Joining, belonging, and re-valuing: A process of meaning-making through group participation in a mental health lifestyle intervention
Abstract
Background Balancing Everyday Life (BEL), a new group-based intervention for mental health service users, was implemented in Sweden. Mental health service users often experience group interventions as meaningful, but knowledge of the process of meaning-making in a group is lacking.Aim To explore participants' perceptions of the group in the Balancing Everyday Life (BEL) lifestyle intervention; specifically, personal experiences of what brings meaning when participating in a group.Methods This qualitative Grounded Theory study included 26 interviews with 19 BEL participants.Results A process of meaning-making in a group was constructed: Joining with others: from feeling alone to connected, A sense of belonging: mutual support and understanding, and Re-valuing Self: respect and self-worth. No longer feeling alone contributed to meaning. Peers and group leaders were considered important parts of the group, and participants appreciated feeling understood, respected, and helping others.Conclusion The proposed process of meaning-making, as well as 'Joining' as a unique step, seems to be new contributions which could help practitioners when organizing groups. Overcoming fear of joining could break a cycle of isolation and lead to connecting and belonging. The value of participants finding purpose through helping others should be further explored.
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Participants reported the BEL program structure and content tailored to their skills and interests were helpful, along with opportunities to connect with peers and share life experiences in a supportive environment.
“Overall, participants reported the BEL program structure and content tailored to their skills and interests were helpful, along with opportunities to connect with peers and share life experiences in a supportive environment (69–71)”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [70]
The BEL group components encouraged reflection, envisioning and connecting to a more positive future, and sustaining change.
“The group components also encouraged reflection, envisioning and connecting to a more positive future, and sustaining change (69–71).”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [70]
Connectedness and belonging were central to participants' experiences of the BEL intervention.
“This suggests connectedness and belonging were central to participants’ experiences of the BEL intervention (70).”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [70]
Peer learning and support were identified as beneficial aspects of the group programs, but only P2P involved lived experience co-facilitators.
“While peer learning and support were also identified as beneficial aspects of the group programs (70, 72), only P2P involved lived experience co-facilitators.”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [70]
Group leaders' and participants' perspectives of the BEL intervention have been reported, suggesting the value of joining with others and group support to bring about meaningful activity changes in daily life.
“Group leaders' and participants' perspectives of the BEL intervention have also been reported, suggesting the value of joining with others and group support to bring about meaningful activity changes in daily life (29, 30).”
From Implementing an action over inertia group program in community residential rehabilitation services: group participant and facilitator perspectives (2021) · cites this paper as [29]
Lund et al. described the power of the group for supporting change, highlighting that group participants gain value from connecting with and helping each other, the sense of belonging and the provision of mutual support in groups, as well as the content of the group.
“Similarly, Lund et al. (29) described the power of the group for supporting change, highlighting that group participants gain value from connecting with and helping each other, the sense of belonging and the provision of mutual support in groups, as well as the content of the group.”
From Implementing an action over inertia group program in community residential rehabilitation services: group participant and facilitator perspectives (2021) · cites this paper as [29]
As in other activity change focused groups, the AOI facilitators used participation in activities along with social interactions between members to educate, inspire, and instill hope.
“As in other activity change focused groups (29, 47), the AOI facilitators used participation in activities along with social interactions between members to educate, inspire, and instill hope.”
From Implementing an action over inertia group program in community residential rehabilitation services: group participant and facilitator perspectives (2021) · cites this paper as [29]
The BEL intervention seemed to enhance activity and key recovery tenets over time.
“Qualitative studies from that project show that the intervention seemed to enhance activity and key recovery tenets over time [23, 24].”
From Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data (2020) · cites this paper as [23]
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“A process of meaning making in a group was constructed where participants could join with others, feel connected, belong, and experience mutual support and understanding through a Balancing Everyday Life (BEL) intervention (*Lund et al., 2019).”
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“Qualitative studies have been carried out as well, where the intervention was seen by participants as contributing to an increased experience of meaning and support to find strategies for a more balanced everyday life [7,8].”
