CENTENNIAL TOPICS
Systematic Review of Occupational Therapy in the
Treatment of Addiction: Models, Practice, and
Qualitative and Quantitative Research
Gloria Rojo-Mota, PhD, is Associate Professor, King
Juan Carlos University of Madrid, Madrid, Spain, and
Occupational Therapist, Institute of Addictions, Madrid
Salud, Madrid, Spain; gloriaroj@yahoo.es
Eduardo J. Pedrero-Pérez, PhD, is Technical
Researcher, Department of Evaluation and Quality,
Teaching and Research Unit of Madrid Salud, Madrid
Salud, Madrid, Spain.
Elisabet Huertas-Hoyas, PhD, is Professor, King Juan
Carlos University of Madrid, Madrid, Spain.
The American Journal of Occupational Therapy
Gloria Rojo-Mota, Eduardo J. Pedrero-Pérez, Elisabet Huertas-Hoyas
OBJECTIVE. The authors conducted a systematic review of theoretical models, professional practice, and
research findings to understand occupational therapy’s role in the treatment of addiction.
METHOD. PubMed, Academic Search Premier, CINAHL, ERIC, OTseeker, and Google Scholar were
searched to identify scientific journal articles, book chapters, or any other similar literature published from
1970 through July 2015 that addressed theoretical approaches, intervention models, and professional roles
or were qualitative or quantitative studies in which occupational therapy had a central role.
RESULTS. The literature search yielded 16 theoretical and professional role studies, 8 qualitative studies,
and 14 quantitative studies. All studies had low levels of evidence, and all were case series, sometimes with
very small samples.
CONCLUSION. Although occupational therapy has been involved in the treatment of people with sub-
stance addiction and, more recently, with behavioral addictions for more than half a century, the research that
has been published is poor.
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
A
ddiction is a complex and multidetermined behavioral phenomenon that
involves genetic, epigenetic, developmental, educational, psychological,
environmental, and cultural elements. It is characterized by the establishment of
habits or repetitive behaviors that bypass behavior oversight mechanisms because
of their short-term pleasant effects, despite negative consequences (Volkow &
Baler, 2014). Addiction is explained as the establishment of habits involving
brain circuits (Newlin & Strubler, 2007). The disease model of addiction has
been strongly criticized, and its principles have been discredited in favor of
environmental elements. Addictive behavior is understood, more or less accu-
rately, as a means of facing life’s difficulties that reflects a condition of the
person in relation to a particular environment. People can recover from an
addictive disorder by learning to more properly manage their difficulties, and
their environment can be modified to promote the full integration of the in-
dividual into that environment (Hall, Carter, & Forlini, 2015; Levy, 2013;
Satel & Lilienfeld, 2014).
Note. Each issue of the 2017 volume of the American Journal of Occupational Therapy features a special Centennial
Topics section containing several articles related to a specific theme; for this issue, the theme is occupational
therapy’s role in mental health. The goal is to help occupational therapy professionals take stock of how far the
profession has come and spark interest in the many exciting paths for the future. For more information, see the
editorial in the January/February issue, https://doi.org/10.5014/ajot.2017.711004.
7105100030p1
 The combination of knowledge, techniques, and con-
cepts of the importance of human occupation and its
relation to health leads us to conclude that there is currently,
beyond the therapeutic aspects, an occupational science—
that is, a joining of knowledge and research—that allows
professionals to think and express themselves in occupa-
tional terms, regardless of occupational therapy concept
(Yerxa, 1990). The core goal of occupational science is
the consideration of the person as an occupational being;
it is the systematic study of humans as occupational be-
ings, including their need and ability to adapt and get
involved and to structure their occupations to shape their
lives. Therefore, the objectives of occupational science are
to generate a systematic basis for describing and un-
derstanding people’s participation in occupations and to
provide basic knowledge to support occupational therapy
practice (Wilcock, 2001).
One area of interest of this new occupational science is
the study of habits as learned and automated elements of
human occupation that make sense in a given ecoculturally
specific context, merging in a dialectical relationship and
related to personal significance, identity, competence,
satisfaction, and self-expression. Occupational science
investigates and summarizes the interdisciplinary knowl-
edge about habits, including the identification of the
environmental conditions that improve occupation and
environmental potential; the contribution of habits to
health or to its deterioration; the identification of strengths,
abilities, and personal interests; and people’s recovery when
they experience a decline and reconstruct themselves by
changing their habits (Yerxa, 2002).
