The Therapeutic Recreation Accountability Model (TRAM) is an attempt to synthesize several important concepts found within the therapeutic recreation accountability literature. Several authors in the field have called for a focus on producing client outcomes, and on being more accountable for the delivery and outcomes of our services. However, most sources discuss only one or a few of the factors in increasing service accountability, resulting in a rather fragmented approach to conceptualizing the total therapeutic recreation service delivery system. The TRAM is intended to help bridge this conceptual gap through use of a pictorial displaying various decision points (often calling for some form of documentation) and their inter-relationships. The TRAM is intended to provide a more comprehensive and cohesive view of actions taken by therapeutic recreation specialists in delivering quality, accountable services.