2003 National Therapeutic Recreation Curriculum Study Part A: Accreditation, Curriculum and Internship Characteristics
Stumbo, Norma J
In 1996, Stumbo and Carter conducted a survey to examine therapeutic recreation curricula across the country and to describe their current status. The intent of the present study was to re-examine, update, and compare therapeutic recreation curricula across the US and Canada from the original study completed in 1996 (Stumbo & Carter, 1999a). The first part of the current 2003 study (Part A) focused exclusively on three areas: (a) accreditation, (b) curriculum, and (c) internship characteristics. The results showed that therapeutic recreation curricula were located at universities and departments that varied widely. Of the 65 responding institutions, 36 (55 percent) were accredited by the NRPA/AALR Council on Accreditation. Almost 80% of responding institutions reported revising their curriculum in the last three years and that NCTRC certification standards had the greatest influence on curriculum revision. Therapeutic recreation curriculum structure between institutions was diverse. The average number of weeks for a senior internship was 13.5, up from 12.6 in 1996, indicating an overall increase in number of weeks required. Based on the results of this study, several recommendations are made for therapeutic recreation faculty and the national organizations. Part B follows in the next article and focuses on (a) university, (b) faculty, (c) student, and (d) placement information.
The environments in which therapeutic recreation services are being offered are in a constant state of change (Monroe & Connolly, 1997/98; Powell & Sable, 2001). Foci on reduction in health care costs and lengths of stay and increased concern for consumer satisfaction and achievement of outcomes have contributed to delivery of services in outpatient, community, and home-based settings. While a number of economic and political factors are contributing to health care reform, educators are taking stock of curriculum delivery approaches as a consequence of several challenges to higher education. Trends toward 1) learner-centered self-paced instruction, 2) delivery by multiple institutions and providers beyond the traditional academy, and 3) public engagement in quality assurance processes, leave educators debating the effectiveness of alternative curricula formats (Ewell, 1998).
“One of the certainties about therapeutic recreation education is that there are few certainties” (Navar, 2001, p. 24). A review of curriculum design and research in therapeutic recreation professionalization, yields consensus on what constitutes the boundaries of the field in terms of practice yet finds little agreement on the content and packaging of curriculum (Stumbo, 2001). Two strands of research have considered the relevance of therapeutic recreation curricula to practice and the relationships of professional preparation to professionalization processes. One focus has centered on the nature of curricular offerings while a second focus has addressed the knowledge and skills of entry-level professionals. Health care and higher education reform dynamics necessitate a revisit to curriculum development and therapeutic recreation education. A well-prepared professional is responsive to the changing nature of health and human services just as a quality professional preparation program adapts to the technological innovations and financial exigencies of higher education. A brief historical review of curriculum and therapeutic recreation education studies is coupled with analysis of recently completed research and is organized by the two previous themes (refer to Stumbo & Carter. 1999a & 1999b for in-depth review of earlier investigations).
Literature Review of Curriculum Design in Therapeutic Recreation
Therapeutic recreation was first recognized as a “specialty area” in professional preparation during a national conference on the College Training of Recreation Leaders in 1937 at the University of Minnesota. The Athletic Institute sponsored two conferences in the late 1940s and early 1950s to develop graduate study curricular guidelines (Lindley, 1970). The outcome of a meeting between the American Association for Health, Physical Education and Recreation (AAHPER) and the National Commission on Teacher Education and Professional Standards, as reported by Lindley, was a core curriculum for graduate study in hospital recreation (cf. AAHPER, 1973). Professional preparation programs evolved around institutes and workshops like those held on the campuses of the Universities of Minnesota and North Carolina in the 1950s. One of the first Master’s curriculum was outlined in 1961 (Comeback, Inc., 1961) with undergraduate content proposed in 1963 (MacLean, 1963).
One of the first and most extensive continuous national curriculum studies was initiated in 1969 with 10-year follow-ups reported each of the subsequent decades (Anderson, Ashton-Shaeffer, & Autry, 2000; Anderson & Stewart, 1980; Stein, 1970; Stewart & Anderson, 1990). The first study found 35 of the 114 reporting institutions offering therapeutic recreation options with the majority housed in physical education or education departments (Stein). The first 10-year follow-up found the existence of therapeutic recreation curricula by title separate from recreation/leisure curricula title with recreation and park curricula shifting away from the health, physical education, and recreation umbrella (Anderson et al.). Of the 157 responding institutions, 92 reported options, 24 identified separate therapeutic recreation degrees, and 23 reported offering general recreation with courses in therapeutic recreation (Anderson & Stewart). A second 10-year follow-up found a reversal in therapeutic recreation education trends (Stewart & Anderson). A decrease in the number of curricula by 32 (i.e., 105 out of 163 respondents reported offering curricula) and a leveling-off of the number of accredited programs were accompanied by decreases in the number of faculty and students. In the most recent follow-up (Anderson et al.), the number of programs offering courses, an option, or degree in therapeutic recreation increased by 29 (28 percent) from 1989 with the number of programs (134) close to the number in 1979 (137) when the field was at its peak in producing graduates. The number of accredited therapeutic recreation options is decreasing (i.e., eight percent decrease from 1989 to 1999) while the number of programs including therapeutic recreation or recreation therapy in their title is increasing (i.e., six percent or twelve of the 134 respondents) (Anderson et al., 2000). Twenty programs offered distance education opportunities while three reported offering on-line courses. This series of longitudinal studies documents the ebb and flow of professional preparation programs. Declines in the 1980s and renewed growth in the 1990s followed growth during the 1960s with peak numbers reached in the 1970s. The 1990s saw decreases in the availability of advanced degrees and those programs with accredited options.
Another research thread has been course significance. Both Lindley (1970) and Smith (1976) found that internships, Introduction to Therapeutic Recreation, Therapeutic Recreation Programming, and psychology classes were perceived as important yet they found little agreement on curricular design. Skalko and Smith (1989) reported from their investigation the need for more progress toward therapeutic recreation professionalization as their results suggested a lack of standardization in professional titles, employment criteria, and credentials. They proposed movement toward standardized curricula might advance the field.
According to Stumbo and Carter (1999a, 1999b) the “average” university enrolled 136 recreation and leisure majors, with approximately 51 of these being in therapeutic recreation. Forty-five of the 106 responding institutions reported graduate programs with an average of 22 graduate students, 11 of which were in therapeutic recreation. Sixty-six of the 109 schools that responded were accredited with 62 percent of the accredited schools having the therapeutic recreation option accredited; this option appeared to be the most popular option accredited by the Council on Accreditation (COA). At the “average” institution, graduation required 130 hours, with 50 in general education, 33 in recreation core coursework, 19 hours in therapeutic recreation, and 24 hours in support coursework. Most programs required three, four, or five therapeutic recreation courses. Typically, these courses were Introduction to Therapeutic Recreation, Principles and Practices of Therapeutic Recreation, TR Program Planning, and a Disability/Specialty course. Internships averaged 13 weeks or 470 hours with most schools adhering to the NCTRC(TM) internship standards in effect at the time of the research. Data from the study indicated curricula were extremely diverse. The investigators recommended that this type of research be conducted every five to 10 years to track trends in higher education. Further noted was the importance of well-designed curricula to the quality of professionals and their services to clients.
