a patient with his therapist undertaking occupational therapy whilst in addiction recovery
Page last updated Monday 29th Jun 2026
Page written by Victoria McCann

Occupational therapy helps when addiction has made everyday life harder to manage. People sometimes picture recovery as a tough week in detox followed by support group meetings. But sustainable progress means rebuilding every part of your life one piece at a time. Addiction can affect your career and education, and take all enjoyment out of the things and people that are most important to you.

At Castle Health, occupational therapy is part of how we help with this rebuilding work. It’s delivered at Castle Craig in Scotland, Smarmore Castle in Ireland, and Beroendeklinik in Sweden, as well as through our outpatient services.

What is occupational therapy?

Occupational therapy, often shortened to OT, is a clinical discipline that helps people rebuild the practical, daily functions that illness or addiction has disrupted. According to the Royal College of Occupational Therapists, the goal is to help people ‘improve their ability to function as independently as possible’ so they can take part in the activities that matter to them.

Addiction tends to make the small but important things in life harder. Sleep is often affected first. Then the energy and motivation needed to go to work or spend time with people who ask you how you’re doing.

a patient with his therapist undertaking occupational therapy whilst in addiction recovery

An occupational therapist works alongside you to identify which parts of daily life have been worn down and help you put them back. You set the goals, and your therapist helps you find a workable route towards them.

Occupational therapy in mental health and addiction settings has a particular focus on what you do, day to day, rather than only how you feel about it. At Castle Health, OT is delivered in person at our residential centres and as part of our outpatient programmes.


How does occupational therapy support addiction recovery?

The longer addiction continues, the more it takes the place of the activities and relationships a person previously gave time to.

A 2023 paper in Nordisk Alkohol Nark by Doğu and Özkan describes occupational therapy as ‘more person-centred’ than many medical approaches to substance use. It focuses on the impact of addiction on the activities of daily living, and the restoration of pre-addiction roles, rather than on quitting the substance alone.

Occupational therapy for addiction isn’t a separate track running alongside the rest of treatment. It’s how what you learn in detox and therapy starts to fit into an ordinary day. Drug and alcohol occupational therapy shows you how to use what you’ve learned even when you’re tired, or back in a place that used to mean drinking.

two happy men sitting next to each other, one an ex addict and the other his sober companion

Doğu and Özkan also note that people who took part in occupation-based programmes ‘experienced fewer episodes of relapse’ and were more likely to disengage from activities associated with substance use. A separate 2023 review by the Canadian Agency for Drugs and Technologies in Health (CADTH) found that OT interventions may help reduce symptoms of depression and anxiety, which often co-occur with addiction.

Rebuilding routine and structure

Addiction often affects normal daily routines before anything more visible. Sleep, meal times, task management, and energy can all be impacted as addiction takes hold. In OT, your therapist will look at what your day used to involve, and help you put structure back in place. That can mean fixed sleep and wake times, a workable plan for meals, scheduled time for rest or exercise, and protected space for things that just help you feel good. These are small changes but they are fundamental to recovery.

Developing coping strategies and managing relapse triggers

Triggers are personal. For one person it’s a time of day. For someone else it’s a place that used to mean drinking.

Part of occupational therapy and substance use work is mapping out which triggers apply to you, and building a practical toolkit for handling them when they arrive.

That toolkit is usually small and specific. It might be a worked-out response to the next time someone offers a drink, or a short list of people you can call.

A 2021 scoping review by Ryan and Boland in the Irish Journal of Occupational Therapy describes life-skills development as core to OT practice in addiction recovery, from managing stress to holding your ground in difficult conversations.

You can’t avoid every difficult moment. The point is to have a workable plan when one arrives.

Rebuilding roles, relationships and confidence

Addiction tends to narrow the roles a person occupies. By the time treatment begins, the parent or partner you used to be can feel a long way off.

Occupational therapy gives explicit space to rebuilding these roles. That can involve communication work, rehearsing difficult conversations, repairing routines with family members, or thinking through which relationships are healthy to invest in and which are not. Ryan and Boland’s review describes the development of social and assertiveness skills as a recurring feature of effective OT programmes in addiction recovery.

Confidence tends to follow function. As the practical work of daily life becomes manageable again, the sense of being a competent person in your own life tends to return with it.

