Occupational therapy focus on the use of meaningful occupations (or daily activities) for a person to regain function or skills in their lives. Occupational therapy practitioners work with children, adults and elderly persons. They treat people with physical, mental health and occupational challenges. OT's require a Masters degree and must be licensed in the state they wish to practice. Their services are covered by insurance.
Recreational therapists focus on leisure. They assist people in regaining or exploring leisure activities to live a full and meaningful life. They do not address medical issues, but focus on the leisure/recreational activities that people wish to participate in. They typically have a bachelor degree and requirements to practice vary by state. Their services are not typically covered by insurance.
While leisure is an area of occupational that occupational therapy practitioners may address, recreational therapists must only address leisure issues.