An interdisciplinary evidence-based review of interventions among persons with substance-use disorders was completed in 2001 as part of American Occupational Therapy Association's (AOTA's) Evidence-Based Literature Review Project (Lieberman & Scheer, 2002). Four effective interventions for adults and adolescents with substance use were identified, including brief interventions, cognitive behavioral therapy, motivational strategies, and 12-step programs. The research studies reviewed reported outcomes primarily related to reduction in alcohol and drug use. Occupational therapy interventions grounded in current evidence-based literature are suggested. Interventions are modified to include an occupational perspective leading to outcomes consistent with the Occupational Therapy Practice Framework (American Occupational Therapy Association [AOTA], 2002). Study findings propose research questions to encourage further investigation of the effectiveness of these best practice interventions.

The Guide to Occupational T h e ra py Practice describes the general scope of occupational therapy practice for all persons or groups of individuals experiencing problems or for those at risk for problems in performing the daily activities necessary for functional independence, health, and well-being. Because this practice guide does not addre s s specific issues related to a particular diagnosis, to a part i cular age gro u p, or to a particular performance pro b l e m , T h e Guide to Occupational T h e ra py Practice was designed for use in conjunction with the other American Oc c u p ational Therapy Association (AOTA) Practice Gu i d e l i n e s. Use of the more general guide with the diagnostic-based or problem-based practice guidelines provides an exc e l l e n t understanding of occupational therapy serv i c e s .

Occupational therapy practitioners must assess how the profession fits within new models of care and be involved in studying the models’ impact on key health care outcomes related to the “Triple Aim” of lowering costs, improving patient experience, and managing the health of populations.

This article compares two differing models of intervention for persons with alcohol dependence--the Moyers Model for occupational therapy and Alcoholics Anonymous (AA). Both models were found to share practice strategies but to differ in their emphasis on spirituality and self-control. Additionally, the Moyers Model was basically procedural in its description of the clinical reasoning process, whereas AA places great emphasis on the spiritual aspects of recovery. Because this disparity may lead to confusion when the person with alcohol dependence is involved in both an occupational therapy program (using Moyers Model) and an AA program, the Moyers Model was revised to include a conditional reasoning structure (i.e., a process for therapists to help clients find meaning in actions). By providing opportunities to explore meaning through action during occupations, the revised Moyers Model is both more consistent with the AA principles of spiritual recovery and in keeping with the occupational therapy philosophy of addressing the needs of the whole person.

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