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Major · Health Professions

Therapeutic Recreation a bachelor's-to-CTRS clinical credential

Therapeutic Recreation/Recreational Therapy (CIP 51.2309) is a clinical bachelor's that prepares students for the NCTRC CTRS credential, the gate to practice in hospitals, psychiatric facilities, SNFs, VA hospitals, and schools. About 628 students complete it across 55 institutions, and the bachelor's-plus-internship-plus-CTRS-exam path is the standard route into the field.

Schools offering
55
Annual completions
628
Typical degree level
Associate's + Bachelor's
Median earnings (5yr)
$56k

About this major

Therapeutic Recreation/Recreational Therapy (CIP 51.2309) is a clinical bachelor's-level major that prepares students to plan and direct purposeful recreational interventions for people who are physically, mentally, or emotionally disabled. CIP coursework spans foundations of therapeutic recreation, leisure education and counseling, program planning, anatomy and physiology, abnormal psychology, human growth and development, patient observation and evaluation, special-needs populations, and professional standards and ethics. The credentialing path runs through NCTRC: a qualifying bachelor's, the required course content, a supervised internship of roughly 14 weeks (560 hours) under a CTRS preceptor, and the CTRS certification exam. Five states (NC, NJ, NH, OK, UT) add state-level licensure or certification on top; the rest rely on the NCTRC credential.

The major fits students drawn to clinical care that uses recreation, leisure, sports, and the arts as the therapeutic vehicle — comfortable in hospital, SNF, psychiatric, and VA settings; willing to work alongside PT, OT, speech, and behavioral-health teams on shared rehab and discharge goals; and willing to commit to the internship and exam path. It rewards good interpersonal skills, comfort with documentation and treatment planning, and a steady stomach for behavioral-health and end-of-life caseloads. About 628 students complete it across 55 institutions, with bachelor's the standard credential — the small associate's cohort represents specific community-college programs feeding into bachelor's completion.

One grounded observation about the credential and pay picture: this is one of the few clinical health-professions majors that's a real bachelor's-level entry point to licensed practice — unlike OT (51.2306, master's or doctoral required) or PT (51.2308, DPT required). Bachelor's-tracked five-year wages run $57,783, and the named BLS occupation (recreational therapists, $60,280 median, 3.3% growth) maps directly. Hospital rehab units, SNFs, psychiatric facilities, VA hospitals, and special-needs school settings are the typical first jobs. Pay does not scale dramatically the way PT does, but the credential is achievable in four years and admits to genuine clinical practice. North Carolina is unusually deep (ECU, UNCW, Winston-Salem State all in the top 10) — a state-licensure jurisdiction with stronger employer demand — and Pittsburgh-area, Wisconsin, and Pennsylvania programs are longstanding pipelines.

Section 3 · Careers

Where this major leads

Occupations most often associated with this major, from the federal BLS+O*NET crosswalk. Job-growth projections and median wages are national.

Occupation Median wage Job growth Typical education
Health specialties teachers, postsecondary $106k +17.3% Doctoral or professional degree
Recreational therapists $60k +3.3% Bachelor's degree
Section 4 · Earnings

Earnings at a glance

Median graduate earnings from the federal College Scorecard, 5 and 10 years out.

Median 5-year earnings

$56k

Associate's vs Bachelor's — early-career earnings

Associate's

$46k

Bachelor's

$58k

Who this major is for

You may thrive here if you're drawn to clinical health work but want recreation, leisure, sports, or the arts as your therapeutic medium rather than range-of-motion exercises or activities of daily living, you're comfortable in psychiatric, SNF, hospital-rehab, or VA settings and can hold steady under behavioral-health and end-of-life caseloads, you want a bachelor's-level clinical credential rather than committing to a master's or doctorate (CTRS is achievable in four years plus the ~14-week internship), you're willing to choose a COAPRT-accredited program with established internship networks, and you're realistic that pay sits in the $55K-$70K range rather than the $90K-$100K of PT or OT.

Think twice if you're looking for community-recreation programming work without the clinical/therapeutic frame — that's Parks, Recreation, Leisure Studies (CIP 31.0101), not this. Reconsider if your real career interest is being a physical or occupational therapist; both require graduate degrees and the bachelor's-only path leads only as far as a PT or OT aide role at $35K-$40K, while Therapeutic Recreation gives you a CTRS-credentialed clinical job at the bachelor's level. Pause if your home state isn't on the completions list (only 55 institutions offer this) and the closest program would mean out-of-state tuition — Exercise Science or Parks-and-Recreation programs are more widely available, and a few schools allow a Recreation Administration major with a Therapeutic Recreation concentration that still satisfies CTRS-eligibility coursework. Also reconsider if you can't commit to the supervised internship requirement; the 14-week, 560-hour CTRS-preceptor internship is non-negotiable for the credential, and skipping or shortening it blocks you from sitting for the exam.

Section 6 · Where to study

Top colleges for Therapeutic Recreation/Recreational Therapy

Ranked by annual completions at the associate's or bachelor's level — a proxy for program scale.

