Evidence for interventions to improve and maintain occupational performance and participation for people with serious mental illness: A systematic review
Abstract
OBJECTIVE. This systematic review evaluates the evidence for the effectiveness of interventions within the scope of occupational therapy to improve and maintain performance and participation for people with serious mental illness. Areas included in this review are activities of daily living, instrumental activities of daily living, leisure, social participation, and rest and sleep. METHOD. Databases searched included MEDLINE, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. Reviewers read and assessed citations, abstracts, and full-text articles for inclusion and analysis. RESULTS. Sixty-one articles were selected for inclusion. The review yielded strong evidence for psychoeducation and occupation- and cognitive-based interventions, moderate evidence for skills-based interventions, and limited evidence for technology-supported interventions. CONCLUSION. Results of this review support use of evidence-based practice within the scope of occupational therapy, inclusion of occupational therapy practitioners as mental health service providers, and continued research.
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The interventions contribute to emerging evidence on interventions supporting personal recovery.
“They contribute to emerging evidence on interventions supporting personal recovery (78–80).”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [78]
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BackgroundMethodInfluentialSammells, E., Logan, A., & Sheppard, L. (2022) · Community Mental Health Journal · doi:10.1007/s10597-022-01020-x · Cited by 7 · see citing works
“The complex and dynamic impact of symptoms, stigma and access to supportive treatments can impede a person’s ability to meet daily needs and perform optimally (Caplan, 2014; D’Amico et al., 2018; Gibson et al., 2011).”
BackgroundJones, M. J. (2024) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2024.2326411 · Cited by 6 · see citing works
Ruhsal Hastalıklarda Gevşeme Eğitiminin Ağrı, Yorgunluk Ve Uyku Üzerine Etkisinin İncelenmesi
Kolit, Z., Ekici, G., & Yağcioğlu, A. E. A. (2019) · Ergoterapi ve Rehabilitasyon Dergisi · doi:10.30720/ered.535384 · Cited by 6 · see citing works
Occupational Therapy in Psychiatric Short-Term Hospitalization Units: Scoping Review
García-Gestal, U., Talavera-Valverde, M.-Á., & Souto-Gómez, A.-I. (2024) · Community Mental Health Journal · doi:10.1007/s10597-024-01286-3 · Cited by 6 · see citing works
DeAngelis, T. M., Mollo, K., Giordano, C., Scotten, M., & Fecondo, B. (2019) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-018-00133-5 · Cited by 6 · see citing works
Stratou, E., Gerosideris, N., Daskalou, S. D., & Katsouri, I.-G. (2025) · OTJR Occupational Therapy Journal of Research · doi:10.1177/15394492251353567 · Cited by 5 · see citing works
“Evidence-based practice in occupational therapy mental health settings ensures that interventions are guided by the best available research (AOTA, 2020; D’Amico et al., 2018).”
Hattori, R., Irie, K., Mori, T., Tsurumi, K., Murai, T., & Inadomi, H. (2023) · Hong Kong Journal of Occupational Therapy · doi:10.1177/15691861231177355 · Cited by 5 · see citing works
“Furthermore, these interventions address occupational engagement through various strategies and approaches such as social skills training and cognitive behavioral therapy (D’Amico et al., 2018).”
BackgroundPanuccio, F., Galeoto, G., Valente, D., Ioncoli, M., Márquez, M. A., Tofani, M., & Berardi, A. (2022) · Spinal Cord Series and Cases · doi:10.1038/s41394-022-00486-x · Cited by 5 · see citing works
“Reintegration and social participation are considered fundamental in rehabilitation and specifically in Occupational Therapists’ practice, in order to allow individuals to regain their previous occupational roles or, if this is not possible, to create new ones [10, 11].”
