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Making Group Therapy Meaningful: Evidence-Based and Creative Approaches to Adult Rehabilitation
Authored by Courtney Crabill, OTR/L, CBIS and founder of OT Queue
-A Hub collaborative partnership: education with marketing element; no paid advertising-
Group therapy in occupational therapy has the power to transform rehabilitation when it is designed with intention, creativity and research-supported strategies. A well-structured hour can simultaneously build functional skills, strengthen social connections and support emotional resilience - all whilst keeping participants engaged and motivated.
As rehabilitation stays are shortened and funder expectations tighten, clinicians need group sessions that are both meaningful and efficient. Occupational therapy groups offer exactly that: a multifaceted approach that addresses physical, social and emotional needs, while fostering collaboration, peer support and shared learning.
When thoughtfully facilitated, groups become dynamic spaces where individuals practise real-world skills, build confidence and experience the therapeutic value of community.
Physical Benefits: Function Through Engagement
Group-based occupational therapy interventions offer a powerful avenue for improving physical function in adults undergoing rehabilitation. Evidence suggests that group-based rehabilitation can produce physical outcomes comparable to individual therapy, with improvements in mobility-related outcomes such as walking speed and walking endurance reported among adults with neurological conditions (Rodrigo et al., 2026).
The physical benefits of group therapy emerge not only from the exercises themselves but from the unique therapeutic dynamics inherent to group participation.
Group environments can create opportunities for repetition, sustained engagement and increased effort. Shared progress and collective accountability may encourage participants to attempt challenging activities and remain engaged in the session.
Creative session structures further amplify these gains. Functional skill stations provide a circuit-style format that keeps energy high while targeting multiple domains simultaneously, including fine motor control, balance, cognition, and endurance. These stations allow therapists to individualise challenges within a group context, ensuring that each participant receives an appropriate level of physical demand while benefiting from the momentum of group participation.
Community simulations - such as navigating a mock grocery store, planning a simple meal, or organising household tasks - offer opportunities to practise real-world mobility and problem-solving.
These simulations require participants to integrate physical movement with cognitive sequencing, environmental scanning and safety awareness, mirroring the complexity of daily life.
Dual-task activities add another layer of therapeutic value. By blending physical movement with cognitive challenges, dual-task circuits support improvements in executive function, divided attention, and gait stability. These activities are particularly relevant for individuals recovering from neurological conditions, where cognitive-motor integration is essential for safe community mobility.
Across these formats, peer interaction plays a meaningful role. Observing others succeed, adapt, or persevere fosters a collaborative atmosphere, that reduces isolation and transforms physical improvement into a shared experience. This collective engagement may encourage consistent participation and greater confidence in physical abilities.
Social Benefits: Connection as a Therapeutic Tool
Social interaction is a foundational element of group-based occupational therapy and plays a critical role in supporting rehabilitation outcomes. Group environments provide a structured yet relational context in which individuals recovering from illness or injury can connect with peers who share similar challenges. This shared experience fosters a sense of community and belonging, counteracting the isolation and loneliness frequently reported during rehabilitation.
The literature on occupation-based group programs identifies social interaction, shared participation in meaningful activities and patient experience as important components of group rehabilitation (Spalding et al., 2022).
The social benefits of group therapy extend beyond simple interaction. Group-based interventions create opportunities for collaborative problem-solving, communication practise, and interpersonal skill development.
When individuals engage in meaningful tasks together - whether preparing a recipe, completing a collaborative project, or participating in a structured discussion - they practise essential social behaviours such as turn-taking, perspective-sharing, negotiation and mutual support.
Thoughtful group design enhances these outcomes. Theme-based sessions provide a shared focus that encourages engagement and helps participants connect around common interests or goals. Activities such as vision boards, team cooking tasks, or wellness-focused discussions promote teamwork and shared accomplishment, reinforcing the idea that recovery is not an isolated journey, but a collective one.
Social skills training embedded within group formats can further support interpersonal development. Evidence suggests that structured opportunities to practise communication skills within a supportive group environment can improve social communication and enhance social functioning. In a randomised controlled trial of adults with acquired brain injury, participants who engaged in group interactive structured treatment demonstrated improvements in social communication skills and achieved meaningful social goals, that were maintained over time (Ingebretsen et al., 2023). These gains are particularly meaningful for individuals recovering from neurological conditions, where changes in cognition, communication, or emotional regulation may affect social participation.
Peer influence also plays a significant therapeutic role. Observing others attempt new tasks, adapt to challenges, or celebrate progress creates a powerful model for engagement and resilience. Participants often report feeling more motivated and more willing to try difficult activities when surrounded by peers who are working towards similar goals. Similarly, adults affected by stroke who participated in a peer-led support group described developing authentic friendships, experiencing meaningful social connection and benefitting from mutual encouragement throughout their recovery journey (May et al., 2023).
This shared momentum transforms the group into a catalyst for growth, helping individuals reconnect with others, rebuild confidence and experience the restorative impact of community.
Emotional Benefits: A Space for Resilience
Group-based occupational therapy provides a supportive environment in which individuals can explore and express the emotional dimensions of recovery.
