Date of Award

2026

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Andrea Young

Keywords

activities of daily living (ADL), holistic care, volition, accessibility, habituation, identity

Abstract

Abstract: Unhoused individuals experience compounded barriers beyond housing access and are often underserved within occupational therapy practice. This doctoral capstone project partnered with a nonprofit residential program to develop a research-informed onboarding manual grounded in the holistic occupational therapy framework, Model of Human Occupation (MOHO, O’Brien, 2017). The manual was designed to clarify expectations of the supportive housing program, address diverse resident needs, and promote independence as the organization expands. Development was informed by a comprehensive literature review and informal needs assessment of the organization, identifying anticipatory barriers and supports commonly experienced prior to program entry. Key areas of need including physical health, mental health, spiritual/social participation, and employment/financial/legal support were organized into a self-paced residential manual. Although direct intervention was not feasible due to site constraints, the occupational therapy lens was used to guide creation of a resource to enhance individualized support and promote independence along a pathway toward permanent housing. Survey measures were developed to support long-term evaluation and program sustainability, demonstrating the value of occupational therapy in an underserved practice area.

Background: Homelessness in Minnesota continues to remain a focused issue, particularly among individuals experiencing chronic homelessness in the Twin Cities metro area, revealing ongoing gaps in access to affordable housing as well as sustained health and wellness supports. Although community-based nonprofit organizations exist, limitations in a holistic, client-centered program continue to be present, hindering successful transitions into permanent housing. The partnered organization began addressing these problems in the community with establishing a meal program to serve community members on weekends. After further discovering the need for holistic models of housing, the program expanded to residential services. Upon partnership with the occupational therapy student, the need for further development of holistic onboarding and clarity of expectations was realized. As the partnering organization prepares for expansion, the lack of a structured, holistic onboarding process presents a significant barrier to consistently supporting residents while maintaining feasible staff involvement.

Purpose: The purpose of this scholarly project was to develop tools including onboarding competencies and a Self-Paced Residential Manual, grounded in occupational therapy framework to address areas of need identified at a suburban supportive housing program and to exemplify the role occupational therapy has in a nontraditional setting through introduction of framework and expertise. The competencies and manual were grounded in the model of human occupation framework and structure was provided to both support the individual residents served and the staff guiding self-growth and independence through the housing program.

Methodology: This doctoral experiential capstone involved the development of a self-paced residential onboarding manual designed to support holistic self-growth and increased independence for individuals in transitional housing. Grounded in the Model of Human Occupation and the Occupational Therapy Practice Framework, the project addressed gaps in existing onboarding processes that often contributed to prolonged transitions into permanent housing (O’Brien, 2017; AOTA, 2020). An extensive literature review and a 14-week experiential placement informed the manual’s structure, which organized content into progressive focus areas of physical, mental, and spiritual/social health as well as employment/financial/legal planning and support through goal setting and routine development. The manual was designed to be accessible, ethically sound, and usable by non-professionals, with planned implementation to support organizational expansion and streamlined onboarding

Results: The site mentor and applicable staff commented admiration for the product created and highlighted how the comprehensive inclusion of resources as well as exercises can impact the existing programming. The onboarding competencies helped in addressing areas of need during the onboarding while providing opportunities for further assessment of program success and guiding goal setting. Lastly, the created manuals helped guide task breakdown of goals and provide guidance for skill building.

Conclusion: Implications to occupational therapy include highlighting the relevance of practice and improving outcomes for residents through promotion of occupational justice and opportunities for meaningful engagement. The product created exemplifies how occupational therapy can play a stronger role in supportive housing, and how the distinct values of practice are aligned with holistic practices in existence at the partnered organization.

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