This systematic review investigated research literature evaluating the effectiveness of occupational therapy interventions focusing on recovery in the areas of community integration and normative life roles for people with serious mental illness. The review included occupation- and activity-based interventions and interventions addressing performance skills and performance patterns, aspects of context and environment, activity demands, and client factors. The results indicated that the evidence of the effectiveness of social skills training is moderate to strong. The evidence for the effectiveness of life skills and instrumental activities of daily living (IADLs) training to improve performance is moderate, as is the evidence for neurocognitive training paired with skills training in the areas of work, social participation, and IADLs. The evidence for client-centered intervention and increased intensity and duration of treatment is limited but positive, and the evidence that providing intervention in the natural context is more beneficial than in the clinic setting is inconclusive.