There are repeated calls for evidence-based practice (EBP) in therapeutic recreation (TR) as a means to improve client outcomes, ensure consistency and communication among professionals, create protocols and criteria for client assessments, and increase recreation therapists' (RTs) research capacity. The purpose of this study was to understand what influences RTs' clinical decision-making in a mental health setting. A qualitative research approach with ethnographic techniques was used. The study consisted of two phases: journaling and a focus group. A systematic, inductive approach guided analysis of the data from 10 RTs located in different workplaces within one Canadian health region. Findings suggested that while RTs had a common practice philosophy, their use of research evidence in decision-making was limited. A lack of infrastructure supporting service provision including minimal clinical leadership, few opportunities for mentorship, and contextual factors such as limited resources influenced clinical decision-making. Implications for research and practice are provided.
