An Occupational Therapy Programme for a Psychiatric Day Hospital

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oliver

Voice of Occupational Therapy Practitioners and Patients

Overview

Occupational Therapy (OT) plays a crucial role in helping individuals rebuild meaningful lives after experiencing mental health challenges. This article summarises a groundbreaking study conducted at Evexia Psychiatric Day Hospital—South Africa’s first private psychiatric day hospital—by Masango and colleagues (2025). The research explored how OT programmes support recovery through structured, evidence-based group therapy.

Background

Psychiatric day hospitals provide an alternative to inpatient treatment, allowing patients to attend therapy during the day while living at home.
They combine structure, affordability, and real-life application of therapeutic skills.

At Evexia, occupational therapists design and facilitate a daily programme (07:30–15:30, Monday to Friday) focused on restoring balance, roles, and engagement through purposeful activity. Yet, before this study, there were no published guidelines for OT in private psychiatric day hospital settings in South Africa.

Research Design

  • Approach: Qualitative exploratory design, using Action Learning and Action Research principles.
  • Participants:
    • 8 OT practitioners (5–14 years of experience)
    • 7 former patients (5–15 days of participation)
  • Data Collection: Semi-structured interviews exploring perceptions of the OT programme.
  • Analysis: Reflexive thematic analysis using Atlas.TI software.

Key Findings

1. Skilled and Competent Facilitator

Successful OT group programmes rely on facilitators with a deep understanding of group dynamics and reflective practice.
They:

  • Lead from behind, creating a safe space for participants.
  • Use self-awareness therapeutically.
  • Encourage person-centred participation.

“The power of the group lies in its members—and the therapist’s ability to guide from behind.” – OT Participant

2. The Group as a Healing Entity

The study identified the group itself as a living, therapeutic entity.

  • Shared experiences create mutual accountability and belonging.
  • Emotional safety promotes honest reflection.
  • Structured interaction mirrors real-life challenges.
  • Activities stimulate self-discovery and learning in the “here and now.”

3. The Patient as an Individual

Every patient’s recovery journey is unique.

  • Self-motivation and readiness for change are key.
  • Group sessions help individuals gain self-awareness and apply insights in daily life.
  • The “here-and-now” focus empowers personal growth through real-time feedback and connection.

4. Ongoing Evaluation, Intervention, and Outcomes

The OT process functions as a continuous therapeutic cycle:

  1. Assessment: Using tools like the Wellness Recovery Action Plan (WRAP) and APOM.
  2. Intervention: Developing weekly group themes (e.g., stress management, communication, sleep hygiene).
  3. Implementation: Facilitating activities that spark engagement and learning.
  4. Review & Outcome Measurement: Using tools such as the STAR Recovery Model for weekly reflection and self-assessment.

This ongoing evaluation ensures accountability and visible progress.

Discussion

The research highlighted how group cohesion, skilled facilitation, and structured reflection promote recovery.
Theoretical foundations include:

  • Vona du Toit Model of Creative Ability (VdTMoCA) – motivation governs action.
  • Model of Human Occupation (MOHO) and CMOP-E – person-centred, occupation-based frameworks.
  • Interactive Group Model (OTIGM) – integrates experiential learning through activity.

These models reinforce OT’s unique contribution to recovery: combining therapeutic relationships, meaningful activity, and scientific process to rebuild function and hope.

Implications for Practice

  • OT practitioners should receive ongoing training in group dynamics and reflective facilitation.
  • Continuous evaluation and feedback enhance programme effectiveness.
  • Group therapy can complement individual sessions, offering both social learning and personal growth.
  • The model can inform similar programmes across public and private psychiatric settings.

Limitations

The study was conducted in a private facility with greater resources. Future research in public psychiatric hospitals is needed to adapt these guidelines to diverse contexts.

Conclusion

This research provides the first structured evidence-based framework for occupational therapy in psychiatric day hospitals.
It reinforces that healing happens through meaningful occupation, skilled facilitation, and shared human experience.

“Occupational Therapy connects the science of recovery with the art of living.”

To learn more about the role of occupational therapy in psychiatric day hospitals and explore the full research article, visit Mental Illness Journal at https://doi.org/10.1155/mij/6341561