Harm Reduction-Oriented Occupational Therapy for Substance Use Disorders: A Retrospective Cohort Study

Abstract

ImportanceIdentifying factors associated with sustained engagement in harm reduction-oriented occupational therapy may help inform more accessible interventions for individuals with substance use disorders (SUDs).ObjectiveTo examine participant characteristics associated with sustained engagement in the Real-Life Program (RLP), a harm reduction-oriented outpatient occupational therapy program for individuals with SUDs, and to explore changes in occupational and psychosocial outcomes among participants who continued the program.DesignRetrospective cohort study.SettingSingle-site outpatient occupational therapy program.ParticipantsFifty-five individuals with SUDs enrolled in the RLP. Participants were classified into continued (≥47% attendance) and noncontinued (<47%) groups based on the median participation rate.Outcomes and MeasuresCanadian Occupational Performance Measure (COPM), Rosenberg Self-Esteem Scale-Japanese version, Shitsu-Taikan-Sho Scale, and visual analog scales for craving intensity and perceived connectedness to others.ResultsPrior self-help group experience was significantly associated with continued participation. Older age showed a nonsignificant association. No other demographic or clinical characteristics differed significantly between groups. Among participants who continued the program, COPM Satisfaction improved significantly, whereas COPM Performance, self-esteem, alexisomia, craving intensity, and perceived connectedness did not.Conclusions and RelevancePrior self-help group experience was associated with sustained engagement in the RLP. Among participants who continued the program, satisfaction with daily occupations improved, although the clinical significance of this change remains uncertain. The RLP may provide a feasible harm reduction-oriented occupational therapy option for individuals with SUDs who have difficulty engaging in abstinence-based treatment programs.