An Examination of the Role of Recreational Therapy in Forensic and Correctional Settings

The estimated prevalence of adults, age 18 and older, with serious mental illness (SMI) in the United States is approximately 6% (NIMH, 2022a). Having a mental illness places individuals at higher risk for arrest and incarceration (NAMI, n.d.b) where they receive treatment, including recreational therapy (RT) in state hospitals, jails or prisons. The purpose of this multi-method study was to gain a better understanding of the role of RT in treating adults with SMI in forensic and correctional settings. A non-standardized 122-item cross-sectional survey (n=49) was used to identify what interventions recreational therapists are using, for what intended outcomes; and to identify what recovery principles are being applied in RT practice. Semi-structured interviews (n=10) were used to gain additional insight regarding the lived experience of RT practitioners working with adults with SMI in forensic and correctional settings, including their knowledge of, and application of mental health recovery in RT treatment. Quantitative results indicated that clients’ social and emotional health are addressed most via RT services, using a variety of interventions and facilitation techniques, and six of 10 recovery principles. Qualitative results highlight several facilitators and constraints to RT service delivery in forensic and correctional settings, including factors associated with job title, safety protocols, complex client needs, and use of the APIED process. Study limitations, as well as implications for RT practice and future research are discussed.