How Has Therapeutic Recreation Supported Adults Living with Complex Disabilities?: A Scoping Review on Recreation Therapy Practices across Service Settings

Abstract

Persons living with complex disabilities may require support with activities of daily living to support their health and well-being, and leisure engagement is no exception. Recreation therapists can support individuals living with complex disabilities to live a higher quality of life. Unfortunately, there is limited understanding regarding the role of recreation therapy (RecT) in the care of individuals living with complex disabilities due to individualized client needs and the wide range of possible supports within the RecT scope of practice. This scoping review aimed to provide a comprehensive overview of the role of RecT with individuals living with complex disabilities across a variety of service settings. We searched seven electronic databases for articles that described the role of RecT in the care of people with complex disabilities since 2006. Two reviewers conducted title, abstract, and full-text screening, as well as forward, backward, and reference list citation searches. We analysed the findings using a narrative synthesis approach due to the heterogeneity of the included articles. Searches yielded 15 articles that met the inclusion criteria. These articles described RecT services across different settings (e.g., no defined setting, living with family or in group home, or living in institution/facility). A CTRS or CTRS/L was identified in one-third of the articles, while other articles described the presence of a therapeutic recreation specialist/professional or recreation therapist. One-third of the articles reported the use of one or more formal or standardized assessments. Nine articles reported a specific intervention, with the most common intervention type being related to fitness and sport (6 articles). Nine articles also reported patient/client outcomes, including outcomes related to emotional wellness (6 articles), physical health (5 articles), social outcomes (4 articles), autonomy and independence (3 articles), and community integration or inclusion (2 articles). This review discusses the role of RecT in supporting persons with complex disabilities. There is a need to explore and expand RecT delivery options to support people living with complex disabilities. While there seems to be evidence on the benefits of RecT for this population, there is limited literature available in some service settings (e.g., group home settings) which should be explored in future studies.