Addiction is a personal problem and a public health
problem. It affects a person’s occupational history and the
people who live in his or her environment, and it changes
the person’s role and affects performance of activities of
daily living (ADLs). Therefore, addiction can be studied
by using an occupational approach. Some authors have
even suggested that addiction is an occupation in itself
and should be studied as such (Sackman, Sackman, &
DeAngelis, 1978). For many years, there have been at-
tempts to study the contributions of occupational therapy
to the treatment of addiction and its effects (Hossack,
1952; Welsh, 1959), but occupational therapy still plays a
secondary role to more prominent disciplines; in many
instances, it is relegated to the role of entertainer—to
keeping people with addiction busy rather than using
occupation as the means and aim of the intervention
according to scientific principles (Rojo-Mota, 2008).
Nevertheless, the scientific basis for occupational therapy
must come from theoretical proposals, the definition of
professional roles, and scientific research.
7105100030p2
The aim of the current study was to conduct a
systematic review of the aspects linking theoretical models,
professional practice, and research findings to the
understanding of addiction and treatment provided by
occupational therapy. The review aims to answer three basic
questions:
1. Does occupational therapy have its own theoreti-
cal and conceptual framework to explain addictive
phenomena?
2. Does it have intervention protocols focused on achiev-
ing strictly occupational objectives?
3. Does it provide data on the implementation of its
techniques in treating people with addiction?
Method
Following Preferred Reporting Items for Systematic Re-
views and Meta-Analyses guidelines (Moher, Liberati,
Tetzlaff, & Altman, 2009), searches were performed in
the following main international databases:
• PubMed, with the MeSH terms “occupational therapy”
AND “addiction,” “substance addiction,” “substance-
related disorders,” “substance abuse,” “drug dependence,”
“drug abuse,” “alcoholism,” and “alcohol abuse”
• Academic Search Premier, CINAHL, and ERIC, with the
terms “occupational therapy” AND “addiction,” “drug
dependence,” “alcoholism,” and “addictive behaviors”
• OTseeker, with the descriptors “[Any Field] like ‘oc-
cupational therapy’ AND [Any Field] like ‘substance
abuse’ OR [Any Field] like ‘addiction.’”
A supplementary search was also performed in Google
Scholar (allintitle: “addictive” “occupational”; allintitle:
“addiction” “occupational”; allintitle: “substance abuse”
“occupational therapy”).
The search was limited to 1970–July 2015. The time
range (45 yr) for inclusion was extensive so as to provide a
broad perspective. The inclusion criteria for article se-
lection needed to be wide to provide an overview of the
relationship between occupational therapy and the un-
derstanding of addiction: articles from scientific journals,
book chapters, or any other similar report written in
English. Publications that provide conceptual issues,
professional roles, or results of qualitative or quantitative
research (in which occupational therapy occupies a cen-
tral place in the understanding of and therapeutic ap-
proach to addictive behaviors) were included. The records
selected addressed theoretical approaches, intervention
models, and professional roles or were qualitative or
quantitative studies in which occupational therapy had a
central role. We used Critical Appraisal Skills Programme
UK (2017) criteria for article selection. To determine the
September/October 2017, Volume 71, Number 5
level of evidence, we used Centre for Evidence-Based
Medicine (2009) criteria.
Results
Figure 1 shows the details of the article search and selection.
We retrieved 16 theoretical studies and professional role
studies, 8 qualitative studies, and 14 quantitative studies.
Most of the 237 discarded articles had an element related to
occupational therapy, but either this discipline was not
central to the article or the study’s theoretical or empirical
objectives did not correspond to occupational therapy’s
concepts and methods. Tables 1, 2, and 3 describe the ar-
ticles selected for the theoretical proposal and professional
role studies, qualitative studies, and quantitative studies.
Discussion
Our first conclusion is that occupational therapy’s con-
tribution to the understanding and treatment of addictive
behaviors is poor. Earlier studies have indicated that oc-
cupational therapy services in psychiatric settings have
two main objectives: therapeutic and diagnostic. In
Figure 1. Process of review and selection of articles.
