2020 ISSUE 1
SERVICES FOR PEOPLE EXPERIENCING HOMELES SNESS:
W H AT O T C A N D O
Amy Reidy
As first semester OT students at UIC, we par-
ticipated in a research methods course to help devel-
op our skills in finding and understanding evidence-
based research, as well as learn about the gaps in
knowledge that our field is attempting to fill. In one
such area, the role of OT in helping persons experi-
encing homelessness to gain meaningful employ-
ment, myself and three other students attempted to
synthesize available information in order to see if our
profession could gain any overarching knowledge
from it. Under the guidance and direction of Mansha
Mirza, PhD, OTR/L, Andrea LeFlore, OTD, OTR/L, &
Susan Magasi, PhD, OTR/L, we began a systematic
review of the literature about OT and homelessness.
This opportunity allowed me to learn not just
research skills and the importance of evidence-
based practice, but also about the role of advocacy
and spreading awareness that we can take on as
practitioners. Utilizing this class as a means to
broaden my horizons as a professional allowed me
to learn what OT has looked like in the past, and
what work in emerging areas of practice looks like
now. Prior to this experience, I was unaware that oc-
cupational therapists had the potential to work in this
area. Through this project, I was able to discover
what OT can look like with this population, as well
what the potential impact can be. My group searched
multiple databases for articles, finding non-research
program descriptions, mixed methods studies that
had limitations due to the diversity of the populations
of the shelters themselves, and qualitative studies
with a variety of adaptations and unique qualities.
Quickly, we realized that for OTs to acquire positions
in shelters in order to attempt interventions, people
would need to know what OT is, and what this field
could do for the homeless. As neither of these are
universally known facts, it leads to few OTs being
hired and a lot of work on the part of the OTs in pro-
moting our profession. As a student, one of the most
impactful lessons I learned that semester was the
importance of advocating for OT, as well as the im-
portance of advocating for our clients.
The research in this particular area is sparse,
and so what is available offers little definitive evi-
dence that occupational therapists can make a
measurable difference in helping people experienc-
ing homelessness obtain employment. However, as
the course continued, my group (composed of my-
self, Kylie Vance, Mia DiGiacomo, and Artemis Se-
fandonakis) realized that while strict data was saying
very little, many of these studies conveyed some re-
curring and convincing messages. Over and over, we
noted quotes and anecdotes from individuals talking
about what barriers to employment they had, such
as: a lack of belief in their own abilities, an inability to
maintain healthy habits and routines on the streets, a
loss of identity or important roles in their life, and not
being able to perform basic ADLs such as hygiene
and bathing due to a lack of facilities (Salsi, et al.,
2017). As this course and this project came to an
end, my fellow novice researchers and I concluded
that there simply is not enough high-quality evidence
in this area to determine if OT interventions are mak-
ing an impact. Larger and more rigorous studies
need to be funded in order to show numerically that
we can make a difference (DiGiacomo, Reidy, Sefan-
donakis, & Vance, 2019).
Despite this lack of quantitative evidence, it is
hard to deny that these aforementioned areas of
struggle fall almost directly under the domain of OT
in the “Occupational Therapy Practice Framework:
Domain & Process” (American Occupational Therapy
Association [AOTA], 2014). Occupations, Client Fac-
tors, Performance Skills, Performance Patterns, and
Contexts and Environments are what make up the
domain of OT, and many individuals experiencing
homelessness face barriers in more than one of
these categories. Occupational therapists have the
knowledge and skills to make an incredible impact on
a system that needs our viewpoint, and from this sys-
tematic review, I learned that our professional frame-
work further exemplifies that. With the U.S. Depart-
ment of Housing and Urban Development’s 2019 An-
nual Homeless Assessment Report putting the point-
in-time number of persons experiencing homeless-
ness in the United States at around 568,000 individu-
als, this makes occupational therapists not just a po-
tential new asset to the team, but a much needed
one (Henry, Watt, Mahathey, Oullette, & Sitler,
2020).
Page 9
Whether it be through research, volunteering,
Continued on Page 10