Michelle Taylor - TR

Timeline of therapeutic recreation

Timeline of historical events in TR
From antiquity to present times

200-1500 BC The Egyptians described diversion and recreation as a means of treating the sick. (Egyptian Kahun papyrus written approx. 1850 BC)

1000 BC Ancient Persians realized the beneficial effects of physical training and utilized it to fit their youth for military duty.

420 BC The Greeks described diversion and recreation as a means of treating the sick.

400 BC Socrates and 347 BC Plato understood the relationship between physical status and mental health.

359 BC Hippocrates, the father of medicine, recommended that their patients exercise in the gymnasium as a means of recovering from illness.

340 BC Aristotle felt that the "education of the body must precede that of the intellect."

100 BC-4 AD The Roman Asclepiades advocated massage, therapeutic baths, and exercise for improving diseased conditions. He also recommended activity treatment for patients with mental diseases. This included diversions and entertainment, but only the diversional value was recognized.

477-900 The Dark Ages, the mental and physical influences of play were regarded by the Church to be evil. (The first half of the Middle Ages, until the 10th century)

1454-1605 The Renaissance, the mental and physical influences of play are again recognized after Arabic texts are translated into German.

1752 Pennsylvania Hospital is established in Philadelphia. Benjamin Franklin was involved in drafting the petition for its establishment. Inmates were provided with light manual labor such as spinning and carding wool for activity.

1780 Clement Joseph Tissot publishes the book "Gymnastique Medicinale et Churgicale" recommending "prescribed craft and recreational activities as therapeutic exercise for the treatment of disabled muscles and joints following disease or injury."

1786 Phillip Pinel introduced work treatment in the Bicetre Asylum for the Insane near Paris.

1798 Benjamin Rush, M.D., one of the signers of the Declaration of Independence, advocated work as a remedial measure for the treatment of patients in the Pennsylvania Hospital.

1801 Pinel publishes a book "Medical philosophical treatise on mental alienation" describing the method as "prescribed physical exercises and manual occupations." It is the first reference in literature to the medically prescribed use of activity for remediation.

1803 Johann Christian Reil suggested the use of exercise and a special hospital gymnasium along with patient participation in dramatic productions and fine arts, in his book "Rhapsodies on the psychic treatment of the insane." This is evidence of one of the first uses of psychodrama in the treatment of the insane.

1810 Rush, in an address to the Board of the Pennsylvania Hospital, advised that "certain kinds of labor, exercise, and amusements be contrived for them, which should act at the same time, upon their bodies and minds."

1816 Samuel Tuke, an English Quaker, established a Retreat Asylum for the Insane at York, England. He used work or occupation therapy as Pinel did but placed special emphasis on humane treatment or treating of patients as rational beings who have the capability of self-restraint. He called it "moral treatment." "...of all the modes by which patients may be induced to restrain themselves, regular employment is perhaps the most generally efficacious; and those kinds of employment are doubtless to be preferred which are accompanied by considerable bodily action, that are most agreeable to the patient, and which are most opposite to the illusions of his disease. ....every effort should be made to divert the mind of melancholias by bodily exercise, walks, conversations, reading, and other recreations. Those who manage the insane should sedulously endeavor to gain their confidence and esteem, to arrest their attention and fix it on objects opposed to their delusions...and to remember that in the wreck of the intellect the affections not unfrequently survive."

1817 Thomas Scattergood, a Quaker minister who visited Retreat, brought the principles of "occupation and nonrestraint" back to the US, and helped establish the Friends Asylum for the Insane in Philadelphia.

1818 McLean Asylum opens near Boston under the supervision of Rufus Wyman, M.D. He established, and was probably the first physician in the country to supervise, a program of occupational therapy.

1821 Thomas Eddy, New York merchant and member of the Society of Friends, was another visitor impressed by treatment methods at Retreat. He submitted suggestions for the "moral management" of the insane to the Governors of the Lunatic Asylum of the New York Hospital. As a result, Bloomingdale Asylum was opened in New York City and began moral management including "occupational therapy."

1840 F. Leuret wrote a book "On the Moral Treatment of Insanity." He said all psychiatrists recommend diversions and work to prevent the effects of idleness and boredom. He utilized exercise, drama, music, and reading along with manual labor. Nearly synonymous with occupation therapy, it is considered the first book entirely devoted to the subject. (Susan E. Tracy is credited with writing the first book on occupational therapy, titled "Invalid Occupations" in 1910)(Dr. William Rush Davis, Jr. is credited with writing the first recreational therapy text titled "Principles and Practice of Recreational Therapy for the Mentally Ill" in 1936)

1840 Thomas Story Kirkbride, M.D. becomes superintendent of Pennsylvania Hospital, and begins a program of mental care that stressed occupation therapy. He said that the value of occupational therapy cannot be measured in dollars and cents but must be judged in regard to the restoration of comfort to the inmates of the hospital. Crafts, amusements, and hospital occupations were used therapeutically. He helped to organize the Association of Asylum Medical Superintendents, which later became the American Psychiatric Association. Through this association, Kirkbride influenced its members regarding the value of occupation therapy.

