Changing substance-related behaviour (A study reviewing the best methods…
Changing substance-related behaviour
A study reviewing the best methods of intervention for adults and adolescents experiencing substance abuse came up with four main interventions that OTs can use which were successful in reducing alcohol and drug use
Cognitive behavioural therapy
involves a combination of principles derived from cognitive and behavioural theorists with emphasis on self-efficacy and the development of successful coping behaviours (particularly to reduce the risk of relapse). The
goal = to change what a person thinks and does in a high risk situation for substance abuse
Includes motivational interviewing, with an emphasis in identifying the person's readiness to change (focus on enhancing their willingness to change, thereby influencing movement to the
the next stage of change
Stages of change include:
5 minute-1 hour sessions (sometimes many short sessions over time) where the focus is to investigate potential problems and motivate the person to change their substance abuse behaviour. May include explaining associated risks, or benefits of reducing drug and alcohol intake to their quality of life. Requires client-directed change to be effective (client must want to do it)
12 step treatment programs
involves people joining a group where each of them share a similarity in identifying as an alcoholic etc. Aimed to promote peer support, spirituality, and taking life on one day at a time to develop key recovery-oriented behaviours.
"An evidence-based and occupational perspective of interventions for persons with substance-use disorders"
This study examines the processes of recovery of people living with mental illness and substance use disorders
Recovery is a personal process, which is individualised for growth. This has multiple pathways, and it is important that we deepen our understanding of recovery for person's with dual disorders
Mental health and addictive services must be integrated and tailored to the complex needs of the client
Recovery is a multifaceted concept for people living with Dual Diagnosis
Although mental illnesses and addictions might be different from each other, the process of recovery may be very similar and entwined at times
RESULTS FROM STUDY:
The first step that consumers had acknowledged was accepting one's illness. This can be very difficult, but it has shown to help people move forward with their recovery
People found themselves dwelling on the past rather than being immersed in the demands of the day ahead.
OT specific interventions
(psychodrama: you look at the roles in your life like a play. Looking at your life from a different perspective)
Facilitating groups, impact of community
help navigate which occupations to take up, and use these to set goals and get a 'high' from natural sources (such as surfing, bungee jumping etc).
Such as the volitional questionnaire. An intervention strategy as well as an outcome measure because it allows them the space to reflect.
Education and awareness
. Not entirely OT specific, but we would use a MOHO lens to understand how their substance use impacts the different constructs (volition, habituation, performance capacity)
; people can be hospitalised (in-patient unit) to detox from a substance (may be medically monitored for 7-10 days, and focus on relapse reduction). People may be given an alternative (e.g. a controlled dose of Methadone will stop heroin withdrawals). Consumers must be monitored because they can go into shock from the withdrawal, and may be given sedatives to calm. The most server withdrawal consequence is ALCOHOL (can have seizures)
Is predominantly a psychological intervention strategy, but can be woven to be occupation focused too
; includes confidence scale, and hopes to make positive changes to substance use
Adventure Therapy; to give them the natural high (adrenaline) so that they don't feel the need to look to drugs. Very strong evidence based
y; example alcohol anonymous .