How to Become a Recreational Therapist: Salary, Degrees & Certification Guide
Recreational therapists use activities like sports, arts, and games to help patients recover from injuries, illnesses, and disabilities. They earn a median salary of $60,280 and need a bachelor's degree in therapeutic recreation, a 560-hour internship, and CTRS certification to practice.
Sometimes the best medicine doesn't come from a pill bottle. Physical therapy, occupational therapy, and mental health counseling all play crucial roles in helping people recover from injuries and manage chronic conditions. But there's another powerful treatment approach that's often overlooked.
Recreational therapy uses enjoyable activities like horseback riding, swimming, art, music, and sports to help patients rebuild their lives after illness, injury, or disability. It's an evidence-based treatment recognized by Medicare and Medicaid that combines the healing power of recreation with clinical expertise.
If you're passionate about helping others while incorporating fun, meaningful activities into treatment plans, a career as a recreational therapist might be the perfect fit for you.
Table of Contents
What Is Recreational Therapy?
Recreational therapy helps people gain or regain the ability to live independent, healthy lives by using enjoyable recreational and leisure activities as treatment. Unlike traditional therapy approaches, recreational therapy focuses entirely on achieving positive health outcomes through activities patients find meaningful and fun.
The American Therapeutic Recreation Association (ATRA) defines recreational therapy as "treatment services designed to restore, remediate, and rehabilitate a person's level of functioning and independence in life activities." This specialized form of therapy addresses physical, emotional, social, and cognitive needs through carefully designed recreational programs.
Recreational therapy isn't new. Florence Nightingale first introduced the concept of using recreational activities to improve patient outcomes in the 1850s. The American Red Cross has been using recreational therapy since 1931. Today, it's recognized as a "skilled therapy" by the Centers for Medicare and Medicaid Services and as an allied health discipline by the Commission on the Accreditation of Allied Health Education Programs (CAAHEP).
Common recreational therapy activities include:
- Swimming and aquatic exercises
- Horseback riding and animal-assisted therapy
- Arts and crafts
- Music and dance
- Cooking and nutrition activities
- Sports and fitness programs
- Gardening and horticulture therapy
- Community outings and social activities
These activities aren't just for fun. They're evidence-based interventions designed to rebuild strength, improve mobility, relieve stress, overcome grief, and build confidence.
Benefits of Recreational Therapy
Research demonstrates significant cognitive, physical, and mental health improvements through recreational therapy. This treatment approach offers measurable benefits across multiple domains of functioning.
Cognitive Benefits
Recreational therapy enhances brain function and cognitive abilities in several ways:
- Improved memory and attention span
- Enhanced decision-making and problem-solving skills
- Increased awareness and decreased confusion
- Better organizational skills
- Improved executive functioning
Physical Benefits
Patients engaged in recreational therapy programs show improvements in:
- Mobility, flexibility, and range of motion
- Fine motor skills and coordination
- Muscular strength and endurance
- Cardiovascular and respiratory functioning
- Balance and agility
Mental and Emotional Benefits
Recreational therapy supports emotional well-being and mental health by improving:
- Self-confidence and self-esteem
- Overall sense of well-being
- Communication skills
- Trust and relationship building
- Relaxation and stress management
- Positive body image
Psychosocial Benefits
Studies show recreational therapy helps reduce:
- Social anxiety and isolation
- Boredom and lack of engagement
- Symptoms of anxiety and depression
- Poor morale
In correctional facilities and substance abuse treatment centers, recreational therapy programs have demonstrated improved community functioning, better decision-making skills, and enhanced ability to manage substance-related stressors.
What Recreational Therapists Do
Recreational therapists combine creativity with clinical skills to design and implement therapeutic programs that address each patient's unique needs. Their work goes far beyond simply organizing fun activities.