1841 The first structure for the Pennsylvania Asylum for the Insane was completed. The facility offered comforts, "humane treatment" philosophy, and mental health treatment programs that set a standard for its day. Unlike other asylums where patients were often kept chained in crowded, unsanitary wards with little if any treatment, patients at the Pennsylvania Asylum resided in private rooms, received medical treatment, worked outdoors and enjoyed recreational activities including lectures and a use of the hospital library. The facility came to be called "Kirkbride's Hospital."

1844 Amariah Brigham, superintendent of the Utica State Hospital in New York advocates the therapeutic value of occupying patients. The idea that only the therapeutic value should be considered in selecting the activity was a new and important advance toward a more scientific use of occupation as therapy.

1854 F1854lorence Nightengale provides recreation to casualties of the Crimean War dubbing her the Mother of Hospital Recreation.

1860-1885 Economic pressures felt in all hospitals during and after the Civil War, busy physicians, lack of public interest and insight, and an underestimation of the therapeutic value of occupation as well as "the real returns as compared to the incidental returns or possible economic proceeds from the treatment," all contributed to the sudden decline and de-emphasis of the allied health therapies for more than 25 years.

1880s The settlement house concept begins in England1889 Hull House, Chicago, IL, founded by Jane Addams and Ellen Gates Starr, provides community services and recreation to the poor.

1892 Dr. Adolf Meyer, a psychiatrist, reported that "the proper use of time in some helpful and gratifying activity appeared to be a fundamental issue in the treatment of the neuropsychiatric patient." He is known for the concept of psychobiology.

1895 William Rush Dunton, Jr., "Father of Occupational Therapy," staff psychiatrist at Sheppard and Enoch Pratt Asylum in Baltimore (SEPA). He fitted a metalworking shop for the treatment of patients. He went on to become editor of "Occupational Therapy and Rehabilitation," and an instructor in psychiatry at Johns Hopkins University, and a President of the AOTA.

1895 Mary Potter Brooks Meyer, (Meyer's wife), a social worker, introduced a systematic type of activity into the wards of a state institution in Worcester, Massachusetts. She was also the first social worker to provide a systematic program to help patients, their families, and the physician.

1903 Dr. Lawrason Brown used occupation therapy to "harden" tuberculosis patients at Trudeau Sanatorium.

1904 Dr. Herbert J. Hall began to prescribe occupation for his patients as medicine to regulate life and direct interest. He called this the "work cure."

1905 Susan E. Tracy, considered the first Occupational Therapist, noticed in her training as a nurse the benefits of occupation in relieving nervous tension and making bedrest more tolerable for patients. Tracy believed that wholesome interests could be substituted for morbid ones and could carry over into the patient's life after discharge from the hospital.

1906 National Recreation Association founded

1906 Hall received a $1,000 grant from Harvard to "assist in the study of the treatment of neurasthenia by progressive and graded manual occupation." He established a workshop in Marblehead, MA, where he used, as a treatment, the crafts of handweaving, woodcarving, metalwork, and pottery "because of their universal appeal and the normalizing effect of suitable manual work."

1906 Tracy, as director of the Training School for Nurses at the Adams Nervine Asylum in Boston, developed the first systematic training course in occupation to prepare instructors for teaching patient activities. She also cautioned that a variety in activity choices must be great in order to meet individual patient requirements.

1908 A. M. Forster opened Eudwood Farm in Towson, MD. The International Congress on TB awarded him their Gold Medal for progressive treatment of tuberculosis patients using activity therapy. He based his work on American philosopher William James' "Tough Minded" concept.

1908 Dunton adds other crafts, and an instructor is engaged to teach patients at SEPA.1908 Hall began a "work as treatment" training program for young women at Devereaux Mansion in Marblehead, MA

1908 Chicago School of Civics and Philanthropy is established at Hull House. Graham Taylor was director of the school, that among others, had classes in occupations and amusements for attendants in public hospitals for the insane. Jane Addams, the director of Hull House, along with Julia Lathrop and Taylor, influenced the development of a number of courses to meet the needs of the community. Attendants learned games, arts, crafts, and hobbies which they could use to "reach" their patients. Dr. Adolf Meyer (a psychiatrist at Kankakee State Hospital) worked with Addams and Lathrop and supported their work for the improvement of the care of the mentally ill in state hospitals in Illinois. Lathrop believed that "occupational treatment was to have a large future in hospital treatment and that this service should be carried on by persons specifically educated for it."

1909 The Society for Mental Hygiene established an occupational department, after recognizing that many persons referred to them needed occupation for therapeutic, economic, and diversional reasons. A workshop was started as an experiment. Follow-up data on clients served, showed the experiment to be so successful that staff members advocated its use with other disabilities. The need for instruction of aides led to the creation of the Henry B. Favill School of Occupations in 1915.

1910 Eleanor Clark Slagle, a social work student at the Chicago School of Civics and Philanthropy, enrolled in Lathrop's first course in "curative occupations and recreations" because of her concern about the detrimental effects of idleness on the patients at Kankakee State Hospital.

