Effectiveness of the Functional-Cognitive and Sensory Treatment for Improving Daily Functioning of Individuals with Substance Use Disorder: A Randomized Controlled Trial.

Purpose: To examine the effectiveness of the Functional-Cognitive and Sensory Treatment (F-CaST) for individuals with Substance Use Disorder (SUD), in supporting daily functioning and reducing dropout from the therapeutic community. Patients and Methods: A single-blind randomized controlled trial was conducted in a therapeutic community. Participants were randomly allocated to either the F-CaST group or a control group receiving standard care. The F-CaST consisted of 16 sessions (eight group and eight individual sessions) delivered over eight weeks and focused on teaching strategies individually tailored for executive function deficits and sensory modulation dysfunction linked to participants' personal occupational goals. Assessments were conducted at pre (T1), immediately post-intervention (T2), and at 1- and 3-month follow-ups (T3-T4). Primary outcomes included occupational performance and satisfaction measured by the Canadian Occupational Performance Measure (COPM), dropout rates, and length of stay in the therapeutic community. Results: Thirty-three participants were randomized to F-CaST (n=20) or standard care (n=13). Both groups demonstrated significant improvements in COPM performance and satisfaction over time; however, the F-CaST group showed a more favorable pattern of improvement and higher rates of clinically meaningful change (72% vs. 39% at 3 months). Dropout rates were significantly lower in the F-CaST group at T2 (22% vs. 62%). No significant between-group differences were found in length of stay. Conclusion: F-CaST appears to be a feasible and promising intervention that may support improvements in occupational performance, satisfaction, and early treatment retention among individuals with SUD in therapeutic communities.