Michael Bradley
Eastern Kentucky University
• Licensure
Currently, there are only 4 states that require Certified Therapeutic Recreation Specialists to be
licensed, they are: North Carolina, Utah, New Hampshire, and Oklahoma.
Kentucky could become a national leader in effective allied health practices if licensure
was mandated for CTRS’s to practice.
• Versatile Health Field
TR’s can work with any population to help achieve holistic outcomes.
Examples of employment opportunities include: adult day care, senior centers, nursing homes,
rehab, psychiatric facilities, non-profits (Special Olympics), children's homes, parks and
recreation special populations dept., schools, VAs, camps, assisted living facilities,
developmentally challenged facilities, department of juvenile justice, and prisons.
Therapeutic Recreation- “a holistic process that purposefully uses
recreation and experimental interventions to bring about change…in an
effort to maintain and improve health status, functional capacities, and
quality of life” (Carter & Van Andel, 2011, p.9).
“S” stands for the strengths of the therapeutic recreation field.
“W” stands for weaknesses of the therapeutic recreation field.
“O” stands for the opportunities of the therapeutic recreation field.
“T” stands for the threats to the therapeutic recreation field.
Strengths
• Strength in Numbers!
According to the U.S department of health and human services office on
disability (2002) there are currently 54 million Americans living with a
disability. That is 1 out of every 5 people.
Additionally, there are 2 million people living in nursing homes and other
long term care facilities.
In Kentucky, there are 830,000 people over the age of 5 who have a form of
disability.
Approximately 153,000 people or 4% of Kentucky’s population
experiences difficulties with performing activities of daily living.
• Tyler’s Story
Tyler Gay was diagnosed at birth with Unknown Multiple Congenital
Anomaly Syndrome. At just 15 minutes old he experienced his first seizure,
but there were many more challenges to come. The doctors said that he
would never learn how to talk or walk.
Tyler proved the doctors all wrong! He can now currently talk, walk, and
is very independent. There were two determining factors in Tyler’s success.
First, his parents superb one on one care and second, his participation in
Special Olympics sports, which is one of the best known forms of
therapeutic recreation!
The most heartwarming moment, according to his mom Kathy was when he
made not one, but two consecutive goals during one of his basketball
games. Tyler had never scored any points during his 2 years of participation
in basketball up to that point. Kathy recalled that it was the most wonderful
surprise and everyone in the audience jumped up and cheered. Special
Olympics sporting events are the big highlight in Tyler's life .“Special
Olympics has meant so much to Tyler and our family. It truly is a
wonderful program and we will participate for as long as we can”.
Threats
Special Olympics Athlete
• Benchmarking Kentucky!
North Carolina vs. Kentucky
University of North Carolina Hospital currently employs 9 CTRS’s in pediatrics/oncology
outpatient, 2 in oncology adult unit, 2 in burn center, 7 in psychology unit and 2 in
rehabilitation. They also have 3 recreation therapy assistants and 1 music therapist on staff.
UNC: 22 CTRS’s vs University of Kentucky Hospital: 0 CTRS’s
• Lack of Evidence Based Practice
According to Peterson & Stumbo (2009) “Without evidence based practice in the field of
therapeutic recreation it will result in the causality of service outcomes and significantly
lower quality of care”.
Evidence based research provides health care related fields with proof that their services
are indeed improving the patients health in one way or another. This proof is also how
health insurance companies decide whether or not they will pay for the health services
provided.
Methodology and Materials
This research has two goals: (1) determine strengths, weaknesses, opportunities, and
threats to the TR field; (2) to be used as education tool emphasizing what TR is and where
the field of TR currently stands in regards to other health related fields.
Researcher interviewed 3 experts in the field of TR and 1 expert in the recreation field,
S.W.O.T analysis method used describing CTRS’s data.
.
Dr. Thomas Skalko, CTRS
Weaknesses
• Lack of Insurance Reimbursement
Therapeutic Recreation is currently not considered by health insurance
companies to be billable service. The therapeutic recreation field must
become a billable service in order to expand and thrive. According to the TR
Directory website “Recreation Therapy can survive this crisis of 3rd party
payers and limited insight by fellow professionals if and only if quantifiable and
qualifiable data can be produced to substantiate the claim of being beneficial to
the patient/client. Without this data all we have are vague generalities and
supposition to try to persuade administrators, insurance companies, other
professionals, patients, etc... that we can offer something of value”.
