Legislation

Dear health profession stakeholder, patient, member of the public:

Recreation Therapy is a health profession that recognizes the significance of leisure and recreation as integral components of optimal health and well-being of individuals with illnesses and disabling conditions.

Since 1985, the profession of Recreation Therapy has been organized under the Alberta Therapeutic Recreation Association (ATRA). ATRA was a leader in the creation of the Canadian Therapeutic Recreation Association (CTRA) and continues to be the province with the highest number of nationally-registered Recreation Therapists in Canada.

We are leading the process of health self-regulation for Recreation Therapy in Canada with close support by Therapeutic Recreation Ontario (TRO) and British Columbia Therapeutic Recreation Association (BCTRA). We are also closely following the United States, whereby licensure in recreation therapy exists in New Hampshire, North Carolina and Utah.  

Since the mid-1990s, ATRA has been involved in a process of strengthening our Association and working toward self-regulation. We engaged with the public to identify practicing Recreation Therapists throughout the province who were not registered with ATRA, and who may be calling themselves Recreation Therapists but without knowing or practicing our standards of practice or completing continuing competency credits. In response, the title “Recreation Therapist” was deemed the most common term used to define employees working within ATRA’s standards of practice. In addition, more and more health employers across the province are requiring their Recreation Therapists to be registered as professional members of ATRA after becoming aware of the standards and education criteria of ATRA.

In 2004, a letter was sent to 600 stakeholders including colleges and associations of health professions in Alberta, education institutions, health regions, community agencies involved in health and disability and continuing care centres, informing the stakeholders of our future intentions to apply for self-regulation under the Alberta Health and Wellness Health Professions’ Act (HPA) and requesting responses for support or concerns.

In 2005, ATRA members formed the Professional Legislative Issues Committee (PLIC) to specifically address issues related to self-regulation such as discipline, role of registrar, entry to practice, policy development and continued competence.

In 2007, we polled our membership as to whether they support ATRA in applying for self-regulation for Recreation Therapists under the Health Professions’ Act. Out of 203 returned ballots, 185 members agreed with self-regulation under HPA.

ATRA has advanced to become more ‘college-like’ in order to better prepare our membership for self-regulation. We have:

1. Established professional registration requirements based on education (since 1989, revised in 1995, 2006, 2007)
2. Established a Continued Competence (CEU) requirement (since 2001).
3. Established consistent terminology to define the profession and our practice (since 2007)
4. Adopted updated Standards of Practice and Competencies (2005)
5. Established a Competency Profile (2008)

To further prepare for college status and to follow the expectations of good corporate governance, we have:

1. Established a Membership Registration Committee
2. Developed a process and funds for complaints and resolution
3. Determined Entry to Practice and Grandfathering criteria, meeting approval by membership
4. Determined a plan to bridge current practicing professionals, especially those in rural areas who do not currently meet Entry to Practice or Grandfathering

Without self-regulation, ATRA feels there is still an inherent risk to the public for the following reasons:

1. Education
   • Inconsistent education curriculum being approved in Alberta as compared to other provinces and the United States – curriculum does not always match ATRA’s defined common body of knowledge and competency profile, resulting in new graduates applying for jobs as recreation therapists when they do not meet ATRA registration criteria
     
2. Interprofessional, innovative and collaborative health care
   • Increased expectation of interprofessional collaboration in health care and subsequent risk of working with professionals who have unknown competencies
   • Increased referrals from other health professions directly to recreation therapy, indicating an assumption of competence and effectiveness on behalf of the referring source
   • Increased role of recreation therapists as clinical leaders, professional practice leaders, case managers, prime therapists whereby leadership, critical thinking and competence in health care is imperative
   • Integration of role of recreation therapy within health care administration systems particularly through new technology such as Patient Care Information Systems and electronic health record
   • Integration of recreation therapy in innovative treatment facilities and methods of care such as telerehabilitation and multi-disciplinary community health teams
     
3. Patient and treatment complexity
   • Increased complexity, acuity, and frailty of patients, increased secondary conditions and co-morbidities resulting in greater risk to patients from health professionals who are not practicing evidence-based and patient-centred care
   • Treatment by recreation therapists provided in a variety of non-traditional health settings (ex. patient home, community settings) whereby the patient may be treated in isolation from other health professionals and may be more exposed to power differential, unprofessional boundaries, dual relationships and unethical practice
     
4. Standardized treatment and outcome guidelines
   • Increased role in reporting province-wide outcome measures such as MDS indicating reliance on documentation and professional accountability competencies of recreation therapists
   • Integration of recreation therapy role within treatment protocols within province-wide standards such as Alberta Provincial Stroke Strategy, Continuing Care Act indicating treatment is standardized and follow established standards and protocols
     
5. Supervision
   • Difficulty for other health professions to provide adequate supervision to recreation therapists if we remain unregulated as we work in clinical areas throughout the continuum of care, with a mix of health professionals and in leadership positions
   • Increased need for competence of recreation therapists in providing mentoring to students and clinical supervision to new professionals in order to address future workforce shortages and representation of health professionals in both urban and rural settings
     
6. Protection to the public
   • Registration with ATRA remains voluntary, resulting in unidentified recreation therapists continuing to practice across the province with  unknown education and no guarantee of continued competence
   • ATRA has no authority to enforce if recreation therapists are following standards of practice or demonstrating competencies
   • ATRA has no power to determine who or who cannot practice the profession, or remove a licence to practice in the case of inappropriate, ineffective or harmful practice

ATRA requests that stakeholders, patients and the public email our office if you have questions, concerns or statements of support for our self-regulation process.

Sincerely,
ATRA Board of Directors