Entry-Level Knowledge and Educational Accreditation
A second line of research has been the identification of entry-level knowledge and the relationship of professional preparation to therapeutic recreation professionalization. Commencing with federally funded projects in the 1970s, a number of studies have identified competencies incorporated into the therapeutic recreation specialization (now option) of the National Recreation and Park Association/American Association for Leisure and Recreation COA standards (Kelley, Robb, Park, & Halberg, 1976; McGhee & Skalko, 2001; Peterson & Connolly, 1981; Stumbo, 1986). Periodic revisions have incorporated feedback from practitioners and educators and have resulted in the first recognized specialization becoming an option with an expanded number of entry-level competency statements. Most comprehensive curricula will follow the guidelines established by the COA for the therapeutic recreation option (National Recreation and Park Association, 2000) and the curriculum guidelines published by the American Therapeutic Recreation Association (Kinney & Witman, 1996, 1997; Navar, 2001). Yet, a lack of validated core competencies for entry-level knowledge is demonstrated by the prevalent inconsistency in professional preparation programs (McGhee & Skalko).
Parr (1997) investigated the “umbrella” nature of the field implied by a core body of knowledge articulated in the COA standards. The key issue investigated was the appropriateness of a “recreation model” to educate competent practitioners. Results indicated that the core body of knowledge for parks, recreation, and leisure services field does not represent a systemic culture pattern for TR students.
Another concern with current accreditation practices is the ability of the processes to measure quality in educational experiences (Zabriskie & McCormick, 2000). “The first function of accreditation is that it is inherently evaluative in nature . . . and the related concept of identifying quality, transcend all areas in which accreditation appears” (p. 33). Yet, criticism suggests accreditation has not served this purpose but rather places emphasis on compliance with minimum standards at the expense of self-evaluation and improvement. The historical evolution of healthcare accreditation finds current practices based on performance measurement or outcome evaluation with accreditation decisions based on the results of services provided. The investigators called for a transition from structure and process measurements evident with present COA processes to outcome-based measurements that assess and improve educational quality.
The relationship between professional preparation and therapeutic recreation professionalization is found in the skills and knowledge areas that define entry-level practice. The results of a job analysis study conducted for the National Council for Therapeutic Recreation Certification(TM) (Oilman, Norback & Rosenfeld, 1989) became the basis for the initial national certification exam administered in November 1990. A core body of knowledge areas and job tasks established and documented job relatedness and content validity of the certification examination. A preliminary investigation to the updating of the job analysis by NCTRC(TM) conducted by Connolly and Riley (1995/96) investigated the actual skills used in entry-level therapeutic recreation practice by NCTRC(TM) certificant renewals in their first two-years of practice. The researchers concluded that the assumed linkage between the initial job analysis and knowledge areas remained valid and relevant to current curricular practices.
McGhee (1987) attempted to develop an educational profile to acquire therapeutic recreation competencies. Study respondents were unable to clearly identify the most appropriate educational experiences for acquiring specific competencies. Significant diversity in pre-professional preparation curricula across one state resulted in a pilot study to empirically validate competencies for entry-level practice in therapeutic recreation (McGhee & Skalko, 2001). Analysis of the data validated the majority of each of the 217 competency items as entry-level practice competencies. Competencies were organized into six therapeutic recreation content categories and seven support content categories. This study extended the investigation of content areas and competencies necessary to entry-level practice beyond competencies considered by earlier studies on accreditation and certification criteria.
In summary, health care systems are experiencing fundamental change while attempting to achieve cost reductions, enhanced client satisfaction and improved care outcomes. Professional preparation programs are expected to align education with changing needs of health care systems. Therapeutic recreation curricula have been in process of development since the 1940s. Researchers have conducted curriculum studies (Anderson et al., 2000; Anderson & Stewart, 1980; Stein, 1970; Stewart & Anderson, 1990); explored curriculum competencies, content and characteristics (Anderson & Leitner, 1978; Brasile, 1992; Kelley et al., 1976; Kinney & Witman, 1997; Lindley, 1970; Monroe & Connolly, 1997/98; Peterson & Connolly, 1981; Powell & Sable, 2001; Smith, 1976; Stumbo & Carter, 1999a, 1999b); investigated the relationship of professional preparation to the professionalization process (Connolly & Riley, 1995/96; McGhee, 1987; McGhee & Skalko, 2001; Oltman et al., 1989; Parr, 1997; Skalko & Smith, 1989; Stumbo, 1986; Zabriskie & McCormick, 2000); and considered the viability of therapeutic recreation curricula and availability of qualified faculty during periods of economic restraint (Austin & Hamilton, 1992; Compton & Austin, 1994/95; Compton, Austin, & Yang, 2001). While there is consensus on what constitutes entry-level practice, there is inconsistency in curriculum content and design: There is less evidence on the relevance of therapeutic recreation preparation for 21st century health care practices. The intent of this study was to revisit and reexamine characteristics of therapeutic recreation curricula across the United States and Canada.
The intent of this study was to re-examine, update, and compare therapeutic recreation curricula across the US and Canada from a study completed in 1996 (Stumbo & Carter, 1999a). The present analysis contains a comparison between the 1996 data and data collected in the spring of 2003. Due to the depth of information, the present analysis (Part A) focuses exclusively on accreditation, curricular, and internship characteristics. Part B, in the following article, focuses on university, faculty, student and placement characteristics.
Methods
In 1996, two of the authors designed an instrument specifically for the purpose of gathering information about therapeutic recreation curricula. The major factors taken into consideration in the design included prior curriculum studies by Stumbo and Peterson (1987), Stewart and Anderson (1990) and other authors; NRPA/AALR accreditation standards; NCTRC standards; and NTRS fieldwork standards. These sources provided guidelines for developing the seven sections of the survey, which included items on the characteristics of the: (a) unit, (b) faculty, (c) accreditation status, (d) students, (e) curriculum and course offerings, (f) internship requirements, and (g) graduation and placement rates. The present analysis (Part A) focused primarily on the results from the sections on: (a) accreditation, (b) curriculum, and (c) internship requirements, with some information describing the sample in terms of: (a) unit structure and (b) faculty and students.
