Enhancing Cognitive Functioning in Schizophrenia Through Occupational Therapy Interventions: A Systematic Review

Abstract

Schizophrenia is marked by significant cognitive deficits affecting daily life and quality of life. Occupational therapy (OT) employs various strategies to enhance cognitive, social, and daily functioning through structured meaningful occupations. To examine the effectiveness of OT interventions targeting cognitive functions in adults with schizophrenia. A systematic review was conducted, including 15 studies published between 2013 and February 2025, sourced from PubMed, Cochrane Library, and CINAHL databases. Key interventions included combined individual and group OT, targeted cognitive interventions, aerobic exercise (dance) interventions, integrated therapies, functional skill training, and self-management programs. These approaches significantly improved attention, memory, executive function, and processing speed. OT is a valuable intervention for cognitive enhancement in schizophrenia. Integrating diverse OT interventions into clinical practice is recommended. Future research should explore long-term studies, larger sample sizes, and the cost-effectiveness of interventions to improve the evidence base and practical implementation.

Plain Language Summary

How Occupational Therapy Can Help Adults With Cognitive Challenges in Schizophrenia

Schizophrenia is a mental health condition that affects thinking, memory, and daily functioning. People with schizophrenia often struggle with cognitive skills like attention, memory, and problem-solving. Occupational therapy helps individuals improve their ability to perform everyday tasks and enhance their quality of life through structured activities and coping strategies. This review examined several studies to evaluate how effective Occupational therapy is in improving cognitive skills in people with schizophrenia. Occupational therapy interventions, such as combined individual and group therapy, targeted cognitive interventions, including metacognitive strategies, computer-assisted remediation, and ecological virtual reality, aerobic exercise (dance) interventions, integrated therapies combining occupational therapy with motivational interviewing, cognitive remediation, and social skills training, and functional skill training and self-management programs, were beneficial. Although the results were promising, there are gaps in the research. For example, many studies did not provide detailed information on how long interventions should last or how often they should be delivered. There is also a need for more research on how occupational therapy can be applied in real-world clinical settings, outside of controlled studies, to better understand its practical value. The review suggests that future research should focus on determining the best ways to deliver occupational therapy interventions. Larger studies and real-world trials are necessary to confirm the findings and evaluate the cost-effectiveness of occupational therapy. By addressing these gaps, future studies can help improve occupational therapy interventions and better support people with schizophrenia in managing cognitive challenges and improving their overall well-being.