1910 Tracy wrote the first book on occupations, "Studies in Invalid Occupations-A Manual for Nurses and Attendants." This was a compilation of Tracy's lectures with an illustrated guide for the use of activities with patients. Primarily a craft book, it also gave methods of teaching and explaining the rationale for the use of specific activities for many patient diagnoses in different types of settings. In her book Tracy describes her concept of occupation by using a quote from John Dewey: "By occupation is not meant any kind of 'busy work' or exercise that may be given to a child to keep him out of mischief or idleness when seated at his desk. By occupation I mean a mode of activity on the part of the child which reproduces or runs parallel to some form of work carried on in the social life...The fundamental point of the psychology of an occupation is that it maintains a balance between the intellectual and the practical phases of experience.

1911 After studying Tracy's book on invalid occupations, Dunton taught a series of classes on "occupation and recreation" for nurses at SEPA.

1911 Following her graduation from Lathrop's course, Slagle conducted a similar course at the State Hospital in Newberry, MI. She then went on to Phipps Psychiatric Clinic in Johns Hopkins Hospital in Baltimore under Meyer where she was the director of the "Occupational Therapy Department," and conducted classes for nurses in "handiwork for the dispensary patients." (Dispensary former term for clinic: a department in a hospital where a person not requiring hospitalization would receive medical care.)

1911 Tracy conducted the first course in occupation at a general hospital, Massachusetts General Hospital Training School for Nurses.

1911 Maryland Psychiatric Quarterly, edited by Dunton from its inception, published articles relating to occupations and amusements. Became the official organ of the NSPOT when founded in 1917.

1912 Dunton is placed in charge of the "occupations and recreation program" at SEPA.

1914 George Edward Barton coins the term "Occupa1914tional Therapy" at a meeting in Boston of hospital workers and the Massachusetts State Board of Insanity. It had been formerly known by many titles such as moral treatment, work treatment, work therapy, occupation treatment, occupation reeducation, and ergotherapy. Barton, an architect became an advocate after a personal experience with treatment of illness. Consequently he organized an institution called Consolation House in Clifton Springs, New York. Barton described the purpose of occupational therapy as "to divert the patient's mind, to exercise some particular set of muscles or a limb, or perhaps merely to relieve the tedium of convalescence." He felt that the fundamental principle upon which occupational therapy rested was "not the making of an object but the making of a man." He defined occupational therapy as "the science of instructing and encouraging the sick in such labours as will involve those energies and activities producing a beneficial therapeutic effect."

1914 Tracy, as Director of the Experiment Station for the Study of Invalid Occupations, Jamaica Plains, MA, wrote a flier describing the occupation course offered. The flier states that: "Each patient is considered in light of his threefold personality-body, mind, and spirit. The aim was to improve the patients physical, educational, and financial well-being. The method was based on three principles: The realization of resources, the ability to initiate activities, and the participation in such activities of both sick and well subjects.

1915 Lake Tomahawk State Camp, WI uses the hardening, activity therapy for its TB patients.

1915 Dunton wrote the first complete textbook on occupational therapy, "Occupational Therapy-A Manual for Nurses." In it Dunton outlines the basic tenets, saying that the primary purpose is "to divert the patient's attention from unpleasant subjects, to keep the patient's train of thought in more healthy channels, to control attention, to secure rest, to train in mental processes by educating hand, eyes, muscles, etc., serve as a safety valve, to provide a new vocation." The largest part of the book deals with simple activities that the nurse could use or adapt to the treatment of patients.

1915 Eleanor Clark Slagle (a graduate of the Chicago School of Civics and Philanthropy) organized the first professional school for occupational therapists, the Henry B. Favill School of Occupations, in Chicago. She served as director from 1915 to 1920. Included in the program were craft activities and preindustrial and vocational work as well as games, folk dancing, gymnastics, and playground activities. The program attempted to create a balance of work, rest, and play for mentally ill patients. The school closed, as many did after the end of Worl War I.

1915 Hall published "The Work of Our Hands-A Study of Occupations for Invalids." He divided invalid occupation into "diversional" occupation for those patients who were incurable, and "remedial" occupation for those patients for whom there was therapeutic and economic value in remedial work.

1917 The US enters WWI, which ended in 1918. The official period of medical emergency was from April 16, 1917 to July 2, 1921.

1917 The Surgeon General's Office forms the Division of Special Hospitals and Physical Reconstruction, employing 2,000 "reconstruction aides" to fill the need for health professionals to rehabilitate the wounded. Practicing in army hospitals, and later in veteran's hospitals, reconstruction aides helped to restore the wounded through the use of indoor and outdoor games, active exercises, passive exercises in the form of massage, muscle reeducation, and hydro, electro, and mechanotherapy.

1917 During a meeting held at Consolation House, the National Society for the Promotion of Occupational Therapy (NSPOT) formed, incorporated, and chartered under the laws of the District of Columbia. Charter members were George E. Barton, Eleanor Clark Slagle, Dr. William Rush Dunton, Jr., Susan C. Johnson (occupational therapist at Montefiore Hospital in New York), Isabel G. Newton (Barton's secretary), and Thomas B. Kidner (vocational secretary of the Military Hospital Commission of Canada). Susan B. Tracy, unable to attend, was elected as an active member and incorporator of the society. Barton became the first president.