Instrument Development
The same survey instrument used to collect the 1996 data was chosen for the present study. In 1996, the survey received three separate reviews or pilot studies to improve its validity and reliability. The first was conducted at a research session of a national conference in the fall of 1995. At this session, copies of the preliminary draft were distributed to the audience of approximately 30 researchers, and feedback concerning the content and item format was collected for the purpose of revising the survey. The second review involved approximately 30 undergraduate students enrolled in a research/evaluation course in the fall of 1995. These students were asked to review the document for both content and item format. Following this procedure, the survey was revised a second time. The third review in 1995 involved a national pilot study of 20 therapeutic recreation professionals who volunteered to review the tool. These individuals were asked to follow the procedure to complete the survey to determine both quality of the instrument and length of time to completion. The instrument was refined a fourth time following the pilot study. In the spring of 2003, the instrument was reviewed by the researchers and updated to reflect newer terminology (for example, changing Joint Commission on Accreditation of Hospitals to Joint Commission on Accreditation of Healthcare Organizations). Changes were minimal in this regard. The survey consisted of 75 questions on eight pages, with an accompanying cover letter.
Sample Selection
For the present study, a list of 144 institutions purporting to offer four-year therapeutic recreation curricula was compiled from lists provided by the American Therapeutic Recreation Association, the National Therapeutic Recreation Society, the National Council for Therapeutic Recreation Certification, and the NRPA/AALR Council on Accreditation. A cover letter explaining how to complete the survey and the survey were sent to the individual identified as the Therapeutic Recreation Coordinator at each institution. In 1996, the survey was sent to 149 institutions that were identified using the same criteria.
Return Rate
An initial mailing and three follow-ups (postcard, e-mail reminder and second survey mailing) produced 71 responses, for a total return rate of 49.3 percent. Six of the responding institutions were dropped from the sample because of unusable data. The final sample consisted of 65 institutions, for a usable return rate of 45.1 percent. In 1996, the final sample consisted of 114 institutions, for a usable return rate of 76.5 percent. The reason for low return rate in 2003 is unknown as the procedures for mailing and follow-up remained the same as in 1996.
Data Analysis
Data analysis included using the SPSS program to analyze closed-ended, quantitative information, and content analysis to code open-ended, qualitative data. Most of the data in the four sections reported in this article were analyzed and reported as grouped data. A number of institutions did not respond to all items, resulting in several points of missing data. The total number of respondents per item is noted, when the number of respondents deviates from the total sample of 65.
Results
The results are reported by the five sections of the survey described in this article. These sections include characteristics of the: (a) university and unit, (b) faculty and students, (c) accreditation status, (d) curriculum and course offerings, and (e) internship requirements. Each of these will be discussed individually. More information is provided in the Part B article that follows.
University and Unit Characteristics
Fifty (76.9 percent) of the 65 responding institutions were public, while the remaining 15 (23.1 percent) were private. Similarly, in 1996 (n = 114), 90 (79.1 percent) were public and 24 (22.1 percent) were private.
In 2003, the average undergraduate enrollment (n = 44) was 11,638, and graduate enrollment (n = 32) was reported at an average of 3,126. In comparison, the average undergraduate enrollment in 1996 (n = 83) was 11,156 and the average graduate enrollment was 3,182. The size of enrollments at responding institutions was similar between 1996 and 2003.
The majority of responding therapeutic recreation programs was in Colleges of HPERD/Health (20 or 31.7 percent), blended Education Colleges (13 or 20.6 percent), Education Colleges (11 or 17.5 percent), and Social Science or Allied Health Colleges (11 or 17.5 percent). In 1996, these four types of colleges also were the most prominent.
The top two department titles in 2003 were Recreation or Leisure (28 or 44.4 percent) and HPERD (26 or 41.3 percent) for a combined total of 85.7 percent. The same two department titles captured 94.3 percent of the respondents in 1996.
Therapeutic recreation was the preferred degree title for 51 (85.0 percent) of the 2003 respondents, while 8 (13.3 percent) reported using Recreation Therapy. This preference continues from 1996 where 102 (95.3 percent) used Therapeutic Recreation and 4 (3.7 percent) used Recreation Therapy as the degree title.
Degree type also was similar between 1996 and 2003. The latest results showed 46 (71.9 percent) having therapeutic recreation as an option or sequence and 18 (28.1 percent) having it as a major or degree. In 74.6 percent of the cases therapeutic recreation was an option or sequence and in 23.7 percent it was a major or degree in 1996.
As in 1996, what appears from these three sets of data is that consensus on titles becomes stronger, the closer one gets to the actual degree program. College titles were widely varied, department titles less so, and degree or sequence titles very much less so. “Therapeutic recreation” is the most preferred term for the degree or sequence, typically housed in a department of Recreation/Leisure Studies or HPER(D), within a diversity of college units (although most were Colleges of Education or Health, Physical Education and Recreation (and Dance). Table 1 shows these results.
Faculty and Student Characteristics
The average number of total recreation and leisure faculty (n = 65) was 4.5, and the average number of total therapeutic recreation faculty (n = 60) was 1.8. In 1996, the averages were 4.4 (n = 113) and 1.7 (n = 104), respectively, indicating little change between the two studies. More detailed information on faculty characteristics is found in Part B.
Per institution (n = 58) the average number of undergraduate recreation and leisure studies majors was 118.5 (down from 135.7 in 1996 with 106 institutions reporting). The average number of recreation and leisure graduate students (n = 34) was reported at 36.4 (up from 21.9 reported in 1996 with 57 institutions reporting). Undergraduate recreation major numbers were down while graduate recreation student numbers increased.
With 63 schools reporting in 2003, the average number of undergraduate therapeutic recreation students was 36.4 (down from 50.7 as reported by 107 schools in 1996). Graduate therapeutic recreation student averages remained relatively constant at 11.0 (n = 26) in 2003 and 10.5 in 1996 (n = 45). Undergraduate therapeutic recreation major numbers were down while graduate therapeutic recreation student numbers remained constant. More detailed information concerning student characteristics is located in Part B.
Accreditation Characteristics
Respondents also were asked for information about status and future with the NRPA/AALR accreditation program. Sixty-three schools responded; 36 were accredited and 27 were not. Of the 36 accredited schools, 36 (100 percent) had their core curriculum accredited, 10 (27.8 percent) had other options accredited, and 19 (52.8 percent) had their therapeutic recreation option accredited. This compares with 63 (95.5 percent) that had core, 23 (34.9 percent) that had other options, and 41 (62.1 percent) that had the therapeutic recreation option accredited in 1996.
The top five reasons for attaining accreditation remained consistent from 1996 to 2003. The top live reasons, in order, were that accreditation (a) provides indication of quality (35 or 97.2 percent), (b) supports the mission of improving curriculum across the university (29 or 80.6 percent), (c) helps in student recruiting (29 or 80.6 percent), (d) provides a competitive edge over similar departments in the state/region (24 or 66.7 percent), and (e) supports the mission of improving curriculum across the country (22 or 61.1 percent). Percentages equal more than one hundred percent as many schools selected more than one answer.
In 2003, accreditation costs most often were paid for by the college or school (24 or 66.7 percent), by the department (22 or 61.1 percent), or by the university (19 or 54.3 percent). In 1996, the costs were paid in 41 (62.1 percent) cases by the college or school, in 31 (47.0 percent) cases by the university, and in 30 (45.5 percent) cases by the department. Percentages equal more than one hundred percent as many schools selected more than one answer. Table 2 details information concerning accreditation status, reasons for maintaining accreditation, and source of funds for the 1996 and the 2003 studies.
