Despite advances in addiction research and practice, addiction remains a significant public health problem with strikingly high relapse rates and low treatment retention rates. This study explored whether the concept of addiction-as-occupation aligned with the experiences of ten persons with addiction(s), and suggests that further development of a model based on this concept may help to elucidate and address some barriers to addiction recovery services.
Methods
Semi-structured interviews were performed to gain descriptions of the occupational lives and first-hand experiences of ten persons with addiction(s). Transcripts were analysed using a qualitative thematic analysis methodology.
Results
Seven themes were identified in the data: connection, locus of control, penetration, habituation, identity, motivation, and coping/escape. Participants in this study described their addictions using occupational terms, and addressed both the gains and harms of performing their addictions.
Conclusion
Further investigation of experiences of addiction-as-occupation could be useful for informing occupational therapy interventions for substance-related and addictive disorders. Potential implications and contributions of a conceptual model based on the notion of addiction-as-occupation, as well as areas for future research, are discussed.
Alcoholics Anonymous (2001) Alcoholics Anonymous: Big book. 4th Edition. New York, NY: A.A. World Services, Inc.
2.
AlexanderBK, (2008) The globalisation of addiction: A study in poverty of the spirit. Oxford: Oxford University Press.
3.
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders. 5th ed.Arlington, VA: American Psychiatric Publishing.
4.
BartG (2012) Maintenance medication for opiate addiction: The foundation of recovery. Journal of Addictive Diseases, 31(3), 207–225.
5.
BerridgeKC, (2007) The debate over dopamine's role in reward: The case for incentive salience. Psychopharmacology, 191(3), 391–431.
6.
BoisvertRAMartinLMGrosekMClarieAJ, (2008) Effectiveness of a peer support community in addiction recovery: Participation as intervention. Occupational Therapy International, 15(4), 205–220.
7.
BrownC (2012) Occupational therapy practice guidelines for adults with serious mental illness. Bethesda, MD: American Occupational Therapy Association. Available at: http://www.guideline.gov/content.aspx?id=38528 Accessed 20.10.14.
8.
BurkeJP, (1977) A clinical perspective on motivation: Pawn versus origin. American Journal of Occupational Therapy, 31(4), 254–258.
9.
CalsynRJMorseGAKlinkenbergWDLemmingMR, (2004) Client outcomes and the working alliance in assertive community treatment programs. Care Management Journals, 5(4), 199–202.
10.
CharmazK (2006) Constructing grounded theory: A practical guide through qualitative analysis. Los Angeles, CA: Sage Publications, Inc.
11.
CharmazK (2003) Qualitative interviewing and grounded theory analysis. In: HolsteinJAGubriumJF, eds. Inside interviewing: New lenses, new concerns. Thousand Oaks, CA: Sage Publications, Inc.311–330.
12.
CourbassonCMNishikawaYShapiraLB, (2011) Mindfulness: Action-based cognitive behavioral therapy for concurrent binge eating disorder and substance use disorders. Eating Disorders, 19(1), 17–33.
13.
CreekJHughesA (2008) Occupation and health: A review of selected literature. British Journal of Occupational Therapy, 71(11), 456–468.
14.
DavisMIJasonLAFerrariJROlsonBDAlvarezJ (2005) A collaborative action approach to researching substance abuse recovery. American Journal of Drug and Alcohol Abuse, 31(4), 537–553.
15.
GutmanSA, (2006) Why addiction has a chronic, relapsing course. The neurobiology of addiction: Implications for occupational therapy practice. Occupational Therapy in Mental Health, 22(2), 1–29.
16.
KarasakiMFraserSMooreDDietzeP (2013) The place of volition in addiction: Differing approaches and their implications for policy and service provision. Drug and Alcohol Review, 32(2), 195–204.
17.
