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My Challenges in Therapeutic Recreation / Recreation Therapy

by Hawke published Jan 11, 2021 09:52 AM, last modified Jan 11, 2021 09:52 AM
As per FB thread discussion.

Thread here:


Heidi Hager
16h ·
Hello! I am curious to hear from anyone who might be in Recreation consulting...what you needed (if anything besides your CTRS) to become a consultant, how you market yourself, target populations, challenges/triumphs, etc. Thank you so much!"


My response...

In the late 1980s and early 90s I worked in nursing, education, and habilitation therapy. I have been working in recreation therapy since 2004. Mostly as "independent consultant", working on project-by-project assignments at different facilities.

I had to get and maintain general liability, errors and omissions, and other insurances as safety nets. I have to carry a minimum of $3M USD total with $1M/incident (MINIMUM!), per self and employee, plus I have $1M+ umbrella coverage for my mobile facilities (wheelchair accessible bus and trailers).

Lots of business stuff to address (created LLC, monthly, quarterly, and annual filings and taxes, payrolls, invoicing, differences between different states, etc.).Most facilities won't accept an independent contractor in RT/TR otherwise.

I have often been brought in to help audit (I also have computer sciences background, and audited SOX, PCI, HIPAA, etc.), recommend, and guide through implementation. In other words, to help them assess, plan, implement, evaluate, document, and re-. :-)

Also, because of my specialized backgrounds in the neurosciences, education, music, and role-playing games (since 1977), brought in for specific skills to provide programs directly to clients, and/or to train other therapeutic recreation professionals on these modalities.

Initially I was only making about $20/hr. As demand grew, by 2014 I was making anywhere from $120 to $250 per hour, but was at 90+ hours per week, between my various projects.I also became sick with a life-threatening lung illness (non-communicable, and possible more vulnerable due to weakened immune system from overworking).

Due to the client overload, I tried to hire people with the skill sets needed, but, after interviewing hundreds of people (after weeding out countless resumes), I could not find anyone that would not require at least many months of additional training.

So I wrapped up my existing client base, stopped taking new clients, and increased my focus on research and training, trying to create the workforce I needed to meet my clients' needs.

This took several more years.

Finally, 2 years ago i was able to hire my first two recreation therapy employees, that I had been training over the prior years. I now have 5 part time employees at my small fledgling business.

Pay for them ranges between $20/hr (absolute beginner without certs), $25 through $35/hr for intermediate without CTRS, and I will pay $35-65/hr for those with intermediate experience and training that also have their CTRS, and up to $120 for experts with a range of certs including CTRS.

An important note, I am a huge advocate for RT/TR, and encouraging people to get the CTRS.

I am periodically presenting and speaking about RT on talk shows, panels, professional conferences, newspapers, magazines, website interviews, etc.

I follow RT/TR guidelines from ATRA and NCTRC, and have helped multiple people study for, and pass, their CTRS exams.

Unfortunately, due to changes in the program paperwork, though I went through all of the courses, thousands of related hours, etc., for the CTRS, I ended up not being eligible to even take the exam due to technicalities in the naming of my interdisciplinary degree and other bureaucratic issues.

I am registered with the state's department of health, and provide services in multiple states, but due to the bureaucracy, I gave up on trying to get the CTRS myself a few years ago.

I have instead been trying to just hire them to work for me, but they need additional training, because our programs are based on more up to date research and evidence-in-practice than they are currently being taught (neurosciences, BCI, and more), which takes at least 4-8 months minimum, to meet our rigorous standards.I currently have half a dozen people training, for free, as volunteers at a non-profit 501(c)3 sister company formed in 2017. This has become, so far, the only talent pool with enough training to meet our client needs.

Ironically I have spoken/presented a number of times since 2014 at multiple state, regional, and national ATRA conferences. I have been the presenter/speaker/instructor providing sessions that were validated by ATRA for CEUs (that I can't get myself) to the participants that are CTRS professionals.

I am also teaching the PBS Network about RT and related topics beginning this February and March, as an independent contractor.

This is one of the many challenges for an independent consultant TRS, compared to the more classical approaches.

Those who have neurodifferences and/or don/t fit within very specific 19th/20th century approaches still governing the TR industry, will likely find things a bit more challenging than their more "standard" cohorts.

The main thing I have seen with consulting in TR, talking to the handful of other independent TR contractors I have met over the years, is that it can be much more lucrative per hour than "regular TR work", but can be feast and famine.

In addition to needing to be exceptional in TR, you also need to have broader skills, be more adaptable, be entrepreneurial, have strong legal acumen, be more of a risk taker (not with the clients, but in taking the chance on your own rather than working as a regular employee), and have good business sense.

Sometimes there is resistance from those facilities and individuals in more classical settings.

All of those I have spoken to, their experiences vary considerably.

Hope that long snapshot is helpful to you Heidi Hager.