The average year that programs were accredited was 1987 (n = 29), although the range was from 1978 to 2002, and the mode was 1986. This compared to the 1996 average accreditation date reported to be 1985, with a mode of 1990. Thirty-five or 97.2 percent (n = 36) felt they would seek re-accreditation similar to the 64 (97.0 percent) that projected seeking re-accreditation in 1996.
Of the 36 that were accredited at the time of the 2003 survey, 35 (97.2 percent) intended to seek re-accreditation. The remaining institution gave the following reasons for not seeking re-accreditation: being able to provide quality without accreditation and accreditation negatively affected the therapeutic recreation curriculum. In 1996, of those few who planned to not seek re-accreditation, reasons cited included lack of funding (four or 6.06%), being able to provide quality without re-accreditation (three or 4.55%), and accreditation not being valued by the university (two or 3.03%).
Of the 27 programs that were not currently accredited by NRPA/AALR in 2003 but planned to seek it in the next five years, seven (25.9 percent) stated they would seek accreditation for the recreation core, three (11.1 percent) would seek all available options, and four (14.8 percent) specifically would seek the therapeutic recreation option accreditation. Thirteen (48.1 percent) had no plans to seek NRPA/AALR accreditation in any form. Of those 13, nine (33.3 percent) reported they could not meet the accreditation standards, eight (29.5 percent) felt they could attain quality with accreditation, three (11.1 percent) reported that accreditation was not valued by the university, three (11.1 percent) stated faculty did not have the time or resources to complete the self-study, and two (7.4 percent) reported no interest in NRPA/AALR accreditation. Five other answers, such as “small faculty,” were given.
Of those in 1996 that were not currently accredited but planned to seek it within the next five years, 28 (62.1%) reported wanting to accredit the core, and 17 (40.0%) wanted to accredit therapeutic recreation. Only six (14.0%) reported wanting to accredit other options besides therapeutic recreation. Of those not accredited and not wanting to seek accreditation in 1996, the most popular reasons were that: (a) quality can be provided without accreditation (11 or 25.5%); (b) accreditation was not valued or recognized by university (7 or 16.3%); and faculty did not have time or resources to complete the required self-study (5 or 11.6%).
Curriculum Characteristics
The first question in the section on curriculum and course offerings asked about the rationale behind the initiation and revision of the therapeutic recreation curriculum. The respondents were asked about a series of reasons for both initiation and revision that they then rated on a four-point Likert scale (1 = very important to 4 = not important). The top five influences on initiation, as reported in 2003, were (a) input from practitioners (mean of 1.9), (b) faculty skills and preferences (2.0), (c) NCTRC certification standards (2.2), and (d) a tie with NRPA/AALR accreditation standards (2.4) and colleagues at other universities (2.4). This showed a slight difference from the 1996 data when the top live influences on initiation were (a) input from practitioners (mean of 1.9), (b) faculty skills and preferences (2.1), (c) colleagues at other universities, (2.4), (d) NCTRC certification standards (2.4), and student skills and preferences (2.5).
In 2003, the five highest reported influences on curriculum revision included (a) NCTRC certification standards (1.2), (b) input from practitioners (1.6), NRPA/AALR accreditation standards (2.1), (c) faculty skills and preferences (2.1), and NTRS fieldwork standards (2.2). Again, this data showed slight differences from the 1996 data, that included the top five influences of (a) NCTRC certification standards (1.2), (b) input from practitioners (1.7), (c) NRPA/AALR accreditation standards (1.8), (d) faculty skills and preferences (2.1), and (e) colleagues at other universities (2.2).
In both curriculum initiation and revision, input from practitioners has remained very influential. Faculty skills and preferences had greater impact on initiation, while NCTRC certification standards and NRPA/AALR accreditation standards had greater impact on revision. Table 3 displays this data. Least impactful at either initiation or revision were NTRS Field Placement Standards, student skills and preferences, and federal grants/studies.
Therapeutic recreation curricula continue to be modified, with the many schools reporting recent curriculum changes in 2000 (14 or 24.1 percent), 2001 (11 or 19.0 percent), 2001 (10 or 17.2 percent), and 2003 (10 or 17.2 percent). This data may reflect the recent changes in NCTRC standards that impacted therapeutic recreation curricula, as can be noted from the responses to the previous question.
Each institution was asked about the number of hours required in the therapeutic recreation major. The responses had a high degree of fluctuation. The average number of hours required for graduation (n = 59) was 124.4, with a range of 90 to 186, and a mode of 120. This compares favorably with the 1996 data (n = 104), with an average of 129.8 hours, a range of 90 to 192, and a mode of 128. The average number of hours required for general education in 2003 (n = 52) was 44.6 with a range of 12 to 72, and a mode of 45. This compares to a mean of 50.4, a range of 15 to 99, and a mode of 60 in 1996 (n = 96). Respondents were also queried about supportive coursework. In 2003 (n = 52), the average was 21.6 hours, with a range of 1 to 51, and a mode of 18 hours. In 1996 (n = 91) supportive coursework averaged 23.7 hours, with a range of 3 to 60, and a mean of 18 hours. Recreation and leisure coursework (n = 51) averaged 31.2 hours, with a range of 9 to 62, and a mode of 9 hours. In 1996 (n = 101), the average was 32.7, with a range of 3 to 99, and a mode of 36 hours. Therapeutic recreation coursework (n = 56) averaged 23.8 hours in 2003, with a range of 9 to 60, and a mode of 12 hours. This compares to an average of 18.7 hours in 1996, with a range of 9 to 44, and a mode of 9 hours in 1996 (n = 102). Overall, the differences in responses from 1996 to 2003 show a decrease in the number of total graduation hours and general education hours, similar numbers of supportive coursework, a decrease in the number of recreation hours required, and an increase in the number of therapeutic recreation hours required. Table 4 displays this data.
Regarding supportive coursework for undergraduate therapeutic recreation majors, institutions were asked the number of hours required in related disciplines. The top supportive coursework in 2003 were exercise physiology, anatomy, and kinesiology (52), psychology/counseling (51), health education (18), and child life/family studies (14). In 1996, the top supportive coursework areas were psychology/counseling, exercise physiology and anatomy, and health education.
