´You treat me like a normal person, it helps me get back to a normal everyday life´: Experiences of activity-based occupational therapy interventions among inpatients with severe mental disorders

Few studies have examined what patients with severe mental disorders experience as meaningful during hospitalization. Opportunities for meaningful activity are considered crucial for supporting recovery and for strengthening functional skills. Despite this, activity-based occupational therapy (OT) interventions remain insufficiently studied as part of the treatment. The aim of the present study was therefore to explore how patients experience activity-based occupational therapy during treatment in specialized mental healthcare. Semi-structured qualitative interviews were conducted with 11 patients with psychotic disorders who were participating in an activity-based OT-program at a mental health hospital in Norway. The interviews explored how the patients experienced the program, what they perceived as meaningful or less meaningful, and whether these experiences contributed to their recovery process. Participant observation was used to supplement and contextualize the interview data, which were analyzed using reflexive thematic analysis. We organized the results into three overarching themes with several subthemes. (1) ´A good place to be´ captured patients’ experiences of the therapeutic environment and the OT-program as a social arena, including their sense of connection with the OTs and how support and challenges enhanced their self-confidence. (2) ´Feeling normal´ encompassed how the patients experienced motivation through engaging in meaningful activities, opportunities for finding themself again through self-expression and personal growth, and transitioning from the patient role. (3) ´It´s useful´ referred to how patients developed everyday and vocational skills that they perceived as relevant and applicable after treatment in specialized mental healthcare. Through engagement in meaningful activities patients experienced personal growth through enhanced self-reflection and increased self-confidence. The transition from the role of a patient to other contributing roles was essential for restoring a sense of normality. Confidence in the ability to transfer acquired skills to life beyond specialized mental health care strengthened the patient’s self-efficacy and reinforced hope for the future, both of which are fundamental components of recovery-oriented care.