Group Occupational Therapy Intervention Helps People With Mental Illness Rebuild Recovery

Recovery from mental illness has long been described as a deeply personal journey rather than a simple return to symptom-free health, yet researchers have few detailed accounts of how specific interventions actually shape that journey. A new qualitative study published in the Scandinavian Journal of Occupational Therapy now offers one of the most systematic looks yet at how participants in a structured occupational therapy programme experience personal recovery, and its findings suggest that the everyday, practical dimensions of life may matter just as much as psychological ones. The research, led by Mona Eklund and Elisabeth Argentzell of Lund University in Sweden, examined the recovery experiences of people who completed Balancing Everyday Life, a sixteen-week group intervention designed to help mental health service users achieve a more balanced daily life and move toward personal recovery.

The scientific significance of the study lies in its deductive design. Rather than letting themes emerge freely from interview data, the researchers deliberately mapped participants’ narratives onto the CHIME framework, a widely accepted conceptual model of personal recovery developed through systematic review. CHIME stands for Connectedness, Hope and optimism, Identity, Meaning and purpose, and Empowerment, and it has become something of a gold standard for characterising what recovery from mental health problems actually involves. By testing whether the experiences of Balancing Everyday Life participants fit this established framework, the investigators could determine both whether the intervention promotes recovery in the sense that the field recognises and whether it offers anything the framework itself has overlooked.

The data came from a re-analysis of in-depth qualitative interviews originally collected during and after a randomised controlled trial of the intervention. From nineteen original interviewees, the researchers purposefully selected eleven information-rich cases: nine women and two men aged between thirty and sixty-three, with an average age of forty-six. Their diagnoses spanned bipolar disorder, psychosis, emotionally unstable personality disorder, ADHD, PTSD, eating disorders, panic disorder, depression, stress-related problems and previous substance abuse. Crucially, all had been interviewed at the completion of the intervention, allowing the researchers to capture recovery reflections at a consistent point in time. Semi-structured interviews lasting between thirty minutes and two and a half hours were transcribed verbatim and then analysed using the three phases of deductive content analysis: preparation, organising and reporting.

The results were striking in their breadth. Every one of the five CHIME categories was represented in the participants’ accounts, and most of the framework’s subcategories appeared as well. Two categories dominated the narratives, however: Connectedness and Empowerment. Participants repeatedly described how the safe, accepting climate of the group allowed them to open up to others, share experiences, exchange tips and support each other’s goals. One participant described recognising fellow group members as comrades in a shared fight, even when their specific goals differed. Another explained that the group was the first place she felt able to talk with people who had also been through hardship, expanding a social network she had not previously had and breaking a cycle of isolation that many mental health service users know intimately.

The importance of trusting relationships extended beyond the peer group to the healthcare staff who led the sessions. Participants emphasised that group leaders who listened without rushing, who radiated calmness and who responded to missed sessions with empathy rather than critique strengthened their confidence in the care system and in themselves. Support from family, friends and even new acquaintances made through the intervention also featured prominently, with one participant describing how a friend introduced through a fellow group member helped her get to a gym activity and became a source of mutual inspiration. These findings align with a substantial body of occupational therapy research showing that group-based activity interventions carry therapeutic value precisely because belonging and shared occupation reinforce one another.

The Empowerment category proved equally central. Participants spoke about personal responsibility in their own care, including having a voice in decisions about medication, and about regaining control over daily life through concrete strategies. One participant set a goal of reducing his sleeping pills and valued the freedom to experiment with his doctor rather than simply following a prescription. Others described learning to set limits, to tell an employment agency when they could not cope with too many changes, to break housework into manageable half-hour segments, and to let go of activities that drained them, such as one participant who abandoned a photography hobby when the fear of failure outweighed the joy. Balancing rest and activity, setting realistic goals matched to one’s abilities, and pacing oneself step by step emerged as practical recovery tools that participants carried into their everyday lives.

Beyond confirming the CHIME categories, the study made a discovery with potentially broader implications: two recovery experiences that the framework does not cover appeared consistently in the data. The first was occupational balance, the sense that daily activities are satisfyingly mixed, aligned with personal values and matched to one’s abilities. Because Balancing Everyday Life is explicitly built around learning about and self-analysing occupational balance, its prominence among participants’ recovery experiences may reflect what is distinctive about occupational therapy as a discipline. The second was self-esteem and self-confidence, which participants reported had grown through the course and which the researchers suggest could be added to CHIME’s Identity category. These additions hint that recovery frameworks developed in psychology and psychiatry may benefit from incorporating occupational science concepts that capture how people structure and experience their daily doing.