InfluentialSelf-citationSawamura, D., Ito, A., Miyaguchi, H., Nakamura, H., & Ishioka, T. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.887069 · Cited by 5 · see citing works
Rosyad, R., Naan, N., & Busro, B. (2021) · TEMALI Jurnal Pembangunan Sosial · doi:10.15575/jt.v4i2.12824 · Cited by 4 · see citing works
“…feel part of a group; (3) Able to fulfill life guidance by setting realistic life goals, being able to make decisions, being able to accept responsibility, being able to design for the future, being able to take new ideas and being satisfied with the work that has been done (Lund et al., 2019).”
BackgroundContributions of a time use perspective in community mental health practice: a scoping review
Fossey, E., Doroud, N., Harvey, C. A., Dun, C., Hitch, D., Farnworth, L., & Krupa, T. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1461705 · Cited by 5 · see citing works
Forsberg, K., Sutton, D., Stjernswärd, S., Bejerholm, U., & Argentzell, E. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07034-5 · Cited by 2 · see citing works
“Furthermore, group-based interventions that facilitate connection and include informal peer support have also shown to support recovery [13, 14].”
Self-citationGalili-Simhon, S., & Maeir, A. (2023) · British Journal of Occupational Therapy · doi:10.1177/03080226231177842 · Cited by 4 · see citing works
Rönngren, Y., Björk, A., Haage, D., & Audulv, Å. (2024) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2344805 · Cited by 4 · see citing works
“The group format seems to facilitate meaning-making by creating a sense of belonging, mutual support, and understanding (Lund et al., 2019) but also represents a way to learn from each other and increase health literacy.”
Skills for life: A review of life skills and their measurability, malleability, and meaningfulness
McGrath, R. E., & Adler, A. (2022) · doi:10.18235/0004414 · Cited by 6 · see citing works
Argentzell, E., & Eklund, M. (2025) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2025.2571891 · Cited by 3 · see citing works
Self-citationStories of Change: Comparative Time-Framed Experience Telling in Health Promotion Group Discussions
Lögren, A., Ruusuvuori, J., & Laitinen, J. H. (2019) · Qualitative Health Research · doi:10.1177/1049732319877858 · Cited by 3 · see citing works
Opportunities and barriers for occupational engagement among residents in supported housing
Argentzell, E., Tjörnstrand, C., Brunt, D. A., Eklund, M., & Bejerholm, U. (2022) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2022.2141315 · Cited by 3 · see citing works
“Having supportive and collaborative relationships with staff is also one of the fundaments of creating motivation to try new occupations and generally engage in occupations [34] and to be in a personal recovery process [7].”
BackgroundSelf-citationDaily life coping—Helping stress-afflicted people manage everyday activities
Kolind, M. I., Vinkler, S., Kristensen, T., Hansen, S. V., & Christensen, J. R. (2022) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2022.2072948 · Cited by 3 · see citing works
The “Managing Fatigue” programme – Experiences shared by MS participants
Gillisdotter, A., Regardt, M., & Lexell, E. M. (2021) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2021.1905057 · Cited by 2 · see citing works
“Our results thereby confirm previous studies with people with MS [24], as well as other diagnostic groups and other group programmes [46,47], who all recognised the importance of sharing experiences in a group format.”
ResultEklund, M. (2023) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2023.2184718 · Cited by 2 · see citing works
Self-citationHenrickson, L., Jennings, G., & Bewick, B. (2024) · Cogent Education · doi:10.1080/2331186x.2024.2373181 · Cited by 1 · see citing works
“Increased senses of belonging have been linked to positive mental health outcomes (Lund et al., 2019), and feelings of ‘ togetherness ’ facilitated by social engagement in group activities have similarly been linked to enhanced well-being (Wheatley & Bickerton, 2017).”
Mental health – An area of high priority in occupational therapy
Eklund, M. (2021) · British Journal of Occupational Therapy · doi:10.1177/03080226211037864 · Cited by 3 · see citing works
Self-citationKugelman, J., Doohan, M. A., Dyer, B. P., O’Brien, J., Kayal, M., & Chapman, J. J. (2025) · Community Mental Health Journal · doi:10.1007/s10597-025-01518-0 · Cited by 2 · see citing works
“Qualitative studies have shown that people with mental illnesses value the social connection and sense of belonging resulting from participation in group-based exercise and lifestyle programs (Lund et al., 2019; Whybird et al., 2022).”
Jansson, I., Thörne, K. E., & Masterson, D. (2023) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2023.2244547 · Cited by 1 · see citing works
“The importance of this belonging, characterized by sharing, has been described as a facilitating factor for people recovering from MHP in several other studies e.g. Lund et al. 2019; Wästberg et al. 2021; Bergman et al. 2021 [42– 44].”
