Date of Award

2025

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Breann Lamborn

Second Advisor

Nicole Harris

Keywords

permanent supportive housing, occupational therapy, Housing First, trauma-informed care, daily living skills

Abstract

Background: Individuals experiencing chronic homelessness often face complex challenges including trauma, mental health conditions, and barriers to daily living. While permanent supportive housing provides long-term housing with supportive services, gaps exist in resources tailored for both residents and residential support staff. Many existing permanent supportive housing programs emphasize behavioral or mental health approaches, with fewer addressing the full range of occupational participation needs. Occupational therapy, with its holistic and client-centered perspective, offers a valuable lens to enhance service delivery in permanent supportive housing.

Purpose: The purpose of this scholarly project was to develop two compatible tools–a Permanent Supportive Housing Residential Services Staff Manual and a Tenant Handbook–to enhance stability, autonomy, and engagement among individuals in permanent supportive housing. Grounded in the ecology of human performance model and Housing First philosophy, these products were designed to provide practical guidance to staff and accessible resources to tenants.

Methodology: The products were developed through an ongoing literature review, fieldwork-based observations, and informal stakeholder input. The ecology of human performance model served as the primary theoretical framework, offering a structure for evaluating how environmental, personal, and task-related factors affect occupational performance of tenants and staff. The Occupational Therapy Practice Framework, 4th ed. (American Occupational Therapy Association, 2020) informed topic selection, especially for the tenant handbook, ensuring coverage of key daily living and health management areas. A needs assessment helped clarify content priorities, and iterative revisions allowed the materials to evolve in response to emerging insights.

Results: Site mentors reported that the materials aligned closely with the vision for PSH expansion. Staff reported learning from the manual and expressed interest in using the handbook with tenants. The staff manual filled a gap in training and documentation tools, while the tenant handbook empowered residents to explore daily living skills independently and without stigma.

Conclusion: This project demonstrates the value of integrating occupational therapy into PSH programming. The two products complement one another and respond to the needs of both staff and tenants. Their development reinforced the need for tools that support both service providers and recipients, while highlighting occupational therapy’s unique contribution to addressing functional, contextual, and environmental barriers in housing.

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