{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/recreational-therapists/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Recreational Therapists", "soc_code": "29-1125", "category": "Healthcare", "us_employment": 14930, "median_annual_wage": 61960 }, "verdict": "SAFE", "risk_resistance": 69, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 14, "embodiment": 16, "liability_shield": 10, "trust_premium": 17, "judgment_accountability": 12 }, "reasoning": { "task_resistance": "Running a wheelchair basketball session, transferring a stroke patient into an adaptive kayak, or de-escalating a psychiatric inpatient mid-group are tasks that stay human, but the Functional Independence Measure scoring, CMS-required treatment plan templates, activity-idea generation, and discharge summaries are a real slice of the week that software now drafts — that documented paperwork share is what holds it at 14 instead of 18.", "embodiment": "You are on the floor in a gym, pool, community bus, or day room, doing physical assists and gait-belt transfers with patients who fall, resist, or seize, in settings you do not control — a community outing to a grocery store or a fishing trip is the opposite of a fixed workstation, which puts this near the top rather than at the mid-range of jobs with 'some' physical work.", "liability_shield": "CTRS credentialing through NCTRC is required by most hospitals and by CMS conditions of participation for inpatient rehab, but only a few states (NC, UT, NH, OK) license the title, so an unlicensed activity aide can legally do adjacent work in most of the country — that gap between employer-mandated certification and statutory practice protection is exactly a 10, not a nurse's 17.", "trust_premium": "A patient with a traumatic brain injury who will not participate in anything does so for the specific therapist who learned they used to play guitar; the leisure interest inventory and rapport-building are the intervention itself, not a wrapper around it, and continuity across a 4-week rehab stay is why families ask for you by name.", "judgment_accountability": "You decide whether a patient is ready for an unsupervised community reintegration outing, whether a fall risk can attempt standing basketball, and when to report suicidal statements disclosed in a group — real calls with real consequences, but they are made inside an interdisciplinary team where the physician and case manager sign off on the plan and the discharge, which caps this at 12 rather than the 16 of the person who owns the decision alone." }, "rationale": "The core of the job is physically leading adaptive sports, arts, community outings, and social-skills groups with patients who have brain injuries, psychiatric conditions, or mobility limits — that is in-room, hands-on work AI cannot do. What AI does absorb is the paperwork layer: treatment plan drafting, progress notes, insurance documentation, and activity ideation. Credentialing (CTRS) plus state licensure in a handful of states gives partial protection, but the stronger moats are embodiment and the therapeutic relationship itself.", "outlook": "Demand grows with aging and rehab populations; the documentation half of the job compresses, so the same headcount spends more hours in direct patient contact.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "Expansion of state practice acts for recreational therapy beyond the current handful (NC, UT, NH, OK licensure; NJ registration) — NCTRC has an active state-licensure advocacy agenda. A state law making 'recreational therapy' a protected scope with a licensed CTRS required to sign the treatment plan in the medical record would convert credential-preference into a legal signature requirement.", "plausibility": "plausible", "would_add": 4 }, { "dimension": "liability_shield", "change": "CMS Conditions of Participation for inpatient rehabilitation facilities and psychiatric hospitals (42 CFR 482.62) already name qualified therapeutic recreation staff; a tightening that names CTRS specifically as the required signer of the individualized activity/treatment plan, or a Joint Commission element of performance requiring a credentialed RT to attest that AI-drafted plans were reviewed, would raise the floor nationally.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Formal inclusion of the RT on documented risk-decision bodies — e.g., facility policy requiring RT sign-off on community-outing risk assessments, elopement risk, or least-restrictive-alternative determinations for psychiatric patients. Where RTs own the written 'is this patient safe to go off-unit' call, the accountability is explicit rather than informal.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "task_resistance", "change": "Task-mix shift: this role has a genuine two-tier structure. If AI absorbs the plan drafting, progress notes, insurance justification and activity ideation, what remains is behavioral de-escalation, in-the-moment adaptation for cognitive/mobility limits, and family negotiation — none of which is documentable-away. The residual job is more resistant than the current average job.", "plausibility": "already happening", "would_add": 3 }, { "dimension": "trust_premium", "change": "Payer or accreditation recognition that group therapeutic recreation is a billable skilled service rather than bundled 'activities' — e.g., MDS/PDPM coding changes in skilled nursing that credit RT minutes toward reimbursement, which historically drove staffing levels. Buyers paying line-item for a human RT rather than absorbing it as overhead hardens the premium.", "plausibility": "plausible", "would_add": 2 } ], "ceiling_note": "Embodiment is already near ceiling and cannot rise meaningfully. The main downside risk sits outside these levers: RT is often a discretionary cost center, and budget deletion — not AI substitution — is the realistic displacement path, which no liability or trust lever addresses." }, "adjudication": null, "employment_history": { "points": [ { "y": 2017, "emp": 18490, "wage": 47680 }, { "y": 2018, "emp": 18840, "wage": 47860 }, { "y": 2019, "emp": 19070, "wage": 48220 }, { "y": 2020, "emp": 20080, "wage": 47710 }, { "y": 2021, "emp": 16980, "wage": 47940 }, { "y": 2022, "emp": 15920, "wage": 51330 }, { "y": 2023, "emp": 15540, "wage": 57120 }, { "y": 2024, "emp": 15060, "wage": 60280 }, { "y": 2025, "emp": 14930, "wage": 61960 } ], "from": 2017, "to": 2025, "change_pct": -19.3, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [], "license": "https://cookedindex.com/terms" }