Living in a house after living on the streets can present day-to-day challenges. At Project Renewal in New York City, occupational therapists help consumers adapt to a new way of life. Working closely with case managers to identify people’s unique needs, they help consumers to rebuild their lives as they transition into housing.
A person who is experiencing homelessness needs a complex skill set to survive. He needs to find food, shelter, and safety on a daily basis. He has to meet basic needs in an insecure environment. In contrast, the skills associated with living housed present different challenges. Tasks like buying groceries, cooking meals, being on time, staying employed, and organizing a home require significant, individualized support. For some people, they are doing these things for the first time in many years. Occupational therapists can fill this support role as part of multi-disciplinary teams in supportive housing.
Kenneth Archbold and Tamar Gold work closely together at Project Renewal in New York City. Together, they support people who are transitioning from homelessness to supportive housing.
Kenneth is a case manager for 15 to 25 individuals who are part of the methadone program. Clients are in the program to transition off methadone, to build “clean time,” and to rebuild their lives. Tamar is an occupational therapist intern from Columbia University in New York City. She is completing fieldwork requirements for her degree. Tamar’s job is to provide a functional perspective on how to improve residents’ daily lives.
“Some people don’t know how to cook anything. Many people I work with don’t have any organizational skills and others are living amidst piles and piles of clothing. A lot of clients have poor social skills related to depression, so we work on those skills on maintaining their apartments, holding a job, taking the functional perspective to get there,” says Tamar.
Tamar and Kenneth have been working with one client who is having relationship struggles with his daughter. This is the most meaningful relationship in his life and a motivating factor to help him take care of his own health. As such, they have focused on helping him to stabilize both this relationship and his diabetes. There was pressure from his daughter to spend what little money he had on her, so Tamar set a goal to work on parenting skills. “We talked about parenting and spending time rather than money. He is really excited about how the relationship with his daughter is developing. He takes notes about what we have accomplished.” Recently, he cooked a healthy meal that he and his daughter could share, bringing together the parenting and health aspects of the goals he had set with Tamar.
“The benefit to me,” explains Kenneth, “is that my clients really grow from the individual attention the occupational therapist can provide. Tamar has the ability to help people organize and accomplish goals. Initially I thought the occupational therapists were here to help people get jobs, but I learned that it is about helping people to manage their time more wisely and to fine tune areas where they need extra help.”
Focused suggestions and structured plans for completing tasks go a long way. These could include something as simple as an extra laundry basket for organizing laundry or a back pack to carry groceries to the second floor of an apartment Individualized attention and having someone who will listen are also things that occupational therapists do to make living more manageable.
Tamar shares that she would have never considered working in homelessness had it not have been for this internship. “This has offered me a new perspective. It is very challenging work and I am sad to leave clients. I would love to work in this field long-term. It never would have crossed my mind if I hadn’t done this field work.” A career in this field is now something that Tamar is strongly considering.