Respondents also were asked about changes to the therapeutic recreation curriculum anticipated in the next five years. The most anticipated changes include (a) the move to on-line courses (20 or 32.3 percent), (b) increased internship requirements (19 or 30.6 percent), (c) more therapeutic recreation courses will be added (18 or 29.0 percent), (d) more assignments will be added to therapeutic recreation courses (14 or 22.6 percent), (e) more supportive coursework will be required (10 or 16.1 percent), and (f) some therapeutic recreation courses will be deleted (10 or 16.1 percent). These represent different anticipated changes than in 1996. In that year, the changes within the therapeutic recreation curriculum anticipated within the next five years included: (a) more therapeutic recreation courses being added (45 or 39.5%); (b) more assignments/requirements being required in therapeutic recreation courses (44 or 38.6%); more requirements in the therapeutic recreation internship (26 or 22.8%); and (d) more supportive coursework would be added (22 or 19.3%). Percentages equal more than one hundred percent due to several schools selecting more than one answer option.
Curriculum Analysis
Faculty were asked to report the number and titles of required and elective undergraduate therapeutic recreation courses. Only undergraduate curricula were studied. These courses were analyzed in two ways: (a) by number of required and elective courses; and (b) content of course titles. The first analysis consisted of grouping university and college curriculum according to the number of required and elective courses. Sixty-five institutions responded to this question.
Table 5 provides a matrix of the number of institutions within a required/elective course framework. For example, there was one school that required one therapeutic recreation course and offered three therapeutic recreation elective courses, and there were eight schools that required three therapeutic recreation courses and no electives. While the table shows great curriculum diversity in terms of required and elective therapeutic recreation coursework, the most consistency exists between those schools requiring three, four, five, six, and seven required therapeutic recreation classes, with no electives in therapeutic recreation content. This is similar to the 1996 data, although a higher proportion of schools required more classes of and offered fewer electives to their therapeutic recreation majors.
The second analysis identified the content of course titles using an adapted version of the NCTRC framework for content courses. Curricula were analyzed by course title, and whether it was required or elective. Again, 65 institutions responded to this question. Table 6 displays the data focusing on course titles. The following narrative combines these two analyses and explains the similarities and differences among curricular offerings in universities across the country.
One or Two Required Courses. Only two schools required two or fewer therapeutic recreation courses; the one school that required one course offered three electives and the school that required two courses, offered four electives. They both required Introduction to Therapeutic Recreation, and one required a Disability/Specialty class; both offered Issues in TR as an elective. Neither of them offered TR Program Planning, Principles of TR, Assessment/Documentation, or Management in TR. These two schools represent a smaller percentage (two out of 65) versus 10 (out of 105) that fit this category in 1996. In both sets of data, unless students were advised to take electives, they would not meet NCTRC certification requirements.
Three Required Courses. Out of eleven schools that required three therapeutic recreation courses, nine offered no electives and two offered one elective. Eight of the schools required Introduction to TR, seven required Principles of TR, four required Issues in TR, three required a Disability/Specialty class, and two required a TR Program Planning class. None offered Leisure Education. This pattern of emphasis on Intro, Principles, a Disability/Specialty, and Issues, with no to little emphasis on TR Program Planning, Assessment/Documentation, Leisure Education, and Management in TR parallels the information from 1996.
Four Required Courses. Eight institutions required four therapeutic recreation classes, with 15 offering no electives, two offering two electives, and three offering one elective. The classes most likely to be required were: Introduction to TR (n = 15), Principles of TR (n = 14), TR Program Planning (n = 11), Assessment/Documentation (n = 7), Issues in TR (n = 6), Leisure Education (n = 6), Disability/Specialty (n = 5), and Management (n = 3). When Introduction, Program Planning, Principles, Assessment/Documentation, and Issues were offered, they were required in all cases. This group of institutions offered few electives and most of the courses they offered were required. Within this group, while Introduction, Principles, and Programming held the top three most frequently required courses, more offered and required Assessment and Leisure Education than in 1996.
Five Required Coursex. Ten schools required five therapeutic recreation courses; five offered no electives, three offered one elective, and two and three electives were offered by one school each. The top required classes were: Leisure Education (n = 9), Introduction to TR (n = 8), Principles of TR (n = 8), Assessment/Documentation (n = 6), Management (n = 6) a Disability/Specialty course (n = 5), and TR Program Planning (n = 4). None of these schools offered an Issues in TR course, either required or elective. Similar patterns were found from 1996 to 2003, although in the 1996 study seven of 22 institutions offered TR Issues courses.
Six Required Courses. Twelve schools required six therapeutic recreation courses; eight required no electives, two offered two electives, and two offered three electives. The top required classes were: Disability/Specialty (n = 10), Introduction (n = 9), Principles (n = 9), Leisure Education (n = 9), TR Programming (n = 8), Issues in TR (n = 6), Management in TR (n = 3), and Assessment/Documentation (n = 2). The pattern of offerings in 2003 mirrors the offerings in 1996, although Leisure Education gained popularity and Assessment remained a very low priority. However, the percentage of schools requiring six therapeutic recreation courses almost doubled from 1996 to 2003 (10 out of 105 compared to 12 out of 65, respectively). As in 1996, the electives of this group were not likely to fit the NCTRC course total categories, and instead, included such courses as Special Topics in TR and Adventure Based Counseling.
Seven or More Required Courses. A much higher percentage of institutions (12 out of 65) fell into this category than in 1996 (11 out of 105). These institutions were very likely to require all of their therapeutic recreation offerings, and their electives carried a wide range of titles from Multicultural Arts and Crafts to Inclusive Community Recreation Therapy. Introduction was required at eleven of the twelve schools, Leisure Education was required at ten, and Programming, Principles, a Disability/Specialty, Assessment Documentation, and Issues courses were each required at eight sites. Management was required at seven. This order was nearly identical in 1996, although for this group Disability courses became more popular and Leisure Education became less popular.
Although analysis is made difficult by the diversity of curricula, the following observations can be made:
* Fewer schools (two out of 65 in 2003 versus 10 out of 105 in 1996) claimed to have a degree/sequence in therapeutic recreation but did not meet minimal NCTRC expectations of three required therapeutic recreation content courses.
* The most common course offered (and always required where offered) was Introduction to Therapeutic Recreation, as it was in 1996;
* The second most common course, Principles of TR, also was always required where offered in 2003, and in 1996 was best represented in institutions that required two, three, six or seven therapeutic recreation courses.
* The third most common course in 2003, Leisure Education/Facilitation Techniques, especially in schools with four or more required courses, was not popular in 1996 except for those schools that required five and seven therapeutic recreation courses. In 2003, Leisure Education was closely followed by TR Program Planning and a Disability/Specialty course, and both also were popular in 1996.
* The least frequently mentioned course was Management of TR, Assessment/Documentation, and Issues. As in 1996, the more courses required by the curricula, the more likely these courses were to be offered and required.
* As in 1996, the greater the number of required therapeutic recreation courses, the more likely the schools were to have courses (sometimes as many as seven) that focused on disability-related information; and
* There was very little uniformity in course offerings, although those universities offering three, four, five, and six required courses seemed to be the most parallel.
Internship Characteristics
Undergraduate internship requirements were another area of wide fluctuation between universities. In 2003, when asked the number of formal internships required of therapeutic recreation majors, the average of responses (n = 63) was 1.8, with a range of one to five, and a mode of one. In 1996, the mean was 1.74 with a range of one to nine, with a mode of one.