The study’s findings also illuminate the temporal nature of recovery. Categories such as Hope and optimism, Identity and Meaning and purpose appeared in the narratives but less prominently, and not all of their subcategories were identified. The researchers propose a plausible explanation: participants were interviewed shortly after completing the intervention, at a relatively early stage of what is often a long, multi-phase recovery journey. People earlier in that journey may experience belonging and connection most vividly, while hope, a redefined identity and a rebuilt sense of meaning may consolidate later. This interpretation is supported by the intervention’s randomised trial data, which showed that quality-of-life improvements among Balancing Everyday Life participants emerged only at a six-month follow-up rather than immediately after completion. The authors therefore call for follow-up studies that track recovery after occupational therapy interventions over longer horizons.

Methodologically, the researchers took deliberate steps to ensure trustworthiness. Two occupational therapy students coded transcripts independently and reached consensus under supervision, while one author independently re-analysed an entire interview, with discrepancies resolved through iterative discussion at the subcategory level. The selection of participants across different regions, group leaders, genders, ages and service contexts strengthened dependability, and illustrative participant quotes bolstered credibility. The authors acknowledge that the interview data was originally collected for earlier inductive studies and that the interview guide did not probe recovery specifically, but they argue that this openness was actually a strength, since questions framed around CHIME would have led participants toward the framework’s own concepts rather than testing whether those concepts genuinely fit their experience.

The clinical implications are concrete. The study concludes that Balancing Everyday Life supports recovery in the way the field has conceptualised it, providing evidence that practitioners can use when encouraging service users to enrol. Perhaps more importantly, it demonstrates that an occupational therapy intervention, grounded in everyday activity rather than symptom management, can foster the connectedness, hope, identity, meaning and empowerment that define personal recovery. For a population that research consistently shows to be under-occupied, isolated at home and struggling with imbalanced daily routines, the message is quietly radical: recovery can be built through the ordinary architecture of daily life, one goal, one homework assignment and one shared group session at a time. As mental health systems worldwide search for recovery-oriented services, this Swedish study suggests that the humble tools of occupational therapy, goal setting, self-reflection, activity strategies and peer belonging, deserve a central place in that conversation.

The broader context of the study’s intervention is worth noting. Balancing Everyday Life was evaluated in a randomised controlled trial across community-based and specialist psychiatry units in southern and western Sweden, where it demonstrated significant gains in occupational engagement, activity level and occupational balance compared with standardised treatment. The intervention itself unfolds over sixteen weeks through fourteen themed group sessions covering topics such as meaning and motivation, daily habits and social activities. Between sessions, participants pursue individually chosen homework activities, a structure rooted in self-reflection, goal setting and the testing of activity strategies in real-world settings.

The concept of personal recovery that anchors the analysis has its own history. Established during the 1990s as an alternative to purely biomedical notions of clinical recovery, it emphasises that individuals can experience health and well-being despite persisting symptoms, regaining control over their lives and participating more actively in meaningful activity. The CHIME framework was developed to bring clarity to this process and is now used in both research and clinical practice internationally.

The study also situates itself within a documented problem: mental health service users tend to live low-active lives, spending much of their time on sleep, meals, self-care and quiet pursuits, with isolation at home common and under-occupation far more frequent than overload. Occupational balance, defined as a subjectively satisfying mix of work, leisure, housework and rest aligned with personal values, has been shown to link with well-being and recovery, making it a natural target for therapeutic attention. The study was approved by the ethical review board in Lund and conducted in accordance with the Declaration of Helsinki.

Subject of Research: Recovery experiences of mental health service users participating in the Balancing Everyday Life occupational therapy intervention, analysed with the CHIME recovery framework

Article Title: Recovery experiences among mental health service users going through the Balancing Everyday Life™ intervention – A deductive qualitative study

Article References: Eklund, M., & Argentzell, E. (2025). Recovery experiences among mental health service users going through the Balancing Everyday Life ™ intervention – A deductive qualitative study. Scandinavian Journal of Occupational Therapy, 32(1), Article 2451267. https://doi.org/10.1080/11038128.2025.2451267

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2451267

Keywords: occupational therapy, mental health recovery, Balancing Everyday Life, CHIME framework, personal recovery, occupational balance, empowerment, connectedness, qualitative research, group intervention, mental illness, Lund University