“I contacted Castle Health (formerly CATCH Recovery) seeking guidance and options to support a relative who was having a difficult time both with addiction and other mental health concerns. The team were incredibly kind and informed, they took the time to go through all the options with me and helped us plan how to approach the matter. Fortunately the person has now been receiving care from CATCH for several months and is doing really well. A big thank you to the wonderful team. I would highly recommend this service.”

Wendy O'Brien, 28/10/22

Returning to work after addiction: how occupational therapy helps

Work is one of the areas addiction reaches into most quickly, and one of the most consequential to rebuild. Sustained alcohol or drug use takes a toll on the clarity and energy that a working day requires. Just returning to work can feel out of reach when you first enter treatment.

Inpatient occupational therapy at Castle Health includes vocational work as a named part of the programme. Returning to work involves a sequence of small but fully-supported decisions. Your therapist will help you think through what return to work might look like, what your current capacity is, and what a realistic pace of reintegration would be. Ryan and Boland’s 2021 review of OT interventions in addiction settings noted that vocational support, including practical help with applications and rebuilding the skills work requires, was a consistent feature of effective programmes.

a man returning to his car manufacturing job after receiving occupational therapy
What to expect from occupational therapy sessions at Castle Health

Sessions begin with a one-to-one assessment with your occupational therapist. The aim is to understand what your day looks like now, what you would like it to look like, and where the practical sticking points are. From that, you and your therapist agree a small set of short and longer-term goals to work on together.

What that looks like depends on those goals. Sessions might include planning around a return to work, or rehearsing how you’ll handle a specific situation. Occupational therapy treatment at Castle Health is delivered within our residential programmes and as part of outpatient care. The work can continue at the appropriate intensity as you move through treatment.

The sessions are practical, and you should leave each one with something that makes the next day a little more workable.

Occupational therapy as part of a wider treatment plan

Occupational therapy is one part of a wider treatment plan. At Castle Health, OT sits alongside medical detox, Cognitive Behavioural Therapy (CBT), group therapy, 12 Step facilitation work and aftercare. All play a role in making sustainable progress towards your goals.

An American systematic review by Wasmuth, Pritchard and Kaneshiro reviewed how OT fits within wider addiction treatment. They concluded that adding occupation-based interventions to other treatment ‘may elicit small but significant improvements in recovery’. The mix that suits you will depend on where you are in your recovery, and what kind of support you need.

Some people begin with inpatient treatment in a residential treatment setting, where occupational therapy is delivered as part of a structured weekly programme. Others access OT through outpatient treatment, alongside other types of therapy that fit the rest of their life. You and your therapist agree the plan together.

Supporting someone in your life who needs occupational therapy

If you’re trying to support someone in your life whose work and relationships have been affected by addiction, you already know how difficult it is to know what to suggest. Occupational therapy can be useful because it gives you something practical to work on together. That can be easier than another conversation about how they’re feeling.

That uncertainty is normal. Family and couples therapy is part of what we offer at Castle Health, and our admissions team can talk you through what is involved in a confidential conversation. If you’re not sure how to start a conversation with someone in your life, we can also help you think through how to approach it, including whether a structured intervention might be appropriate.

The first step is the hardest one to take. But we’ll be here when you’re ready.

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Occupational therapy: frequently asked questions

Is occupational therapy available as part of inpatient rehab?

Yes. At Castle Craig in Scotland, Smarmore Castle in Ireland, and Beroendeklinik in Sweden, occupational therapy is built into the residential treatment programme. You’ll have individual sessions and, where relevant, group work as part of your structured week.

How is occupational therapy different from CBT or counselling?

Cognitive Behavioural Therapy (CBT) and counselling work mostly with how you think and feel. Occupational therapy works with what you do, day to day. The two complement each other. CBT helps you understand the patterns. OT helps you build the practical routines that change them.

How long does occupational therapy take to make a difference?

It varies. Some people notice small shifts within the first two weeks of structured work, particularly around sleep and routine. Bigger changes take months, and often keep developing well after the formal sessions end.

Can occupational therapy help with behavioural addictions as well as substance use?

Yes. Occupational therapy looks at how an addictive behaviour gets in the way of daily life. That’s true for substance use and behavioural addictions like gambling or gaming. The principles are the same: understand which parts of daily functioning have been displaced, and rebuild them deliberately.

Do I need a referral to access occupational therapy at Castle Health?

No referral is needed to enquire. You can contact our team directly to discuss whether occupational therapy as part of our wider programme is right for you, and our admissions team will guide you through what happens next.