Occupation-focused intervention for in-patient mental health settings: Pilot study of effectiveness

Purpose: Participation in meaningful occupation is associated with recovery in serious mental illnesses, however, few evidence-based, occupation-focused interventions for hospital settings exist. This study investigated the effectiveness of "Occupational Connections" (OC), a manualized, short-term, group intervention, addressing issues in daily-life occupations' participation and functioning of people with serious mental illness as early as during hospitalization. Methods: Thirty-three inpatients with schizophrenia completed single-blind, pre-post study procedures (up to 10 weeks) in two groups: OC group intervention and open leisure activity group (control condition), in addition to treatment as usual. They were assessed for occupation and participation dimensions, perceptions of services as recovery-oriented, comprehensive cognitive functioning and schizophrenia symptoms. The sampling was convenience with sequential group allocation. Results: Improvements were found in the study group in the following measurements: intention to participate in daily activities (t(15) = -2.62, p < .05), participation diversity (t(15) = -2.11, p < .05), experience the recovery orientation of the service (t(15) = -3.15, p < .01), functional capacity (t(15) = -3.44, p < .01), cognitive abilities of language understanding, memory and shifting ( - 4.5 < t(15) < 3.3, p < .05), and schizophrenia symptoms (positive, negative and general: 8.47 < t(15) < 9.12, p < .01). The control group has improved on attention (t(16) = -2.89, p < .05), visual-motor organization (t(16) = 2.14, p < .05) and schizophrenia symptoms (4.4 < t(16) < 6.6, p < .01) only. Conclusions: The study provides initial evidence for the effectiveness of OC. The results suggest that interventions with a focus on personal, meaningful daily life occupations such as the OC, may be a useful tool contributing to a positive experience of the in-patient staying and successful community reintegration after acute psychiatric hospitalization.