Lund, K. (2019) · Lund University Publications (Lund University)
Self-citationAfar from Creativity: The Lived Experiences of Multifaceted Professionals in the State of Qatar
Formaran, N. F. (2021) · International Journal for Research in Applied Science and Engineering Technology · doi:10.22214/ijraset.2021.32880
Occupation-based Interventions in Patients With Severe Mental Disorders: A Review Study
Nasiri, E., Nouri, A. K., & Hosseini, S. A. (2023) · Scientific Journal of Rehabilitation Medicine · doi:10.32598/sjrm.12.4.12
Supportive housing residents’ experiences of the intervention active in my home
Tjörnstrand, C., Brunt, D. A., Bejerholm, U., Eklund, M., & Argentzell, E. (2025) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2025.2528803
“One important feature of this environment is the accessibility of social networks, and the so-called informal peer support in group interventions, which have been highlighted as increasing occupational engagement and recovery for mental health service users [20].”
Self-citationMeaning Making and Meaning Made Relating to Longevity Among Taiwanese Indigenous People
Chen, C.-W., & Shiah, Y. (2025) · Journal of Loss and Trauma · doi:10.1080/15325024.2025.2553875
“To date, meaning making has been associated with a sense of belonging (Lund et al., 2019), reduced mental distress (Miklin et al., 2019; Schnell & Krampe, 2020), successful psychological adjustment to stressful life events (Park, 2010, 2017), and psychological well-being (Graci et al., 2018).”
Brooks, H. L., Devereux‐Fitzgerald, A., Richmond, L., Caton, N., Cherry, M. G., Bee, P., Lovell, K., Downs, J., Edwards, B. M., Vassilev, I., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23647517
Brooks, H. L., Devereux‐Fitzgerald, A., Richmond, L., Caton, N., Cherry, M. G., Bee, P., Lovell, K., Downs, J., Edwards, B. M., Vassilev, I., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23647520
Brooks, H. L., Devereux‐Fitzgerald, A., Richmond, L., Caton, N., Cherry, M. G., Bee, P., Lovell, K., Downs, J., Edwards, B. M., Vassilev, I., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23647514
Belonging and Smartphone Addiction Among Adolescents: The Role of Meaningful Living
Kaya, B., & Sözen, C. (2026) · The Journal of Genetic Psychology · doi:10.1080/00221325.2026.2658639 · Cited by 1 · see citing works
Lönn, M. E., Westberg, K. H., Holst, A.-C., & Erlandsson, L. (2026) · Occupational Therapy International · doi:10.1155/oti/9972405
Ayden, J., Hanson, S., Ajayi, J., & Gracey, F. (2026) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2026.2742366
Li, R., & Zhao, N. (2026) · Medicine · doi:10.1097/md.0000000000051140
“[35] In contrast, exploring the path of travel to reduce anxiety through psychological capital may operate through mechanisms such as mastery learning and cognitive flexibility.”
- Authors
- Lund, K., Argentzell, E., Leufstadius, C., Tjörnstrand, C., & Eklund, M.
- Affiliations
- Lund University (SE)
- Corresponding author
- Lund, Kristine
- Venue
- Scandinavian Journal of Occupational Therapy
- Published
- 2017-11-28
- Volume
- 26
- Issue
- 1
- Pages
- 55-68
- ISSN
- 1103-8128 (ISSN-L)
- 1651-2014
- OpenAlex
- W2768406920
- Semantic Scholar
- 3d78bdf8d423f45303024f41b0a59c7d09f5d829
- Cited by
- 56
- References
- 65
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 4 · 2023: 10 · 2022: 8 · 2021: 12 · 2020: 4 · 2019: 6 · 2018: 1
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Occupational Therapy (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Swedish Research Council (521-, -)
- Vetenskapsrådet
- Topics
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Keywords
- meaning-making, group participation, mental health service users, lifestyle intervention, sense of belonging, social isolation, peer support, self-worth, group leaders, helping behavior
- MeSH terms
- Mental Disorders, Female, Humans, Life Style, Male, Middle Aged, Occupational Therapy, Patient Participation, Quality of Life, Sweden, Qualitative Research, Grounded Theory
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