Assessing Executive and Community Functioning Among Homeless Persons with Substance Use Disorders Using the Executive Function Performance Test

Abstract

This study investigates the utility of an occupational therapy assessment of executive and performance functioning and indicators of community adjustment among adults with histories of homelessness and substance abuse. A sample of 60 individuals living in a supported housing programme was interviewed about community living experiences and was assessed using the Executive Function Performance Test (EFPT). A descriptive and correlational study design was used. Measurable levels of cognitive and task impairment were documented, in older adults, non-US citizens and those diagnosed with cognitive impairments. Those who had completed a supported education/employment programme (Total EFPT t = -2.83, 0.008) performed better as did those who were employed (Total EFPT t = -2.33, 0.03), met regularly with their case managers (cooking t = -2.07, 0.04), had hobbies (paying bills r = -0.31, 0.02) and had longer periods of abstinence (organization/planning t = -3.59, 0.001). Limitations of the study include the unanticipated need by the clients for additional translation services. Future directions include a randomized controlled intervention study using the EFPT. 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.

Neurocognitive impairment in a large sample of homeless adults with mental illness

“…Deficits in several neuropsychological domains such as verbal memory, visual memory, attention, processing speed, and executive functioning have been reported among homeless samples . However, previous studies have major limitations, including small sample sizes, unique service settings, the use of generalized and brief measures of neurocognitive functioning (e.g., Mini Mental State Examination), and only a single neurocognitive measure .…”

Psychosocial Benefits of Cooking Interventions: A Systematic Review

“…Cooking tasks have been used to evaluate motor skills in clinical populations including those with chronic obstructive pulmonary disease (Bendixen, Waehrens, Wilcke, & Sorensen, 2014), strokes (Poole, Sadek, & Haaland, 2011), cardiovascular disease (Putzke, Williams, Daniel, Bourge, & Boll, 2000), and in the frail elderly (Provencher, Demers, Gelinas, & Giroux, 2013). Assessment of the ability to perform cooking tasks also is used to evaluate executive function planning in individuals with traumatic brain injury (Poncet et al, 2015), substance abuse (Raphael-Greenfield, 2012), strokes (Baum et al, 2008), and in the elderly (Provencher et al, 2013; M. Y. Wang, Chang, & Su, 2011).…”

Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

“…Several studies have employed performancebased occupational therapy evaluations and cognitive assessments with individuals who are homeless to assess instrumental ADL performance relative to functional cognition, safety, and community living [31,[35][36][37][38][39][40]. These studies demonstrate that occupational therapy evaluation can adequately assess for ongoing functional difficulties, and identify effective treatment plans in order to increase independence for individuals with SMI and TBI.…”