Reclaiming Teen Recovery: Tailored Therapeutic Recreation To Boost Engagement, Satisfaction, and Participation

Purpose: This QI project evaluated the impact of four tailored group therapeutic recreation modules on six recovery outcomes: satisfaction, engagement belief, participation likelihood, motivation to seek help, perceived usefulness, and perceived importance, among adolescents at a residential treatment facility in Houston, TX, targeting ≥ 20% improvement in each domain. Background: Adolescents in short-term, often court-mandated, treatment lack personalized leisure activities that promote emotional expression and resilience. Structured leisure engagement is linked to positive affect and treatment motivation, yet interest-based programs for court-involved youth remain underexplored. Methodology: Using Plan-Do-Study-Act cycles and Self-Determination Theory, weekly 90-minute modules (mindfulness trivia, art Jeopardy, music trivia, kickball) ran over four weeks. Of 29 enrollees, 25 began the intervention; five briefly attended a conflicting activity in Week 2 but returned to finish. Baseline and post-session bipolar Likert surveys measured each domain. Process metrics included attendance logs, mixed-method opt-out tracking, staff focus groups, and safety-incident reports. After funding was rescinded, incentives were personally covered to preserve voluntary participation. Results: All six domains improved by >20%. Satisfaction rose from 55.2% to 89%, engagement belief from 58.6% to 92%, participation likelihood from 41.4% to 89%, motivation from 41.3% to 76%, perceived importance from 62.1% to 83%, and perceived usefulness averaged 88%. Implications: Co-designed, autonomy-supportive recreation can substantially boost recovery engagement in mandated settings. Embedding these modules into standard programming, securing dedicated incentive funding, and using suggestion-box feedback will sustain gains. Future work should assess scalability, cost-effectiveness, and durability at 3- and 6-month follow-ups.