A scoping review of occupational therapy interventions in the treatment of people with substance use disorders

Purpose Diagnosis of substance use disorders and addictive behaviours are growing worldwide. It is timely to examine and collate literature on the nature of occupational therapy intervention in this field, to increase understanding of current practice and inform future directions. The purpose of this paper is to source and synthesise literature on occupational therapy interventions used in the treatment of people experiencing addiction. Design/methodology/approach Four databases were searched in August 2019. A total of 597 titles were screened, and 18 studies with varying methods met inclusion criteria. A narrative synthesis of the included literature was arranged into themes to summarise key findings. Findings Findings were grouped into three themes about occupational therapy provision to people experiencing addiction: single occupation focused intervention; skills training (including sub-themes on daily living skills and vocational skills); and establishing a community-based sober routine. Research limitations/implications Further research on this topic should focus on efficacy of treatments and build on current findings to develop more rigorous research with appropriate sample sizes to support evidence-based practice. Originality/value This study presents a synthesis of how occupational therapy interventions have been used to treat people experiencing addiction issues. Findings indicate occupational therapy appears to fit well within addiction treatment and assert that occupational therapy is most supportive when interventions go beyond the teaching of skills alone to prioritise occupational engagement and client centred practice.

A gardening and woodwork group in mental health: a step towards recovery

Purpose This paper aims to evaluate the impact of an eight-week gardening and woodwork group programme on individuals’ recovery goals in an adult community mental health setting. Design/methodology/approach Seven individuals participated in the research. The programme was designed and facilitated by two occupational therapists (the authors) and one horticulture and trade skills facilitator. The goal attainment scale was used as a quantitative outcome measure as it allowed individuals to collaboratively set occupation-focused recovery-oriented goals. Due to the small sample size, descriptive statistics were used to analyse this data. Qualitative feedback was gathered through participant feedback forms when the programme ended. Findings Quantitative findings indicate positive results for individuals’ progression towards their recovery goals, with six out of seven participants either achieving or exceeding their goals. One person who attended only one out of eight groups had “worse than expected” goal achievement. Originality/value While there is evidence for the use of gardening and woodwork group therapy in mental health settings, most studies have relied on symptom-focused questionnaires or qualitative results rather than quantifiable recovery-oriented measures (Cipriani et al., 2017; Kamioka et al., 2014; Parkinson et al., 2011). It is hoped that this paper begins to bridge that gap and also outlines how recovery principles, gardening and woodwork can be incorporated into occupational therapy group programmes. This is of particular merit during the COVID-19 pandemic, which has led to a greater need for group intervention in outdoor settings, where social distancing can be comfortably facilitated.

The meaning of open-water swimming for adults in Ireland: a qualitative study

Purpose There has been an increase in swimming in natural bodies of water as reported in personal qualitative accounts. However, limited academic research has explored the meaning of this occupation. Engaging with nature, exercising and being part of a community contribute to better mental and physical health. The purpose of this research was to explore the meaning that adults attribute to open-water swimming in natural bodies of water. Design/methodology/approach This study used phenomenological interviews to explore the meaning that five adults attribute to open-water swimming. Findings Open-water swimming contributes to meaning-making in many ways. Participants reported swimming as necessary for maintaining mental and emotional well-being and forming meaningful connections with the social environment, nature and their true selves. Research limitations/implications This study contributes to the understanding of the meaning of open-water swimming for adults in Ireland. Understanding the meaning of this occupation may add to the body of evidence exploring blue-space to promote health. Originality/value Open-water swimming is an occupation growing in popularity. This is the first paper to explore open-water swimming from an occupational perspective. This may provide an alternative perspective for viewing blue-space engagement and understanding the relationship between health, blue-space occupations and our oceans.

Post-operative management of flexor tendon injuries at zone II and flexor Pollicis Longus – a survey of Irish practice

Purpose The post-operative management of flexor tendon injuries has been the focus of considerable exploration and there continues to be variation in approaches and methods of mobilisation. The purpose of this paper is to explore therapy management following repair to flexor tendons at zone II and flexor pollicis longus (FPL) (all zones) in Ireland. Design/methodology/approach A descriptive survey questionnaire design through an online format was used. Therapists were recruited through the Irish Association of Hand Therapists, the national bodies for occupational therapy and physiotherapy and therapy managers in acute hospitals, with 29 therapists participating in the study. Descriptive statistics were used to analyse the survey data. Findings Patients were generally seen three to five days following surgery. Early active mobilisation approaches were favoured by all but one therapist, with 62% using the Belfast protocol and 34% the Manchester Short Splint (MSS) protocol. Each early active protocol exercise session commences with passive motion followed by graded active flexion. Tenodesis is incorporated by the majority of respondents within the first four weeks. Therapy programme and splints are modified based on patient presentation. Resistance exercises are commenced from week seven. Patient compliance was identified as the most influential factor in the post-operative intervention approach taken. Originality/value This study provides the first Irish profile of current practice in the post-operative management of flexor tendon repairs at zone II and FPL which has not previously been reported. Further research should explore the reasoning behind the interventions chosen and also the implications for practice of changes to surgical techniques.

