It is important that OTs are familiar with the literature relating to habitual lifestyle behaviors and health. Key works are those associated with diet (Benton and Nabb 2003), fluid intake (Wilson and Morley 2003), exercise (Broman-Fulks et al. 2004), and habitual lifestyle drug use, including alcohol (Marquenie et al. 2007), nicotine (McLeish et al. 2009), and caffeine (Masdrakis et al. 2007). These behaviors should not be considered in isolation; however, as evidence suggests high levels of interaction among these habitual lifestyle behaviors (Poitras and Pyke 2013).

Results from a randomized controlled trial have been published in which the lifestyle intervention was compared with routine general practitioner (GP) care (Lambert et al. 2007). This showed a significant short-term benefit using the Beck Anxiety Inventory (BAI) as the primary outcome measure, assessed at 20 weeks. However, between-group differences were not significant at the 10-month follow-up. The conclusion was that the lifestyle intervention was at least as cost-effective as routine GP care (Lambert et al. 2010). It also produced improved results when compared with a broad range of prescribed medications, including benzodiazepines and selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor (SSRI; Lambert 2012). The LMI was equivalent in efficacy to the use of cognitive behavioral therapy (Lambert et al. 2007). This trial has shown that when symptom profiles are similar at baseline, lifestyle review provides a rational explanation for experienced symptoms, along with a strategy for regaining control, that the fear of the previously misinterpreted symptoms reduces dramatically (Lambert et al. 2008).

Many interventions in mental health are focused either on a purely neurobiological approach through the use of medication or on mainly cognitive approaches through the use of differing forms of cognitive behavioral therapy, either alone or in combination. The proposed LMI provides the patient with increased awareness of their own specific neurobiological sensitivities and also their physical and cognitive responses. It also provides positive strategies through which the patient can regain control over these. The evidence base is increasingly in support of this focus of intervention. The LMI provides a specific, patient-focused, occupational therapy intervention based on occupational behavior. It has been shown to provide both a clinically effective and cost-effective intervention with evidence of longer-term benefits. There is an ongoing need to evaluate its use with different patient groups (such as psychosis and depression) , and in different settings (such as inpatient care) and formats (such as group work). The author would be very happy to work with anyone wishing to develop the work further.