Occupational therapy: activity as a working tool in the acute dual pathology unit

Abstract

Dual pathology —the comorbidity of a psychiatric disorder and a substance use disorder— entails greater clinical and social severity, more admissions and suicide risk, and poorer adherence, so it is recommended to treat both disorders simultaneously with multidisciplinary teams. The article describes the contributions of occupational therapy (OT) in acute dual pathology hospitalization units, where the average stay is 15 to 21 days. Starting from models of the discipline (Model of Human Occupation, Canadian Model of Occupational Performance) and of the approach to change (Transtheoretical Model, Motivational Interviewing), an individualized and voluntary treatment is proposed with common objectives: to foster awareness of illness, the positioning towards consumption, adherence to treatment and linkage to referral resources at discharge. The use of purposeful activity and its analysis, adaptation and gradation throughout the exploration, competence and achievement phases is detailed. The author concludes that almost 80% of patients voluntarily engage with OT and that activity makes it possible to experience and analyse the improvement process through occupation.