Background <p>Assessing perceptions of occupational balance is essential in both clinical occupational therapy and research. Attempts to characterise occupational balance often arrive at multi-faceted explanations, including a <i>variety of occupations</i>, <i>personal satisfaction</i>, and <i>time allocation</i>.</p> Aim <p>This study aimed to deepen the understanding of occupational balance as a phenomenon and investigate the relevance and usability of the Satisfaction with Daily Occupations and Occupational Balance (SDO-OB), which assesses occupational balance from the multi-faceted perspective mentioned above.</p> Methods <p>A cross-sectional and longitudinal design was employed. Patients undergoing the treatment method Tree Theme Method^™ for depression and/or anxiety completed the SDO-OB and a background questionnaire. Conventional statistical analyses were used.</p> Results <p>Variety of occupations and personal satisfaction remained stable between baseline and follow-up, while participants’ time allocation shifted from underoccupied towards balanced in the home and maintenance domain. All three perspectives of occupational balance were intercorrelated at baseline, and baseline scores on variety of occupations and on time allocation in work, leisure, and household domains were associated with personal satisfaction at follow-up.</p> Conclusion and significance <p>The three perspectives appeared to represent a unified phenomenon—occupational balance—while still offering unique insights. The SDO-OB seems relevant for both clinical occupational therapy and research.</p> Trial Registration <p>Clinical Trials.gov: NCT01980381</p>