Primary Responsibilities
Patient Assessment: Recreational therapists evaluate each patient's physical, emotional, social, and cognitive needs to develop personalized treatment plans. They consider the patient's interests, abilities, limitations, and goals.
Program Design: Using their education and training, recreational therapists create evidence-based therapeutic interventions that are safe, effective, and meaningful to each patient. They select activities that align with the patient's view of healthy living.
Treatment Implementation: Recreational therapists lead therapeutic activities and programs, adapting them as needed to meet individual patient needs. They ensure activities are appropriately challenging while remaining achievable.
Documentation and Evaluation: Like other members of the interdisciplinary care team, recreational therapists document patient progress, maintain detailed records, and evaluate treatment effectiveness. They adjust interventions based on patient outcomes.
Team Collaboration: Recreational therapists work closely with physicians, nurses, physical therapists, occupational therapists, and mental health counselors to coordinate comprehensive care. They contribute their unique perspective to treatment planning.
Patient Populations
Recreational therapists work with diverse patient groups ranging from pediatric to geriatric, including those with:
- Physical disabilities and injuries
- Mental health conditions
- Developmental disabilities
- Substance use disorders
- Chronic illnesses
- Age-related conditions
Work Settings
Most recreational therapists work in long-term care facilities, nursing homes, and assisted living facilities. However, job opportunities exist in many settings:
- Acute care hospitals
- Home healthcare agencies
- Correctional institutions
- Adult daycare centers
- Public and private schools
- Addiction and substance abuse rehabilitation facilities (inpatient and outpatient)
- Mental and behavioral health facilities (inpatient and outpatient)
- Rehabilitation units within hospitals (inpatient and outpatient)
- Community recreation centers
- Veterans' facilities
Recreational therapy serves as a complementary treatment approach, working alongside occupational therapy, physical therapy, and mental health counseling to improve overall quality of life.
Education Requirements
Becoming a recreational therapist starts with earning a bachelor's degree in therapeutic recreation or a closely related field. Most programs are titled BS in Therapeutic Recreation, Recreation and Leisure Studies with a Therapeutic Recreation concentration, or similar.
How Long Does It Take?
You can become a recreational therapist in four years by completing a bachelor's program and an integrated internship as a full-time student. Part-time study extends this timeline.
Degree Program Components
A comprehensive recreational therapy degree program includes:
Foundation Courses:
- Human anatomy and physiology
- Human development and behavior across the lifespan
- Characteristics of illnesses and disabilities
- Medical terminology
- Psychology and counseling fundamentals
Specialized Coursework:
- Foundations and philosophy of recreational therapy
- Theories and practice of therapeutic recreation
- Assessment and treatment planning
- Delivery of therapeutic recreation services
- Program design and evaluation
- Adaptive equipment and modifications
- Professional ethics and standards
Internship: Most programs require a supervised clinical internship of at least 560 hours (14 weeks), providing hands-on experience in real treatment settings. This internship is often integrated into the degree program and is required for professional certification.
Accredited Programs
More than 80 colleges and universities in the U.S. offer bachelor's programs in therapeutic recreation. The Committee on Accreditation of Recreational Therapy Education (CARTE), created in 2010 under the CAAHEP umbrella, establishes minimum quality standards for recreational therapy programs.
Explore recreational therapy programs to find accredited options near you.
Can You Become a Recreational Therapist Without a Degree?
No, you need a bachelor's degree in therapeutic recreation or a related field to qualify for national certification and most recreational therapist positions. The knowledge and clinical skills learned through a degree program are essential for safe, effective practice.
Advanced Education
A bachelor's degree in recreational therapy also serves as a foundation for master's degree programs in recreational therapy, occupational therapy, applied behavior analysis, psychology, special education, and related fields. Advanced degrees can open doors to supervisory, administrative, research, and teaching positions.
Professional Certification Requirements
Most recreational therapists hold the Certified Therapeutic Recreation Specialist (CTRS) credential offered through the National Council for Therapeutic Recreation Certification (NCTRC). While not legally required to practice in most states, the CTRS has become a common professional requirement and is preferred or required by many employers.
