Creation of the National Council for Therapeutic Recreation Certification, Inc.
Marcia Jean Carter, ReD, CPRP, CTRS, FALS, FDRT
Chair NCTRC 1981-1985

Foundations of the National Council for Therapeutic Recreation Certification, Inc.

The Council for the Advancement of Hospital Recreation (CAHR) in 1956 put forth a National Voluntary Registration Plan for Hospital Recreation Personnel. Applications, transcripts with verification of the information and a $10.00 registration fee were submitted to the Registration Board for review. An Appeals process was also established. In 1957, 68 individuals were the first to be registered as either Hospital Recreation Director, Hospital Recreation Leader, or Hospital Recreation Aide. The CAHR plan in October 1968 became the National Therapeutic Recreation Society (NTRS) Voluntary Registration Plan. The first Registration Board convened in 1969 with the Executive Committee of NTRS serving as the Appeals Committee. Two more registration levels were added with title changes to more inclusive terminology of therapeutic recreation from hospital recreation; eventually there were six levels of registration with several categories of criteria in each. Each level was distinguished by various degrees of training and academic degrees with the lowest the Therapeutic Recreation Assistant requiring 200 clock hours of training in therapeutic recreation while the highest registration level “Master Therapeutic Recreation Specialist” required a Baccalaureate degree from an accredited college, graduate credit, and work experience or a Master’s degree from an accredited college with a major or emphasis in therapeutic recreation and two years of work experience. The initial cost under NTRS was $25.00 membership to NTRS, a $10.00 registration application fee, and $2.00 renewal fee every two years (without evidence of continuing education).

The profession recognized the need to systematically address credentialing in the late 1970s. An initial survey of the NTRS membership found the registration plan did not meet the needs of the profession. The NTRS Registration Board surveyed professionals to determine the status of the voluntary registration plan as a regulatory plan; and reviewed private, state, and federal health care agency documents including job descriptions to determine the credentialing criteria of these bodies. While respondents did indicate NTRS registration was encouraged for employment and in some instances was identified as a prerequisite, at least 50 different job titles were noted as being assigned to therapeutic recreation. At a 1979 meeting convened as a result of the President’s Commission for the Assessment of Critical Issues constituted by President Robb in 1977, a panel presented their research and investigative efforts on credentialing. Topics included, development of a national exam, transitions from registration to certification standards, continuing (education) professional development, and philosophical issues surrounding credentialing. As a result of these efforts, a recommendation was made to further study the administrative and fiscal independence of a certification program for therapeutic recreation personnel using the guidelines of the National Commission for Health Certifying Agencies (NCHCA) (now National Commission for Certifying Agencies (NCCA).

Creation of the National Council for Therapeutic Recreation Certification, Inc.

A January 1980 meeting with representatives from NTRS, the National Park and Recreation Association (NRPA), the National Commission for Health Certifying Agencies and the Manpower Utilization Branch (an entity within the former U.S. Department of Health, Education and Welfare) explored certification requirements of these bodies.  In February 1980, the NTRS Board of Directors adopted the concept that administrative independence was necessary for the continued growth of credentialing. A second proposal the Directors accepted from the Registration Board called for a two-level plan with Professional and Paraprofessional certification—this proposed plan followed a survey of the registrants and NTRS members. Also supported was the requirement of two continuing education units (CEUs)each two-year renewal period for both the professional and para-professional levels. Two documents were drafted and shared with NRPA on October 20, 1980.The intent was to create an independent body outside of the governance of both NRPA and NTRS; the documents were a “Proposal for the Creation of an Administratively Independent Council for Therapeutic Recreation Certification (NCTRC)” and the “By-Laws” for the Council. While formalizing the criteria for  the two-level certification plan, the NTRS Registration Board also reviewed materials from six allied health credentialing programs and studied state credentialing programs for occupational and physical therapists and licensed practical and registered nurses through materials collected from the Council of State Governments, Lexington, Ky. Materials documented fee structures, plan content, examination and renewal requirements, and the operation of continuing education programs. NCHCA documents outlined the developmental stages of association credentialing programs.

Newly installed NTRS President Peterson appointed me to Chair the Certification Council Interim Committee (October, 1980)—Peterson directed the NTRS Registration Board to revise the formation documents in order to sustain the continuity and integrity of the credentialing process. As Chair of the NTRS Registration Board, I and the Board had drafted the Council formation documents and conducted the surveys and investigations of the membership, allied health professions, and regulatory agencies. The NTRS Board of Directors on February 13, 1981 accepted revised documents and forwarded them to the NRPA Trustee Constitution and By-Laws Committee which advanced the By-Laws for NCTRC to the NRPA Board of Trustees for approval, May 22, 1981. The Interim Committee was dissolved. Authority for the operation of the NTRS Registration Board was transferred to the Certification Review Board of NCTRC; the Certification Review Board and past NTRS presidents assumed responsibility for the Council until October, 1981. While NTRS and NRPA were receiving the By-Laws, legal council guided the preparation of Memorandum of Agreement (MOA) between NRPA and NCTRC, as the NTRS Registration Board was incorporated under the auspices of NRPA with operational procedures and funds managed by NRPA. Therefore, a transfer of financial resources and policies was required and desired by first official meeting of the Council, October 29, 1981.

