KNR 273:
Credentialing
Credentialing
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Process where by the competency of a
professional is ensured as a provider of
quality services
Defines minimum competence to practice
What is the difference between credentialing
and accreditation?
Credentialing vs. Accreditation

Credentialing

Accreditation

Individual
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Agency
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NCB (CPRP)
NCTRC (CTRS)
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COAPRT
CAAHEP
Council on
Accreditation of Allied
Health Education
Programs
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If in community/SRA
may need both CTRS
and CPRP
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CARTE (adopted in
2010)
Quality in TR
Professional
(Credentialing)
Education
(Accreditation)
Professional
Practice
(SofP, Ethics)
Credentialing
3 types:
 Registration
 Certification
 Licensure
Registration

The process by which qualified individuals
are listed on an official roster maintained
by a governmental or non-governmental
agency
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Could be state, national or professional
organization
Can look at education & professional experience
Certification

A governmental or non-governmental agency
grants recognition to an individual who has
met certain predetermined qualifications
set by a credentialing agency or association
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Education & professional practice
Greater weight than registration
Restricts use of title, does not restrict practice
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Title protection
Licensure

An agency of government grants
permission to an individual to engage in a
given occupation upon finding that applicant
has attained the minimal degree of
competency required to ensure that the
public health, safety, and welfare will be
reasonably well protected
Licensure
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Strictest form of credentialing
Requires state government to enact
legislation that defines the professional
practice
Practice protection---illegal to practice if not
licensed
Why is it important to have professional
credentials?
Credentialing
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Enables: the public (and gov't and 3rd party
payers) to distinguish those who have
attained some qualifying level of competency
from those who have not
Provides: prestige, recognition and earning
power
Credentialing
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Increases the quality and accountability of
services to the consumer
Increases credibility, respect, and professionalism
Increases the minimal qualifications of the
professional
Increases the likelihood of providing uniform
services based on consumer need
Encourages education and continuing education
Credentialing in TR
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Registration

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1956: Council for the Advancement of Hospital
Recreation created National Voluntary
Registration Plan for Hospital Recreation
Personnel
1969: National Therapeutic Recreation Society
created the NTRS Voluntary Registration Plan
Credentialing in TR
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Certification---Certified Therapeutic Recreation
Specialist (CTRS)
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1981: National Council for Therapeutic Recreation
Certification (NCTRC) is established by NRPA
1985: NCTRC is legally incorporated
1988: NCTRC conducts initial Job Analysis Study
November 1990: 1st NCTRC exam administered
1994: CTRS credential trademark is registered
1997: 2nd Job Analysis Study completed
November 2001: 1st computer based exam is offered
2007: 3rd Job Analysis Study completed
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International Job Analysis of CTRS
International
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CTRS working in 9 countries
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Braham
Great Britain
Bermuda
Australia
Asia
2009 Canadian Therapeutic Recreation
Association = CTRS is preferred credential
Credentialing in TR

Licensure
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Few states have licensure for TR
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Utah (1974)
North Carolina (2005)
New Hampshire (2006)
Oklahoma (2009)
Georgia in the past, sunset law
Periodically TR has drives toward licensure
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7-8 states working on (including New York)
7-8 thinking about starting (including Illinois)
CTRS exam = basis of licensure
Credentialing in TR

State Registration
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Texas
California
NCTRC
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National Council for Therapeutic Recreation
Certification
Independent of NTRS and ATRA
Why?