The minimal number of weeks required for a senior internship (n = 62) was an average of 13.5, with a range of 10 to 24, and a mode of 12 weeks. In 1996, the average was 12.6 weeks, with a range from ten to 32, and a mode of 10. The average number of weeks has increased slightly as has the modal (most frequent) response.
As reported in 2003, the minimal number of total hours of the senior internship averaged 521.2, with a range of 360 to 640, and a mode of 480 hours. Similarly in 1996, the average minimal number of hours required was 469.6, with a range from 90 to 640, and a mode of 400 hours. As above, the average number of hours increased, as has the modal response.
The vast majority of institutions required the agency supervisor to be NCTRC certified (61 or 96.8 percent), but only 30 (46.2 percent) required the university supervisor to be similarly certified. This echoes statistics from 1996, in which 107 (93.9 percent) required the agency supervisor to be certified, while only 54 (47.4 percent) required the university supervisor to be NCTRC certified.
Schools reviewed a variety of qualifications for approving senior internship sites for therapeutic recreation majors. Of the 62 (96.8 percent) universities that required an approval system, 41 (67.2 percent) required documentation, such as an internship manual, 57 (93.4 percent) required the agency supervisor to be NCTRC certified, 24 (39.3 percent) required the agency show proof of adherence to the NCTRC standards, 20 (32.8 percent) required a visit by faculty, and two (3.3 percent) required a visit by an advisory council member. In 1996, of the 109 institutions reporting an approval system, 100 (91.7%) required the agency to employ CTRSs, 73 (67.0%) required documentation such as an internship manual, 45 (41.3%) required a visit and subsequent approval from the therapeutic recreation faculty, and 38 (34.9%) required an approval form showing adherence to NCTRC standards. While most other requirements stayed in relative proportion, fewer schools required visits by faculty to approve internship agencies.
Many restrictions were placed on senior internships. For example, in 2003, 28 (44.4 percent) of the institutions placed no geographic limit to internship sites, down from 93 (or 81.6 percent) in 1996, suggesting more schools were limiting the distance from campus of the agency site. Only three schools instituted mileage limits (averaging 350 miles), while in 1996, seven instituted limits that averaged 153.9 miles. In 2003, no schools required students to stay in state, while in 1996, four (3.5 percent) schools did so. Neither in 2003 or 1996 did any schools require students to stay within a time limit of the university. Twenty-four (88.9 percent) of schools in 2003 required the student to attain a specific GPA prior to entering the internship.
The majority of schools (59 or 98.4 percent) never had students pay for internship supervision travel and one school (1.7 percent) did when out of state. In 1996, the majority (99 or 86.8%) never had the student pay for internship supervision travel, while three (2.6%) had the student pay all expenses, and five (4.4%) had them pay part of the travel expenses.
At 51 (85.0 percent) of the 60 responding colleges, supervising internships was considered part of the faculty member’s official load. Load weights for internship supervision varied widely. Twenty-three (36.5 percent) of the institutions had one faculty member supervise all interns, regardless of the number per semester, 19 (30.2 percent) had a specific number of interns per .25 FTE load, two (3.2 percent) institutions had a faculty member take a specified number of interns, and two (3.2 percent) distributed interns equally among supervising faculty.
Similar data was recorded in 1996; at 92 (80.7%) of the institutions, the internship supervisor was considered part of the faculty load. With regard to faculty load credit, 48 (42.1%) schools had one faculty supervise all interns regardless of the number per semester, 24 (21.1%) specified a certain number of students per .25 FTE load, and at 11 (9.7%) institutions, each faculty supervised a certain number of interns per semester.
Students were able to complete internships during the summer semester at 57 (90.5 percent), compared with 100 (or 87.7 percent) in 1996. Grading systems for internships included A/B/C/D/F grading at 45 (72.6 percent) of schools and a pass-successful/fail-unsuccessful system at 17 (27.4 percent). More schools have moved to an A/B/C/D/F system since 1996, when it was used by 74 (64.9 percent) of schools. A pass/fail system was utilized at 38 (33.3 percent) of the schools. In 2003, 19 (31.7 percent) of schools allowed students to take other coursework while completing the senior internship, while in 1996, 42 (38.8 percent) did so.
Conclusions
Therapeutic recreation curricula are located at universities that vary widely. Over three-fourths of the respondents were at public institutions (76.9 percent), with an average of 11,638 undergraduates and 3,126 graduate students. These numbers parallel those reported in 1996. Most therapeutic recreation programs were housed in Colleges of HPER(D)/Health (31.7 percent), blended Education (20.6 percent), Education (17.5 percent), or Social Sciences/Allied Health (17.5 percent). Home departments were most likely to be titled Recreation and Leisure (44.4 percent) or HPER(D) (41.3 percent). The overwhelming majority called their degrees/sequences “Therapeutic Recreation” (85.0 percent). All data were similar from 1996, although “Therapeutic Recreation” was the preferred degree title in 95.3 percent of the institutions in 1996. Approximately 72 percent of the programs were sequences or options, with 28.1 percent being degrees or majors. The percentages were 74.6 percent and 23.7 percent, respectively, in 1996.
Most recreation and leisure studies units were small, with an average number of faculty at 4.5 (4.4 in 1996), and the average number of therapeutic recreation faculty was 1.8 (1.7 in 1996). Total number of undergraduates averaged 118.5 (down from 135.7 in 1996) and total graduate students averaged 28.1 (up from 21.9 reported in 1996). The average number of therapeutic recreation undergraduate students was 36.4 (down from 50.7 in 1996), and therapeutic recreation graduate students averaged 11.0 (10.5 in 1996). Both recreation and therapeutic recreation undergraduate numbers were down from 1996. However, therapeutic recreation graduate student numbers remained stable, while recreation graduate students increased slightly.
A slightly lower percentage of programs were accredited in 2003 (57.1%) compared to 60.6% of the reporting programs in 1996. Of the 36 schools reporting accreditation status in the present study, 36 had their core curriculum accredited, while 10 had other options accredited, and 19 had therapeutic recreation accredited. The overall percentages of option accreditation (both for others and therapeutic recreation) were lower than in 1996. The top five reasons for attaining accreditation remained consistent from 1996 to 2003 and included that accreditation: (a) provides indication of quality (97.2 percent), (b) supports the mission of improving curriculum across the university (80.6 percent), (c) helps in student recruiting (80.6 percent), (d) provides a competitive edge over similar departments in the state/region (66.7 percent), and (e) supports the mission of improving curriculum across the country (61.1 percent). Percentages equal more than one hundred percent as many schools selected more than one answer.
For therapeutic recreation curriculum initiation and revision, input from practitioners remained very influential, while faculty skills and preferences having a greater impact on initiation and NCTRC certification and NRPA/AALR accreditation standards had greater impact on revision.
