“…This situation also reflects the fact that rigorous evidence is limited for any nonpharmacological interventions that are effective in a population with severe and enduring mental illness; however, such evidence is building (Buchain, Vizotto, Neto, & Elkis, 2003;Scott, Palmer, Paykel, Teasdale, & Hayhurst, 2003). The literature has shown that a substantial amount of consensus exists with regard to the benefit of activity-based group work across professionals, service users, caregivers and family, and mental health organizations (Eklund, 1997;Moll & Valiant Cook, 1996;Willcock, 2006). However, "because patients so often get better or worse on their own, no matter what we do, clinical experience is a poor judge of what does and does not work" (Doust & Del Mar, 2004, p. 474).…”