Nissen, R. M., Ikiugu, M. N., Barash, B., Kathol, M., & Oorlog, A. (2022) · Occupational Therapy In Health Care · doi:10.1080/07380577.2022.2031371 · Cited by 5 · see citing works
“This finding was consistent with the professional historical roots in mental health (American Occupational Therapy Association, 2017) and a surprise considering the departure of occupational therapy practitioners away from the mental health specialty in the last few decades (D’Amico et al., 2018).”
BackgroundResultInfluentialContributions 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
Occupational Therapy: A Potential Solution to the Behavioral Health Workforce Shortage
Read, H., Zagorac, S., Neumann, N., Kramer, I., Walker, L., & Thomas, E. C. (2024) · Psychiatric Services · doi:10.1176/appi.ps.20230298 · Cited by 4 · see citing works
Kinney, A. R., Penzenik, M. E., Forster, J. E., O’Donnell, F., & Brenner, L. A. (2024) · American Journal of Occupational Therapy · doi:10.5014/ajot.2024.050583 · Cited by 4 · see citing works
“Indeed, occupational therapy services have been shown to improve performance of ADLs and other activities among those with psychiatric conditions (D ’ Amico et al., 2018; Lipskaya-Velikovsky et al., 2016, 2020).”
Coles, A., & Elliott, T. (2020) · Mental Health Review Journal · doi:10.1108/mhrj-02-2020-0012 · Cited by 4 · see citing works
Kannenberg, K., & Conley, M. (2020) · Work · doi:10.3233/wor-203082 · Cited by 4 · see citing works
“As was found in D’Amico, Jaffe, & Gardner’s systematic review of the research, this case study further demonstrates the value of using occupation-based interventions tailored to the individual’s context and performance environment [20].”
Patmisari, E., Huang, Y., McLaren, C., Bhatia, P., Orr, M., Govindasamy, S., Hielscher, E., & McLaren, H. (2025) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2025.2468421 · Cited by 3 · see citing works
“…IADL categories of Velligan, Mintz [7], where interventions covered in this review are [1]: household skills training, such as cooking and cleaning [2]; skills that enable navigation of more complex challenges in life, e.g. managing finances and medication adherence [3]; skills that enhance…”
InfluentialSargent, J., & Valdes, K. A. (2021) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2021.1875956 · Cited by 3 · see citing works
Kinney, A. R., Penzenik, M. E., Forster, J. E., O’Donnell, F., Fox, V., & Brenner, L. A. (2025) · American Journal of Occupational Therapy · doi:10.5014/ajot.2025.051064 · Cited by 3 · see citing works
Establishment of Reliability of the Occupation-Based Practice Assessment
Stav, W. B., Brothag, A., Krenik, E., Rohr, L., Rubeck, C., Singer, K., & Zukowitz, L. (2021) · OTJR Occupational Therapy Journal of Research · doi:10.1177/15394492211050633 · Cited by 3 · see citing works
“By monitoring the therapeutic use of occupation, practitioners can implement the occupation-based approach proven to be effective (D’Amico et al., 2018; Powell et al., 2016; Robinson et al., 2016; Skubik-Peplaski et al., 2014; Smallfield & Heckenlaible, 2017) to assist clients achieve greater…”
BackgroundKinney, A. R., Penzenik, M. E., Forster, J. E., O’Donnell, F., & Brenner, L. A. (2024) · Psychiatric Services · doi:10.1176/appi.ps.20230650 · Cited by 3 · see citing works
Atler, K. E., & Fox, A. L. (2020) · British Journal of Occupational Therapy · doi:10.1177/0308022620954340 · Cited by 3 · see citing works
“…of occupation in occupational therapy in mental health service contexts Despite the growing evidence for the therapeutic use of occupation in mental health (D’Amico et al., 2018; Kirsh, et al., 2019), there is a paucity of literature examining occupation assessments used in this area of practice.”
