1st Edition

Promoting Activity and Participation in Individuals with Serious Mental Illness The Action Over Inertia Approach

    218 Pages 21 B/W Illustrations
    by Routledge

    216 Pages 21 B/W Illustrations
    by Routledge

    This book presents "Action Over Inertia," a recovery-orientated, strengths-based approach to address the profound disruptions in daily activities and community participation often experienced by those living with serious mental illnesses.

    With a focus on supported "doing", the Action Over Inertia approach engages individuals in small activity and participation efforts as an opening to making longer term and sustained changes that offer meaning and well-being. The book helps service providers develop their own knowledge of activities and the health and well-being benefits an individual might receive from activities. It also asks them to consider the biases, assumptions, and constraints that might impact their ability to implement interventions related to activity and participation. A range of worksheets, resources, vignettes, and other tools are provided to support this practice.

    The manual was developed from the knowledge and practice of occupational science and therapy, but it will be of interest to any mental health professional, peer-provider, administrator, or policy maker interested in promoting recovery for people with serious mental illness

    Authors and Contributors

    Foreword I

    Peggy Swarbrick

    Foreword II

    Ellie Fossey

    Foreword III

    Elizabeth Taylor




    Chapter One: Preparing to use this workbook

    Chapter Two: Understanding personal activity and participation patterns

    Chapter Three: A first step: Making rapid changes in activity and participation

    Chapter Four: Providing education about activity and participation, mental illness and recovery

    Chapter Five: Making longer-term changes

    Chapter Six: Supporting sustained changes in activity and participation patterns

    Chapter Seven: Raising the profile of activity and participation in mental health service delivery

    Chapter Eight: Evaluation of activity and participation to inform service development


    Appendix A: Additional vignettes

    Appendix B: Activity Engagement Measure (AEM)

    Appendix C: Other applications of Action Over Inertia

    C1: Anxiety Disorders and Activity and Participation

    C2: Chronic Pain and Activity and Participation

    C3: Mood Disorders and Activity and Participation

    C4: Posttraumatic Stress Disorder and Activity and Participation

    C5: Action Over Inertia Together (4- and 10-Session Group Outlines)


    Terry Krupa, PhD, is professor emerita, School of Rehabilitation Therapy, Queen’s University, Canada. Her research and practice have focused on promoting the community participation of people living with serious mental illness.

    Megan Edgelow, EdD, is assistant professor, School of Rehabilitation Therapy, Queen’s University, Canada. She has clinical, teaching, and research experience in mental health and activity participation.

    Shu-Ping Chen, PhD, is associate professor, Department of Occupational Therapy, University of Alberta, Canada. Dr. Chen's teaching and research focuses on empowerment, recovery, and social inclusion for people with mental health issues.

    Carol Mieras, MScOT, is adjunct academic staff and co-manager of the MasterCard Scholars Program, Queen’s University, Canada. Her research and practice focus on inclusion and disability, particularly related to mental health.



    "Action Over Inertia is required reading for all mental health trainees and practitioners from any discipline, as well as peer specialists, who are committed to supporting people in pursuing meaningful, self-directed lives in the community. The evidence-based approach is built on solid conceptual frameworks and has been further refined in this second edition as a result of the extensive practice and research knowledge of an accomplished group of authors. Community inclusion and participation are increasingly being recognized as a medical necessity. Action Over Inertia provides a roadmap for making it happen that can be embedded in any mental health program or service." —Mark Salzer, PhD, professor, Department of Social and Behavioral Sciences at Temple University and director of the Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities

    "What people do in their everyday lives matters to their health and well-being! Action over Inertia starts with empirical evidence about the power of participation in daily activities and translates this into practical tools for mental health practitioners. It combines the art and science of supporting individuals with serious mental illness, and is an important addition to every therapist’s toolbox for recovery-oriented practice." —Sandra Moll, PhD, OT Reg (Ont) and Rebecca Gewurtz, PhD, OT Reg (Ont), associate professors, McMaster University, Canada and members of the Do-Live-Well Framework development team (www.dolivewell.ca)

    "Developed from the knowledge base of occupational science and occupational therapy, Action Over Inertia is a quantum leap for the development of practices focused on promoting activity and participation in the mental health field. It is an intervention that consistently combines client-centering and the systematisation of  services. Both clients and service providers confirm this through high demand and the benefits they realize from the success of their own doing." —Andreas Pfeiffer, president, German Occupational Therapy Association

    "With the first edition of this book, it became no longer acceptable to blame the inertia that may be associated with a serious mental illness on the person struggling with it, as the reader was led down a path that broke through what at times could be an impasse in treatment. With the addition of the capabilities framework as a foundation, culture as a context, and community inclusion as a primary goal, this second edition takes additional steps in laying out concrete practices which can support the person in identifying and pursuing engagement in the kinds of activities that give meaning and purpose to all of our lives. What results is an invaluable resource for promoting recovery-oriented practice." —Larry Davidson, PhD, professor of Psychiatry and director, Program for Recovery and Community Health, Yale University