Many differences existed in institutional requirements for the degree program. Overall, the differences in responses from 1996 to 2003 showed a decrease in the number of total graduation hours and general education hours, similar numbers of supportive coursework, a decrease in the number of recreation hours required, and an increase in the number of therapeutic recreation hours required.
This diversity continued within the therapeutic recreation option or major. Fewer schools (two out of 65 in 2003 versus 10 out of 105 in 1996) claimed to have a degree/sequence in therapeutic recreation but did not meet minimal NCTRC expectations of three required therapeutic recreation content courses.
The most common undergraduate course offered (and always required where offered) was Introduction to Therapeutic Recreation, as it was in 1996. The second most common course, Principles of TR, also was always required where offered in 2003, and in 1996 was best represented in institutions that required two, three, six or seven therapeutic recreation courses. The third most common course in 2003, Leisure Education/Facilitation Techniques, especially in schools with four or more required courses, was not popular in 1996 except for those schools that required five and seven therapeutic recreation courses. In 2003, Leisure Education was closely followed by TR Program Planning and a Disability/Specialty course, and both also were popular in 1996. The least frequently mentioned course was Management of TR, Assessment/Documentation, and Issues. As in 1996, the more courses required by the curricula, the more likely these courses were to be offered and required.
As in 1996, the greater the number of required therapeutic recreation courses, the more likely the schools were to have courses (sometimes as many as seven) that focused on disability-related information. There was very little uniformity in course offerings, although those universities offering three, four, five, and six required courses seemed to be the most parallel.
The average number of weeks for a senior undergraduate internship was 13.5, up from 12.6 in 1996. The modal response in 2003 was 12 while in 1996 it was 10 weeks, indicating an overall increase in number of weeks required. Most institutions required the agency supervisor to be NCTRC certified (96.8 percent, up from 93.9 percent in 1996), while not requiring the university supervisor to be certified in 46.2 percent of the 2003 (nearly equivalent to 47.4 percent in 1996).
Recommendations
It remains difficult to extract recommendations from state of the art studies, largely due to many factors that are outside the therapeutic recreation faculty member’s sphere of control, such the college or department in which the program is housed. However, some suggestions are provided because, as in 1996, the state of therapeutic recreation curricula remains problematic due to extreme degrees of variability.
First, in 2003 therapeutic recreation programs were largely housed in one of two types of colleges (colleges of health, physical education and recreation [31.7 percent] and colleges of education blended with some other academic area [20.6 percent]). In 1996, the two most prevalent types of colleges in which TR was housed were education (28.2 percent) and HPER(D)/Health 28.2 percent). In 1996, Recreation and Leisure departments housed 50.0 percent of the TR programs, while this dropped to 44.4 percent in 2003. Conversely, “other” departments (not recreation, not HPERD, not TR) housed only 4.4 percent of the programs in 1996, which increased to 11.1 percent in 2003. In addition, those institutions using “Therapeutic Recreation” as the degree/sequence title decreased from 95.3 percent in 1996 to 85.0 percent in 2003. Whether these changes are significant or affect the therapeutic recreation program in critical ways is unknown. As in 1996, it is recommended that a further study be conducted to determine the impact of these administrative locations on therapeutic recreation faculty and curricula. This recommendation is echoed in 2003.
Second, the change in NRPA/AALR accreditation standards has most likely been the cause of change in therapeutic recreation options being separately accredited. In 1996, 34.9 percent had their TR option accredited while this percent rose to 52.8 in 2003. The top three reasons for seeking and maintaining accreditation remained the same from 1996 to 2003: providing indication of quality, support instructional mission across the university, and helping recruit students. In 2003, accreditation costs seemed more likely to be shared among the department, college, and university than in 1996. Seven of the 27 (25.9 percent) programs not accredited in 2003 reported the intent to seek accreditation in the near future, while 13 (48.1 percent) had no intentions of seeking accreditation. Reasons for both seeking and not seeking accreditation varied among the schools. It is recommended that a more indepth study be conducted concerning the benefit/cost analysis of accreditation, especially for therapeutic recreation graduates whose certification is not tied to program accreditation in any form. As in 1996, it also may be beneficial to NRPA/AALR Council on Accreditation to conduct further research on the nature and characteristics of programs that both intend and never intend to seek accreditation, and then develop a marketing plan accordingly.
The data collected in both studies demonstrated the continuing diversity of therapeutic recreation curricula. This diversity was seen throughout numerous data points, from graduation requirements to therapeutic recreation coursework requirements. In this study, curricula were analyzed through course titles, and required and elective status of courses. It appeared that more programs were requiring more therapeutic recreation courses, moving from requiring three, four, and five courses most frequently, to more offering six and seven courses and as many as eight to eleven in four schools. It also appeared that therapeutic recreation courses were required, with fewer optional or offered as electives. Those courses that were offered were required. The three most frequently required courses were Introduction to TR, Principles of TR, and Leisure Education/Facilitation techniques. The least mentioned courses were Management in TR, Assessment/Documentation, and Issues in TR. The more courses the program offered, the more likely these three courses were to be required.
One recommendation from this data is for more in-depth research to be conducted on the content of the courses, beyond course titles. The diversity of offerings suggests that commonality within course titles may not be assumed. More information is needed here. A second recommendation from this data is that, after more thorough research is completed, a national movement for consensus on curriculum design and internship requirements be initiated by one of the national membership or credentialing organizations (National Therapeutic Recreation Society, American Therapeutic Recreation Association, and/or the National Council for Therapeutic Recreation Certification(TM)). It is believed that no two of the 65 reporting institutions were identical in their therapeutic recreation course titles/offerings. The lack of uniformity is a cause for concern, if not, alarm. If there is no standardization of curricula, then it follows that there is no or little standardization of the degree of “exit skills” for graduates. This recommendation is repeated from the 1996 study.
An increase in the number of internship weeks (average of 13.55 weeks, with a mode of 12 weeks) reflected the change from 10 to 12 weeks required by NCTRC(TM). However, 3.2 percent of schools in 2003 did not require the agency supervisor to be certified, an additional requirement of NCTRC(TM). Although this percent is down from 1996 (when it was 6.0 percent) it still means that students graduating under those conditions are not eligible to sit for the NCTRC(TM) exam. Two schools did not require three therapeutic recreation content courses, also not in compliance with NCTRC(TM) standards. Although these numbers have been reduced since 1996, it remains problematic as it places students at risk for future employment opportunities. It is recommended that the national organizations mentioned above work more diligently to assist those departments/programs that have sub-standard curricula.
Lastly, in-depth research that provides a national view of therapeutic recreation curricula needs to be conducted every five to ten years. Tracking trends is important both for setting and maintaining national standards. Research, such as the present study, provides information that is not available from any other means, and yet so richly describes the current state of affairs. Since higher education is the cornerstone of many professional issues and efforts, it is imperative to track its everchanging status.
References
American Association for Health, Physical Education, and Recreation. (1973). Guidelines for professional preparation programs for personnel involved in physical education and recreation for the handicapped. Washington, D.C.: Author.
