For many individuals with disabilities, specialized camps offer intentional recreational activities designed to meet specific goals. The purpose of this study was to identify the most important elements of Therapeutic Recreation (TR) when applied to residential summer camps for individuals with disabilities. This study used a panel of experts using a Delphi approach. Experts initially identified 29 elements and in subsequent rounds provided ratings and definitions of each element. Statistical analysis identified nine elements as most important: Planning, Evaluation, Socialization, Implementation, Staff Qualifications & Competency Assessment, Management, Prevention, Safety Planning, & Risk Management, Program Evaluation & Research, Quality Improvement. Identifying key elements is critical in developing a framework for future research, as well as justifying TR service and prioritizing which elements should be considered when creating a TR camp program.