People with severe psychiatric disability (SPD) and impaired autonomy, living in sheltered or supported housing facilities, generally lead sedentary, solitary lives and have significantly poorer health than others in the population. Therefore, recovery towards a meaningful and enrichening everyday life is crucial.

 

The ELR was constructed as an intervention model for integrated occupational therapy (OT) in sheltered and supported housing facilities, in close collaboration with housing staff (HS) and the resident (Lindström, 2007; 2011), aiming at personal recovery and engagement in meaningful everyday life and daily activities. ELR includes person-centered, motivational-, recovery- and activity-based interventions, built on mediators and certain process steps, allowing for individualized content. Additionally, ELR includes a web-based educational and information package, devices for co-planning, and peer-support.

 

The uniqueness of ELR is that it combines these ideologies and mediators in an intervention model specifically designed and developed for the context of supported and sheltered housing facilities, not focusing on symptom reduction but rather acceptance, and instead aiming at increasing engagement, personal recovery, and an enrichening everyday life. The language and actions of professionals promote hope, self-discovery and shared-decision making, shaped in partnership with residents.

ELR has shown significant outcomes in feasibility studies, and therefore an RCT is next. The ELR development is based on a previous five year research with feasibility studies, and has shown significant impact on residents’ everyday functioning and health, as well as the practices of professionals. This feasibility project with qualitative and quantitative studies was conducted to evaluate perspectives of participants and professionals, indicating very promising tendencies, such as successful rehabilitation with goal-attainment, improved health, re-discovered personal agency, and re-engagement in homebased as well as social and outreach occupations (Lindström et al, 2011b; 2012; 2013; 2017). Based on these feasibility studies, the original ELR has been slightly revised, adding a monthly follow-up by housing managers, and clarified tools for co-planning, in order to promote early involvement in enhancing strategies (Lindström, 2020).

 

ELR consists of a weekly session with an OT, followed by regular collaboration with HS, who support the resident on a daily basis, in line with guidance given by the OT and input shared from the HS. During the feasibility period, the length of intervention was individually set, with an average time of 6,2 month. In light of this, 6 months is proposed as a recommendation, for comparability in research, otherwise the time can be adapted based on the individual´s wishes and needs.