Kawa Model-guided occupation-based group intervention in severe mental illness

Introduction: Individuals with severe mental illness (SMI) often experience limited community participation and reduced quality of life. Occupation-based group interventions informed by culturally responsive models such as the Kawa Model may support well-being and engagement. This study aimed to examine the effects of a Kawa Model–guided occupation-based group intervention on quality of life and community participation in individuals with SMI. Method: A single-group pretest–posttest design was used. Eight adults with SMI participated in a 10-week group intervention guided by the Kawa Model. Quantitative outcomes were assessed using the World Health Organization Quality of Life–BREF (WHOQOL-BREF) and the Community Integration Questionnaire. Qualitative data were collected through Kawa-based interviews and real-time reflections. Results: Post-intervention improvements were observed in community integration and social relationships. Participants reported enhanced self-expression, motivation, and a greater sense of belonging. River drawings illustrated changes in occupational identity and perceived life flow. Conclusion: A Kawa-guided group intervention may enhance participation and well-being among individuals with SMI. Findings support the utility of culturally grounded, metaphor-driven approaches in occupational therapy mental health practice.