Although employment, housing, education, health care, transportation, and long-term services and support are all pressing issues for people with disabilities, recreation, and in particular therapeutic recreation, has increasingly been viewed as a pathway to improved quality of life. But less understood are the factors associated with engaging in therapeutic recreation. The Harford County Therapeutic Recreation (HCTR) Study used structured interviews, focus groups, and a questionnaire collect primary data applicable to our specific aims. The study addresses two specific aims: • evaluate therapeutic recreation behaviors, attitudes, and perceptions among people with disabilities in Harford County • examine environmental and social factors that influence therapeutic recreation patterns among people with disabilities in Harford County. The study found that the community of Harford County citizens with disabilities and their caregivers share a strong positive perception of the County’s TR program. The positive perception was reflected in the finding that a large proportion of the community plans to participate in County TR programming in the future. Good communication, new programs, and positive perceptions of staff were cited by the community as major enablers of participation. The data indicate room for improvement. Improvements in therapeutic outcomes for physical fitness and overall health and well-being were noted by fewer than half of all participants. Also, there are barriers to participation in TR programming. To improvement the programming, the community suggested new and more targeted activities, and improved outreach, suggestions that are in line with best practices of other counties’ TR programs. Among factors that can be changed easily, communication appears to be key in minimizing barriers and facilitating participation in future therapeutic recreation programming.