Power Up! Using Appreciative Inquiry to Explore and Enhance Perceptions of Empowerment in a Day Shelter for People Experiencing Homelessness

BACKGROUND AND PURPOSE: People experiencing homelessness have significant insight, knowledge, and ability to identify solutions to address homelessness and poverty-related issues (Hammell, 2016). However, they generally are not asked about what they need or want, nor are they consistently consulted on the most effective ways to deliver programs and services. Evidence indicates that they are routinely excluded from decision making that affects their lives (Sakamoto et al., 2008).

The purpose of this study was to use an inclusive, strengths-based approach (appreciative inquiry) to determine perceptions of key stakeholders regarding a day shelter environment’s role in supporting empowerment for engagement with and participation in needed, wanted, and expected occupations. On the basis of these perceptions, environmental enhancements were made to support occupational engagement and reduce the potential for perpetration of occupational injustices such as marginalization and deprivation (Wilcock & Townsend, 2004).

METHOD: This phenomenological study was conducted at a local day homeless shelter. Participants included attendees, staff, and board members, all of whom were recruited both verbally and electronically. Criteria for attendee participation included consistent attendance at the shelter (1×/mo for 3 consecutive mo). Those who demonstrated behaviors associated with untreated mental illness, such as aggression, were excluded from the study.

Based on the 5-D cycle of the appreciative inquiry model (define, discover, dream, design, and destiny), we developed a questionnaire to guide focus groups. The questionnaire was designed with five purposes: (1) to develop a working definition of empowerment as defined by the study participants; (2) to determine positive ways the shelter currently supported empowerment to engage with and participate in occupations; (3) to elicit a vision for the future of the shelter; (4) to elicit ideas for promoting, planning, and prioritizing an ideal organization; and (5) to explore the sustainability of proposed environmental changes.

We conducted four focus groups with shelter attendees, staff, and board members. The focus groups were audio recorded and field notes taken. The data were transcribed, coded, and analyzed for themes using a constant comparative method (Glaser, 1965). Member checking occurred after data coding.

On the basis of the data analysis, a list of potential social and physical environmental changes was generated. Participants were provided with this list and asked to prioritize items on the basis of their perceptions of importance. Priorities generated guided the environmental intervention phase. A follow-up questionnaire was administered to determine satisfaction with environmental changes made regarding enhancement of subjective empowerment.

RESULTS: Codes were collapsed, and six themes emerged: (1) networking, (2) paying it forward, (3) voice and choice, (4) at-homeness, (5) teach me to fish, and (6) see me. The researchers further collapsed the themes into two broad categories that reflected internal and external loci of control with regard to empowerment. These two categories reflect that although personal responsibility is critical to changing a personal situation, external forces such as a shelter environment must also align to support empowerment and foster sustainable change.

CONCLUSION: Results highlight the environment’s potential to support or hinder occupational justice by the way in which it affords or does not afford opportunities for empowerment. The American Occupational Therapy Association’s (2017) Vision 2025 calls us to find solutions to maximize health and well-being not only for individuals but for communities and populations as well. Solutions for these tasks are best developed by using a positive and inclusive approach with all stakeholders to maximize empowerment and sustainability.

References

American Occupational Therapy Association. (2017). Vision 2025. American Journal of Occupational Therapy, 71, 7103420010. https://doi.org/10.5014/ajot.2017.713002

Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12, 436–445. https://doi.org/10.2307/798843

Hammell, K. W. (2016). Empowerment and occupation: A new perspective. Canadian Journal of Occupational Therapy, 83, 281–287. https://doi.org/10.1177/0008417416652910

Sakamoto, I., Khandor, E., Chapra, A., Hendrickson, T., Maher, J., Roche, B., & Chin, M. (2008). Homelessness—Diverse experiences, common issues, shared solutions: The need for inclusion and accountability. Toronto: Factor-Inwentash Faculty of Social Work, University of Toronto. Retrieved from http://www.wellesleyinstitute.com/wp-content/uploads/2011/11/Homelessness_DiverseExperiences_SharedSolutions_FINAL_LowRes.pdf

Wilcock, A., & Townsend, E. (2004). Occupational justice and client-centered practice: A dialogue in progress. Journal of Occupational Science, 71, 75–87. https://doi.org/10.1177/000841740407100203