Abstract
Because drug and alcohol addiction remains a significant societal concern, it is important to understand the experiences and the daily lives of those affected. The results of this research add to the growing knowledge of the potential role for OT for individuals with substance-related disorders. Additionally, the results emphasize the distinct value that OT has in fostering an interdisciplinary approach to the treatment of substance-related disorders.
Primary Author and Speaker: Roshni Patel
Additional Authors and Speakers: Hyun Kyoon Lim
Contributing Authors: Il Doh
In the United States, 19.7 million individuals struggled with substance use disorder (SUD) in 2017 and upwards of $740 billion was spent addressing lost productivity, healthcare costs, and crimes due to drug and alcohol addiction (American Addiction Centers [AAC], 2020). Only 19% of those with SUD received treatment and for those who did, specialized behavioral health services, which include both medication and counseling, were the most frequent. Despite treatment, the relapse rate for individuals with SUD ranges from 40%-60% (AAC, 2020). There has been a growing body of occupational therapy (OT) literature investigating the potential role for OT in addressing the occupational needs of those experiencing drug and alcohol addiction (Rojo-Mota et al., 2017; Wasmuth et al., 2016), however, the majority of those affected have never received OT services (Sullivan et al., 2020). Those living with substance related disorders often experience changes in body structures and function and performance skills, (American Psychiatric Association [APA], 2013) all within the domain of OT practice. Subsequently, there may be a role for OT as part of an interdisciplinary approach to the treatment of substance related disorders. The purpose of this study was to explore the lived experiences and daily life of individuals with substance related disorders who were receiving behavioral health services. Additionally, the purpose was to gain an understanding of the perceptions of individuals with substance related disorders regarding the treatment services they were receiving. Exploring the perceptions of traditional treatment programs to help identify a potential role for OT is a novel approach used in this study. This study utilized a qualitative phenomenological design. Participants consisted of a convenience sample that included five adults with substance related disorders receiving behavioral health services for at least 6 months. Semi-structured face to face interviews were completed with follow-up phone interviews completed with three of the five participants. Interview questions were developed based on a review of literature and use of the Model of Human Occupation as a guiding theoretical framework. Data analysis involved both independent and collaborative descriptive coding by the primary and secondary researcher in an iterative process until themes emerged. A peer review was conducted by a third researcher to further promote trustworthiness. Four primary themes emerged in relation to the participants lived experiences which included cycle of addiction, fear of relapse, loss, and guilt and remorse. Five primary themes emerged in relation to daily life which included giving up control, staying connected, meeting expectations, occupying time, and living in the moment. Two primary themes emerged related to behavioral health services perceptions which included meeting immediate needs and valuing external control. The majority of participants were unable to identify long term goals or specific plans to maintain sobriety and health beyond the present. Fostering a sense of internal control, self-efficacy, healthy habits and routines, and a sense of occupational competence through collaborative goal setting, planning, and occupation-focused interventions may be the distinct value of OT as part of an interdisciplinary approach to the treatment of individuals with substance related disorders to help mitigate relapse rates and offset societal costs. This study highlights key areas necessary for satisfactory occupational participation and quality of life and supports a critical role for OT as part of the behavioral health services team. Further, understanding OT’s role may influence practitioners desire to work in this emerging of practice.
Rojo-Mota, G., Pedrero-Pérez, E. J., & Huertas-Hoyas, E. (2017). Centennial Topics-Systematic review of occupational therapy in the treatment of addiction: Models, practice, and qualitative and quantitative research. American Journal of Occupational Therapy, 71, 7105100030. https://doi.org/10.5014/ajot.2017.022061
Wasmuth, S., Pritchard, K., & Kaneshiro, K. (2016). Occupation-based intervention for addictive disorders: A systematic review. Journal of Substance Abuse Treatment, 62. 1-9. http://dx.doi.org/10.1016/j.jsat.2015.11.011
Sullivan, V., Macone, A., Lucey, J. R., & Erler, K. (2020). An occupation-based approach to treatment of substance use disorder: An interactive panel discussion [Unpublished doctoral dissertation]. MGH Institute of Health Professions.
American Addiction Centers. (2020, June 1). Alcohol and Drug Abuse Statistics. https://americanaddictioncenters.org/rehab-guide/addiction-statistics