CTRS Eligibility Requirements
To qualify for the CTRS credential, you must:
- Complete a bachelor's degree from an accredited program
- Complete a formal internship of at least 560 hours (14 weeks) under qualified supervision
- Pass the NCTRC Certification Exam
The NCTRC Certification Exam
The certification exam is a comprehensive three-hour test consisting of 150 multiple-choice questions covering:
- Foundational knowledge
- Assessment and planning
- Implementation of recreational therapy interventions
- Documentation and evaluation
- Organizing and managing recreational therapy services
- Advancement of the profession
Applicants can take the exam via Live Remote Proctoring or at a PSI Testing Center near them. The NCTRC provides a detailed exam content outline and study resources to help candidates prepare.
CTRS Specialization Area Designations
Recreational therapists holding the CTRS credential may further specialize by earning a CTRS Specialization Area Designation. This designation indicates advanced experience and knowledge in a specific area of practice.
To earn a specialization, professionals must provide proof of their advanced knowledge and skills through continuing education, conference attendance, specialized coursework, and focused clinical practice.
Available specialization areas include:
| Specialization Area | Focus |
|---|---|
| Adaptive Sports and Recreation | Modified sports and recreational activities for people with disabilities |
| Behavioral Health | Mental health and substance abuse treatment settings |
| Community Inclusion Services | Helping individuals participate fully in community life |
| Developmental Disabilities | Working with individuals with intellectual and developmental disabilities |
| Geriatrics | Older adults in various healthcare settings |
| Pediatrics | Children and adolescents with various conditions |
| Physical Medicine/Rehabilitation | Physical injuries, illnesses, and rehabilitation |
Credential Maintenance
The CTRS designation (and any specialization area designations) must be renewed every five years through continuing education and professional development activities.
Holding both the CTRS credential and a specialization designation is an excellent way to increase marketability and earning potential in the field.
State Licensure Requirements
As of 2025, only five states require recreational therapists to be licensed. All five states require CTRS certification as a prerequisite for licensure.
| State | Licensing Authority |
|---|---|
| New Hampshire | Office of Licensed Allied Health Professionals |
| New Jersey | Division of Consumer Affairs, State Board of Medical Examiners |
| North Carolina | Board of Recreational Therapy Licensure |
| Oklahoma | Medical Board |
| Utah | Division of Occupational and Professional Licensing |
If you plan to practice in one of these states, check the specific licensing requirements with the appropriate board, as they may have additional requirements beyond CTRS certification.
Recreational Therapist Salary and Employment Outlook
Recreational therapists earn competitive salaries, with earnings varying based on experience, certification, specialization, work setting, and geographic location.
National Salary Data
According to the Bureau of Labor Statistics, recreational therapists earned a median salary of $60,280 as of May 2024. The salary range varies significantly:
| Percentile | Annual Salary |
|---|---|
| 10th Percentile (Entry Level) | $39,520 |
| 25th Percentile | $48,000 |
| 50th Percentile (Median) | $60,280 |
| 75th Percentile | $75,000 |
| 90th Percentile (Experienced) | $96,600 |
Early career professionals typically earn around $39,520 to $48,000, while those with considerable experience, CTRS certification, and specialized expertise can earn upwards of $96,600.
Salary by Work Setting
Work setting significantly impacts earning potential. The highest-paying settings for recreational therapists include:
| Work Setting | Median Annual Salary |
|---|---|
| Physician Offices | $84,770 |
| Federal Government Agencies | $80,450 |
| Home Healthcare Services | $65,520 |
| Colleges and Universities | $61,270 |
| Elementary and Secondary Schools | $60,960 |
As of May 2024, psychiatric, substance abuse, medical, and surgical hospitals employ the most recreational therapists nationwide.
