Schizophrenia is frequently associated with impaired social interaction, communication difficulties, disturbed reality orientation, and reduced psychosocial functioning, particularly among patients experiencing delusions. This study aimed to evaluate the effectiveness of Group Activity Therapy (GAT) for Establishing Trust Relationships in improving psychosocial recovery among patients with schizophrenia and delusions. A quantitative quasi-experimental study with a pretest-posttest control group design was conducted from May to July 2026 in the working area of Lela Community Health Center. Sixty patients were recruited using purposive sampling and allocated to an intervention group and a control group, with 30 participants in each group. The intervention group received four sessions of GAT for Establishing Trust Relationships over four weeks, while the control group received routine nursing care. Psychosocial recovery was assessed using the Health of the Nation Outcome Scales and Social Functioning Scale. Data were analyzed using paired t-tests, independent t-tests, and Analysis of Covariance. The intervention group demonstrated a significant improvement in psychosocial recovery, with mean scores increasing from 51.23 to 74.81 (p < 0.001), whereas the change in the control group was not statistically significant (p = 0.081). Significant improvements were also observed in social interaction, communication ability, reality orientation, and psychosocial functioning (p < 0.001). GAT for Establishing Trust Relationships was effective in improving psychosocial recovery and may be incorporated as a complementary nursing intervention in community-based psychosocial rehabilitation for patients with schizophrenia and delusions.