{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:55Z","timestamp":1792787815378,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","award":["JP23K19931"],"award-info":[{"award-number":["JP23K19931"]}],"id":[{"id":"https:\/\/ror.org\/00hhkn466","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Identifying factors associated with sustained engagement in harm reduction-oriented occupational therapy may help inform more accessible interventions for individuals with substance use disorders (SUDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine participant characteristics associated with sustained engagement in the Real-Life Program (RLP), a harm reduction-oriented outpatient occupational therapy program for individuals with SUDs, and to explore changes in occupational and psychosocial outcomes among participants who continued the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single-site outpatient occupational therapy program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Fifty-five individuals with SUDs enrolled in the RLP. Participants were classified into continued (\u226547% attendance) and noncontinued (&lt;47%) groups based on the median participation rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Measures<\/jats:title>\n                    <jats:p>Canadian Occupational Performance Measure (COPM), Rosenberg Self-Esteem Scale-Japanese version, Shitsu\u2013Taikan\u2013Sho Scale, and visual analog scales for craving intensity and perceived connectedness to others.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prior self-help group experience was significantly associated with continued participation. Older age showed a nonsignificant association. No other demographic or clinical characteristics differed significantly between groups. Among participants who continued the program, COPM Satisfaction improved significantly, whereas COPM Performance, self-esteem, alexisomia, craving intensity, and perceived connectedness did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Prior self-help group experience was associated with sustained engagement in the RLP. Among participants who continued the program, satisfaction with daily occupations improved, although the clinical significance of this change remains uncertain. The RLP may provide a feasible harm reduction-oriented occupational therapy option for individuals with SUDs who have difficulty engaging in abstinence-based treatment programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19437676261464094","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:12:38Z","timestamp":1788592358000},"page":"785-794","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Harm Reduction-Oriented Occupational Therapy for Substance Use Disorders: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3083-7210","authenticated-orcid":false,"given":"Yuichi","family":"Murata","sequence":"first","affiliation":[{"name":"Social Rehabilitation Department, Saitama Prefectural Mental Health Center, Ina, Saitama, Japan"},{"name":"Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7076-2161","authenticated-orcid":false,"given":"Toshihiko","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0714-0342","authenticated-orcid":false,"given":"Naomichi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan"},{"name":"Department of Health Sciences, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5645-0439","authenticated-orcid":false,"given":"Toyohiro","family":"Hamaguchi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3987-0383","authenticated-orcid":false,"given":"Toshiyuki","family":"Ishioka","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"issue":"2","key":"e_1_3_3_2_1","first-page":"7412410010","article-title":"Occupational therapy practice framework: Domain and process (4th ed.)","volume":"74","author":"American Occupational Therapy Association","year":"2020","unstructured":"American Occupational Therapy Association. 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