Top-Paying States
Geographic location plays a significant role in salary potential. The states with the highest median wages for recreational therapists include:
| State/Area | Median Annual Salary |
|---|---|
| California | $78,190 |
| New Jersey | $75,490 |
| Washington, DC | $72,110 |
| Washington | $67,330 |
| Oregon | $67,200 |
Employment Outlook
The BLS projects employment of recreational therapists to grow 3 percent from 2024 to 2034, about as fast as the average for all occupations. This translates to approximately 1,300 annual job openings due to a combination of new job growth, retirements, and natural job turnover.
The aging baby boomer population will continue to drive demand for recreational therapists, particularly in:
- Senior community centers
- Nursing homes
- Assisted living facilities
- Home healthcare settings
- Rehabilitation facilities
Growing awareness of mental health needs and the effectiveness of complementary therapies is also expanding opportunities in behavioral health and substance abuse treatment settings.
Frequently Asked Questions
What's the difference between recreational therapy and occupational therapy?
While both professions help people improve daily functioning, occupational therapy focuses on helping patients perform activities of daily living (like dressing, eating, and working), while recreational therapy specifically uses leisure and recreational activities as the primary treatment modality to improve overall quality of life, social skills, and physical and emotional well-being.
Do I need to be athletic to become a recreational therapist?
No, you don't need to be an athlete. While some recreational therapy involves physical activities, the field encompasses many creative, cognitive, and social activities. Your ability to assess patient needs, design appropriate interventions, and build therapeutic relationships is more important than athletic ability.
Can recreational therapists work with children?
Yes, many recreational therapists specialize in pediatrics, working with children who have developmental disabilities, chronic illnesses, behavioral health needs, or physical limitations. Pediatric recreational therapists often work in schools, children's hospitals, rehabilitation centers, and community programs.
Is recreational therapy covered by insurance?
Yes, recreational therapy is recognized as a skilled therapy by Medicare and Medicaid. Many private insurance plans also cover recreational therapy when prescribed as part of a comprehensive treatment plan. Coverage varies by plan and state, so patients should check their specific benefits.
What's the job outlook for recreational therapists?
The BLS projects 3 percent job growth from 2024 to 2034, with about 1,300 annual openings. The growing senior population and increased awareness of mental health treatment options are driving demand, particularly in long-term care facilities and mental health settings.
Can I work as a recreational therapist in all states?
You can work as a recreational therapist in any state, but five states (New Hampshire, New Jersey, North Carolina, Oklahoma, and Utah) require state licensure in addition to CTRS certification. Other states don't have specific licensing requirements, though most employers prefer or require CTRS certification.
Key Takeaways
- Recreational therapists use enjoyable activities as evidence-based treatment to help patients recover from injuries, illnesses, and disabilities, addressing physical, emotional, cognitive, and social needs.
- A bachelor's degree in therapeutic recreation and a 560-hour internship are required to enter the field, with most employers preferring or requiring CTRS certification from the NCTRC.
- The median salary for recreational therapists is $60,280 (May 2024), with experienced professionals in specialized settings earning up to $96,600 annually.
- Only five states currently require licensure for recreational therapists (New Hampshire, New Jersey, North Carolina, Oklahoma, and Utah), though CTRS certification is widely recognized as the professional standard.
- Job growth is projected at 3 percent through 2034, with the aging population and growing mental health awareness driving steady demand for qualified professionals.
- Recreational therapists can specialize in areas like pediatrics, geriatrics, behavioral health, adaptive sports, or physical rehabilitation to enhance career opportunities and earning potential.
Ready to Start Your Recreational Therapy Career?
Explore accredited therapeutic recreation programs and take the first step toward a rewarding career helping others through the healing power of recreation.
2024 US Bureau of Labor Statistics salary figures and job growth projections for Recreational Therapists are based on national data, not school-specific information. Conditions in your area may vary. Data accessed October 2025.