1917 NSPOT has its first annual meeting in New York. The theme of presentations were centered on the theme "The Reconstruction of the Mentally and Physically Disabled." Vocational education is proposed by Dunton. Dunton is elected president, a post he held for two years. The Maryland Psychiatric Quarterly becomes their official publishing organ.

1918 The first reconstruction aides go to La Fauche, France, to serve at Base Hospital 117 near the front lines. The Red Cross issued their uniforms (gray coat-suit) and supplies, although they were not a part of that organization. To supplement the supplies, the aides raided trash heaps for metal and wood for the workshop crafts. The unit leader, Mrs. Clyde McDowell Meyers, reflected in the AJOT, 2, 211-212, that "nobody was forced to do anything. That was the principle of the shop. The work was to attract and interest the men and they, through it, were to be drawn back to the normal, away from the horrors that had shaken and broken them; the opportunity for creative self-expression, self-forgetfulness, and then health... To stimulate their interest and make them forget was our object in all the work."

1918 The St. Louis School for Reconstruction Aides opens. It was the first school west of the Mississippi River and remains with Tufts, as one of the only original programs still operating.

1918 The Menninger Clinic opens.

1918 Army Medical Department Bulletin a-329 outlines qualifications and job description for reconstruction aides, as "civilian employees whose province is to teach various forms of simple hand craft to patients in military hospitals and other sanitary formations of the Army, especially to those patients in the orthopedic and surgical wards as well as to the patients suffering from nervous or mental diseases." An undated War Department memorandum authorized a metal "R.A." 1/2 inch in height to be worn on the collar.

1918 Mrs. Howard Mansfield, chair of the committee on War Service Classes, established training for forty-two reconstruction aides at the Lennox School in NY, with the goal of "proving the therapeutic value of activity to our convalescent soldiers and sailors both here and abroad."

1918 First National Recreation Congress is held.

1918-1919 Red Cross publishes "Carry On-a Magazine on the Reconstruction of Disabled Soldiers and Sailors" references to occupational therapy are consistent and positive.

1918 Dunton, at the second annual NSPOT meeting, delivered nine cardinal rules to guide practice. They were expanded by a committee of therapist to fifteen. Out of these principles came the first universal definition of occupational therapy: "A method of treatment by means of instruction and employment in productive occupation." The objectives were "To arouse interest, courage and confidence; to exercise the mind and body in healthy activities; to overcome functional disability; and to re-establish a capacity for industrial and social usefulness."

1919 Dunton wrote "Reconstruction Therapy." It includes the first OT Credo:That occupation is as necessary to life as food and drink. That every human being should have both physical and mental occupation. That all should have occupations which they enjoy, or hobbies. These are the more necessary when the vocation is dull or distasteful. Every individual should have at least two hobbies, one outdoor and one indoor. A greater number will create wider interests, a broader intelligence. That sick minds, bodies, and souls may be healed through occupation.

1919 The St. Louis School for Reconstruction Aides, changed its name to the St. Louis School of Occupational Therapy. Two programs were offered: a three-year diploma course, and a four-year course leading to a B.S. degree in education granted by Washington University through University College.

1919 Dr Sidney Schwab, medical director of Base Hospital 117, speaks enthusiastically of occupational therapy: "A method of treatment that can meet its purpose so surely and definitely as this did would seem to have something of the adaptability of a proven thing, and must be regarded a definite part of the medical organization."

1920 The National Association of Ex-Military Reconstruction Aides is formed. They publish a quarterly magazine titled; "Re-Aides' Post"

1920 Vocational Rehabilitation Act of 2 JUN 1920 (PL113)

1922 First issue of the "Archives of Occupational Therapy" (becomes the official organ of the NSPOT, then the AOTA when founded in 1923), in it Meyer's philosophy of occupational therapy is published. He states, "Our conception of man is that of an organism that maintains and balances itself in the world of reality and actuality by being in active life and active use, i.e. using and living and acting its time in harmony with its own nature and the nature about it. It is the use that we make of ourselves that gives the ultimate stamp to our every organ." He further describes the rhythms of life that must be kept in balance even under difficulty as, work, play, rest, and sleep. Meyer felt that the treatment of the mentally ill must be a blending of work and pleasure that included both recreation and productive activity.

1922-1955 Dr. John Eisele Davis Chief of Corrective Therapy, Physical Medicine and Rehabilitation Service, Veterans Administration Hospital, Perry Point, MD. Founder of the Association of Physical and Mental Rehabilitation, an affiliate of AAHPER. Fellow of the American Physical Education Association.

1923 The NSPOT changes its name to the American Occupational Therapy Association (AOTA) (Archives of Occupational Therapy official organ).

