Occupational Therapy Interventions for Substance Use Disorders (2021)

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.