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Assessing executive and community functioning among homeless persons with substance use disorders using the executive

Emily Raphael-Greenfield1

  • 1Programs in Occupational Therapy, Columbia University, NY, NY, USA. eir12@columbia.edu

Occupational Therapy International
|May 9, 2012
PubMed
Summary

Occupational therapy assessments reveal cognitive impairments in adults experiencing homelessness and substance abuse. Addressing these executive function deficits is crucial for improving community adjustment and successful supported housing outcomes.

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Area of Science:

  • Occupational therapy
  • Neuroscience
  • Public health

Background:

  • Homelessness and substance abuse often co-occur with cognitive impairments.
  • Executive functioning deficits can hinder community adjustment and independent living.
  • Occupational therapy offers a framework for assessing and addressing these functional deficits.

Purpose of the Study:

  • To evaluate the utility of an occupational therapy assessment for executive and performance functioning.
  • To identify indicators of community adjustment in adults with histories of homelessness and substance abuse.
  • To explore the relationship between cognitive functioning and community living experiences.

Main Methods:

  • A descriptive and correlational study design was employed.
  • Sixty adults in a supported housing program were assessed using the Executive Function Performance Test (EFPT).
  • Interviews were conducted regarding community living experiences.

Main Results:

  • Cognitive and task impairments were documented, particularly in older adults, non-US citizens, and those with diagnosed cognitive impairments.
  • Employment, participation in supported education/employment programs, regular case management, hobbies, and longer abstinence periods correlated with better performance on the EFPT.
  • Specific executive functions like organization/planning and cooking showed significant correlations with life factors.

Conclusions:

  • Occupational therapy assessments, like the EFPT, are valuable for identifying cognitive impairments in this population.
  • Addressing cognitive deficits is essential for improving community adjustment and outcomes in supported housing.
  • Future research should include randomized controlled intervention studies based on EFPT findings.