LaFleur knew that belly dance couldn’t treat, let alone cure, cancer. But the practice incorporates a mix of gentle movements and intense focus that she realized was the perfect balance of physical activity, play, and meditation for her recovery. In fact, maybe it could be the perfect activity for other people recovering from cancer, too. Soon, she was thinking through how she could design a belly-dance class.

Beyond Charlottesville, LaFleur’s inclination to connect healing with play aligns with a growing sector of therapists in the United States. The field, known as recreational therapy, uses games and other leisurely pursuits, including activities as mundane as bean-bag tosses and art projects, to help patients regain fine motor skills and reduce anxiety or depression. Like its better-known relatives—such as physical or occupational therapy—recreational therapy relies on measurable outcomes, but aims for fun and socialization outside of the medical office.

The field isn’t widely known—and it’s controversial. Because most states don’t license recreational therapists, it’s difficult to determine whether a practitioner is offering legitimate therapy or promising unrealistic results. Music therapy, a subset of recreational therapy, has also come under scrutiny in recent years as some people insist that it helps children with developmental disorders and others worry the impact is irresponsibly exaggerated.

According to the Bureau of Labor Statistics, employment opportunities for recreational therapists are predicted to grow by 12 percent between 2014 and 2024, a rate faster than average across all occupations, due in part to America’s aging of population as baby boomers retire. Currently licensed in Utah, North Carolina, Oklahoma, and New Hampshire, with bills pending in several other states, recreational therapists must earn a four-year college degree, complete a 560-hour internship, and pass a national-certification exam. Since its formation in 1984, the American Therapeutic Recreation Association—the largest national membership organization for recreational therapists—has grown from 60 to more than 2,200 practitioners.

Vincent Bonadies has practiced recreational therapy for nearly 38 years and currently serves on ATRA’s board. In reflecting on his career, he recalled one of his first patients, a young man who had been in a motorcycle wreck that left him almost completely paralyzed. The man spent hours every day sitting in bed with little to break up the monotony. “He had the ability to move his head, and he loved painting,” Bonadies says. So Bonadies helped the patient learn to hold a paintbrush in his mouth.

Like many other patients whose cancer has come back after remission, LaFleur remains afflicted by the nagging doubt that the cancer is ever truly gone. “Cancer is, at its core, your body turning against itself,” she says. “You have a hard time trusting your immune system. It’s very alienating, and it can be frustrating to not have the stamina you’ve had your whole life.”