Changes in Self-Identified Priorities, Competencies, and Values of Recently Homeless Adults with Psychiatric Disabilities

Abstract

This study examined changes in self-reported priorities, competencies, and values in 73 previously homeless people with psychiatric disabilities who participated in a life skills intervention. Participants living in emergency or single-room occupancy housing enrolled in curriculum modules to increase residential stability (room and self-care, money management, nutrition management, or safe community participation) and completed the occupational self-assessment at baseline, postintervention, and 3 and 6 months later to examine change over time. Mean competency and value ratings and frequency of priorities were compared by time point, as well as between types of housing and primary diagnosis. Managing finances, a place to live, and self-care were consistently rated high in value and as top priorities. At baseline and post-intervention, participants rated themselves more competent on items related to meeting basic needs, however increased competency for more difficult items was observed over time. Individuals in more stable housing reported overall significantly higher competency ratings. Priorities, competencies, and values shifted in complexity following the life skills intervention and as part of the natural recovery process suggesting specific supports in rehabilitation planning may need to be tailored to changing perspectives.

Keywords:

• Homelessness
• Self-competence
• Values
• Life Skills

Acknowledgments

The authors thank Emily Simpson, MS, OTR/L, Deborah Walens, MHPE, OTR/L, FAOTA; Peggy Sabol, MA, OTR/L, FAOTA; and Tom Allen, MD, for their input on early data analysis; and Jessica Kramer, PhD, OTR/L and Anne Sullivan-Soydan, Sc.D., CRC, CPRP, for reviewing earlier drafts of this paper. This study was funded by the National Institute for Disability and Rehabilitation Research, U.S. Department of Education (Grant No. H133G060180). An earlier version of this paper was presented at the 90th American Occupational Therapy Association Annual Conference in Orlando, Florida, and at the 2011 National Council on Rehabilitation Education Conference in Manhattan Beach, California. The authors report no declarations of interest.

Notes

Note. SRO = Single room occupancy; EHP = Emergency housing program.

^a n = 66; seven participants did not have a primary diagnosis of affective disorder or thought disorder.

Note. Highest rated item for each category and time point in bold.

*Highest rated competencies per time point.

**Highest rated values per time point.

***Highest rated priorities per time point.

^Lowest rated competencies per time point (<2.5).

^^Lowest rated values per time point (<2.5).

^^^Lowest rated priorities per time point.

^a Between 48% and 59% of the sample responded at each time point based on applicability.

Note. All comparisons significant at the p = .05 level. A = Affective disorder; T = Thought disorder.

Note. All comparisons significant at the p = .05 level. SRO = single room occupancy; EHP = emergency housing program.