1925 Archives of Occupational Therapy changes name to Occupational Therapy and Rehabilitation (still official organ of AOTA, until 1947)

1926 Recreation Act of 1926-43ss 869-869-3

1926 Potts Memorial Hospital, Livingston, NY uses recreational therapy

1928 Dunton writes "Prescribing Occupational Therapy." Reiss. in 1945 and 1947. 1929 Wall Street crashed

1929 Olive View Sanatorium, CA uses activity therapy

1932 The Menninger Clinic begins "attitude therapy"

1933 Davis begins working for the VAMC in corrective therapy (retires in 1955)(credited with founding the Association of Physical and Medical Rehabilitation)

1934 The Works Progress Administration-Recreation Division funds recreation leaders at institutions.

1934 In order to meet growing demands in the professional field and because increased opportunities were available through the cooperation of Washington University, courses in recreation and group work were included in the curricular requirements. The name of the school was changed to the St. Louis School of Occupational and Recreational Therapy.

1935 Social Security Act establishes a federal program of old-age insurance.

1935 Davis publishes "Recreational Therapy, Play and Mental Health."

1936 Edward Livingston Trudeau's Saranac Lake, NY, Dr. Blanchet founded the Study and Craft Guild for the treatment of patients.

1936 Davis and Dunton collaborate to publish "Principles and Practice of Recreational Therapy" the forward is written by Adolf Meyer, May 3, 1933. Recreational therapy is defined as "any free, voluntary and expressive activity; motor, sensory or mental, vitalized by the expansive play spirit, sustained by deep-rooted pleasurable attitudes and evoked by wholesome emotional release; prescribed by medical authority as an adjuvant in treatment."

1937 US Congress continues funding VAMCs for recreational articles and facilities at institutions.

1938 American Association for Health and Physical Education, adds Recreation to the name, becomes AAHPER 1938 Davis publishes "Recreational Therapy, Play and Mental Health."

1938 The St. Louis School of Recreational and Occupational Therapy's curriculum was evaluated and approved by the AMA. The program currently only offers advanced degrees, and is a school of the Washington University Medical School, reporting directly to the Dean of Medicine.

1939 "Occupational Therapy-A New Profession" Occupations, The Vocational Guidance Magazine, 17:293-298, Jan., 1939, describes AMA approved occupational therapy curriculum with recreational therapy as one of three branches of OT specialization.

1941 Menninger Foundation established by psychiatrist Karl Augustus Menninger (1893-198?). A nonprofit organization dedicated to the furtherance of psychiatric research in Topeka, KS.

1941 AAHPER-News from the Therapeutic Section begins

1942 Karl Menninger "Love Against Hate" chapter 7 about play

1942 American Recreation Society, "recreation worker"

1943 Davis publishes "Principles and Practice of Rehabilitation"

1943 Pending Congressional action, the Red Cross Gray Ladies are cooperating with the Army Medical Corps by providing diversional occupations and recreation to wounded soldiers in Army Hospitals

1943 AAHPER-News from the Therapeutic Section column: "Great nationwide stress is also being placed on rehabilitation of the grossly crippled and handicapped, so that they may be mobilized for constructive service in meeting the manpower shortages in industry and civilian duty, service which is essential to keep our armies in the field." Rehabilitation of war casualties and maximum mobilization of manpower.

1943 Federal Vocational Rehabilitation Act of 6 JUL. 1943 (PL 190) funds physical and vocational restoration, amendment to Vocational Rehabilitation Act of

1920 (PL113) "remunerative occupation"

1945 VA Recreation Service established. The objectives are: "to assist the doctor in getting his patients well, and to make life as satisfying and meaningful as possible for those patients who must remain in the hospital."

1945-1960 Increase in nursing homes

1946-1964 Steep increase in the U.S. birthrate following WWII called the "Baby Boom". 76 Million people are born accounting for nearly one-third of the U.S. population in 1980. The resulting uneven age distribution has had a multitude of social effects on educational systems, job markets, urban and suburban economies and so on, including almost every aspect of contemporary life.

1947 "American Physical and Mental Rehabilitation" APMR

1947 AOTA assumes responsibility of publication of its own organ, The American Journal of Occupational Therapy (current) Occupational Therapy and Rehabilitation continued publishing

1948 American Recreation Society, Hospital Recreation Section

1948 College Recreation Association founded

1950 Dunton and Licht "Occupational Therapy Principles and Practice" ch: 12 Recreational Therapy authored by Davis; Defines RT as: "any free, voluntary and expressive activity; motor, sensory or mental, vitalized by an expansive play spirit, sustained by deep rooted pleasurable attitudes and evoked by wholesome emotional release; prescribed by medical authority as an adjuvant in treatment."

1950 Masters Programs Springfield College; M.S. PE & Rec. in Rehabilitation U of MN; M.S. Hospital Recreation (taught at med school) Columbia U; PE & Rec. in Rehabilitation

1950 The National Association for Music Therapy is founded

1951 JHPER, v22 p13+ N '51 "We Prescribe Recreation"

1951 Esther Goetz Gillian (Ed.) "Music Therapy"

1951 VA "Recreation Service" VA Manual M6-4

1952 Davis writes book "Clinical Applications of Recreational Therapy"

1952 The Department of Physical Medicine, Graclyn Hospital, Winston Salem, N.C. offers the first 12 month Recreational Therapy internships.

