Graduation Year


Document Type


Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy


Background: Exploring occupational therapy (OT) practitioners’ competence when working with clients with co-occurring substance use disorders (SUD). Current literature demonstrates a gap regarding OT practice and SUD as a co-occurring diagnosis.

Purpose: The purpose of this qualitative instrumental case study design is to illustrate and more fully understand the issue of OT evaluation and intervention for clients co-diagnosed with SUD, specifically using the Model of Human Occupation Screening Tool (MOHOST) (assessment) in multiple settings.

Theoretical Framework: The Occupational Therapy Practice Framework (OTPF) and the Model of Human Occupation (MOHO) is the framework and theoretical lens used to guide this project.

Methods: The design of this qualitative study involved semi-structured interviews to evaluate participants’ knowledge of SUD and the Model of Human Occupation (MOHOST). The MOHOST was disseminated to all participants with instructions during the initial interview. Follow-up interviews completed at 5 weeks post initial interview. Interviews were electronically recorded for data collection and analyzed and coded to identify emerging themes.

Results: A total of four OT practitioners participated in this study. Primary themes included: The city of Baltimore, MOHO/MOHOST, SUD, and on the job training. OT practitioners identified several systemic limitations within Baltimore, directly impacting clients’ ability to abstain from substances. Furthermore, the MOHOST was informally utilized during evaluation and treatment. Limited formal training opportunities currently exist for OTs to use the MOHOST. Secondly sub-themes were alcohol abuse, pain medication abuse, withdrawal, and the importance of client background.

Conclusions: The study objectives were met. The introduction of the MOHOST allowed therapists to become more comfortable and begin to integrate SUD within evaluation and treatment approaches with clients of co-occurring SUD. This capstone recognizes OT practitioners and the importance of clinical competence for clients with co-occurring SUDs, specifically within the urban area called Baltimore. It also demonstrates the importance of evidence-based practices in this emerging area of substance abuse.

Faculty Mentor

Christine Privott

Department Affiliation

Occupational Therapy

Committee Member

Shirley P. O'Brien

Department Affiliation

Occupational Therapy

IRB Approval Number (if applicable)