The American Journal of Occupational Therapy
both cases, these concepts refer to the psychiatric in-
tervention, not to occupational activity itself (Welsh,
1959). In addition, Welsh (1959) referred to an at-
tempted clinical alcoholism treatment trial in the scope
of occupational therapy. However, Welsh referred not
to a specific protocol but to a project from which he
drew on material scattered throughout the source cited
(Hossack, 1952). There is no evidence that this project
was ever carried out. In any case, these references sup-
port the existence of occupational therapy services in
treating people with addiction since the middle of the
20th century.
Therefore, as in other clinical settings, occupational
therapy has separated from the preeminent disciplines
and developed its own framework, which is used in the
treatment of addiction. The articles published in the
1980s refer, in the vast majority of cases, to roles framed by
psychiatric services, with occupational therapy as a secondary
and complementary activity. The paradigm of alcoholism as
a mental illness and the understanding of alcoholism from a
psychoanalytic perspective are predominant in the field of
psychiatry, in which occupational therapy has provided
complementary actions, such as training in handling money
(Kunz, 1988). Articles that tackle alcohol addiction from a
biopsychosocial perspective and apply occupational therapy
concepts appeared only at the end of the 1980s (Van
Deusen, 1989). The first attempt to provide a theoretical
framework of addiction from a strictly occupational per-
spective appeared in 2003 (Helbig & McKay, 2003).
Authors such as Helbig and McKay (2003) considered
addiction a complex activity that alters the person’s oc-
cupational sphere. Other authors have studied addic-
tion as an occupation itself, to the extent that it can give
meaning to life; act as an important determinant of
health, well-being, and justice; organize behavior; develop
and change over a lifetime; shape and be shaped by en-
vironments; and have therapeutic potential (Haltiwanger,
Lazzarini, & Nazeran, 2007). In both theoretical ap-
proaches, addiction is, in essence, an occupation that
is strongly influenced by environmental elements, ex-
ceeding biological or psychological approaches that give
a central role to factors specific to the individual. Sur-
prisingly, no studies have been derived from these theo-
retical approaches, except for 1 qualitative study that
explored addiction as occupation and its potential utility
in implementing occupational therapy interventions for
substance-related and addictive disorders (Wasmuth,
Crabtree, & Scott, 2014). However, a recent article’s in-
quiry into the concepts relevant to occupational therapy
suggests the need to validate and adapt the occupa-
tional assessment tools available in this particular clinical
7105100030p3
Table 1. Theoretical Proposals and Professional Roles in the Systematic Review of Occupational Therapy in the Treatment of Addiction
Author/Year Issue Conclusions
Buijsse, Caan, & Application of occupational therapy in the A framework for service organization promoted the effective integration of
Fowler Davis (1999) treatment of people with addictive behaviors occupational therapy into multidisciplinary treatment provision.
Chacksfield & Forshaw Role of occupational therapy in assessing and The article focuses on occupational therapy in the forensic addictive behaviors
(1997) treating patients with the tripartite problems unit, but many of the issues discussed apply to patients with addiction in
of mental disorder, dangerousness, and an other forensic psychiatric settings.
addictive behavior
Crouch & Wegner Multidisciplinary intervention for substance use The article describes how occupational performance is affected by drug and
(2014) and abuse that includes occupational therapy alcohol dependency, the place of occupational group therapy in the treatment
of persons with drug and alcohol problems, the importance of follow-up and
aftercare, and the importance of community drug and alcohol programs and
how they are implemented. It also describes occupational assessment tools
and details of activities used in occupational therapy.
Gutman (2006) Brain Disease Model of addiction: implications Therapists can help clients practice and learn needed social skills in group
for occupational therapy practice settings. Practice should involve specific situations that are likely to be
encountered by clients as they attempt to assume desired roles in the larger
community. Possessing the skills to interact with others in socially ac-
ceptable ways and to resolve conflicts nonaggressively can reduce stress
that could potentially trigger relapse.
Haltiwanger, Lazzarini, Nonlinear dynamics systems theory, also Occupational therapists can use their boundless creativity to create strategies
& Nazeran (2007) referred to as chaos theory, in the practice of to build on the habitual routines established in brain dynamics. The
occupational therapy: the Neuro-Occupation reinstatement of habits is clearly sensitive to initial conditions, so the person
Model develops new habits and never returns to old routines.
