Date Presented 4/20/2018
People with substance use disorder participated in a 6-wk theater intervention to supplement recovery. This study examined the qualitative experience of participants before, during, and 6 mo after the intervention to understand changes in addictive behavior after this occupation-based intervention.
Primary Author and Speaker: Sally Wasmuth
Additional Authors and Speakers: Michaela Thomas, Haley Hackman, Danyele Clingan, Jill Hecht, Aubriana Adney
PURPOSE: Previous research has suggested that an occupation-based theater intervention is feasible and acceptable for improving recovery-based outcomes in people with substance use disorders (SUD). Although some quantitative measures have demonstrated increased abstinence and improved participation in occupations as a result of a theater intervention, it is unclear whether these measures indicate subjective experiences of wellness-enhancing change (Wasmuth & Pritchard, 2016). The purpose of the current study was to examine the qualitative experiences of participants before and after a 6-wk occupational therapy theater intervention in order to detail possible mechanisms of change and identify areas for future research. This study aimed to expand on the science behind changes in addictive behavior resulting from occupation-based intervention.
METHOD: This study used convenience sampling to recruit participants via announcements at open 12-step meetings and at outpatient groups in a local, prominent recovery center in a Midwestern city. Twelve people underwent the 6-wk theater intervention, which consisted of three 3-hr rehearsals per week for 6 wk, followed by two public performances in the community. An occupational therapist, a director, and a professional actor were present for each rehearsal session.
The Occupational Circumstances Assessment Interview and Rating Scale (OCAIRS; Haglund et al., 2001) was administered in interview format by an occupational therapist or occupational therapy student before and after the intervention and 6 mo later. Sessions were recorded and transcribed. Transcripts were analyzed using a five-step coding process as detailed by Charmaz (2014). Memos and reflexivity journals were kept throughout the process. All procedures were approved by the appropriate institutional review board.
RESULTS: The nine themes that emerged among the participants include structuring, achieving, connecting, adaptability, forgiving/accepting, regretting, self-worth, spirituality/being grateful, and life circumstances. Each theme possesses subthemes that detail the experiences of the participants. Implementation of the theater-based intervention increased overall self-satisfaction and -acceptance and occupational participation. The intervention gave participants structure to their day, preventing participation in unhealthy occupations. Increased occupational participation and structure also elicited feelings of self-worth and achievement.
CONCLUSION: This line of research will likely influence trends in addiction research. Recovery-based programs and addiction-related sciences will gain increased knowledge of the value of occupation-based intervention. Especially because of increased emphasis on integrated and recovery-based care, a better understanding of the subjective experiences of clients is critical. This study gave a voice to people in recovery, allowing them to detail not only their experiences of SUD but also their experiences of change within their communities resulting from occupation-based intervention.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Bickel, W. K., Quisenberry, A. J., Moody, L., & Wilson, A. G. (2015). Therapeutic opportunities for self-control repair in addiction and related disorders change and the limits of change in trans-disease processes. Clinical Psychological Science, 3, 140–153. https://doi.org/10.1177/2167702614541260
Blakemore, S. (2015). Creating occupational justice through activity that promotes choice and change around the challenges of drug and alcohol addiction in an involuntary and voluntary setting [Abstract]. Australian Occupational Therapy Journal, 62, 65.
Charmaz, K. (2014). Constructing grounded theory (2nd ed.). London: Sage.
Haglund, L., Henriksson, C., Crisp, M., Freidheim, L., & Kielhofner, G. (2001). The Occupational Circumstances Assessment Interview and Rating Scale (OCAIRS) Version 2.0. Chicago: Model of Human Occupation Clearinghouse.
Wasmuth, S., & Pritchard, K. (2016). Theater-based community engagement project for veterans recovering from substance use disorders. American Journal of Occupational Therapy, 70, 7004250020. https://doi.org/10.5014/ajot.2016.018333
