Occupational value outcomes among people with mental health issues participating in activity-based interventions - The importance of internal and external factors.

Background: Perceived occupational value is an important treatment outcome but is still relatively unexplored as a phenomenon.

Aim: To evaluate whether the Balancing Everyday Life (BEL) intervention for people with mental health issues was effective compared to Standard Occupational Therapy (SOT) regarding improvement on three dimensions of occupational value (concrete, socio-symbolic and self-reward), and how internal factors (self-esteem and self-mastery) and external factors (sociodemographics) were related to occupational value.

Methods: The study was a cluster RCT (n = 226) and used self-report questionnaires on three occasions (baseline = T1, completed intervention = T2, six-month follow-up = T3).

Results: No differences between the groups were seen in occupational value change scores. Within-group analyses (T1-T3) indicated a change in the BEL group on concrete value and self-reward value. No change was indicated in the SOT group. Associations showed that self-esteem and self-mastery were correlated with all three aspects of occupational value. Having children was negative for experiencing occupational value, whereas having a friend was positive. None of the correlates could predict changes in occupational value.

Conclusion: Self-related factors appeared to be integral in occupational value.

Significance: Since occupational value is essential for a meaningful life, therapists should consider such factors and peer support when supporting people with mental health issues.