Chair of the National Council for Therapeutic Recreation Certification, Inc., 1981-1985

After receiving approval in May, 1981 to independently administer certification, at the summer Certification Review Board meeting two-level plan standards were finalized, potential initial NCTRC Board members were identified, and standards of The American National Standard Institute (ANSI) and International Accreditors for Continuing Education and Training (IACET) were accepted as guidelines to administer CEUs in the two-level certification plan. The packet received for the October, 29,1981 by the Board included the Council By-Laws, the Certification Review Board and Continuing Professional Development Review Board By-Laws, the two-level certification plan-effective October 15, 1981 and a CEU operational document. Tasks during and following the Minneapolis meeting besides election of officers were the establishment of standing committees (Finance, Nomination, Appeals, Test Development and Research, and Procedures Manual), development of a strategic plan, design of a Council newsletter, and continued revisions and updating of the MOA to articulate Council autonomy, eventually signed in October, 1982 by NRPA. During the initial years of Council operation, focus was on developing an operating budget, preparing a national registry (printed July, 1983), communicating and meeting with peer credentialing bodies, securing fiscal and managerial autonomy from NRPA, and exploring test development and administration (Test Development and Research Committee was renamed the Test Management Committee) that included establishing liaisons and meetings with testing companies. Ultimately the goal was to become an independent non-profit organization with the mission of protecting the consumer through the provision of services by qualified professionals.

Tax-exempt Non-Profit Incorporation

One of the initial moves to achieve independence was to hold an election with voting by the currently certified members. This occurred in the fall of 1983. With legal advice, when the NRPA and NTRS board member terms expired their positions were no longer filled. Thus, fall of 1984 the Council board consisted of three professional level and two paraprofessional level members, and a consumer and an employer representative. The professional organizations were invited to create liaisons with the Council. While managerial autonomy was effective October 1, 1981, fiscal autonomy was effected July 1, 1984.  This involved numerous revisions and addendums over a three-year period to the MOA originally signed in October of 1982 with NRPA. Funds were redirected from the NRPA general fund to the “NTRS Registration Fund” with management by the Council commencing FY 1984. During this period with legal support, the Council investigated a preferred name for the Council and its primary credential through trademark clearance searches in Austin, Tx and Washington DC—RT was evidenced by Rehabilitation, Restorative, and Respiratory Therapists, leaving TR as the choice for a tax-exempt non-profit body to incorporate. On July 1, 1984 a mailing was sent to all certified members requesting their proxy vote on the articles of incorporation of NCTRC, Inc. An October 1984 meeting of the Council approved the constitution and by-laws and an open forum was held with certificants to explain the need for their vote and the anticipated criteria for future certificants (passage of an exam and CEUs to maintain the credential)—in April, 1985 after two additional mailings and phone calls, the necessary number of votes were realized. The legal papers were filed in May 1985 in Austin and I presented the official recognition documents to the NCTRC Board of Directors in Dallas, October, 1985. This allowed us to trademark the organization title and credential, hire professional staff, develop and manage an exam process and constitute a continuing professional development program communicating with certified professionals independent of professional membership organizations.


Bullock, C. C., & Carter, M.J. (1981). Status report: Continuing professional development program for therapeutic recreation. Therapeutic Recreation Journal, (15)2, 46-49.

Carter, M. J. (1981). Registration of therapeutic recreators: Standards from 1956 to present. Therapeutic Recreation Journal, (15)2, 17-22.

Carter, M. J. (1983). Therapeutic recreation credentialing: Its history, issues, and future. Therapeutic Recreation Personnel Registry, pp. 1-9. Alexandria, VA: National Council for Therapeutic Recreation Certification.

Carter, M. J., & Folkerth, J. E. (1989). The evolution of the National Council for Therapeutic Recreation Certification, Inc. In D. M. Compton (Ed.), Issues in therapeutic recreation: A profession in transition (pp. 505-510). Sagamore Publishing.

Folkerth, J. (1986). Certification—historical perspectives, the first thirty years 19[4]56-1986. In G. S. O’Morrow. National Therapeutic Recreation Society: The first twenty years 19[4]66-1986 (pp. 50-59). National Therapeutic Recreation Society.

National Council for Therapeutic Recreation Certification. (2006). 1981-2006 A legacy of achievement.

National Council for Therapeutic Recreation Certification. (1982). Memorandum of Agreement Between National Recreation and Park Association and National Council For Therapeutic Recreation Certification.

Stumbo, N. J. (1989). Credentialing in therapeutic recreation: Issues in ensuring the minimal competence of professionals.  In D. M. Compton (Ed.), Issues in therapeutic recreation: A profession in transition (pp. 66-86). Sagamore Publishing.

Stumbo, N. J., & Dickenson, J. (1984). Update: National Council for Therapeutic Recreation Certification. In G.L. Hitzhusen (Ed.), Expanding Horizons in Therapeutic Recreation XI, (pp. 16-29). Curators University of Missouri.