Activity and social participation in the period following a first episode of psychosis and implications for occupational therapy

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Purpose: The study advances a conceptual understanding of activity and social participation in the period following the first episode of psychosis.

Method: A constructivist, grounded theory approach was used. Data were collected from 25 primary participants who had experienced a first episode of psychosis in the previous 5 years; 15 secondary participants, such as family and friends, with knowledge of the activity and social experiences of primary participants, personal records and documents; and six key informants.

Findings: The first episode of psychosis was highly disruptive and even damaging to activity and social participation. Recovering from this fall-out, to maintain engagement in activities and social participation, included the need to create new plans, adjust to affective disconnection, develop balanced lifestyles, match participation to abilities, learn new skills, and participate under new and constraining social conditions.

Conclusion: The period following the first episode of psychosis is a time of high risk for disengagement from activity and social participation. Occupational therapists have an important role to play in enabling activity and social engagement. The findings offer examples of how occupational therapy services might address critical tasks for activity and social engagement.
More about this publication?
  • The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.

    BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at

    Submissions can be made at

    The 2013 Impact Factor for The British Journal of Occupational Therapy is 0.897.

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