Date Presented 04/05/19
This study investigated the occupational needs of LGBTQ young people in a transitional housing facility. Primary needs identified were home management, work and work preparation, social skills, and financial management. OTs can develop programming for young people that addresses independent living skills for residential stability using a developmental, trauma-informed, occupation-based approach.
Primary Author and Speaker: Callan McDermott
Additional Authors and Speakers: Emily Simpson
Contributing Authors: Lauren Hild
PURPOSE: Unaccompanied young people (YP) aged 18 to 24 make up 32% of the homeless population. A disproportionate number of them identify as LGBTQ (42%), many of whom have been victimized or rejected by adults, which may result in a distrust of authority and wariness of social services. YP may find it challenging to access relevant support services that they perceive to be safe, especially LGBTQ YP, who are most at risk for victimization. When LGBTQ YP do access services, it is often from under-resourced agencies, which are ill-prepared to address their unique and complex needs. Because LGBTQ YP are often forced to leave their homes at a young age, they don’t receive the support and guidance necessary to adopt adult roles or to develop independent living skills, which are crucial to residential stability. To inform OT program development and create a novel psychosocial fieldwork experience for OT students, researchers partnered with a transitional housing facility (THF) for LGBTQ YP and conducted a preliminary needs assessment. The aim was to understand the occupational needs of LGBTQ YP in a THF.
DESIGN: Researchers used a convergent mixed-methods design to gather data from surveys, individual interviews, and focus groups with both residents and staff of the THF. Researchers spent prolonged time within the THF in order to establish trust, recruit participants, and provide information about the study and OT.
METHOD: Surveys were completed by 13 residents and four staff members. Focus group interviews were conducted with residents (n=2, n=3, n=3), and staff (n=2), and individual interviews were also conducted (staff: n=1; resident: n=1). The semi-structured interview guides were developed using the OTPF-3, with particular attention to occupation, performance patterns, and context/environment. Quantitative data was analyzed using descriptive statistics and qualitative data was analyzed thematically. A side-by-side comparison was applied to the results in order to identify patterns and confirm themes.
RESULTS: Qualitative themes included: (1) supports to programming, such as incentives for attending programs; (2) barriers to programming, such as lack of space and privacy, and structure of house rules; (3) performance skill development, such as emotional regulation; and (4) occupational needs, including establishing routines. Of the 21 occupational needs identified, both residents and staff prioritized social skills (R: n=100%; S: n=100%), and home management services (R: n=100%; S: n=75%). Staff (n=100%) also prioritized money management. 46.1% (n=6) of residents self-identified as having a mental health condition; however, only 30.7% (n=4) had received helpful services on medication/symptom management.
CONCLUSION: In order to best support LGBTQ YP in THFs to secure and maintain permanent housing and manage adult responsibilities, there is a need for occupation-based, trauma-informed, independent living skills programming. Within this THF and other agencies, OTs can facilitate the development of occupational performance skills by modifying interventions aimed at the adult population for the developmental needs of YP, including those directed at pre-vocational and employment skills, health and self-management skills, and home and financial management. OTs can also assist YP in THFs to access and maintain permanent housing and employment through the identification of environmental barriers, such as time constraints and transportation restrictions, and strategies to eliminate their impact, and can promote the development of healthy habits to lead to productive daily routines. OTs can support staff to understand the complexity of personal and environmental factors that contribute to challenges in long-term success.
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