Activities of daily living are a part of everyday life to most people. Activities like daily hygiene, cooking, shopping, cleaning, conversation and transportation issues are second nature to most, but to the schizophrenic, they become uncomfortable, if not difficult. Individuals with schizophrenia may have to learn or relearn many or all of these things in order to return to an optimum level of competent and confident functioning. Stuart & Sundeen (1995) state that a major goal of rehabilitation is to assist the person to develop independent living skills. Initially, an assessment must be made to determine what new skills are needed, and then from there a program could be developed and individualized for that client.

Most schizophrenics are not well off financially and find it hard to know what to do with the spare time on their hands. Leisure time becomes one of the most important areas of rehabilitation focus. Lalonde (1995) states that leisure desires and needs of schizophrenics determine the range of activity. The focus is on assisting the schizophrenic that neither works nor attends school to use his or her time effectively. It is imperative that the rehabilitation team is made aware of local activities that are inexpensive. These activities could be accessed at community centres, libraries, churches, parks and adult education centres. Bigger cities may have specialized drop-in centres for activities and fellowship for the schizophrenic.

Socializing is difficult for the individual with schizophrenia. Keltner et al (1991) state that a client is so focused on internal processes that his external social world collapses. Kalman & Waughfield (1987) state that one of the most important factors in a schizophrenic is the loss of self-esteem. Carson & Arnold (1996) also state that the person who is socially incompetent due to mental illness is unable to function smoothly in society because of feelings of low self-esteem, isolation and anger. Ideally, social skills training would begin in the hospital. This is more important to those who have had extended hospital stays. Upon discharge, schizophrenics can be referred to specialized community based programs such as social-recreational day programs with a focus on group interaction and activity. For example, some groups may use art or music to stimulate clients to interact and encourage socialization.

Physical fitness is also very important to help preserve a sense of well being. "Physical health and mental health are linked" (Keltner et al, 1991, p. 258). As schizophrenics become withdrawn and unsociable, their desire to exercises wanes. An exercise group will do a lot to counter this problem. Another important factor is that exercise and achieving overall physical and mental health can offer a different focus or diversion for those experiencing fear, tension and anxiety. Schizophrenia sufferers should be encouraged to get sufficient amounts of moderate daily exercise. A medical check-up would be advised before starting any exercise program.

Interventions in rehabilitation must also address spiritual and cultural issues. "To treat all clients the same is to treat them poorly" (Hunt & Zurek, 1997, p. 93). Culturally specific care focuses on treatment that is acceptable and reasonable to each client. Care must match each individuals' beliefs, values, norms and perceptions of the illness they are suffering from. Hunt & Zurek (1997) also state that even though cultural knowledge and sensitivity signify concern for the client, we cannot ignore the influence of spirituality on his or her perspective of health and well-being. Spiritual aspects of care are vital for individuals who have had serious health problems and who continue to lead difficult lives. Meaning in life is crucial to all, perhaps even more so for the mentally ill.

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