Bridging the transition from homelessness: Developing an occupational therapy framework

Abstract

Background

Occupational therapists support individuals experiencing homelessness in traditional roles, and occupational therapy positions focussed specifically on homelessness appear to be growing.

Objectives

To develop and refine a framework to guide occupational therapy practice and research in homelessness.

Method

We developed a framework and refined it through a stakeholder consultation process conducted with 17 international occupational therapy experts using an online survey. In this survey, we presented an initial framework and requested qualitative feedback. We analyzed this qualitative data using content analysis.

Results

Stakeholder feedback was categorized into eight recommendations: (1) Revision to the ‘four processes’; (2) Emphasizing social justice and systems-level advocacy; (3) Reflecting intersectionality; (4) Emphasizing meaningful activity; (5) Emphasizing peer support; (6) Incorporating a focus on independent living skills; (7) Increasing a focus on an activity for addressing substance misuse; and (8) Acknowledging cognitive and physical health. Each of these recommendations was incorporated into a refined version of this framework. These recommendations and a refined version of the framework are presented in this paper.

Conclusions

We have developed and refined a framework aimed at guiding practice and research in occupational therapy in homelessness that will be evaluated in future research.

Significance

Though a range of frameworks exists for guiding the practice of occupational therapists more generally, this framework represents the first that is focussed specifically on guiding occupational therapy practice and research with individuals who experience homelessness. Research and practice implications are discussed.

Keywords:

• Homeless persons
• poverty
• mental health
• substance-related disorders
• mental health recovery
• professional practice
• social occupational therapy
• health promotion
• community integration

Acknowledgements

We want to thank the occupational therapy researchers and practitioners who provided their valuable input on the development of this framework, and to Ms. Melodie Wakefield, the graphic designer who helped us to refine the graphic representation and companion document which describes our framework.

Disclosure statement

The authors claim no financial interest or benefit arising from the direct applications of this research.

Additional information

Funding

This study was funded by the Ontario Society of Occupational Therapists in the form of a Strategic Priorities Grant awarded in 2018.