Occupational therapy and substance use disorder

Substance use disorders (SUD) can have a significant effect on one’s function in all areas of occupation.[1][2] Physical and psychosocial issues due to SUD can impact occupational performance.[3] Unfulfilled life roles and disruption in meaningful activity can result from lack of structure or routine, poor motivation, limited skills, and poor social networks.[1][3] These deficits may also contribute to stress, affecting the ability to cope with challenges.[3] While SUD can affect a client’s participation in therapy and ability to follow recommendations, occupational therapists are trained to facilitate occupational participation and performance.[4]

Interventions

Occupational Therapists (OT) address substance use through focus on self-care, leisure, and productivity,[3] and may encounter SUD in a variety of settings. OTs address substance use by determining occupational needs, executing assessments and interventions, and creating appropriate prevention programs.[1] They evaluate a client’s ability to function, help them set short- and long-term goals, and evaluate their likelihood for relapse.[5]

An OT session for SUD may address: development of coping strategies, rebuilding roles, balancing responsibilities, managing money, effectively communicating with others, and developing stress management skills.[5]

Sustaining recovery is addressed through stress and anger management, modifications to social behavior, occupational exploration, and development of life skills.[3] Through improvements in occupational performance, clients with SUD can improve their quality of life and sustain recovery.[3]

Frames of reference

Two frames of reference employed by OTs are Dr. Gary Kielhofner's model of human occupation (MOHO) and cognitive behavioral frame of reference. MOHO focuses on the effects a SUD has on volition, habituation, and performance.[4] Cognitive-behavioral frame of reference focuses on skill building. The client identifies negative thoughts affecting function or skills, finds alternative thoughts for replacement, and rehearses or role plays situations while implementing these alternative thoughts.[4]

Notes
  1. Brown, Catana; Stoffel, Virginia C.; Munoz, Jaime Phillip (2010). Occupational Therapy in Mental Health. A Vision for Participation. Philadelphia: FA Davis Company. ISBN 0803617046. OCLC 900403015.
  2. "Substance use disorder: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2019-11-20.
  3. Martin, Linda M; Bliven, Michelle; Boisvert, Rosemary (March 2008). "Occupational performance, self-esteem, and quality of life in substance addictions recovery". OTJR: Occupation, Participation and Health. 28 (2): 81. doi:10.3928/15394492-20080301-05.
  4. Stoffel, Virginia C. (January 1994). "Occupational therapists' roles in treating substance abuse". Hospital and Community Psychiatry. 45 (1): 21–22. doi:10.1176/ps.45.1.21. PMID 8125455.
  5. Opp, Ashley. "Recovery With Purpose: Occupational Therapy and Drug and Alcohol Abuse". American Occupational Therapy Association. Retrieved August 22, 2014.
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