Date Presented 04/05/19
This study explored how homelessness influences the daily routines and occupational experiences of young people. OTs can support homeless young people through community programming to facilitate development of productive routines, engagement in meaningful occupations, and social participation.
Primary Author and Speaker: Emily Simpson
Contributing Authors: Evan Semmelhack, Bridget Conniff, Breanna Faber
PURPOSE: In both schools and community practice areas, occupational therapists (OT) have the potential to work with homeless young people (YP). Homelessness disrupts YP’s participation in the productive occupations that facilitate transition to adulthood, such as school and early employment, which has a compounding influence on the cycle of homelessness. Other consequences to YP include increased risk for victimization and exploitation, mental health issues such as depression, anxiety, and substance use, and participation in risky and criminal survival activities, all of which jeopardize their overall development and ability to inhabit adult roles. Despite prevalence estimates that nearly 39,000 unaccompanied YP are homeless on a given night in the U.S. (7% of the homeless population), there is limited research from the perspectives of YP on how the lack of stable housing impacts their ability to engage in their daily routines and occupations. Therefore, the purpose of this study was to better understand how the experience of homelessness influences the daily routines and occupational participation of YP.
DESIGN: Researchers conducted a descriptive qualitative study with homeless YP between the ages of 18 and 24. Participants self-referred from flyers posted at an emergency homeless shelter in a large metropolitan area in the Midwestern U.S. that provides services to unaccompanied YP and were reimbursed for their participation with $15 Target gift cards.
METHOD: 19 participants between the ages of 19 and 24 (M= 22 years) were engaged in one of three focus groups conducted onsite at the emergency shelter. A semi-structured interview guide was developed using the conceptual framework and thematic areas of the Occupational Performance History Interview-II and was grounded in the literature. Basic descriptive data was also collected on participants’ time use and demographics. Focus groups were audiotaped and transcribed verbatim and data was analyzed thematically. Rigor was enhanced through the use of multiple coders and peer review.
RESULTS: Analysis resulted in the identification of three major themes, including: Lack of meaningful occupations/valued time, which was influenced by a lack of access to resources and an overall deprivation from desired occupations like sleep, school, and work; Limited social participation, resulting from stigma, discrimination, and lack of social support, and negatively affecting familial and intimate relationships; and Altered routines, which stemmed from a lack of control over daily schedules and had a detrimental effect on basic ADLs. Findings suggest that homelessness has a powerful negative impact on the daily routines and occupations of YP, ultimately leading to occupational deprivation in desired occupations.
CONCLUSION: Limited participation in valued occupations coupled with unstructured and unproductive routines contribute to a continuous cycle of homelessness that is hard for YP to break. As a result, homeless YP may experience decreased volition and limited self-efficacy to obtain residential stability and engage in productive occupations. OT’s may play a critical role in direct intervention for homeless YP, specifically targeting the development of meaningful routines and the facilitation of role transition during times of instability. Additionally, OT’s can contribute to comprehensive community-based programming aimed at increasing social opportunities, advocating for awareness of stigma and exclusion, and decreasing intrinsic and extrinsic barriers to residential stability.
References
Barman-Adhikari, A. (2014). Social networks as the context for understanding employment services utilization among homeless youth. Evaluation & Program Planning, 45, 90-101.
Kim, S. (2014). A review of research on runaway and homeless youth: A comparison of trends between American and South Korean Journals from 2001 to 2010. Child & Adolescent Social Work Journal, 31(2), 107-118.
Marshall, C. A., & Rosenberg, M. W. (2014). Occupation and the transition from homelessness. The Canadian Journal of Occupational Therapy, 81(5), 330-338. https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf.
Murphy, J. F., & Tobin, K. J. (2011). Homelessness comes to school: How homeless children and youths can succeed. Phi Delta Kappan, 93(3), 32-37. National Conference of State Legislature. http://www.ncsl.org/research/human-services/homeless-and-runaway-youth.aspx.
