Evidence-Based Practice in Therapeutic Recreation: An Examination of Clinical Decision-Making in Mental Health


  • Sheri A.P. Steffen "University of British Columbia"
  • Colleen J. Reid Douglas College, University of British Columbia




clinical decision-making, clinical leadership, contextual factors, evidence-based practice, therapeutic recreation


There are repeated calls for evidence-based practice (EBP) in therapeutic recreation (TR) as a means to improve client outcomes, ensure consistency and communication among professionals, create protocols and criteria for client assessments, and increase recreation therapists’ (RTs) research capacity. The purpose of this study was to understand what influences RTs’ clinical decision-making in a mental health setting. A qualitative research approach with ethnographic techniques was used. The study consisted of two phases: journaling and a focus group. A systematic, inductive approach guided analysis of the data from 10 RTs located in different workplaces within one Canadian health region. Findings suggested that while RTs had a common practice philosophy, their use of research evidence in decision-making was limited. A lack of infrastructure supporting service provision including minimal clinical leadership, few opportunities for mentorship, and contextual factors such as limited resources influenced clinical decision-making. Implications for research and practice are provided.

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Author Biographies

Sheri A.P. Steffen, "University of British Columbia"

Sheri Steffen, MRSc, CTRS is a Recreation Therapist working in community mental health within a British Columbia health authority.  She has an interest in community base research design and is member of a research network. Her research interests include clinical decision making and evidence base practice.

Colleen J. Reid, Douglas College, University of British Columbia

Colleen Reid, PhD is on faculty in the Department of Therapeutic Recreation at Douglas College and is an Adjunct Professor at both Simon Fraser University and the University of British Columbia. Her research interests include the social determinants of health, community mental health, gender and women’s health, and community development.





Qualitative Papers