
Introduction
Is mental health in the US lacking? What role can occupational therapy practitioners play in this shortage? Are occupational therapists equipped to provide services to this population?
A 2014 report found that many counties in some states have no primary mental health professionals and practicing psychiatrists.[1]Maxey, H. L., & Norwood, C. W. (2014, November). Indiana mental health workforce. Policy Report. https://www.in.gov/children/files/cisc-2014-1119-2012-
Indiana-Mental-Health-Workforce-Report.pdf Occupational therapists can provide services that support mental health and recovery as their training includes clinical fieldwork experience that focuses on psychosocial issues.[2]Castaneda, R., Olson, L. M., & Radley, L. C. (2013). Occupational therapy’s role in community mental health. … Reference List Research supports the role of occupational therapy for the effective interdisciplinary treatment of mental health conditions. Occupational therapists often combine medication-assisted treatment with behavioral therapy for people with substance use disorders (SUDs).
Strengths of Occupational Therapy for Substance Use Disorders
- Holistic focus
- Skills in occupational enablement[3]Amorelli, C. (2016), “Psychosocial occupational therapy interventions for substance-use disorders: a narrative review”, Occupational Therapy in Mental Health, Vol. 32 No. 2, pp. 167-184, doi: … Reference List
- Long history of working with inpatient addiction treatment since 1952.[4]Hossack, J.R. (1952), “Clinical trial of occupational therapy in the treatment of alcohol addiction”, American Journal of Occupational Therapy, Vol. 6 No. 6, pp. 265-282.
- Specific training with psychosocial populations
Medication Modalities
Examples of US FDA-approved medications such as Buprenex, Methodone, and Vivitrol in combination with counseling and wrap-around services to treat people with SUDs.[5]Jones, C. M., Byrd, D. J., Clarke, T. J., Campbell, T. B., Ohuoha, C., & McCance-Katz, E. F. (2019). Characteristics and current clinical practices of opioid treatment programs in the United … Reference List
Evaluation Assessment
- Standardized cognitive assessments and reassessments
- Functional evaluations
- ADLs, IADLs, Habits, Routines, Volunteer, Work, Leisure, Community roles
- COPM and re-administration every 60 days
- Environmental/In-home safety assessments with follow-up visits[6]Synovec, C. E., Merryman, M., & Brusca, J. (2020). Occupational Therapy in Integrated Primary Care: Addressing the Needs of Individuals Experiencing Homelessness. The Open Journal of Occupational … Reference List
OT Intervention Practice
- How and when occupational therapists specifically work with people with SUDs remains unclear.
- Research shows the use of single occupation-focused interventions, daily living skills, vocational skills, and community-based sober interventions.[7]Ryan, D. A., & Boland, P. (2021). A scoping review of occupational therapy interventions in the treatment of people with substance use disorders. Irish Journal of Occupational Therapy.
- A focus on life-skills and re-engagement in meaningful routines aligns with OT practice to support clients moving away from dysfunction from addictive behaviors.
- Clients with SUDs can be empowered by OTPs to take control of their lives through engagement in occupations.[8]Tayar, S. (2004), “Description of a substance abuse relapse prevention programme conducted by occupational therapy and psychology graduate students in a United States women’s prison”, British … Reference List
- OTs may also explore novel interventions for treatment in clients with SUDs such as exercise, theatre, and horticulture.
- Interventions should be scheduled with structure and familiarity, e.g., weekly.
- The integration of OT services into an established health care setting enables more consistent access to clients needing services as well as for providers on the interdisciplinary team.[9]Synovec, C. E., Merryman, M., & Brusca, J. (2020). Occupational Therapy in Integrated Primary Care: Addressing the Needs of Individuals Experiencing Homelessness. The Open Journal of Occupational … Reference List
- Clients such as those who are homeless with SUDs can benefit from OT interventions that target healthy functional skills that align with the goals of the clients.
- OTs can refer and support groups such as AA (in-person or virtual) for social support systems.
- The goal of OT is to enhance and provide positive outcomes with symptom management, support for the healthcare team, and transition into the community.
References
↑1 | Maxey, H. L., & Norwood, C. W. (2014, November). Indiana mental health workforce. Policy Report. https://www.in.gov/children/files/cisc-2014-1119-2012- Indiana-Mental-Health-Workforce-Report.pdf |
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↑2 | Castaneda, R., Olson, L. M., & Radley, L. C. (2013). Occupational therapy’s role in community mental health. https://www.aota.org/About-OccupationalTherapy/Professionals/MH/Community-Mental-Health.aspx |
↑3 | Amorelli, C. (2016), “Psychosocial occupational therapy interventions for substance-use disorders: a narrative review”, Occupational Therapy in Mental Health, Vol. 32 No. 2, pp. 167-184, doi: 10.1080/0164212X.2015. 1134293. |
↑4 | Hossack, J.R. (1952), “Clinical trial of occupational therapy in the treatment of alcohol addiction”, American Journal of Occupational Therapy, Vol. 6 No. 6, pp. 265-282. |
↑5 | Jones, C. M., Byrd, D. J., Clarke, T. J., Campbell, T. B., Ohuoha, C., & McCance-Katz, E. F. (2019). Characteristics and current clinical practices of opioid treatment programs in the United States. Drug and Alcohol Dependence, 205, 107616. https://doi.org/10.1016/j.drugalcdep.2019.107616 |
↑6, ↑9 | Synovec, C. E., Merryman, M., & Brusca, J. (2020). Occupational Therapy in Integrated Primary Care: Addressing the Needs of Individuals Experiencing Homelessness. The Open Journal of Occupational Therapy, 8(4), 1-14. |
↑7 | Ryan, D. A., & Boland, P. (2021). A scoping review of occupational therapy interventions in the treatment of people with substance use disorders. Irish Journal of Occupational Therapy. |
↑8 | Tayar, S. (2004), “Description of a substance abuse relapse prevention programme conducted by occupational therapy and psychology graduate students in a United States women’s prison”, British Journal of Occupational Therapy, Vol. 67 No. 4, pp. 159-166, doi: 10.1177/030802260406700404. |