We are doctoral students from Western New England University’s Occupational Therapy program who have had an amazing opportunity to complete capstone projects with the city of Northampton’s Hampshire HOPE opioid prevention coalition.
While occupational therapy does not typically come to mind as a treatment option for substance use disorder, over the course of our three-month internship, we studied the ways occupational therapy can help people with substance use disorders.
We firmly believe it is an effective intervention that can help people who abuse substances improve their health and well-being, reestablish a new lifestyle, achieve and maintain recovery, and live a fulfilling life.
First, let us clear up some misconceptions. Occupational therapy is often confused with physical therapy, and while both modalities are valuable, they differ greatly. Physical therapists focus on movement, helping individuals get from point A to point B. Occupational therapists focus on the activities — often extremely meaningful activities — that individuals engage in once they’re at point A or point B.
When occupational therapists refer to meaningful activities, we are not referring to anything particularly grand, but to everyday activities such as walking the dog, gardening, preparing a meal, doing laundry or playing video games. We also work on what are known as activities of daily living, such as tasks essential to independent functioning (eating, bathing, dressing, toileting) that people participate in every day.
These are not minor activities: They enrich our lives, define who we are and play a role in how we feel about ourselves. They give our lives meaning. Finding meaning in life is a known protective factor against addiction. This is why we see a role for our profession amid the scourge of overdose deaths.
Like many other types of injuries or illness, substance use disorders often impact physical health, mental health and a general ability to participate in meaningful tasks of daily living. As trained health care professionals, occupational therapists possess extensive knowledge on injury, illness and social factors that enhance or hinder levels of functioning. Our goal is to improve functioning.
In our work with clients, we seek creative solutions by examining all aspects of a person’s life that will help them engage in purposeful activities and the tasks of daily living, thus improving their quality of life. We work collaboratively with people to foster hope, motivation and empowerment.
For example, we help people look critically at daily routines to gain insight into their physical and emotional well-being and their ability to carry out tasks that are important to them. We take a holistic approach in an effort to help individuals achieve success in meaningful activities. In this whole-person approach, we acknowledge that both the body and the mind can be impacted by substance use disorder.
Occupational therapy practitioners use scientific research to ensure each intervention is both safe and effective for each individual and that it plays an important role in substance use treatment. Interventions can include:
■Pain management strategies: Working to empower individuals to live healthy and safe lives using approaches that don’t always rely on drugs, such as mindfulness practices, exercise, and the promotion of safe ergonomics and body mechanics.
■Occupational exploration: Encouraging the exploration of leisure interests and hobbies that may essentially help fill the gap of substance misuse as a coping mechanism or strategy for fulfillment.
■Addressing deficits and potential harm in everyday activities: Educating about negative effects substance misuse can have on essential activities of daily living like eating, toileting, bathing, sleep and sexual activity.
Prevention: Developing or enhancing health promotion and stress management strategies that protect against substance misuse or relapse into addictive patterns.
While we are confident that occupational therapy is beneficial and an effective intervention when incorporated into treatment plans for people dealing with substance use disorders, it is sadly underused. According to the Bureau of Labor and Statistics, 2.9% of registered occupational therapists work in mental health and substance use treatment. This could be due to the fact that occupational therapy is usually not a reimbursable service for substance use treatment. This can vary from state to state.
In Massachusetts, occupational therapy professionals are not placed in the reimbursable category of “qualified mental health providers” for people being treated for mental health and substance misuse issues, which results occupational therapy being non-reimbursable.
We hope that may change, thanks to a statewide movement to amend the law. An Act Relative to Mental Health Providers was a bill filed by Sen. Nick Collins and Rep. Natalie Higgins in 2018 to include “occupational therapist” and “occupational therapy assistant” to the definition of “qualified mental health provider” in the state.
As soon to be entry-level practitioners, we see occupational therapy as supportive to people with substance use disorder. By educating others about the profession, we hope our health care systems will incorporate occupational therapy into treatment plans.
Kim Phu and Shelby Spears, doctoral students at Western New England University, are former interns with Hampshire HOPE, the opioid abuse prevention coalition run out of the city of Northampton’s Health Department. Hampshire HOPE members contribute to this monthly column about local efforts addressing the opioid epidemic.