Anderson, S. C., Ashton-Shaeffer, C., & Autry, C. E. (2000). Therapeutic recreation education: 1999 survey. Therapeutic Recreation Journal, 34(4), 335-347.
Anderson, S. C., & Leitner, M. J. (1978). Course sequencing in recreation curricula. Therapeutic Recreation Journal, 12(2), 15-20.
Anderson, S. C., & Stewart, M. W. (1980). Therapeutic recreation education: 1979 survey. Therapeutic Recreation Journal, 14(3), 4-10.
Austin, D. R., & Hamilton, E. J. (1992). The future of therapeutic recreation education: In the 1990’s and beyond. In G. Hitzhusen & L. T. Jackson (Eds.), Expanding Horizons in Therapeutic Recreation XIV (pp. 77-104). Columbia, MO: Curators University of Missouri.
Brasile, F. (1992). Professional preparation: Reported needs for a profession in transition. Annual in Therapeutic Recreation, 3, 58-71.
Compton, D. M., & Austin, D. R. (1994/95). Perceptions of therapeutic recreation in higher education. Annual in Therapeutic Recreation, 5, 57-67.
Compton, D., Austin, D., & Yang, H. (2001). A national study of perceptions related to therapeutic recreation faculty and curricula. In G. L. Hitzhusen & L. Thomas (Eds.). Expanding Horizons in Therapeutic Recreation XIX (pp. 49-60). Columbia, MO: Curators University of Missouri.
Comeback, Inc.. (1961). Therapeutic recreation curriculum development conference. New York, NY: Author.
Connolly, P., & Riley, B. (1995/96). Entry level job skills: Reinvestigation of the national job analysis of the practice of therapeutic recreation. Annual in Therapeutic Recreation, 6, 26-37.
Ewell, P. T. (1998). Examining a brave new world: How accreditation might be different. Council for Higher Education Accreditation [On-line]. Available: http://www.chea.org/Events/Usefutness/ 98May/98_05Ewell. html
Kelley, J. D., Robb, G. M., Park, W., & Halberg, K. J. (1976). Therapeutic recreation education: Developing a competency-based entry-level curriculum. Champaign, IL: University of Illinois.
Kinney, T., & Witman, I. (1996). Recommendations for guidelines for curriculum planning in therapeutic recreation for colleges and universities and individual self assessment on competencies for professional practice and career-long learning. Hattiesburg, MS: American Therapeutic Recreation Association.
Kinney, T., & Witman, J. (1997). Guidelines for competency assessment and curriculum planning in therapeutic recreation: A tool for self-evaluation. Hattiesburg, MS: American Therapeutic Recreation Association.
Lindley, D. (1970). Relative importance of college courses in therapeutic recreation. Therapeutic Recreation Journal, 4(10), 8-12.
MacLean, J. R. (1963). Therapeutic recreation curriculums. Recreation in Treatment Centers, 2, 23-29.
Martin, F. W. (1971). Survey of college and university coursework in therapeutic recreation service. Therapeutic Recreation Journal, 5(3), 123-129, 140.
McGhee, S. A. (1987). Professional preparation: Matching competency acquisition with appropriate educational experiences. Therapeutic Recreation Journal, 21(4), 63-73.
McGhee, S. A., & Skalko, T. K. (2001). A pilot study for the validation of entry-level competencies for therapeutic recreation practice. Annual In Therapeutic Recreation, 10, 57-71.
Monroe, J. E., & Connolly, P. (1997/98). Responsive curriculum development in therapeutic recreation: One approach to comprehensive curriculum design. Annual In Therapeutic Recreation, 7, 64-73.
National Recreation and Park Association. (2000). Standards and evaluative criteria for recreation, park resources, and leisure services baccalaureate programs. Alexandria, VA: Author.
Navar, N. H. (2001). Keynote: Thoughts on therapeutic recreation education. In N. J. Stumbo (Ed.). Professional issues in therapeutic recreation on competence and outcomes (pp. 23-35). Champaign, IL: Sagamore.
Oltman, P. K., Norback, J., & Rosenfeld, M. (1989). A national study of the profession of therapeutic recreation specialist. Therapeutic Recreation Journal, 23(2), 48-58.
Parr, M. G. (1997). The core body of knowledge as perceived by therapeutic recreation students vs. leisure services management students. Schale: A Journal of Leisure Studies and Recreation Education, 12, 75-90.
Peterson, C. A., & Connolly, P. (1981). Professional preparation in therapeutic recreation. Therapeutic Recreation Journal, 15(2), 39-45.
Powell, L., & Sable, J. (2001). Professional preparation of allied health practitioners and special educators using a collaborative transdisciplinary approach. Schale: A Journal of Leisure Studies and Recreation Education, 16, 33-48.
Skalko, T. K., & Smith, M. M. (1989). The status of therapeutic recreation in state personnel systems: A national study. Therapeutic Recreation Journal, 23(2), 41-47.
Smith, S. H. (1976). Practitioners’ evaluation of college courses, competencies, and functions in therapeutic recreation. Therapeutic Recreation Journal, 10(4), 152-156.
Stein, T. A. (1970). Therapeutic recreation education: 1969 survey. Therapeutic Recreation Journal, 4(2), 4-7, 25.
Stewart, M. W., & Anderson, S. C. (1990). Therapeutic recreation education: 1989 survey. Therapeutic Recreation Journal, 24(3), 9-19.
Stumbo, N. J. (1986). A definition of entry-level knowledge for therapeutic recreation practice. Therapeutic Recreation Journal, 20(4), 15-30.
Stumbo, N. J. (2001). A national view of therapeutic recreation curriculum: What does it mean for our future? In N. J. Stumbo (Ed.). Professional issues in therapeutic recreation on competence and outcomes (pp. 37-51). Champaign, IL: Sagamore.
Stumbo, N. J., & Carter, M. J. (1999a). National therapeutic recreation curriculum study part A: Accreditation, curriculum, and internship characteristics. Therapeutic Recreation Journal, 33(1), 46-60.
Stumbo, N. J., & Carter, M. J. (1999b). National therapeutic recreation curriculum study part B: University, faculty, student, and placement characteristics. Therapeutic Recreation Journal, 53(3), 241-250.
Stumbo, N. J., & Peterson, C. A. (1987). Therapeutic recreation curricula: Professional preparation and its relationship to the knowledge base. In R. Paulsen & D. Ferguson (Eds.). Proceedings of the Fourth Annual Therapeutic Recreation Research Colloquium, Michigan State University.
Zabriskie, R. B., & McCormick, B. P. (2000). Accreditation and academic quality: A comparison with healthcare accreditation. Schale: A Journal of Leisure Studies and Recreation Education, 15, 31-45.
Norma J. Stumbo, Ph.D., CTRS, Marcia J. Carter, Re.D., CTRS, CLP, and Jin Kim, M.S.
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