As an occupational therapist working within Change Grow Live’ s Coventry drug and alcohol service, I’ ve seen how occupational therapy can be used to offer a person-centred approach to individuals with complex needs. We’ ve embedded these practices within our service

offering, with significant success.

Occupational therapy remains underused in substance services across the UK, despite calls from the Royal College of Occupational Therapists for a greater presence. Some NHS trusts and third sector providers have begun integrating occupational therapists into their teams, contributing to a small but growing network of occupational therapists within the sector, but it is far from standard practice.

One of the reasons for this slow uptake is a widespread misunderstanding of what occupational therapy is.

It’ s common for people’ s understanding of what an occupational therapist can do to be limited to a few settings they’ re already familiar with, such as physical rehabilitation. While that’ s one area of practice, it’ s actually much broader and deeply rooted in enabling people to do the things that they need and want to do.

SAFER ALTERNATIVES At the heart of occupational therapy, we look at under standing what we call‘ occupation’. This includes not just work, but everything a person does that gives them meaning – cooking,

self-care, managing money, socialising, even rest.

We work with individuals to identify barriers in their daily lives – physical, psychological, environmental, or social – and support them to overcome these. In a substance use context, this can mean helping someone regain the confidence to cook for themselves, advocate for accessible housing, or create a structured daily routine.

For many people, substance use can be a coping mechanism. Alcohol may help someone feel more confident. Crack cocaine might block out intrusive thoughts. Opiates might relieve

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