WRNMMC, Bethesda, Md.  –   Department of Rehabilitation staff members at Walter Reed recognized National Recreational Therapy (RT) Month, observed during February, with an information table set up in the America Building at the medical center Feb. 14, to inform patients, staff, and visitors about RT and its benefits.

“Recreational therapists are trained clinical providers [who] enhance quality of life through the focus on leisure engagement,” shared Cara Navarro, a certified therapeutic recreation specialist (CTRS) at Walter Reed.

In addition to Navarro, other recreational therapists, or RTs, at Walter Reed include Stephanie Seeley (Outpatient RT), Jennifer Beattie (Inpatient RT), Jennifer Zumwalde (Department of Behavioral Health Outpatient RT), Meghan Campano (RT for the Army Soldier Readiness Unit) and Jahniya Kiliru-Liontree (Outpatient RT).

“We are involved in a patient’s treatment team,” Navarro added. She explained recreational therapists work with patients and their primary care managers to engage in the patients in therapeutic activities to assist in their recovery.

“Recreational therapists at Walter Reed see active-duty service members, retirees, and their family members to develop individualized goals for the patient, such as addressing strength, balance, community reintegration, motivation, or depression,” Navarro explained. “Treatments may occur in-person or virtually, individually or in small group settings, indoors or outdoors, and on or off post. Time needed for sessions vary depending on the location and activity, and the recreational therapist will communicate any additional needs, such as swim attire, or your planner/organizational strategy.”

She added discharge from recreational therapy depends upon when the patient’s treatment goals have been met, transition from one recreational therapy service to another, or the patient being able to demonstrate the ability to manage leisure lifestyle independently with local resources to support a sustained level of functioning.

“At Walter Reed, we are grateful for the Recreational Therapy continuum of care available here. Patients may begin their journey at various points within the healing process and transition recreational therapy services up and down the continuum as needed,” said Navarro.

She shared that being a recreational therapist means providing “a holistic, non-pharmacological, strengths-based approach focusing on the patient and their leisure lifestyle to support positive outcomes in their treatment. It means meeting our patients where they are to support them in accessing a meaningful leisure lifestyle, to be their advocate in the healing process, and to foster and encourage skills to seek resources and connect with clinical and community supports.”

This can involve a variety of intervention modalities including adaptive sports, yoga, games, exercises, and even incorporating creative arts such as crafts, music, dance, and drama among others, to enhance the patient’s motor, locomotion, sensory, cognition, communications, and behavioral skills and abilities.

“Recreational therapy at Walter Reed exists in a variety of levels of care such as while patients are in the hospital, in day treatment programs, in outpatient rehabilitation services, and in community adaptive sports programs,” Navarro added.

“Services are adapted to the level of care that is being provided and may include therapeutic games, leisure skills and education, enhancing coping skills, therapeutic horticulture, community reintegration, animal assisted services, adaptive aquatics, equine assisted learning, and therapeutic use of yoga and other healthy outlets. We work with many of the patients who need assistance with mood, motivation, socialization, leisure exploration, healthy outlets, and wellness planning,” she shared.

Navarro said its rewarding “to hear patients express positive shifts in their moods, improvement in social or physical functioning, improvement in motivation and initiation in activities of interest or seeking out resources and supports, finding meaning and purpose post illness or injury, and sharing stories with others about gains made during recreational therapy programs.”

Mallory Van Fossen, an art therapist and the Arts in Health Program clinical coordinator at the National Intrepid Center of Excellence (NICoE) at Walter Reed, agreed.

“Art therapy is a form of psychotherapy that uses artmaking and the creative process as a means of self-expression and mental health treatment,” Van Fossen explained. “The most rewarding thing that I have encountered in my career is when a patient discovers that art making has provided them with an opportunity to heal that they didn’t know existed. While considering oneself an artist, or ‘good at art’ is not a prerequisite for finding success in art therapy, it is incredibly meaningful when I find out that former patients are able to heal through their own commitment to art making and self-exploration after treatment has ended.”

Van Fossen added that art therapy provides “a visual language allowing participants to identify, express, and resolve thoughts and emotions for which words alone cannot adequately describe.” She shared that NICoE offers two unique opportunities for patients to engage in art therapy and express themselves creatively.

“The first is through participation in the clinical art therapy program, which aims to address and treat symptoms related to mental health and traumatic brain injury. The second is through the Arts in Health program, which provides multiple opportunities to participate in the arts as an ongoing support for maintaining health and wellness outside of a clinical setting.”

The use of therapeutic recreation in the healing process has been traced back to the 1850s with Florence Nightingale, recognized as the founder of modern nursing. She was one of the first advocates for using recreation to help benefit people with health challenges. While caring for wounded soldiers during the Crimean War, she wrote of the benefits of having patients participate in activities such as caring for pets, needlework and listening to music. Nightingale advocated for more holistic treatments, established a recreation room and developed various recreation programs based on patients’ levels of functioning rather than relying solely on administering drugs or performing surgery.