BackgroundNasiri, E., Nouri, A. K., Hosseini, S. A., & Mandani, G. (2025) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_1036_23 · Cited by 3 · see citing works
“[29,32] All of these factors could reduce the disease symptoms, recurrence, and risk of hospitalization [30,31] promote doing, activity balance, level of functioning [35] and social functioning [36] improve the patient’s well‑being.”
Bouzas, M. S., De‐Rosende‐Celeiro, I., & Meijide-Faílde, R. (2021) · Health & Social Care in the Community · doi:10.1111/hsc.13544 · Cited by 2 · see citing works
Doğu, S. E., Örsel, S., & Kahiloğulları, A. K. (2025) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2025.2457323 · Cited by 3 · see citing works
“Therefore, occupational therapy facilitates enhancing people’s ability to manage their own health and supports individuals with SMI in self-managing their everyday lives beyond mental illness (D’Amico et al., 2018).”
Kinney, A. R., Nance, M., Penzenik, M. E., Forster, J. E., & Brenner, L. A. (2025) · American Journal of Occupational Therapy · doi:10.5014/ajot.2025.051015 · Cited by 2 · see citing works
“Indeed, inpatient psychiatric occupational therapy services are associated with increased performance of ADLs and other life activities as well as decreased risk for 30-day readmission in the VHA (D ’ Amico et al., 2018; Kinney et al., 2024a; Lipskaya-Velikovsky et al., 2016, 2020).”
Noguchi, T., Kyougoku, M., Kawakami, T., Nishimoto, Y., & Kashihara, K. (2021) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2021.1957065 · Cited by 2 · see citing works
Lee, H., Hwang, E. J., Wu, S.-L., & Hsu, W. (2022) · American Journal of Occupational Therapy · doi:10.5014/ajot.2022.049126 · Cited by 1 · see citing works
“…support the efficacy of occupational therapy in improving occupation-based or psychosocial outcomes (e.g., employment, social participation, ADLs, quality of life, depression, satisfaction) for people with various mental illnesses (D ’ Amico et al., 2018; Ikiugu et al., 2017; Noyes et al., 2018).”
Sánchez-Balsa, A., & Sobrido, M. (2023) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.1590/2526-8910.ctoar252332993 · Cited by 1 · see citing works
Ventura, J., Roell, L., Maurus, I., & Firth, J. (2026) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgag006 · Cited by 1 · see citing works
“45 Also, there is some direct evidence that those with schizophrenia who engage in regular AE have demonstrated clinically meaningful improvements in ADLs, including personal care, household tasks, and meal preparation.”
Kinney, A. R., Nance, M., Penzenik, M. E., Forster, J. E., & Brenner, L. A. (2026) · American Journal of Occupational Therapy · doi:10.5014/ajot.2026.051399 · Cited by 1 · see citing works
“…occupational performance among patients with mental health conditions, including activities of daily living (ADLs; e.g., bathing, dressing), instrumental activities of daily living (IADLs; e.g., shopping), and other life activities (D ’ Amico et al., 2018; Lipskaya-Velikovsky et al., 2016, 2020).”
Analysis of Occupational Therapy In Schizophrenic Patients
Khadijah, S., Darni, D., & Sulaihah, S. (2020) · Jurnal NERS · doi:10.20473/jn.v14i3.17178 · Cited by 2 · see citing works
Sargent, J., & Valdes, K. A. (2021) · American Journal of Occupational Therapy · doi:10.5014/ajot.2021.75s2-rp208
Neverdal, K., & Pinxsterhuis, I. (2021) · Nordisk tidsskrift for helseforskning · doi:10.7557/14.5536
Occupation-Based Interventions for Addictive Disorders
Aguilar, C. J. (2023) · doi:10.1093/med/9780197630402.003.0026
Client Perceptions of an Occupational Therapy Program in a Community Rehabilitation Residence
Nichols, A., Seiver, A., Lockhart-Keene, L., & Meyer, K. (2023) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2023.2287055
“Evidence supports the value of occupational therapy in a variety of mental health community settings, outpatient facilities, inpatient facilities, and when combined with psychotherapy (Bailliard, 2021; D’Amico et al., 2018; Gibson et al., 2011; Haertl et al., 2009).”
