Background: The study illuminated how persons with psychiatric disabilities experienced the processes of change in a residential context.

Material: Qualitative interviews with residents living in supported housing were conducted and analyzed using constant comparative analysis.

Discussion: Residential conditions appear to provide a complex structure that facilitates rehabilitative interactions, in which ‘progressive tensions’ arise between opposing values, such as authentic versus artificial, and independence versus dependence, both of which are important in the process of change.

Conclusions: A client-centred approach could be taken further if clients are engaged in productive discussions about challenging these ‘progressive tensions’. Awareness of the meaning of home also emerged as central.

the authors offered home-based occupational therapy integrated into supported or sheltered housing to help individuals with severe psychiatric disability identify their specific needs of engagement in meaningful occupation. This study aimed to evaluate the client outcomes in activities of daily living (ADL) ability and health factors following their participation in occupation-centered interventions in home and community settings. Seventeen participants (7 women) between the ages of 27 to 66 years, living in sheltered or supported housing participated in the intervention project based on the Everyday Life Rehabilitation (ELR). The following instruments were administered before and after the intervention and at a six-month follow-up: Goal Attainment Scaling, Assessment of Motor and Process Skills, Assessment of Social Interaction, Satisfaction with Daily Occupations, ADL-taxonomy with an effort-scale, and the Symptom Check List-90. Pretest, posttest, and follow-up differences in test scores on goal attainment, occupation, and health-related factors indicate that important progress was made.  These findings support the use of the intervention and suggest that larger randomized clinical trials are needed.

As part of a larger study, we offered Everyday Life Rehabilitation (ELR) as a model for integrated occupational therapy in sheltered or supported housing facilities, to enable meaningful daily occupations for people with psychiatric disabilities. Our aim of this article was to understand how participants make sense of their occupational transformations in the context of their everyday life and life history. We carried out qualitative interviews and field observations with 16 participants with psychosis-related disorders. We used narrative analysis and disclosed stories of ‘rediscovering agency’, referring to occupational and identity transformations. A parallel outcome article has shown positive results for participants, and by narrative inquiry we contribute with a deeper understanding of the meaning-making of their transformations and mechanisms of the intervention; i.e. hope, extended value of reaching goals, re-entering the majority world, and transparency of process and attunement to the individual. The findings support the use of the ELR-intervention.

The importance of engagement in meaningful occupations and participation in life situations of people with psychiatric disabilities is well known. Therefore, community care workers (CCWs) in sheltered or supported housing are a key resource in the facility context. Yet, the role and views of CCWs, in facilitating or inhibiting rehabilitative opportunities for residents, is only beginning to be understood. We offered an intervention project using the Everyday Life Rehabilitation (ELR), to integrate recovery- and occupation-oriented interventions, including collaboration between occupational therapists (OT) and CCWs, into supported or sheltered housing. As one part of the intervention project, focus group interviews were conducted with 21 CCWs involved in the intervention project. The aim was to illuminate the views of CCWs working with residents partaking the Everyday Life Rehabilitation. Qualitative content analysis revealed seven categories, with associated subcategories. These categories relate to two different disability ideologies: a stabilisation oriented, and a recovery oriented approach to rehabilitation. Related to organisational aspects, we have also identified two different tensions to change: resistance, and responsiveness to the intervention. The findings have implications for the forthcoming development of housing facilities, personnel development, and rehabilitative efforts for people with severe psychiatric disability.