Date Presented 04/19/2023

A growing number of OTs are involved in research and practice with persons who experience homelessness. To support OT research and practice in this area, our team developed the Bridging the Transition Framework (BTTF). This workshop will provide an overview of the BTTF and its various components and engage attendees in activities that illustrate ways of using the BTTF in research and practice using videos conducted with persons with lived experience.

Primary Author and Speaker: Carrie Anne Marshall

Additional Authors and Speakers: Rebecca Gewurtz, Skye Pamela Barbic, Patti Y. Plett, Corinna Easton, Abrial Cooke

PURPOSE: A growing number of occupational therapists support individuals who experience homelessness in their traditional occupational therapy roles in community and inpatient mental health, or in direct service positions dedicated to working with this population. In recent years, occupational therapy research related to homelessness has increased significantly. An occupational lens has the potential for supporting housing stability and community integration for individuals who are leaving homelessness. Resources to support research and practice are needed. In this workshop, we will present the Bridging the Transition Framework (BTTF), developed to support occupational therapists in their research and practice efforts across the trajectory of homelessness to housing.

DESIGN: The BTTF was developed from the findings of empirical research conducted by our team with persons who were unhoused, and housed following homelessness (Marshall, Gewurtz et al., 2022). Themes from this qualitative study were translated into a draft framework, which was presented to occupational therapy researchers and practitioners in middle to high income countries internationally. Feedback generated from these consultations was used to refine this framework (Marshall, Cooke et al., 2021). A refined version of this framework was released in 2020 in the form of a practice guide, and has been since distributed broadly (Marshall, Cooke et al., 2020). From this, our team developed a one-day workshop, which has been disseminated to occupational therapists and students in two provinces in Canada. In this pre-conference workshop, we will present the BTTF using video case studies with persons with lived experiences of homeless to illustrate each framework component. Attendees will be engaged in activities that will help them to understand the components of the framework, and how they might be applied across a range of research and practice scenarios with individuals who are unhoused, housed following homelessness, or living in housing precarity. Once all components of the framework have been presented and applied in workshop activities, attendees will be engaged in discussions regarding future applications of the BTTF and possibilities for collaborating on research and practice efforts in this area.

RESULTS: The findings of research generated during the process of developing the BTTF will be presented throughout this workshop. Implications for future research and practice will be explored.

CONCLUSION: Homelessness is growing in high and middle income countries internationally. In response, a growing number of occupational therapists are conducting research and practicing in the area of homelessness. Research and practice tools are needed to support these efforts to improve the lives of this population from an occupational perspective. The BTTF has the potential to inform future research in this area, inform policy by describing the unique contributions that occupational therapists can make in the lives of persons who experience homelessness, and provide guidance for occupational therapists who are supporting this complex population. Since the BTTF has been disseminated for the first time in 2020, it has been used to structure fieldwork placements, hire occupational therapists in new positions, and has been used to educate occupational therapists new to this area of practice. We anticipate that this framework will continue to influence research, practice and policy in the future as it is disseminated further. Mostly, we hope that it will continue to be used to describe the unique and important contributions that occupational therapists can and do make in the lives of individuals across the trajectory of homelessness to housing.


Marshall, C., Gewurtz, R., Ross, C., Becker, A., Barbic, S., Roy, L., Lysaght, R., & Kirsh, B. (2022). Beyond securing a tenancy: Using the capabilities approach to identify the daily living needs of individuals during and following homelessness. Journal of Social Distress and Homelessness, Online ahead of print.

Marshall, C., Gewurtz, R., Barbic, S., Roy, L., Lysaght, R., Ross, C., Becker, A., Cooke, A., & Kirsh, B. (2020). Bridging the Transition from Homeless to Housed: A Social Justice Framework to Guide the Practice of Occupational Therapists.

Marshall, C. A., Cooke, A., Gewurtz, R., Barbic, S., Roy, L., Lysaght, R., & Kirsh, B. (2021, Nov 16). Competencies for occupational therapy practice in homelessness: A Delphi study. Scand J Occup Ther, 1–15.

Marshall, C. A., Cooke, A., Gewurtz, R., Barbic, S., Roy, L., Ross, C., Becker, A., Lysaght, R., & Kirsh, B. (2021, Sep 28). Bridging the transition from homelessness: Developing an occupational therapy framework. Scand J Occup Ther, 1–17.