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
The Effects of Cervical Cancer Diagnosis on Occupational Performance
Sinclair, W., McConnell, C., Clark, E., McEntire, K. B., Lewis, C., Pound, L., & Wuertz, K. (2024) · The Open Journal of Occupational Therapy · doi:10.15453/2168-6408.2172
Sánchez-Balsa, A., & Sobrido, M. (2023) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.1590/2526-8910.ctoar252332992
Occupational therapy and rehabilitation: fostering mental resilience and professional re-entry
Smrity, J. A., Mahbub, K. A. S., Afroze, R., Nahar, L., & Roy, J. (2025) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20250662
Suzuki, M., Tamura, T., Tanimura, A., Kobayashi, N., & Naito, Y. (2025) · Asian Journal of Occupational Therapy · doi:10.11596/asiajot.21.149
The Whole Health Group Series: A Case Series of an Occupation-Based Intervention for Adults with HIV
Wikel, R., Meyer, K., & Navarro-Walker, L. (2026) · Journal of HIV & Social Services · doi:10.1080/15381501.2026.2617282
Lönn, M. E., Westberg, K. H., Holst, A.-C., & Erlandsson, L. (2026) · Occupational Therapy International · doi:10.1155/oti/9972405
“One potential explanation for this phenomenon is the multifaceted nature of the concepts, as well as the extensive variety in the categorization of occupational therapy interventions [4, 6, 7].”
Stein, S. N., Kraake, S., Pabst, A., Breilmann, J., Hasan, A., Allgöwer, A., Kilian, R., Falkai, P., Ajayi, K., Brieger, P., et al. (2026) · Community Mental Health Journal · doi:10.1007/s10597-026-01678-7
Hely, A., & Pearce, C. (2026) · Australian Occupational Therapy Journal · doi:10.1111/1440-1630.70104
“As holistic, practical, and recovery-oriented health professionals, occupational therapists are uniquely equipped to support people with these more complex presentations (D ’ Amico et al., 2018; Read et al., 2018; Scanlan et al., 2017).”
Gühne, U., Becker, T., Weinmann, S., & Riedel-Heller, S. G. (2026) · Springer Reference Medizin · doi:10.1007/978-3-642-45028-0_50-2
- Authors
- D’Amico, M. L., Jaffe, L. E., & Gardner, J. A.
- Affiliations
- Nova Southeastern University (US)
- Lynn E. Jaffe, ScD, OTR/L, FAOTA, is Professor and Program Director, Florida Gulf State University, Fort Myers
- Kean University (US)
- Corresponding author
- D’Amico, Mariana L.
- ORCID
- Jaffe, Lynn E.
- Venue
- American Journal of Occupational Therapy
- Publisher
- SAGE Publications
- Published
- 2018-08-02
- Volume
- 72
- Issue
- 5
- Pages
- 627-638
- ISSN
- 0272-9490 (ISSN-L)
- 1943-7676
- OpenAlex
- W2885865594
- Cited by
- 68
- References
- 77
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 10 · 2022: 8 · 2021: 12 · 2020: 9 · 2019: 5 · 2018: 1
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Occupational Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, occupational therapy intervention, occupational performance, participation, activities of daily living, instrumental activities of daily living, leisure, social participation (health and rehabilitation), sleep and rest, psychoeducation, cognitive intervention, skills-based intervention, technology-based interventions, evidence-based practice
- MeSH terms
- Activities of Daily Living, Humans, Leisure Activities, Occupational Therapy, Rehabilitation, Vocational, Rest, Self Care, Sleep, Cognitive Behavioral Therapy, Treatment Outcome, Evidence-Based Practice, Social Participation, Social Skills
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