1952 Bernath Eugene Phillips announces the creation of the Recreational Therapy Section of the American Association of Health, Physical Education, and Recreation, a branch of the National Education Association. The RTS replaces the Institutional half of the Industrial and Institutional Section.

1953 National Association of Recreational Therapists (NART) is established Feb. 1953, their official publication is the "Inter-State News"

1953 The Council for the Advancement of Hospital Recreation (CAHR) is formed in Feb. 1953 at a meeting held at NEA offices, and was attended by two representatives each of:
('48) American Recreation Society, Hospital Section (2 representatives)(Annabelle Story-ARC)
('52) AAHPER's Recreational Therapy Section (2) (Jack Anderson)
('53) National Association of Recreational Therapists (2)
('53) National Recreation Association's Hospital Consultant (originally 1, later 2)

1953 Sacramento State College offers B.A. in Recreational Therapy; San Francisco State College develops a Hospital Recreation program; New York University starts a Hospital Recreation Graduate program

1954 U of MN offers Hospital Recreation correspondence course

1954 The Revised 1954 Standards for Psychiatric Hospitals and Clinics, published by the APA, describes Activity Therapy as on of the professional services in the mental hospital, and further indicates that it "may be divided into occupational therapy and recreation."

1955 The first educational film on the therapeutic value of recreation for patients (hospital recreation) in the non-government hospitals "Rx for Recreation" (originally So Much for So Little) is a 28 minute color film produced by the NRA. The script was written by Beatrice Hill and Robert Wald, and was directed by Robert Wald, who produced the radio/TV series "American Inventory." The film premiered at the American Hospital Association convention the week of Sep. 20th, and again at the 37th National Recreation Congress.

1955 CAHR publishes the first hospital recreation personnel standards, separating registration into three sections: Hospital Recreation Director, Hospital Recreation Leader, and Hospital Recreation Aide.

1956 A critical shortage of physical therapists seriously impedes the national rehabilitation program. Over 5,800 jobs for qualified physical therapists are available throughout the US.

1956 The Veterans' Administration begins their Student Affiliate Recreation Trainee Program

1957 Bernath Eugene Phillips becomes CAHR's first registered Hospital Recreation Director at their Mar. 18, 1957 meeting in Chicago.

1957 SUNY Cortland offers a master's degree in Hospital Recreatio; San Jose Starts a Hospital Recreation program, and is affiliated with the Palo Alto VA; Texas Women's University offers Recreational Therapy bachelor's degree

1958 U of Iowa offers undergraduate and graduate specialization in Hospital Recreation

1958 NRA Hospital Recreation Consultant becomes Consulting Service on Recreation for the Ill and The Handicapped

1961 UNC-Chapel Hill hosts the 5th Regional Institute on Hospital Recreation. The theme was "Expanding Horizons".

1961 Beatrice Hill resigns after seven years as director of the NRA Consulting Service on Recreation for the Ill and the Handicapped to establish Comeback, Inc. Comeback, Inc. implements methods developed by the Homebound Recreation Demonstration Project, which was funded by the Office of Vocational Rehabilitation and conducted by the NRA. Comeback, Inc. is dedicated to serving the social rehabilitation needs of the ill and handicapped.

1965-present Medicare (Health Insurance for the aged) is added to Social Security benefits, and Medicare starts regulating nursing homes.

1966 The NRA and ARS merge into the National Recreation and Parks Association (NRPA)

1966 On Sunday, October 9, 1966, the NRPA Board of Trustees in session at the Washington-Hilton Hotel, Washington, D.C., approved the Charter and Bylaws of the National Therapeutic Recreation Society and accepted NTRS as a professional branch of NRPA. NTRS takes over the administration of the credentialing program from CAHR.

1967 On January 28, 1967, Hilton Motor Inn, Kansas City, Missouri, the first official meeting of the NTRS Board of Directors was held, and Ira J. Hutchinson was elected president...During the April mid-year meeting, President Hutchinson requested the board accept his resignation as president, so he could accept the NRPA position of "Consultant on Therapeutic Recreation." He also became NTRS Executive Secretary on a part-time basis...First publication of the Therapeutic Recreation Journal.

1969 David C. Park was appointed NRPA Therapeutic Recreation Specialist and NTRS Executive Secretary...The first Registration Board was convened under NTRS.

1971 Dr. Paul Haun, "Recreation: A Medical Viewpoint"

1971 Adoption of "NTRS Standards for Psychiatric Facilities," which were later incorporated into the JCAHO Accreditation Manual for Psychiatric Facilities...NTRS State Section Advisory Council established.

1972 Draft of the first NTRS Code of Ethics was completed...Legislative Action Committee was developed...Competencies for therapeutic recreation specialists were developed.

1973 PL 93-113 Rehabilitation Act of 1973, Section 504

1974 PL 94-142 Education for All Handicapped

1974 NTRS Newsletter was developed.

1975 NTRS Field Placement Guidelines were completed...NTRS 750-Hour Training Program was completed...After David Park’s resignation, Yvonne A. Washington assumed the duties of NTRS Branch Liaison.