Experiencing success: an occupational therapy partnership programme. Gymnastics for children with attention deficit hyperactivity disorder

Purpose This paper aims to outline and evaluate a pilot partnership programme – an Occupational Therapy–led gymnastics group intervention for children aged eight to twelve with a diagnosis of attention deficit hyperactivity disorder (ADHD). Design/methodology/approach The overall aim of this programme was to increase participation in a valued leisure occupation. Based on the needs of the children, a physical-activity-based intervention was chosen that was challenging, novel and motivating. The intervention was then developed to target executive functioning and processing skills; enhance motor coordination skills; develop social skills; and primarily provide a positive experience. Seventeen children attended 75-minute sessions weekly for eight weeks. The programme was evaluated using non-standardised qualitative measures – parent, child and coach evaluation questionnaires were developed by the occupational therapist for this purpose. Findings Children engaged well in the programme with results showing increased participation and enjoyment of a new leisure occupation; improvement in social interaction levels and a sense of belonging; and development of motor and process skills. The results demonstrate the benefit of a partnership approach and suggest sustainability of the programme as well as the gains made. Originality/value The results of this evaluation suggest that the programme met its aims and supports further research into the efficacy of this type of partnership approach and intervention in supporting children with ADHD attending Child and Adolescent Mental Health Services.

Multidisciplinary approach to assessment and intervention of feeding problems in children with autism spectrum disorders: a clinical perspective

Purpose The aim of this paper is to share the details of a multidisciplinary approach, which includes occupational therapy, and to review the factors that should be considered in the evaluation and treatment of children with autism spectrum disorders (ASD) who are excessively selective in their food choices. Issues in this area are complex and often related to several complementary domains (medical, nutritional, psychosocial, sensorimotor, etc.). However, feeding disorders are frequently assessed and treated from a single discipline and important issues are missed or confounded. Design/methodology/approach A team of experienced clinicians in the field of paediatric feeding disorders gathered the knowledge and experience they acquired from working with individuals with ASD as well as with individuals with other neurodevelopmental diagnosis. A review of current literature in paediatric feeding disorders was used to document and explicate the multifactorial nature of feeding disorders in children with ASD and justify the need for a multidisciplinary approach to issues in this area. Findings Feeding disorders in children with ASD are linked to multiple sensory, motor, behavioural, nutritional and gastrointestinal comorbidities. A multidisciplinary approach is needed and increasingly recommended. However, multidisciplinary teams, specialised in the care of children with ASD and feeding issues, continue to be difficult to locate and access for families. The authors sought to highlight the signs of feeding problems in children with ASD from different domains and share a model of a multidisciplinary approach that can lead to more successful interventions. Originality/value The detailed description of the domains linked to feeding issues and the clinical descriptions provided throughout the paper create a roadmap for other clinicians aiming to set up similar teams.

Skills for transition: the perspectives of women seeking asylum in Ireland

Purpose Current domestic and international research predominantly examines the past experiences of people seeking asylum and the negative influences such experiences have on health and well-being. However, few studies address the future needs of people seeking asylum, as they transition from Direct Provision. This study aims to address this gap in knowledge by exploring the perspectives of women seeking asylum in Ireland on the skills they think they will need, as they transition from Direct Provision to life in Ireland. Design/methodology/approach A qualitative methodology using a community-based participatory research (CBPR) approach was used, to collect data collaboratively and sensitively with a vulnerable population group. Convenience sampling was used to recruit six women seeking asylum in Ireland, to participate in focus groups and semi-structured interviews. Data were transcribed and analysed using thematic analysis. Findings Women seeking asylum identified four themes of skills for doing, skills for being, skills for becoming and skills for belonging that are necessary for life in Ireland after Direct Provision. Barriers and opportunities to develop these skills were documented as sub-themes. The skills identified under these themes and sub-themes included work, education, driving, childcare, social integration, money management, home management, health management and leisure. Originality/value Using participatory methodologies, future research should further explore the skills required for transition from Direct Provision, to continue to raise awareness of the potential for occupational injustice and the role occupational therapists could play in this transitional period.

Can an ecological-transactional systems model in occupational therapy contribute to a social prescribing programme?

Purpose The spread and level of loneliness is today considered a public health issue. Attempts to promote or reduce the level of loneliness have been made, one of which is social prescribing (SP), developed and extensively used. Complex interventions such as SP are advised to be connected to theory. Design/methodology/approach For this purpose, the Person-Environment-Occupation-Participation model (PEOP) will be reviewed and used as an example, both as a way of organize occupational knowledge and as a model for practice. Findings Occupational therapy underpinned by transactional system theory such as the PEOP model seems to give comprehensive and relevant support in the SP process. Particularly, this model can guide practitioners through crucial phases when assessing needs, matching interests and goals with relevant occupations, as well as understanding of important components embedded in the program. Originality/value This opinion piece offers insights in why and how specific components connected to SP needs to be understood by theory and applied by personnel to facilitate a meaningful and sustainable occupational performance for the individuals.