Helbig & McKay Addiction in relation to occupational risk factors, Addiction is occupational in nature and can lead to occupational disruption.
(2003) the nature of occupation, environmental in- Viewing addiction from an occupational perspective may reveal new un-
fluences, flow, and boredom derstanding about ways to maximize the health and capacity of people with
addiction.
Kiepek & Magalhães Addiction as occupation The findings have implications for the conceptualization of occupations,
(2011) including the relationship between occupation and health, the potential risk
for negative consequences through occupational engagement, a deeper
exploration of occupational patterns and performance, and the influence of
context. A potential role for occupational science in the field of addictions is
proposed.
Kunz (1988) Money management problems of patients with This article describes teaching modules for budgeting, experiential shopping
addiction and their need to develop new skills excursions, and ways to obtain referral to community resources for help with
to manage their incomes successfully money management problems after discharge from the program.
Lindsay (1983) Role of the occupational therapist in the treat- Patients are given support to accept the chronic disease of alcoholism, are
ment of alcoholism taught skills needed to maintain sobriety, have opportunities to begin using
resources for sobriety, and are assisted in regaining a sense of self-worth.
Moyers (1988) Organizational framework for occupational The article describes psychodynamic levels of occupational intervention in the
therapy in the treatment of alcoholism treatment of alcoholism.
Moyers (1992a) Neurocognitive approach to alcoholism Emphasis is given to occupational therapy evaluation and assessment of
neurocognitive recovery and the corresponding treatment strategies
designed to facilitate experience-dependent recovery in alcoholism.
Moyers (1992b) Occupational intervention with the family of the A family treatment approach, based on systems theory, is organized into three
person with alcoholism hierarchical treatment levels that accommodate the family’s maladaptive
roles. Family treatment methods thought most likely to produce the desired
results are delineated according to treatment level.
Moyers (1997) The Moyers Model for occupational therapy: The revised Moyers Model is both more consistent with the Alcoholics
spiritual recovery Anonymous principles of spiritual recovery and in keeping with the
occupational therapy philosophy of addressing the needs of the whole person.
Rotert (1989) Role of the occupational therapist in treatment Occupational therapy supports a biopsychosocial premise in assisting people
of people with alcoholism with alcoholism to establish a sober lifestyle for recovery as a part of
treatment.
Smith & Glickstein Art as a therapeutic modality for people with Because people are often sensitive about their artistic skills, all rewards for
(1982) alcohol problems aesthetically pleasing productions were minimized. The authors told the
group that drawing, for the purpose of the art experience, was secondary to
allowing themselves to experience their art productions and their feelings.
Artistic skills were not a prerequisite.
Van Deusen (1989) Perceptual–motor deficits in patients with The occupational therapist must document a relationship between dysfunction
alcoholism in activities of daily living and perceptual–motor dysfunction in the patient
with alcoholism. Unless such a relationship is established, treatment of
perceptual–motor dysfunction in patients with alcoholism would not fall
within the scope of occupational therapy.

7105100030p4 September/October 2017, Volume 71, Number 5

Table 2. Qualitative Studies Included in the Systematic Review of Occupational Therapy in the Treatment of Addiction
Author/Year Aim Method N Results CASP
Cardinale, Malacari, Brog- Empowerment of mothers Mixed quantitative and 3 Two participants improved their personal 9
gi, Savignano, & Fisher in recovery qualitative method growth initiative. Participant reflection
(2014) provided insight into the women’s inner
feelings.
Heuchemer & Josephsson Homelessness and Narrative 2 Homelessness was identified as a life of high 8
(2006) addiction intensity lived within a limited time
perspective related to drug addiction, which
was experienced at first as a solution to life
situations that seemed impossible
to handle.
Knis-Matthews (2007) Experiences of 5 men Observation and in- 6 Themes were related to the role of spouses 9
and 1 woman with depth interviewing and extended family members who
substance dependence assumed primary responsibility for children
who were parents and during a parent’s drug addiction.
receiving treatment
Knis-Matthews (2010) Experiences of 5 men Observation and in- 6 An overarching metathematic category, the 9
and 1 woman with depth interviewing, destructive path and powerful appeal of
substance dependence using constant addiction, describes why the participants
who were parents and comparison method reported feeling most comfortable in the
receiving treatment and thematic role of drug addict and found order in the
analysis chaos of the addictive lifestyle.