1975 Utah Recreation Therapy Licensure Rule goes in effect

1976 A committee was established to develop a philosophical position statement on therapeutic recreation.

1977 White House conference on Handicapped

1977 NTRS Presidential Commission on Assessment of Critical Issues was established.

1977 Dictionary of Occupational Titles 076.124-014 RECREATIONAL THERAPIST: "Plans, organizes, and directs medically approved recreation program for patients in hospitals and other institutions: Directs and organizes such activities as adapted sports, dramatics, social activities, and arts and crafts, regulating content of program in accordance with patients' capabilities, needs, and interest. Prepares reports for patient's physician or treatment team, describing patients' reactions, and symptoms indicative of progress or regression."

1978 NTRS Registration Program was recognized by NRPA as the sole registering body for therapeutic recreation personnel.

1979 Guidelines for Community-Based Recreation Programs for Special Populations, Standards of Practice for Therapeutic Recreation Services, and Guidelines for Administration of Therapeutic Recreation Service in Clinical and Residential Facilities were developed by NTRS.

1980 NTRS conducted a national survey on the status of recreation as a related service in PL 94-142.

1981 National Council for Therapeutic Recreation Certification (NCTRC), formerly NTRS Board of Registration, became a completely autonomous credentialing body, administratively and financially independent from NRPA/NTRS...NTRS published Quality Assurance: Concerns for Therapeutic Recreation and Guidelines for Third-Party Reimbursement...Philosophical Position Statement on Therapeutic Recreation was accepted and endorsed by the membership and the Board of Directors of NTRS...Model Practice Act was developed by NTRS to assist states in addressing licensure...CARF incorporated therapeutic recreation services into their Standards Manual.1981 Designated by the United Nations as the International Year of Disabled Persons Designated by the United Nations as the International Year of Disabled Persons

1982 NTRS Philosophical Position Statement

1984 NTRS established National Therapeutic Recreation Week.

1984 The American Therapeutic Recreation Association (ATRA)

1985 "ATRA Annual" ATRA

1985 NTRS developed a Strategic Plan—at least 85 percent of the objectives were completed.

1987 NTRS published Philosophy of Therapeutic Recreation...NTRS developed a Marketing Committee...NTRS representative invited to attend the JCAHO PTAC meeting for the first time...Policies and Procedures Manual was revised, approved and disseminated to the NTRS Board of Directors...NTRS Regional Directors began to represent their region on NRPA Regional Councils.

1988 The first NTRS Board Retreat was held in Denton, Texas...The following topic areas were discussed: marketing, communications/publications, public policy, professional standards, and the NTRS committee structure. A work plan was developed to address issues within the topic areas...NTRS unveiled its new "logo" at the NRPA Congress.

1988 NCTRC job analysis establishes a unique and coherent body of knowledge

1990 NCTRC and ETS (Educational Testing Service) administer first certification exam.

1990 Revised Standards for Internship in Therapeutic Recreation published...NTRS revised Guidelines for the Administration of Therapeutic Recreation Service was published...After Yvonne Washington’s resignation, Rikki S. Epstein assumed the duties of NTRS Program Manager...A revised Code of Ethics was adopted.

1990 Encyclopedia of Careers and Vocational Guidance, volumes 1 & 2.
Volume 2, page 577: As a form of medical treatment: "Recreational therapists plan, organize, and direct medically approved recreation programs for patients in hospitals and other institutions."
Volume 1, page 417: In the recreation and park service: "Therapeutic recreation staff: The development of classes, sites, and opportunities in recreation for the mentally and physically disabled is a relatively new area in research and development."

1991 Dictionary of Occupational Titles 076.124-014 RECREATIONAL THERAPIST: alternate title: therapeutic recreation worker: "Plans, organizes, and directs medically approved recreation program for patients in hospitals and other institutions: Directs and organizes such activities as sports, dramatics, games, and arts and crafts to assist patients to develop interpersonal relationships, to socialize effectively, and to develop confidence needed to participate in group activities. Regulates content of program in accordance with patients' capabilities, needs and interests. Instructs patients in relaxation techniques, such as deep breathing, concentration, and other activities, to reduce stress and tension. Instructs patients in calisthenics, stretching and limbering exercises, and individual and group sports. Counsels and encourages patients to develop leisure activities. Organizes and coordinates special outings and accompanies patients on outings, such as ball games, sightseeing, or picnics to make patients aware of available recreational resources. Prepares progress charts and periodic reports for medical staff and other members of treatment team, reflecting patients' reactions and evidence of progress or regression. May supervise and conduct in-service training of other staff members, review their assessments and program goals, and consult with them on selected cases. May train groups of volunteers and students in techniques of recreation therapy. May serve as consultant to employers, educational institutions, and community health programs. May prepare and submit requisition for needed supplies."

1991 NTRS initiated a move to enhance the therapeutic recreation profession by establishing Ad Hoc Committees with NCTRC and ATRA...A proposed alternate certification plan was developed by NTRS...The NTRS 750-Hour Training Program for Therapeutic Recreation Assistant was revised.

