Margie Kron has had patients contact her years after she cared for them to say her work in recreational therapy was their saving grace.

A certified therapeutic recreation specialist at Bethesda Hospital in St. Paul (www.healtheast.org), Kron mainly works with patients who have brain injuries, respiratory failure and mental health issues. She uses recreational activities to help these patients to overcome their physical and cognitive disabilities, focusing on what they enjoyed doing before their injury or illness.

Keeping it real

"The recreational activities that they participate in, they identify as real life and it makes them feel like a human being again," Kron says. "I really focus on what the person likes to do, so it's very individualized to their interests."

For instance, she uses computer games to work on cognitive issues, attention span, alternating attention and problem solving with brain-injury patients who previously enjoyed using computers. With geriatric patients who have cognitive and behavioral issues, Kron will work in groups on reminiscing. "My goals in a group like that would be to have them participate in the group, have the social skills to get along with others and to not have negative behaviors during that group."

Bethesda Hospital, which is an acute, long-term care hospital, requires recreational therapists to be certified by the National Council for Therapeutic Recreation Certification (www.nctrc.org). The state of Minnesota does not require certification or licensure, according to James Wise, a certified therapeutic recreation specialist and professor in the Department of Recreation, Parks and Leisure Services at Minnesota State University, Mankato (www.mnsu.edu).

An education program

Minnesota State Mankato offers a Bachelor of Science degree in Recreation, Parks and Leisure Services with an emphasis on therapeutic recreation, requiring students to take courses in human anatomy and physiology, abnormal psychology, human growth and development, sociology, special education and rehabilitation counseling, among others. For certification, they must complete a clinical internship of at least 480 hours.

Therapists learn to assess patients' strengths and weaknesses and may work closely with other members of a treatment team, including psychiatrists, psychologists, physical and occupational therapists, and speech-language pathologists.

Recreation therapists should have flexibility, empathy, high energy and the ability to engage people who don't feel like participating, Kron says.

Recreation therapists may expect to find work in nursing homes, rehabilitation hospitals, children's hospitals, psychiatric units, corrections and in chemical dependency treatment centers. An aging population means the employment outlook is good locally and nationally, according to Wise. Starting wages range from the high $20,000s to the low $40,000s, he says.