• Misconceptions of other Health Professionals
According to Edward (n.d.) “recreation therapists have often had difficulty in
describing their roles to others and having other allied team members
understand what it is that they do. This is due to a lack of confidence in trying
to understand this role on the interdisciplinary team.”
Dr. Bryan McCormick, CTRS
Opportunities
What is TR? What is S.W.O.T. ?
Equine Therapy
Strengths:
(East Carolina University)
• Profession is represented by one organization representing RT in US.
• Professional organization is instrumental in public policy issues for RT.
• Professional body of knowledge.
Weaknesses:
• Insufficient fiscal resources to meet the needs of the profession.
• No Executive Director to assist the professional organization and profession.
Opportunities:
• Increasing support for licensure in RT.
• Younger professionals have opportunity to move profession forward.
• Initiatives to include RT in Affordable Care Act under essential health benefits.
Threats:
• Continued philosophical divide..
• Lack of Ph.D. students.
Strengths:
(Indiana University)
• Genuine concern for clients/patients/residents.
• Cost effective services.
• Baccalaureate degree to practice.
Weaknesses:
• Limited body of knowledge for practice.
• Few researchers in field.
Opportunities:
• Affordable Care Act moving health services to community.
• Increasing focus of health services on prevention.
Threats:
• Encroachment by other professions (particularly Occupational Therapy).
• Lack of legal recognition of qualified service provider.
• Lack of doctorally prepared personnel.
Dr. Jon McChesney
Strengths:
(Eastern Kentucky University)
• A profession that positively changes lives!
• Cost effective in comparison to OT, PT.
• Demographic changes – aging population in need of TR services.
Weaknesses:
• Lack of resources – marketing.
• Lack of leadership at national level.
• Lack of cohesion among profession – needs united front.
Opportunities:
• Kentucky could be a leader – licensure.
• Exploding Health Care Costs – TR as wellness initiator.
• It can be done – think Wounded Warriors! Emotion sells (Miracle League in
Lexington) – need to capture the “story” and tell folks!
Threats:
• Encroachment of OT into TR services.
• Lack of cohesive messaging – research, branding, marketing.
Dr. Michelle Gerken, CTRS
Strengths:
(Eastern Kentucky University)
• Variety of places for employment.
(Hospital, prison, long term care, rehab facility, adult day care, nonprofit
organizations, parks and recreation, assisted living).
• Greater knowledge is required to perform the job of an RT.
Weaknesses:
• General public does not know about Recreation Therapy/Therapeutic Recreation.
Pay is not always market price.
Opportunities:
• Accumulation of greater knowledge for growth of the profession (i.e. adventure
therapy).
• Grant opportunities for at-risk youth working in different areas.
Threats:
• Other professions delivering recreation therapy services (i.e. Activity Director
Certified for Long Term Care, Child Life Specialist for children, OT, etc.).
• Rehab not potentially hiring as many RTs due to reimbursement.
References
ATRA (2009). ATRA Homepage. Retrieved from http://www.atraonline.com/associations/10488/files/TRACostBene
ficialOption.pdf.
Carter, J.C.,& Van Andel, G.E. (2011). Therapeutic recreation: A practical approach. Long Grove, IL: Waveland Press, Inc.
Disabled World: <i>Kentucky Health and Disability News</i><br><a href="http://www.disabledworld.com/news/america/kentucky/">http://www.disabled world.com/news/america/kentucky/</a>
Edward, C (n.d.). MARKETING THE ROLE OF RECREATION THERAPISTS AMONGST INTERDISCIPLINARY
TEAM MEMBERS. University of Waterloo Aurora, Ontario, Canada.
Stumbo, N. J., & Peterson, C. A. (2009). Therapeutic Recreation Program Design: Principles and Procedures. San
Francisco, CA: Pearson Benjamin Cummings.