Duke Oncology Recreation Therapy (ORT) assists patients and families in coping with psychosocial issues that evolve with the diagnosis of cancer and cancer treatment.

Recreation therapy is a process that utilizes recreation services for purposeful intervention in order to develop, regain, or maintain a patient’s capacity for full living -- their physical strength, emotional growth, or social self-confidence.

The ORT program facilitates a patient’s adjustment to the hospital environment and creates a milieu for successful treatment, but also focuses on helping patients and families begin to adapt to changes in their lifestyles and leisure needs.

Historical Overview

Roots of the recreational therapy profession date back to the Crimean War of the 1850s, when recreation was used to improve the counterproductive impact military hospital settings played on the recovery process.

The concept of wars and epidemics resulted in continued need for the expansion of health care and likewise, recreation-based personnel over the next 55 years. From 1945 to 1953 undergraduate education programs were developed in recreation to meet the demand of the evolving work force. By 1956 credentialing of therapeutic recreation personnel began. In 2004 there were around 24,000 reported recreation therapy jobs in the clinical and community setting.

The value of credentialed recreation therapy personnel was identified by Duke’s Comprehensive Cancer Center in the early 1970s. By 1976 Duke ORT was developed and considered one of the pioneers in the establishment of formal population specific programs. The ORT department parallels Duke University Health System’s mission to providing the highest caliber of quality patient care, education, and research while respecting the needs of the human spirit.

Scope and Complexity of Patient Needs Addressed

• Prolonged length of stay
  
• Social isolation/declines in social network
  
• Anxiety/fear related to illness or hospitalization
  
• Need to develop additional strategies for pain management
  
• Need to develop additional strategies for stress management
  
• Need to develop additional strategies for effective communication
  
• Grief and issues of loss
  
• Periods of depression
  
• Body image concerns
  
• Decline in self-esteem or self-confidence
  
• Fatigue/decreased endurance
  
• Limited physical mobility
  
• Difficulty in structuring discretionary time
  
• Difficulty in coping with illness and hospitalization
  
• Decreased ability to concentrate

The program's staff gets at least 100 letters a year from medical institutions and caregivers nationwide wanting to know about the program. A highly structured internship is offered to provide an opportunity for a practical experience matched with the student’s education level, previous experience and professional goals.