Recreation in institutional settings has come to be recognized as particularly helpful in the rehabilitation and recovery process. In addition it also provides a vehicle for enhancing people's general sense of well being, therapeutic recreation has proven to be a vital component of treatment. When recreation services first appeared in hospital settings in the post-World War II period recreation was regarded more as diversionary than rehabilitative in focus. However, given the potential of recreation to more than fun and enjoyment into a person's rehabilitation program, the emphasis is now more clearly sen as a vehicle for bringing about functional change as well as enhancement of quality of life. Consequently, therapeutic recreation can be viewed as both a means and an end. It is used as a means in those instances where recreation is part of a planned intervention to bring about improvement in physical, social, emotional, and cognitive functions.
Recreation as a means, is commonly used in rehabilitation settings. There, therapeutic recreation forms part of the treatment program along with other clinical interventions. Recreation as an end in itself relates to the sense of emotional and physical well-being that is associated with engaging in intrinsically motivated leisure pursuits. Recreation as an end may be viewed as inherently therapeutic and is engaged in for its own sake, rather than as a means to bring about change in some other aspect of a person's life.
The current emphasis on community living, and shifts in long-term care whereby many individuals who might have once been faced with institutionalization are now afforded the opportunity to remain in their communities, mean that treatment and rehabilitation modalities including therapeutic recreation should be available in community settings. Research finding suggest that people with disabilities who are experiencing diminished levels of independant activity may need support in accessing preferred leisure and recreation oppotunities. It is important to recognize that without appropriate support services, community living will fall short of its potential to offer people the best possible level of physical health and emotional well-being.
Therapeutic recreation has been found to be an effective intervention with a wide range of populations in clinical and rehabilitation settings. Upon discharge from clinical settings, people confront a range of choices and decisions related to their leisure time. The move from the more structured institutional environment to recreation participation in the community is far from straightforward. Arole exists for therapeutic recreationists with respect to facilitating people's involement within the community. Therapeutic recreationists trained in leisure value, understand the centrality of freedom and self-determination in leisure and its goal of ensuring that the individual gains or regains skills and an understanding of leisure that will enable them to exercise self-determined leisure choices.
It is interesting to note that as facility and community service providers attempt to maximize their resources in time of fiscal constraint, new and significant opportunities for collaboration are emerging. Where recreation in rehabilitation facilities and community settings may have come to be regarded as serving different populations, today there is a sense that these resources can include a wider range of individuals in more intergrated pursuits.
Evidence suggests that with careful planning and incorporation of appropriate training from therapeutic recreationists, intergrated recreation is indeed feasible. Recent discussions of the relationship between health and well-being have emphasized the importance of social relationships and community. In order for the individual to experience the benefits of rehabilitation on an ongoing basis, people are increasing recognizing the need to avoid social isolation and remain involved in the life of their community. Therapeutic recreation is able to move individuals from simply being 'in' the community, toward being part 'of' their community and, in turn, further the positive outcomes of the total rehabilitation process.
Alison Pedlar, PhD., is an Associate Professor at the Department of Recreation and Leisure Studies, Faculty of Applied Health Services, University of Waterloo.