An Editorial Perspective...

For a number of years, and perhaps since its inception as a field, professionals and others have debated the meaning of the labels used to connote the working role of the professionals providing recreation services for handicapped populations. Some common descriptors have included: hospital recreator, therapeutic recreator, recreational therapist, and more recently, activity therapist. More than a simple question of nomenclature, the controversy reflects various philosophical positions about the "proper" role that special population recreators should be carrying out in relationship to their clientele. Should that role be treatment oriented within basically clinical models, or does such an approach negate the intrinsic value of recreation and leisure activities? Or should the specialist in therapeutic recreation direct his efforts to working with the "healthy" aspects of an individual and leave pathology for those disciplines historically educated to and focused on treatment approaches?

This question of professional definition seemingly has not moved toward closure in recent years but has rather intensified due, in part, to two counterbalancing pressures. The movement of large segments of previously institutionalized populations into the community has generated a significant visible community population of handicappers needing service in mainstreaming models. Typically the direction taken by recreators both philosophically and because of pragmatic reasons (high client-staff ratios and nonclinical training), has been toward a leisure services model in which the thrust is toward maximizing involvement with little focus on treatment approaches. Contrastingly, clinical treatment settings have been subjected to increasingly higher levels of treatment and programmatic accountability and the therapeutic recreator working in these settings as an integral member of "treatment teams" is often highly dependent on clinical skills. This continuum (Figure A), marked by leisure activities for their intrinsic value at one end and clinical therapy models at the other also embraces any number of perspectives falling between the two extremes. Realistically, it is also true that the therapeutic recreation professional is often called on to simultaneously function at many points on the continuum as a function of situational determinism, i.e. the differing needs of heterogeneous special populations within the same setting. Illinois serves as a prime example of this entire continuum with special recreation association directors besieging the educational establishment for individuals having basic recreation skills accompanied by some knowledge of the characteristics of special populations and institutional administrators calling for recreators who have the skills necessary to operate effectively within high accountability treatment models.

These ongoing questions of role identity and philosophical direction can be resolved, if not solved, by defining therapeutic recreation as a multi-dimensional, multi-faceted range of services rather than as any single role or approach. Thus the "proper" role training is that which meets the needs of the particular clientele within a particular setting. Having specialists within a professional field is hardly an innovative concept, and therapeutic recreators have taken that approach practically for a considerable period of time even if they have been unwilling to adopt it philosophically.

However, another perspective on this argument is that the argument itself may have inadvertantly become secondary to or a portion of a larger question that asks whether or not the evolving field of clinical therapeutic recreation should be part of recreation at all. Although the range of services approach does reduce the need for dichotomous argument about a single proper philosophical thrust, many of the same forces that have operated to produce the necessity for this approach may have made the solution obsolete even before it is adopted (if ever it would be). A problem inherent in the solution is that the answer revolves around a range of recreation services rather than a range of therapeutic services. Thus the focus remains on recreation and

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leisure behavior outcomes. This seems appropriate in general for professionals operating within the first two thirds of the continuum, but perhaps unsatisfactory for professionals focused on clinical treatment models that attempt to generate behavioral outcomes that are not recreation or leisure specific.

Why further split a field that has yet to develop a unanimity of professional purpose? The question implies that a single perspective on therapeutic recreation service is or has been desirable, a concept in itself debatable, given the multiplicity of clients that therapeutic recreation has always served. In any case, the answer revolves around a positive evolutionary outcome common to developing professions. We have become sophisticated and knowledgable enough to consider looking beyond the original context of recreation from which we have grown. Indebted as the profession may be to general recreation for its original sustenance and support, it may well be time for the therapeutic professional focused on clinical service to affiliate more strongly with those professionals focused on treatment models.

These affiliations to some extent, have always been present. Indeed it can be argued that therapeutic recreation is an almost totally "borrowed profession" which has always been highly dependent not only on its parent, recreation, but on psychology, social work, special education, and physical therapy along with the specific adjunct therapies (art, music, dance, and drama). The problem with this past and present level of interaction from a professional perspective is that we have in some respect been subservient to all of them. All of the professions noted above, with the exception of general recreation, have tended to be more sophisticated in technique, more rigorous in training, more demanding in their professional credentialing, and with the possible exception of some of the specific art therapies, have more professional credibility with consumers and the public at large. It should be noted that therapeutic recreation has, at least recently, taken the lead in professional viability within the recreation profession. Present trends in individual credentializing and institutional accreditation show strong leadership from TR professionals. But is it sufficient?

Is it time for the clinical specialist in therapeutic recreation to step beyond the confines of recreation as a whole and begin to identify himself not as a recreator, but as a developmental therapist whose goals and expertise have become markedly different from that of the "recreation specialist"? Has our basic affiliation with recreation become counterproductive at a time when increased accountability and generally declining resources have become the order of the day? Buoyed by federal and state legislature mandates that therapeutic recreation services in rehabilitative models be provided for handicapped consumers and threatened by the accompanying demand that treatment accountability be provided, the profession seems to be at a crossroads. It may be that the clinical therapeutic recreation professional, supported by a still limited but growing body of specific knowledge and an increasing level of professional rigor, needs to declare his professional independence from the rubric of general recreation.

This movement toward independence could take the form of seeking independent professional status or affiliation with those disciplines having similar goals and rigorous professional standards. Utilizing the strength in numbers concept, clinical therapeutic recreation specialists, hereinafter indentified as activity therapists, could take the leadership role in forming a professional federation encompassing similar relatively small disciplines generally identified as "developmental therapies". This association could conceivably include such adjunct therapies as movement, music, horticulture, poetry, drama and related disciplines such as occupational therapy, physical therapy, and special education. Adopting the title "activity therapist," besides developing an identity distinct from recreation in general, connotes a philosophical orientation toward a treatment model that uses activity, i.e. experiences that generate positive holistic development and growth in clients (as opposed to passive treatment approaches), in a therapeutic model having generalizable goals. This experience may be purely recreational in nature or not, dependent on the need of the client.

The suggestion then is for a distinct entity of professionals, identified as activity therapists, whose orientation toward clients is holistic in concept, characterized by generalizable treatment outcomes, and having rigorous professional standards and clearly defined clinical skills. Recreation per se would not be the basis for the profession, and professional affiliation would generally be with those disciplines focused on treatment outcomes. The disabled leisure consumer in non-clinical settings would not have his or her basic leisure and recreation needs neglected but would be served by general recreators having some special training in the needs and characteristics of special populations.

Increased recognition and credibility, professional development and growth, and ever more rigorous demands from funding sources, consumers, and allied professions have created a unique situation for professionals generally identified as therapeutic recreators. The direction of the profession is simultaneously blessed and cursed by multiple needs and multiple options.

Shall we continue to be little brother to all — or shall we undertake the risky business of being an equal?

Dr. Len Cleary is Coordinator of Therapeutic Recreation, Department of Recreation, Southern Illinois University, Carbondale and Associate Editor, Illinois Parks and Recreation.

IAPD and IPRA believe that the democratic process functions best through frank and open discussion. Materials published in this magazine, therefore often presents divergent and controversial points of view which do not necessarily represent the views or policies of the two sponsoring organizations.

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