Feasibility of Self-regulation in Purposeful Activities (SPAC): An intervention for maltreated children in out-of-home care

Introduction: Children who have experienced maltreatment often face self-regulation difficulties that hinder participation in daily occupations. The Self-regulation in Purposeful Activities (SPAC) intervention is an occupation-centred approach, designed to enhance self-regulation and participation through regulation strategies and environmental support. This study examined the feasibility of the SPAC and its preliminary impact on engagement, volition and functional goal attainment among children in out-of-home care. Methods: A retrospective mixed-methods feasibility study using clinical data from 11 children (ages 6–12) in an emergency residential-care centre. Participants received approximately 20 weekly sessions. Data on adherence, engagement, volition and goal attainment were collected from therapists’ logs and standardised occupational therapy tools. Results: The intervention showed good adherence among the children, alongside significant improvements in engagement, volition, and high rates of functional goal attainment. However, inconsistent staff participation and low adherence to standardised outcome assessment procedures highlighted implementation challenges. Conclusion: Findings provide preliminary support for the feasibility of several core components of the SPAC as a trauma-informed, occupation-centred intervention for maltreated children in out-of-home care. However, staff involvement and outcome assessment procedures indicate the need for further adaptation to the organisational characteristics. Therefore, further feasibility evaluation is needed before progressing to larger controlled studies.