Patients in hospital facilities and especially on rehabilitation units have the unique opportunity to work with a TRS. After sustaining an injury or illness, there are many reasons for a patient to consider treatment at a rehabilitation center that employs a TRS.

The TRS begins by conducting an assessment to identify patients' past leisure interests. Next, with input from the patient, the TRS will create a plan of treatment that includes goals as well as steps to accomplish those goals. The patient and TRS then work together individually and in group sessions to prepare the patient for community integration. Within these individual and group sessions, they may work on adaptations to leisure interests and community integration skills for continual enjoyment and future participation in recreation.

Sam Andrews, Director of Therapeutic Recreation at Craig Hospital in Denver, says that TRSs "provide skill training in adaptive techniques and the use of adaptive equipment...cognitive stimulation, and community integration activities" in regards to leisure participation. TRSs may also educate patients regarding personal, attitudinal and community barriers that may prevent them from fully participating in leisure, and assist in creating solutions for these barriers.