PURPOSE: This study examined the effectiveness of the Living Skills Recovery Curriculum (LSRC) on reducing substance abuse and improving time and stress management, activities of daily living, and social skills in dual-diagnosis (DD) clients (substance abuse and mental illness).

RATIONALE: Although there are many DD treatment facilities, few have standardized occupational therapy interventions or published outcomes. Skill training that does not integrate substance use cannot impact the brain’s addictive state or foster engagement in nonaddictive occupation.

DESIGN: A 3-yr quasi-experimental controlled effectiveness study of the LSRC was performed using multifactorial analysis.

PARTICIPANTS: The 164 participants were at least 18 yr old, had a DD, and were receiving treatment at an outpatient DD clinic in the United States. The experimental group (n = 99) received the LSRC, and the control group (n = 65) did not. Clients were clinically assigned to groups in order to maintain ethical procedures of the clinic. Analysis showed no significant demographic differences between groups, allowing for comparison.

METHOD: The following outcome measures were gathered for each module (stress management, time management, social skills, activities of daily living) in the LSRC: pre- and posttest scores (10 items), attendance, number of objectives met each session, number of topic-related goals achieved during the 4-mo module, whether or not clients reported that they learned new material and made changes in their lives, staff observations, and clean time (urine samples).

INTERVENTION: The LSRC is a standardized integrated-treatment intervention for DD clients designed to incorporate the 12-Step model into a living skills acquisitional training program utilizing a cognitive–behavioral, psychoeducational approach. Each skill is taught in relation to how it aids in relapse prevention and recovery for each client’s personal lifestyle and pattern of addiction. Two modules (time and stress management) of the LSRC were run by an occupational therapist simultaneously in the clinic for 4 mo. Each module met twice a week for 45 min with no more than 10 clients per closed group. Then, the other two modules (social skills and activities for daily living) were run for 4 mo. This pattern of LSRC intervention alternated over 2.5 yr.

ANALYSIS: Paired (within-subjects) and independent (between-subjects) t tests, percentages, and Pearson product–moment coefficients were used to examine the effectiveness of the LSRC on living skills acquisition, and analyses of variance were used to examine the effect of the LSRC on clean time. The data distribution was evaluated using Levene’s Test for Equality of Variance.

RESULTS: The following results supported the hypotheses. Clients receiving LSRC showed significantly more improvement (p < .05) in time and stress management, social skills, and activities of daily living than clients in the control group. Stress management, social skills, and activities of daily living modules of the LSRC significantly increased clean time in the experimental group versus controls (p < .05); however, time management training did not.

DISCUSSION: Overall, as hypothesized, the LSRC was found to be effective in reducing substance abuse and increasing living skills in DD clients from the clinic studied. Perhaps 4 mo of time management training was not sufficient to significantly increase clean time even though improvements were seen in the ability to manage time. Based on these results, implementation of this curriculum at other DD clinics and randomized controlled trials are recommended.

IMPACT STATEMENT: These findings provide initial support for occupational therapists to use the LSRC in the recovery process of DD clients.