1992 UT Title 58 Recreational Therapy Practice Act, licensure

1992 NTRS became an Associate Member of CARF and joined the JCAHO Coalition of Rehabilitation Therapy Organizations. Revised Preparing for a Career in Therapeutic Recreation... NTRS developed promotional kits to assist agencies in celebrating National Therapeutic Recreation Week, a national observance sponsored by NTRS.

1993 NTRS adopted a comprehensive Strategic Plan to guide the organization's work...A definition of therapeutic recreation was developed...An NTRS Vision Statement was approved...The NTRS Board approved the Research Proposal Guidelines and Criteria developed by the Research Committee, thereby establishing a program to provide partial funding of research projects which investigate the efficacy of therapeutic recreation services.

1994 NTRS approved Interpretive Guidelines for the Code of Ethics...Promoting Therapeutic Recreation—A Marketing Guide was published...NTRS and NRPA held the first annual National Therapeutic Recreation Professional Development Forum...NTRS focused grassroots advocacy efforts on the need for comprehensive health care reform...NTRS established an Ad Hoc Committee on International Affairs...NTRS completed "Therapeutic Recreation Practitioner Analysis Study."

1995 Western Carolina University is the first institution of higher education to offer B.S. in Recreational Therapy, offering a clinical perspective of recreation, rather than just a therapeutic bent to a recreation degree. WCU defines recreational therapy as the prescribed use of recreational and other activities as treatment interventions to improve the functional living competence of persons with physical, mental, emotional and/or social disadvantages.

1995 NTRS established the NTRS Fred Humphrey Internship Program...NTRS revised Standards of Practice for Therapeutic Recreation Services was published...Impacting Public Policy: An Advocacy Manual for Therapeutic Recreation and Manual for Recreation Therapy in Long-Term Care Facilities were published.

1996 CA Assembly Bill 2853-Recreation Therapy title legislation.

1996 NTRS became a National Organization Patron of the 1996 Atlanta Paralympic Games...NTRS revised its Philosophical Position Statement...APRS and NTRS formed a joint committee on community recreation for people with disabilities...Understanding Financing and Reimbursement Issues was published...Philosophy of Therapeutic Recreation: Ideas and Issues, Volume II was published...Preparing for a Career in Therapeutic Recreation was updated...NRPA/NTRS established a Home Page on the Internet...Joint Task Force on Credentialing established by NTRS and ATRA...NTRS invited by the American Medical Association to include its information on "Preparing for a Career in Therapeutic Recreation" in the AMA’s 1997-1998 edition of Allied Health and Rehabilitation Professions Education Directory.

1997 Revised NTRS Internship Standards and Guidelines for Therapeutic Recreation were published...NTRS invited to participate in the Health Care Financing Administration’s (HCFA) Sharing Innovations in Quality Initiative...First NTRS Edith Ball Scholarship was presented...Revised NTRS Strategic Plan was approved...Position Statement on Inclusion adopted by NTRS...NTRS represented on CARF National Advisory Committee.

1998 NTRS was invited to submit written testimony to the Institute of Medicine’s Committee on Improving Quality in Long Term Care...Revised Manual for Recreation Therapy in Long Term Care and Preparing for a Career in Therapeutic Recreation published...NTRS approved Standards of Practice for Paraprofessinals in Therapeutic Recreation...NTRS and ATRA approved a Resolution and Letter of Agreement to Communicate, Cooperate and Collaborate...NTRS established new committees and task forces in the areas of technology, assistive technology, benefits training, adventure based programming, and therapeutic recreation in the schools...NTRS developed its own website...Consumer At-Large Director position was approved for the NTRS Board of Directors.

1999 NTRS met with the Health Care Financing Administration (HCFA) regarding therapeutic recreation in long term care...NTRS and VSA arts entered into a partnership to collaborate on projects...Joint Task Force on Long Term Care established by NTRS and ATRA...NTRS Resolution on Inclusion was approved by the NRPA National Forum...NTRS received $17,000 in special funds from NRPA for the "Therapeutic Recreation—The Benefits are Endless...™" project.

2000 NTRS developed the "Therapeutic Recreation--The Benefits are Endless...™" training program and materials...Higher Education Work Group established by NTRS and ATRA...NRPA adopts the NTRS Position Statement on Inclusion as an NRPA policy...Revised NTRS Vision Statement was approved...NTRS developed a videotape highlighting the benefits of therapeutic recreation.

2001 State Recognition Options in Therapeutic Recreation: An Educational Resource was published by NTRS and ATRA...NTRS joined the Alliance for Disability Recreation and Sport...Best of Adventure Recreation was published...Joint Task Force on Higher Education was established by NTRS and ATRA.

2003 Nicki Booth was the first person to receive the Edith Ball Scholarship outisde of North America that was also studying therapeutic recreation in a foriegn country.

2005 NTRS testified in formal IDEA hearings across the country.

2006 North Carolina Recreational Therapy Licensure Rule goes in effect

2006 NTRS celebrated its 40th Anniversary.

2007 New Hampshire Recreational Therapy Licensure rule goes in effect

2009 Oklahoma Senate Bill 546, Therapeutic Recreation Practice Act is signed