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Independence provides for a better relationship
with regulatory groups like JCAHO and CARF
Doesn’t appear to be self serving
NCTRC - Mission

To protect the consumer of therapeutic
recreation services by promoting the
provision of quality therapeutic recreation
services by NCTRC certificants
NCTRC - Purpose
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To establish national (& international) evaluative
standards for the certification and recertification
of individuals who attest to the competencies of
the therapeutic recreation profession
To grant recognition to individuals who voluntarily
apply and meet established standards for
certification in therapeutic recreation; and
To monitor adherence to the standards by the
certified therapeutic recreation personnel.
General Requirements for
CTRS

Education
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Experience
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Minimum: Bachelor-level degree
Documented field placement or work experience
in TR
Examination

Successful completion of NCTRC exam
2 Paths

Academic
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Major in TR or recreation with option in TR

Accredited university or college

Not program
NCTRC Requirements
(Effective 1/1/13)
•
Min. 18 semester hours with 15 in TR and the remainder in
recreation
•
5 courses and each course must be 3 hours
•
Must include:
•
•
•
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Assessment
TR Process
Advancement of Profession
Not accepted:
•
Specific activity skill course for a specific population
•
•
Aquatics for People with Intellectual Disabilities
Camping for Special Populations
NCTRC Requirements
(Effective 1/1/13)
•
18 semester hours of supportive course work
•
Courses outside of department
•
Minimum of:
•
•
•
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3 in anatomy and physiology (1/2)
3 in abnormal psychology
3 in human growth & development across the lifespan
Remaining in content areas of social science and humanities
•
Medical terminology
NCTRC Requirements
(Effective 1/1/13)
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Internship
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Minimum 14 consecutive weeks/560 hours
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In TR services that use the TR process as defined by the current
NCTRC Job Analysis
No less than 20 hours/week and no more than 45 hours/week
Must be at 1 agency
Keep log of hours & duties
Supervisor
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Agency supervisor must be CTRS for 1 year before supervise intern

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ISU says must be in field 2 years plus 1 year as CTRS
University supervisor must be CTRS
Online verification
Internship Cont.
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Supervisor
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Must be full time at agency (32 hours/week)
50% of job duties must be in an established TR
program in an agency
Must be 1 identified primary supervisor
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Work consistently with student
Coordinates all secondary supervision
Oversees/signs off all evaluations and reports
Ensures exposure to all Job Analysis Task Areas
Signs field placement verification form
2 Paths
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Equivalency – work experience

Path A
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Same courses plus 5 years full time in TR
Path B

Same courses plus 1 year full time under supervision
of CTRS
Internship Cont.
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Job Analysis
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Basis of internship
Basis of exam content
Basis of continuing education
Basis of ISU TR curriculum
MUST BE exposed to ALL of the job task areas in
internship
2007 Job Tasks
(Practical Experience/Basis of Internship)
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Job Task = TR Process
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Professional roles & responsibilities
Assessment
Planning interventions/programs
Implementation
Evaluate outcomes
Documentation
Work with treatment/service teams
Organizing programs
Managing TR services
Public awareness/advocacy
2007 Job Tasks
(Professional Knowledge Domains - Theoretical Knowledge)

Basis of TR exam
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Foundational knowledge (33%)
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Practice of TR/RT (47%)
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Organization of TR/RT service (13%)
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Advancement of the profession (7%)
Foundational Knowledge
Examples
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Theories of play/rec/leisure
Diversity factors
Human growth/development
Theories of human behavior
Leisure thru lifespan
Leisure lifestyle
Health/human services
Societal attitudes
Legislation
Guidelines & standards
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Cognition & related
impairments
Anatomy, physiology
Senses & related impairments
Psychology & related
impairments
Normalization & inclusion
Accessibility & barriers
Group interaction/leadership
Behavioral change
Practice of TR/RT Examples
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Concepts of TR/RT
Models
Practice settings
Standards of practice
Code of ethics
Impact of impairment
Selection of assessment
Implementation of assessment
Behavior observation
Interview techniques
Functional testing
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TR/RT assessments
Other sources of assessment
data
Interpretation of assessment
Documentation
Activity analysis
Leisure education
Activity modifications
Modalities/interventions
Facilitation techniques
Organization of TR/RT Service
Examples
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Program design
Goal/behavior
objectives
Progress notes
Evaluation
Quality improvement
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Plan of operation
Personnel/volunteer
supervision
Payment
Facility/equipment
management
Budgeting
Advancement of Profession
Examples
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History
Accreditation
standards
Professionalism
Certification
Advocacy
Legislation
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Standards
Ethics
Public
relations/marketing
Professional
association
Continuing education
Accommodations for
Examination
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When submit application, include a separate letter
describing
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Candidate’s disability or special need
Adaptations being requested
Documentation from doctor that confirms disability and
prescribes appropriate accommodations
 (Disability Concerns)
If approved must contact Special Conditions Coordinator at
the Prometric Candidate Services Contact Center at 1-800967-1139 to schedule appointment for administration
Accommodations for
Examination
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Accommodations available are:
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Reader
Marker/writer
Sign language interpreter for instructions
Separate room
Double test time
Extended time by 1.5
CTRS Examination