Rehabilitation often involves uncertainty, loss of previous roles and significant lifestyle changes; group formats offer a structured space where these experiences can be acknowledged and processed.
Evidence suggests that group rehabilitation provides valuable psychosocial support, through reflective communication, peer interaction and shared experiences, helping individuals adapt to chronic illness and disability, while enhancing their overall rehabilitation experience (Mäkeläinen et al., 2024). Occupation-based group programs have also been associated with improved patient satisfaction and positive rehabilitation experiences, highlighting the therapeutic value of social connection within group settings (Spalding et al., 2022; Spalding et al., 2023).
The emotional benefits of group therapy emerge through several interconnected mechanisms. Shared experiences create a sense of validation and understanding; individuals recognise that others face similar challenges, which reduces feelings of isolation and promotes collective resilience. In a study of adults attending a peer-led stroke support group, participants described the importance of mutual encouragement, social connection and authentic friendships developed through shared recovery experiences (May et al., 2023).
Observing peers navigate frustration, celebrate progress, or articulate personal fears normalises the emotional complexity of recovery and encourages open expression.
Mind-body practices can also be incorporated into group sessions to create opportunities for emotional regulation. Techniques such as guided breathing, grounding and brief mindfulness activities can give participants a structured opportunity to pause, reset and reconnect with the present moment.
Reflective discussion also plays a meaningful role. Group conversations allow participants to articulate personal experiences, explore coping strategies and receive encouragement from peers. Qualitative evidence suggests that reflective communication and peer support are key components of psychosocial support within rehabilitation groups, helping participants adapt to life changes and develop greater confidence in managing their condition (Mäkeläinen et al., 2024).
These exchanges help individuals reframe challenges, recognise strengths and build confidence in their ability to adapt. Over time, the group becomes a community where emotional resilience is practised and strengthened.
Peer influence contributes significantly to emotional growth. Witnessing others persevere through difficult tasks or openly express vulnerability can inspire hope and reinforce the belief that progress is possible. For example, stroke survivors participating in peer-support groups have described recovery as a shared process in which members encourage one another and contribute to each other's success (May et al., 2023). This collective momentum supports emotional healing and empowers participants to engage more fully in rehabilitation.
-Case Study- Dog Treats: Cooking-Based IADL Group
To illustrate how a group can integrate physical, cognitive, social and emotional elements, the following case study highlights one of the structured interventions in OT Queue's Occupational Therapy Groups for Adults in Rehabilitation: First Edition.
Setting
Inpatient rehabilitation, mixed neurological and orthopaedic caseload.
Purpose
This group was designed to address instrumental activities of daily living (IADL) engagement, fine motor coordination, functional cognition and social participation, through a meaningful cooking-based activity. The task also provided an opportunity to introduce kitchen-related skills without the added complexity of preparing food for participant consumption, managing individual dietary restrictions, or developing individualised meal plans.
Because the finished product was not consumed by participants, the activity could be adapted to a variety of abilities and preferences. Creating something for a pet or for donation also gave participants a tangible purpose for completing the activity.
What Happened
Participants worked together to make homemade dog treats, moving through the recipe as they measured ingredients, mixed the dough, rolled it out and used cookie cutters to create different shapes.
The activity incorporated a variety of functional demands. Kneading and rolling the dough required participants to use both hands and manipulate materials, while following the recipe required attention, sequencing and problem-solving. Participants were encouraged to complete as many steps as possible independently, with assistance or adaptations provided when needed.
Throughout the session, the therapist introduced opportunities for participants to respond to small challenges. When tools were difficult to locate or the consistency of the dough needed to be adjusted, participants worked together to identify solutions and continue the task.
Conversation developed naturally throughout the activity. Participants shared stories about their pets, cooking experiences and daily routines, while working alongside one another. These interactions contributed to an atmosphere that was welcoming, collaborative and focused on participation.
Observed Outcomes
Participants demonstrated observable engagement across functional, cognitive, social and emotional domains throughout the session.
The activity required repeated bending, reaching, standing, walking within the shared workspace and transferring of materials. Participants also practised following multi-step directions, maintaining attention to the task, adapting when something did not go as planned and coordinating their actions with the rest of the group.
Peer encouragement was particularly noticeable during challenging portions of the activity. Participants spontaneously encouraged one another with comments such as "You've got this - try one more!" These interactions appeared to help some participants remain engaged when they experienced fatigue, frustration, or hesitation. Participants encouraged one another, celebrated completed steps and shared responsibility for keeping the activity moving.
The group also incorporated a brief grounding and reflection period. Participants were given an opportunity to pause, participate in a short mindfulness activity and reflect on their experience before completing the final steps of the task. Several participants reported feeling calmer afterwards and expressed increased confidence about finishing the activity. One participant summarised the experience perfectly: "I didn’t think I could do half of this, but seeing everyone else try made me want to keep going."
This moment captured an important aspect of the session: participants were not simply completing a cooking task. They were working towards a shared goal, responding to challenges together and encouraging one another throughout the process.
