The comparison condition The comparison group received care as usual (CAU). The gate-keeper occupational therapists mainly invited clients they met in their clinical practice. This entailed that, although standard psychiatric treatment varied between the settings, it usually involved occupational therapy. The CAU occupational therapy sometimes included some form of group intervention, addressing for example daily living skills, social skills or creative activities, while some occupational therapists offered individual therapy only. The CAU intervention was provided by a licensed occupational therapist in all cases. The CAU therapists were part of a team that could provide a range of interventions, as was the case for those in the BEL program group. This meant that those who received CAU occupational therapy generally also received psychotropic medication, sometimes also some form of supportive therapy and/or follow-up.