The Certified Therapeutic Recreation Specialist

Become the Chief Experience Officer in Long-Term Care

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Residential living communities for seniors, from continuous care retirement communities to assisted living from personal care homes to long-term care facilities share more than an aging population. Each has a unique responsibility to provide for the mental well being of their residents. The activities program is one way to provide for that and the Certified Therapeutic Recreation Specialist is a unique individual specially-trained to administer an effective activities program. Here's how to become a Certified Therapeutic Recreation Specialist.

The challenge first starts with the misconception that activities equal bingo.

The professionals charged with the task of providing fun and worthwhile activities for residents fall into two categories – Certified Therapeutic Recreation Specialists (CTRS) and Activity Professionals Certified that include Activity Directors, Activity Assistant and Activity Consultants Certified (ADC, AAC & ACC). This article will focus on CTRS.

Julie N. Fusco, CTRS, is the Program Service Coordinator for Arden Courts King of Prussia Memory Care Community in Pa. She has a staff of three assistants and is responsible for year-round daily programs for 54 residents.

“As a recreation therapist we use recreation as a means of therapy to improve and/or maintain the highest level of functioning for a person with illness or disability,” Fusco said. “A CTRS can work in residential living facilities; adult day centers…hospitals, schools, sub-acute rehab, behavioral health, substance abuse, jails and/or vocational facilities.”

Nursing homes particularly must adhere to what are called F-Tags. F-Tag 248 states that ”the facility must provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident.”

Every 5 years a CTRS has to recertify and each year during that cycle the CTRS has to submit an Annual Maintenance Application and fee. There are two ways to recertify: 1 is to successfully complete the NCTRC exam (again); and 2 is to obtain 50 hours of Continuing Education Units (CEUs).

You can attend conferences or workshops, take classes for academic credit; be the author, co-author, or editor of a written publication, or be a presenter at a conference to obtain CEUs. Regardless of which way you choose, the title of the course of program must relate to one of the Job Analysis Knowledge Area items for it to be recognized through NCTRC.

For Fusco and CTRS members around the country, each day presents its own challenges. She must plan a variety of activities ranging from spiritual to intellectual, physical to social, as well as meeting sensory, creative and musical needs of a group and the individual members.

Every job also has difficult responsibilities. “The most challenging part is definitely coordinating programs for residents who are declining. (For) those who are becoming more aggressive, less communicative (every day) is very frustrating for them,” Fusco said. “It’s easy to plan programs when residents can still read, write, walk, and talk and are willing to do things. But when they don’t want to (take part in a scheduled program) we have to come up with more creative and fun ways to get people engaged in our programs and that is not always easy.

“You have to have a passion and patience for the people you serve to be in this career. I genuinely love what I do and the people I work with every day,” Fusco said. “You also have to be able to go with the flow and not worry about the small stuff. Every day my schedule changes and I roll with the punches.” Readers may contact Fusco at A ​complete activities program should include a certified professional at its head.

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