Lange (1988) Ethnographic interview as Interview and self- 5 interviews, Habilitation and rehabilitation must be offered 7
an occupational therapy reports 31 self-reports in a context relevant to the individual and
needs assessment tool should include family participation when
for Native Americans possible. The occupational therapist should
with alcoholism encourage clients’ cultural identification as
a way to increase self-esteem and sense of
affiliation, necessary components of
health.
Martin, Smith, Rogers, Women in treatment for Narrative inquiry with 10 Alterations in occupational identity, 9
Wallen, & Boisvert substance addiction thematic analysis of occupational performance patterns, and
(2011) data performance capacity were revealed.
Environmental elements contributing to
addiction and those important in recovery
were identified.
Ussher, McCusker, Mor- Implementation of a Single-group multiple 10 Four of the 5 participants for whom case 8
row, & Donaghy (2000) physical activity in- case and self- studies were presented made substantial
tervention by an occu- reports gains in all the target areas: independence,
pational therapist in a integration, education, and health.
community alcohol
service
Wasmuth, Crabtree, & Exploration of addiction Qualitative thematic 10 This study adds new insight into firsthand 9
Scott (2014) as occupation analysis experiences of addiction as occupation.
Destigmatizing addiction and understanding
it as an occupation may aid occupational
therapists in developing rapport and
facilitating more satisfactory occupational
lives for people struggling with substance-
related and addictive disorders.
Note. CASP 5 Critical Appraisal Skills Programme (CASP criteria range from 0 to 10).

setting and design the occupational therapy framework
in a specific way (Crouch & Wegner, 2014).
Regarding occupational therapy, few studies have
focused on the field of addiction. Just 8 qualitative stud-
ies focused on specific issues, such as ethnic differences,
homelessness, addicted fathers and mothers, and gen-
der differences, and the number of quantitative studies
focusing on occupational therapy in comprehensive
treatment programs is not much greater. To conduct
studies, validated measures to estimate variables char-
acteristic of occupational therapy are required. Although
many validated occupational therapy instruments exist for
other clinical settings (Asher, 2007), few have been used
with people with addictions. The psychometric properties
of these measures have rarely been explored, and in any
case, they have replicated the few results available.
All the studies included in this review had a low level
of evidence. They were limited to case series and provide
little of relevance; they used small or incidental samples
and no control groups; and they did not randomize
participants, which does not allow generalization of the
findings. The only study that provided a better level of

The American Journal of Occupational Therapy 7105100030p5

evidence is a systematic review of effective treatments
for addictive behaviors (Stoffel & Moyers, 2004), which
included only self-help and psychological studies. The
authors stated that occupational therapy studies that ex-
amine the efficacy and effectiveness of interventions for
people with substance use disorders were lacking. The only
controlled clinical trial (Detweiler et al., 2015) had severe
deficiencies in its methodology, which make its results
questionable. Its main conclusion was that occupational
therapy researchers need to examine interactions among
person, environment, and occupation to understand some
of the complex aspects of prevention and recovery that are
ignored in the current literature.
Certainly, occupational therapy has developed a wide
range of instruments for populations with impairments in
occupational performance resulting from brain injury,
psychomotor disorders, environmental factors, mental
health, and so forth, many of which seem potentially ap-
plicable to occupational assessment and diagnosis of people
in recovery from addiction. A critical requirement of such
measures is the determination of their psychometric prop-
erties, construct validity, and diagnostic validity in a pop-
ulation with distinct characteristics, such as the population
with addictive behaviors. Some of the interventions that
must be measured to quantify the impact on addiction re-
covery, beyond the mere achievement and maintenance of
abstinence, are rehabilitation of brain function, alternative
roles to addiction, performance improvement, enrichment of
the environment, empowerment of the person, and, ulti-
mately, use of the therapeutic process as a means and as a goal
(Haltiwanger et al., 2007).
This systematic review was intended to answer three
questions. The answer to the first question is clear: Oc-
cupational therapy has models that are able to explain
addiction from the occupational perspective, without
requiring concepts and models from other disciplines. The
answers to the other two questions are not so optimistic.