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Must meet all eligibility requirements
Then pass a written, knowledge-based examination
 Pass courses, qualify for test, pass test
 Do ASAP because qualification standards can change and
then would not be eligible to sit for examination
Offered 3 times a year (5 day period)
 February 1 for May
 July 1 for October
 October 1 for January
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New: Can take during internship ($25)
www.2test.com for locations
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Prometric
CTRS Examination
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Mastery testing
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Some receive more questions
Starts with base test everyone takes
 90 questions / 86 minutes
 Pass/fail/unclear
 Testlets
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15 questions / 14 minutes
Maximum of 6 testlets
Get preliminary score of if not pass feedback on weak
areas
Last 3 years, 66-75% passed
CTRS Examination
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Cost
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New application: $100
Exam registration fee: $300
Total: $400
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If do early = $425
Certification good for 5 years
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Annual maintenance fee ($80)
CTRS
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Can’t say certification eligible until receive
notification from NCTRC
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Can’t use CTRS until receive official letter
from NCTRC of passing
How Prepare for Exam?
 STUDY
STUDY
STUDY
How Prepare for Exam?
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Print/review current standards
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Review texts & notes
Practice tests
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Make sure all areas have been covered in internship
Go over requirements with supervisor
Complete practice application
NCTRC 50 sample questions ~$25
Study guides (Stumbo & Folkerth)
Study groups / sessions
Flash cards (cost ~$50)
How maintain certification?
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Annual Renewal
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Form
Fee
Recertification to
proved continuing
professional
competence
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Form
Fee
Documentation
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Keep:
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Original documentation
Conference schedule
Hours
NCTRC areas
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Audit process
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Recertification
Must earn 100 credits to renew
certification after 5 years
 Points can be earned
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Professional Experience (minimum of 480 hours over 5
years…could be volunteer) and
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Continuing Education (50 hours) or
Reexamination (passing score on exam)
Recertification
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Continuing education
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Conferences, workshops
Publications
Presentations (c/b online)
Academic courses
(take/audit)
Webinar/teleconference
Thesis or dissertation
Guest lecture
NCTRC test writing
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No more than 25 credits
from
publications/presentations
Continuing Education
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Points are measured according to the
equivalency of an educational contact hour
(60 minutes)
1 contact hour = 0.1 CEU = 1 credit
Content of the experience must be linked
with the knowledge areas of the NCTRC
Job Analysis Study ** be careful because
some things don’t count
How keep up with NCTRC
changes?
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NCTRC Newsletter
NCTRC Web site
Meetings at conferences
Professional journals/literature
Specialty Certification (2010)
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Physical Medicine/Rehabilitation
Geriatrics
Developmental Disabilities
Behavioral Health
Community Inclusion Services
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Valid 5 years
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$100/$20 year
Specialty Certification Path A
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CTRS active status
5 years FT experience in area (1,000 hours)
75 continuing education hours
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Min of 3 professional certificate trainings
Each training must be min. of 6 CE hours
2 professional references
Specialty Certification Path B
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CTRS active status
Graduate degree in TR/RT
9 graduate-level credit hours in specialty
1 year FT experience in area
2 professional references
Why don’t people seek out
continuing education
opportunities?
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Cost
Work constraints
Lack of benefits
Family constraints
Disengagement