The Dog Treats Group demonstrates how a relatively simple, meaningful activity can provide opportunities to address multiple occupational therapy goals within a single group session, while maintaining a strong focus on participation, choice and functional engagement.
Research Foundations for Group Therapy: A Recap
A growing body of literature supports the potential value of both group-based rehabilitation and occupation-based group programs in adult rehabilitation. Across physical, social and emotional domains, these have been associated with improvements in functional performance, social participation, patient experience and psychosocial well-being (Rodrigo et al., 2026; Spalding et al., 2022; Mäkeläinen et al., 2024).
Evidence for physical outcomes is emerging and suggests potential benefits in several areas of functional recovery. Group-based rehabilitation interventions have been associated with improvements in walking speed and walking endurance among adults with neurological conditions, while occupation-based group programs provide opportunities for intensive practise of meaningful daily activities that can support functional recovery (Rodrigo et al., 2026; Spalding et al., 2023). These findings highlight the potential value of occupation-based group formats for supporting occupational performance, confidence and engagement in meaningful rehabilitation activities (Spalding et al., 2023).
Social benefits are similarly supported in the literature. Occupation‑based group programs have been shown to promote social interaction, shared participation in meaningful activities and improved patient satisfaction and rehabilitation experiences (Spalding et al., 2022). Social engagement was identified as an important component of occupation‑based rehabilitation, while participants in peer-support rehabilitation groups reported meaningful social connections, mutual encouragement and the development of authentic friendships (May et al., 2023). Furthermore, structured group interventions targeting social communication skills have demonstrated improvements in social communication and goal attainment among adults with acquired brain injury (Ingebretsen et al., 2023).
Emotional well‑being is another domain strengthened through group participation. Qualitative evidence indicates that group rehabilitation provides psychosocial support through reflective communication, peer interaction and shared experiences, helping individuals adapt to chronic illness and disability (Mäkeläinen et al., 2024). Participants in rehabilitation support groups frequently describe benefits such as encouragement, validation and a sense of belonging, all of which contribute to emotional resilience and adjustment during recovery (May et al., 2023). The shared experience of rehabilitation has also been identified as a key factor contributing to positive outcomes in occupation-based group programs (Spalding et al., 2023).
Together, these studies suggest that group-based rehabilitation and occupation-based group programs can provide meaningful opportunities to address functional, social and psychosocial dimensions of recovery.
References
Ingebretsen, S.M.H., Kirmess, M., Småstuen, M.C., Hawley, L., Newman, J. and Stubberud, J. (2023) Rehabilitation of social communication skills in patients with acquired brain injury with intensive and standard group interactive structured treatment: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 104(7), 1016-1025. https://doi.org/10.1016/j.apmr.2023.02.023.
Mäkeläinen, J., Jämsä, U., Oikarinen, A., Kääriäinen, M. and Siira, H. (2024). Experiences of psychosocial support in group rehabilitation interventions from adults with chronic conditions: A qualitative systematic review. Patient Experience Journal, 11(3), 117-135. https://doi.org/10.35680/2372-0247.1935.
May, C., Bieber, K., Chow, D., Mortenson, W.B. and Schmidt, J. (2023) Experiences of adults with stroke attending a peer-led peer-support group. Brain Impairment, 24(3), 443-455. https://doi.org/10.1017/BrImp.2023.3.
Rodrigo, T., Hillier, S., Serrada, I., Gerges, A., Zwar, J., Chamberlain, S. and Hordacre, B. (2026). Group versus individual therapy for neurologic recovery: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 107(3), 496-506. https://doi.org/10.1016/j.apmr.2025.08.007.
Spalding, K., Gustafsson, L. and Di Tommaso, A. (2022) Occupation-based group programs in the inpatient hospital rehabilitation setting: A scoping review. Disability and Rehabilitation, 44(10), 2138-2148. https://doi.org/10.1080/09638288.2020.1813818.
Spalding, K., Gustafsson, L. and Di Tommaso, A. (2023). Evaluation of an inpatient occupation-based group program using a process evaluation framework. Australian Occupational Therapy Journal, 70(1), 32-42. https://doi.org/10.1111/1440-1630.12829.
Next Steps
The continued advancement of group-based occupational therapy is strengthened by curiosity, collaboration, and engagement with emerging ideas. Many of the interventions described in this article - such as cooking-based IADL practise, dual-task mobility training, structured safety education, and cognitive-motor integration - serve as practical examples of how meaningful activity can be woven into group formats across rehabilitation settings.
Clinicians may expand upon these concepts by integrating small group elements into daily practice, exploring structured sessions that blend functional tasks with cognitive challenge, or connecting with colleagues who share an interest in creative, evidence-supported intervention design. Additional resources, templates and discussions related to group-based occupational therapy can be found through OT Queue - a platform dedicated to developing tools that support meaningful, efficient and human-centred rehabilitation.
Group therapy will continue to evolve through shared insight and purposeful innovation, creating opportunities for rehabilitation to remain both meaningful and responsive to the needs of the people it serves.
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