These theoretical models have not yet been translated into
proposals for occupational intervention whose results
could be measured and translated into controlled clinical
trials. Only recently have we found proposals that rep-
resent the start of an occupational intervention that is
capable of generating effectiveness studies in coming years
(Crouch & Wegner, 2014).
Limitations of this systematic review include the
article selection process. The main inclusion criterion was
the centrality of occupational therapy in conceptual or
professional proposals or qualitative or quantitative re-
search studies. The concept of centrality is ambiguous
and can lead to biases in its application. If the inclusion
criteria had been more flexible, we could have included
7105100030p6
more studies, but we considered the inclusion criteria
necessary to investigate the role of occupational therapy in
the problem treated. Therefore, we omitted articles that
applied explanatory models and interventions from other
disciplines (psychology and psychiatry) and offered only a
tangential view of the role of the occupational therapist.
Implications for Occupational
Therapy Practice
The results of this study have the following implications
for occupational therapy practice:
• Even though occupational therapy has intervened in
the clinical field of addiction for more than 70 yr, its
scientific production has been poor; few studies have
been conducted, all with low levels of evidence.
• In the past decade, occupational therapy researchers
have proposed models of addiction that attempt to
explain how addiction affects a person’s occupational
life and that consider addiction itself to be an occupa-
tion. Despite having a conceptual framework and the-
oretical models, few studies have evaluated occupational
therapy treatment of people with addiction.
• A critical deficiency is the absence of validation studies
of assessment tools for people with substance abuse or
behavioral addictions. In the absence of specialized
occupational therapy instruments, it is difficult to de-
sign rigorous studies to provide scientific evidence on
the effectiveness of occupational interventions.
• Occupational therapy practitioners must address the
challenge of finding evidence of their usefulness in the
field of addictions, as they have done in many other
clinical settings, and as corresponds to their method-
ological reference, occupational science.
Conclusion
Despite the fact that occupational therapy has been in-
volved in the treatment of people with substance addiction
and, more recently, with behavioral addictions for more
than half a century, the volume of research published is
poor. As a start, models exist to guide research that is based
on concepts and objectives strictly from occupational
therapy, without overlapping with other clinical disci-
plines. An urgent need exists to validate instruments that
measure occupational variables in populations with ad-
diction as a prerequisite for the design of quality research
projects. Occupational therapy, as an independent sci-
entific discipline, must prove this state through the de-
velopment and publication of studies that explore the
benefits of interventions for ADL performance. s
September/October 2017, Volume 71, Number 5
 Table 3. Quantitative Studies Included in the Systematic Review of Occupational Therapy in the Treatment of Addiction
Author/Year Aim
Andersson, Eklund, Relationship between women’s
Sundh, Thundal, & patterns of everyday occupation
Spak (2012) and alcohol consumption using the
broader concept of occupation
from occupational therapy models
Boisvert, Martin, Grosek, Peer-support communities
& Clarie (2008)
Method
Cross-sectional
Mixed methods including pretest–
posttest measures, semistructured
interviews, and participant
Tools
Semistructured interview
Volitional Questionnaire 4.0
Level of
N Conclusions Evidence CASP
851 Using an individually oriented method, 4 —
2-step clustering, 3 distinct patterns
of everyday occupations were
identified. Significant associations
with problematic alcohol
consumption were found in the
clusters characterized by lower
engagement in leisure activities
and larger amount of spare time.
18 A peer-supported community 4 —
program focused on self-
determination can have a

The American Journal of Occupational Therapy

Detweiler et al. (2015) HT as a subgroup of OT. Studies have
indicated that gardening promotes
neuroendocrine and affective
restoration from stress.
Lindstedt, Grann, & Assessment of occupational
Söderlund (2011) performance and social
participation in offenders with
a mental disorder (50% with
addiction)
Martin et al. (2015) Development of a measurement
instrument, the LHQ
Miguez (1981) Comparison of the effectiveness of
4 therapeutic orientations in
alcoholism treatment: behavioral,
psychosocial, occupational, and
multiple
observation
Random assignment to the HT or the • Quality of Life Enjoyment and
OT group; attendance at supervised Satisfaction Questionnaire–Short
HT and OT groups 5 hr/day for 3 wk Form
• Alcohol Craving Questionnaire
• Posttraumatic Stress Disorder
Checklist, Civilian Version
• Center for Epidemiologic Studies
Depression Scale
Longitudinal • Capability to Perform Daily
Occupations
• Allen Cognitive Level Screen
Psychometrics (cases) LHQ
Longitudinal: treatment (2 wk) and Abstinence length
follow-up (1 yr)
significant positive impact on
recovery from addiction.
