Worker role perceptions and work participation among people with mental health issues taking part in interventions focusing on everyday life.
Mona Eklund, Martin Bäckström
PMID 36938770WHAT IT FOUND
Both activity-based occupational therapy interventions improved how capable participants felt for work, but neither changed their belief they could hold a job in the future.
Satisfaction with non-work daily life and self-esteem drove these gains in work readiness.
Key findings
01Participants in both the Balancing Everyday Life (BEL) and Care as Usual (CAU) groups showed similar improvements in resources for having a worker role, but no change in their belief in having a future worker role.
02Changes in satisfaction with non-work daily activities, self-esteem, and perceived activity value were the strongest mediators of improvements in work readiness.
03Higher baseline satisfaction with non-work activities and self-esteem were associated with less positive change in work readiness, suggesting participants who were worse off at the start benefited more.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study could not blind participants or therapists to the intervention type, which may introduce bias. The results showed no difference between the specific BEL intervention and standard care, meaning BEL was not superior to existing OT practices for work readiness outcomes. The direction of causality between mediators and outcomes cannot be confirmed; it is possible that improved work readiness led to better self-esteem, rather than the other way around. The sample was heterogeneous in diagnosis, and the findings may not apply to specific subgroups like those with psychosis or substance use disorders alone.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume that activity-based interventions improve a client's confidence that they will get a job. The study found that while clients felt more capable, their belief in a future worker role did not change. Also, do not interpret the lack of difference between BEL and CAU as a failure of the intervention; both groups improved, suggesting that standard OT care is already effective for these specific outcomes.