KielhofnerG (2008) The environment and human occupation. In: KielfofnerG, ed. A Model of Human Occupation: Theory and application. 4th ed.Baltimore, MD: Lippincott Williams & Wilkins. 85–97.
18.
KoobGFLe MoalM (2005) Plasticity of reward neurocircuitry and the ‘dark side’ of drug addiction. Nature Neuroscience, 8(11), 1442–1444.
19.
LaudetABHumphreysK (2013) Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services?Journal of Substance Abuse Treatment, 45(1), 126–133.
20.
McGovernMPFoxTSXieHDrakeRE, (2004) A survey of clinical practices and readiness to adopt evidence-based practices: Dissemination research in an addiction treatment system. Journal of Substance Abuse Treatment, 26(4), 305–312.
21.
Narcotics Anonymous (2008) Narcotics Anonymous. 6th ed.Chatsworth, CA: N.A. World Services, Inc.
22.
O'BrienC (2011) Addiction and dependence in DSM V. Addiction, 106(5), 866–867.
23.
O'BrienCP, (2008) Evidence-based treatments of addiction. Philosophical Transactions of the Royal Society. B: Biological Sciences, 363(1507), 3277–3286.
24.
O'BrienCVolkowMLiTK, (2006) What's in a word? Addiction versus dependence in DSM-V. American Journal of Psychiatry, 163(5), 764–765.
25.
Overeaters Anonymous (2000) Overeaters anonymous. 2nd ed.Rio Rancho, NM: O.A. Anonymous World Services, Inc.
26.
PotenzaMN, (2006) Should addictive disorders include non-substance-related conditions?Addiction, 101(Suppl 1), 142–151.
27.
ProchaskaJODiClementeCC, (1983) Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.
28.
QureshiNAal-GhamdyYSal-HabeebTA, (2000) Drug addiction: A general review of new concepts and future challenges. Eastern Mediterranean Health Journal, 6(4), 723–733.
29.
RosenheckRAMaresAS, (2007) Implementation of supported employment for homeless veterans with psychiatric or addiction disorders: Two-year outcomes. Psychiatric Services, 58(3), 325–333.
30.
RossDSharpCVuchinichRSpurrettD (2008) Midbrain mutiny: The picoeconomics and neuroeconomics of disordered gambling. Cambridge, MA: MIT Press.
31.
ShafferHJLaPlanteDALaBrieRAKidmanRCDonatoANStantonMV, (2004) Toward a syndrome model of addiction: Multiple expressions, common etiology. Harvard Review of Psychiatry, 12(6), 367–374.
32.
ShumwaySTBradshawSDHarrisKSBakerAK, (2013) Important factors of early addiction recovery and inpatient treatment. Alcoholism Treatment Quarterly, 31(1), 3–24.
33.
StensrudMKLushboughRS, (1988) The implementation of an occupational therapy program in an alcohol and drug dependency treatment center. Occupational Therapy in Mental Health, 8(2), 1–15.
34.
StoffelVCMoyersPA, (2004) An evidence-based and occupational perspective of interventions for persons with substance-use disorders. American Journal of Occupational Therapy, 58(5), 570–586.
35.
Verdejo-GarcíaABecharaARecknorECPérez-GarcíaM (2006) Executive dysfunction in substance dependent individuals during drug use and abstinence: An examination of the behavioral, cognitive and emotional correlates of addiction. Journal of the International Neuropsychological Society, 12(3), 405–415.
36.
VolkowNDWangGJTomasiDBalerRD, (2013) Unbalanced neuronal circuits in addiction. Current Opinion in Neurobiology, 23(4), 639–648.
37.
WaltersGD, (1996) Addiction and identity: Exploring the possibility of a relationship. Psychology of Addictive Behaviors, 10(1), 9–17.
38.
WatsonDP, (2012) From structural chaos to a model of consumer support: Understanding the roles of structure and agency in mental health recovery for the formerly homeless. Journal of Forensic Psychology Practice, 12(4),325–348.