49 The trends suggest that HT may 4 5
modulate stress in veterans, as
evidenced by
decreased cortisol levels and
depressive symptoms, and may
improve quality of life more than
the programs in which the OT
group participated.
36 The group was generally more 4 —
satisfied and engaged in daily
occupations after treatment.
229, Phase 1 The LHQ is a promising new 4 —
268, Phase 2 assessment of occupational
dysfunction for people
entering treatment for substance
abuse. It contains factors that
reflect occupational therapy
practitioners’ concerns with
clients’ performance in context.
145 People receiving occupational and 4 —
behaviorally oriented treatments
achieved a 5-mo abstinence period
as an estimated average
effectiveness. People receiving
psychosocially oriented
treatments achieved 7 mo
of abstinence.

(Continued)

7105100030p7
 Table 3. Quantitative Studies Included in the Systematic Review of Occupational Therapy in the Treatment of Addiction (cont. )
Author/Year Aim
Peloquin & Ciro (2013) Satisfaction in self-development
7105100030p8
groups
Raphael-Greenfield (2012) Occupational therapy assessment of
executive and performance
functioning and indicators of
community adjustment among
adults with a history of
homelessness and substance
abuse
Rojo-Mota, Pedrero-Pérez, Development of a measurement
Ruiz-Sánchez de León, instrument: ADO
Llanero Luque, &
Puerta Garcı́a (2011)
Rojo-Mota, Pedrero-Pérez, Administration of the AMPS
Ruiz-Sánchez de León, to people in treatment for
& Miangolarra Page addictive behaviors
(2014)
Scaffa (1991) Determination of whether significant
differences in temporal adaptation
exist between alcoholic and
nonalcoholic participants through an
evaluation of interests and use of
time
Stoffel & Moyers (2004) Description of effective interventions Evidence-based review
from other disciplines that improve
outcomes consistent with the domain
of occupational therapy and use an
occupational perspective to modify
the interventions shown to be
effective in order to facilitate
engagement in activity and
participation within the community
September/October 2017, Volume 71, Number 5
Method
Cross-sectional
Descriptive and correlational
Psychometrics (cases and controls)
Case series
Cross-sectional (cases and controls)
Level of
Tools N Conclusions Evidence CASP
Ad hoc survey 1,488 Self-development activity groups 4 —
appear to be a satisfactory and
engaging intervention for women in
recovery from substance abuse.
Executive Function Performance Test 60 Measurable levels of cognitive 4 —
and task impairment were
documented. An implication of this
study for occupational therapists
working with homeless clients
who abuse substances is the
importance of assessing and
treating their cognitive
impairments as well as
providing these services within
housing-first agencies.
ADO (self-assessment of occupational 300 addicts A self-report tool was validated 4 —
performance) 25 nonclinical measuring occupational
population performance in everyday life in a
population with addiction.
AMPS 101 Motor and cognitive performance 4 —
were negatively related to duration
of addiction and its severity. Sixty
percent of the sample reached
suboptimal scores.
Matsutsuyu’s Interest Checklist, 25 alcoholics in People with alcoholism tend to have a 4 —
Hourly Time Log treatment variety of leisure interests but
25 nonclinical actively engage in very few of
population these activities. Other areas of
dysfunction for this population
include maladaptive habits,
deficits in the worker role, and
poor use of time. Problems in daily
life organization or temporal
dysfunction can be associated
with alcoholism.
Various 20 Occupational therapy studies that 3a 4
examine the efficacy and
effectiveness of interventions for
persons with addiction are lacking.
(Continued)
 References

Evidence CASP

Note. — 5 study was not evaluable; ADO 5 self-assessment of occupational performance; AMPS 5 Assessment of Motor and Process Skills; CASP 5 Critical Appraisal Skills Programme (CASP criteria range from 0 to 10);
—

—
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