Poster Session
Issue Date: July 2015
Published Online: July 01, 2015
Updated: April 30, 2020
Occupation-Based Intervention for Addictive Disorders: A Systematic Review
Author Affiliations
  • Indiana University
  • Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, and Indiana University
Article Information
Evidence-Based Practice / Translational Research
Poster Session   |   July 01, 2015
Occupation-Based Intervention for Addictive Disorders: A Systematic Review
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911520177.
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911520177.

Date Presented 4/17/2015

This systematic review examined whether occupation-based interventions are more effective than standard interventions in improving recovery outcomes in persons with addiction(s). Occupation-based interventions are contrasted from more didactic therapeutic approaches.

INNOVATION AND SIGNIFICANCE: The concept of occupation-based intervention is not salient in mental health and addiction literature. Therefore, a comprehensive review of the effectiveness of occupation-based interventions required innovation and creativity to develop an effective search strategy and method for synthesizing the broad range of data collected. This study will benefit occupational therapists working in mental health settings as well as in the many other settings in which addiction appears as a comorbid condition by synthesizing the evidence of occupation-based interventions.
APPROACH: This study attempted to answer the following research question: In persons with substance use disorders, are occupation-based interventions more effective than standard interventions in improving short- and long-term recovery outcomes?
Addictive disorders disrupt individuals’ occupational lives, indicating that occupational therapists can play a crucial role in addiction rehabilitation. However, literature on the effectiveness of occupation-based interventions—which are central to occupational therapy practice—is limited. This study defines an occupation-based intervention as an intervention in which an occupation is performed. This type of intervention can be contrasted with more didactic interventions in which a form of skill training, for example, is provided, but performance of the actual occupation does not take place.
Although systematic reviews have examined evidence of occupational therapy interventions in mental health, few have focused specifically on problems of addiction. An older systematic review identified evidence-based interventions for addiction from other disciplines and suggested that occupational therapists adopt these evidence-based approaches and tailor them to facilitate occupational participation. However, occupational therapy has a unique tool—occupation-based intervention—that may be particularly effective for addressing addictive disorders. Yet, little research has synthesized various occupation-based intervention approaches, making it difficult for occupational therapists to appraise the evidence of occupation-based approaches in addiction rehabilitation. The current systematic review therefore addresses this gap by examining and synthesizing findings from studies of occupation-based interventions for addictive disorders.
METHOD: This systematic review was undertaken at the VA Center for Health Information and Communication, Indianapolis, Indiana. In collaboration with a medical librarian and in consultation with four Fellows of the American Occupational Therapy Association, we examined Medical Subject Headings (MeSH) term trees to create an inclusive search strategy for examining the use of occupations in addiction rehabilitation. Searches were then conducted in Ovid MEDLINE, PsycINFO, Social Work Abstracts, OTSeeker, HealthSTAR, CINAHL, and ACPJournalClub. This search produced 1,095 articles. Abstracts were screened by the first and second authors for eligibility. Prospective outcome studies with a sample of persons with addictive disorders of N ≥ 5 that examined the effectiveness of an occupation-based intervention were included. Studies examining didactic interventions that did not include actual performance of an occupation were excluded, yielding 66 studies for qualitative synthesis and potential meta-analysis. MacDermid’s standards for occupational therapy research were used for article appraisals.
RESULTS: The analyses of the results are in progress, so conclusions cannot be made at this time.