College Location Assoc. Bach. Total
CUNY Lehman College Bronx, NY 0 38 38
Grand Valley State University Allendale, MI 0 37 37
East Carolina University Greenville, NC 0 36 36
Brigham Young University-Idaho Rexburg, ID 0 36 36
University of Wisconsin-La Crosse La Crosse, WI 0 35 35
Southern University and A & M College Baton Rouge, LA 0 30 30
University of North Carolina Wilmington Wilmington, NC 0 28 28
Winston-Salem State University Winston-Salem, NC 0 28 28
Slippery Rock University of Pennsylvania Slippery Rock, PA 0 27 27
Kean University Union, NJ 0 24 24
Section 7 · Explore sideways

Related majors to explore

Rehabilitation Science

843 completions/yr

Occupational Therapy/Therapist

501 completions/yr

Music Therapy/Therapist

451 completions/yr

Massage Therapy/Therapeutic Massage

402 completions/yr

Rehabilitation and Therapeutic Professions, Other

374 completions/yr

Physical Therapy/Therapist

255 completions/yr

Art Therapy/Therapist

195 completions/yr

Vocational Rehabilitation Counseling/Counselor

155 completions/yr

Considering this direction?

We've taken a hard look at the debt, earnings trajectory, and degree-level tradeoffs for the Therapeutic Recreation/Recreational Therapy field. Read our verdict before you commit.

Is Therapeutic Recreation/Recreational Therapy worth it? Read verdict
Section 9 · Frequently asked

Common questions

What's the credential gate — is this a licensed field?
The national credential is the CTRS (Certified Therapeutic Recreation Specialist) issued by NCTRC. Most clinical employers require CTRS — hospitals, psychiatric facilities, SNFs, and VA settings will not hire without it. To sit for the CTRS exam you need a bachelor's with specific course content (anatomy/physiology, abnormal psychology, human development, therapeutic recreation theory and process), plus a supervised internship of roughly 14 weeks (560 hours) under a CTRS preceptor. A handful of states regulate the field at the state level (North Carolina, New Jersey, New Hampshire, Oklahoma, and Utah have state licensure or certification), and the rest rely on NCTRC's national credential.
Where do CTRS-credentialed graduates actually work?
The named BLS occupation, recreational therapists ($60,280 median, 3.3% projected growth), maps directly to this CIP. Common settings: hospital inpatient rehab units (working alongside PT, OT, and speech), inpatient and outpatient psychiatric facilities, skilled nursing and long-term-care facilities, VA hospitals (a meaningful pipeline given veteran behavioral-health needs), schools serving students with special needs (often inclusion-model recreation programming), community mental-health programs, and adaptive-recreation positions in parks-and-recreation departments. SNF and behavioral-health caseloads are the largest pools; VA work is a steady federal track with GS-pay-scale benefits.
How is this different from Parks and Recreation, OT, or PT?
Three sibling distinctions matter. Parks, Recreation, Leisure Studies (CIP 31.0101) trains community-recreation programmers — no clinical or therapeutic credential, no CTRS pathway. Occupational Therapy (CIP 51.2306) is a master's or doctoral entry-level field (MOT or OTD) and licensed differently — OTs earn far more but the credential ceiling is graduate-only. Physical Therapy (CIP 51.2308) requires a DPT and is also graduate-only. Recreational therapy is its own complementary discipline that uses purposeful recreation (sports, arts, community reintegration, leisure education) as the therapeutic modality, often working on the same rehab team as PT and OT but addressing goals around quality of life, leisure functioning, and community participation rather than range of motion or activities of daily living.
Does program accreditation matter?
Yes — choose a COAPRT-accredited program (Council on Accreditation of Parks, Recreation, Tourism and Related Professions) when possible. NCTRC accepts graduates from non-accredited programs if coursework meets the academic-eligibility requirements, but COAPRT accreditation gives you a built-in guarantee that the curriculum, faculty credentials, and internship structure satisfy the path to CTRS. The university programs at the top of the completions list — East Carolina, Grand Valley State, Wisconsin-La Crosse, Slippery Rock, and UNC Wilmington — are long-running COAPRT-accredited programs with established hospital and SNF internship networks.
What's the realistic pay picture — is the bachelor's-only path viable?
Yes — unlike PT and OT, this is a true bachelor's-level clinical credential. The five-year tracked wage runs $57,783 for bachelor's graduates and $46,466 for the small associate's cohort (only a few schools offer it; the bachelor's is the standard credential). The BLS recreational-therapist median is $60,280 with 3.3% projected growth — modest but steady, driven by aging populations needing rehab and SNF services and by behavioral-health expansion. VA federal positions sit on the GS scale (typically GS-9 to GS-11 entry, $55K-$80K range depending on locality) with strong benefits. Pay does not scale dramatically with experience the way PT or OT does, and supervisor or director roles in larger SNF chains and hospital systems sit in the $70K-$85K range.
Where is this major actually offered, and who leads it?
About 55 institutions produce 628 bachelor's completions per year — concentrated rather than thinly spread. CUNY Lehman College (38), Grand Valley State (37), East Carolina University (36), and BYU-Idaho (36) lead the list, with Wisconsin-La Crosse (35), Southern University (30), UNC Wilmington (28), Winston-Salem State (28), Slippery Rock (27), and Kean (24) rounding out the top tier. North Carolina is unusually deep (ECU, UNCW, Winston-Salem State all in the top 10) — partly because NC is a state-licensed jurisdiction with employer demand. If your home state isn't represented, plan on either an out-of-state public-research program or check whether your nearest parks-and-recreation department offers a related undergraduate path through its college's recreation administration program with the right CTRS-eligible coursework.