Personalized Occupational Transformations: Narratives from Two Occupational Therapists’ Experiences with Complex Therapeutic Processes

Recovery and occupation-centered practices with persons with severe psychiatric disabilities involve many dynamic issues and processes. This study aimed to develop an understanding of how the therapeutic process unfolds in occupational therapy among persons with severe psychiatric disabilities living in sheltered or supported housing. Repeated interviews were conducted with two occupational therapists working in sheltered and supported housing facilities. Narrative analysis was used to analyze their stories. The findings reveal “personalized occupational transformations” describing significant events of interaction establishing therapeutic processes to promote personal agency and social recovery while targeting meaningful activities based on each resident’s wishes.     

Refugee pathways out of homelessness in urban Alberta,Canada: implications for social justice-oriented counselling

Although refugees flee their homelands in search of a better life, they often face continued displacement and homelessness after arrival in their host countries. This constructivist grounded theory study investigated pathways out of homelessness through interviews with a mixed sample of 19 adult refugees from Afghanistan, Congo, Ethiopia, Iraq, Pakistan, Rwanda, Somalia, Sudan and Syria who had experienced short or long-term homelessness after their arrival in Canada and who were subsequently adequately settled for at least 6 months. Data analysis yielded a theoretical framework consisting of four interrelated pathways for exiting the cycle of homelessness: (a) drawing on religiosity to replace the lack of one’s own physical dwelling with a virtual spiritual shelter, promoting resilience in dealing with housing obstacles; (b) creative problem-solving to move up the income ladder to make housing affordable; (c) crying out for help and stumbling on a housing advocate; and (d) engaging in self-advocacy. Social justice-oriented counselling with refugees can facilitate satisfaction of their basic needs after migration in order to realize their fundamental human right to access safe shelter.     

Housing Experiences of Recent Immigrants to Canada’s Small Cities: the Case of North Bay,Ontario

Adequate, suitable and affordable housing is one of the basic needs that must be successfully attained in the process of immigrant integration into a community. This case study consisting of semi-structured interviews and focus groups with new immigrants and landlords centres particularly on the housing experiences of immigrants in North Bay, a small city in Northeast Ontario. North Bay, like many small urban centres in Canada, has undertaken an immigration strategy in order to counter demographic challenges and boost economic development. The housing experiences were examined in terms of suitability given household size and composition, affordability relative to the immigrants’ financial resources as well as ownership and dwelling type. The connection between the immigrant’s housing experiences, their interactions with neighbours and landlords and their perceptions of the city as a welcoming community were also explored. Generally, the immigrants who participated in the study were satisfied with their current housing situation. Several participants were surprised to find a limited and older housing stock in North Bay and rental prices that were not significantly different from the larger cities they had left. Their housing experiences tended to either have a positive impact on their perceptions of the city or not at all. Policy implications and recommendations are also discussed.     

Employment Instability among Less-Qualified Young Workers

More than 40% of a sample of less-qualified Scottish school-leavers, surveyed in 1979, left their first jobs early in their occupational careers. Although most of these left voluntarily, further analysis suggests that their instability was generated more by occupational than by personal factors: it was mainly the product of unstable jobs rather than of unstable workers. Many of the young people who left their first jobs subsequently became unemployed; their chances of finding new employment depended on personal factors more than on their earlier occupational experiences. There was considerable occupational mobility among those who found new jobs.     

Exploring the Experiences of Newcomer Women with Insecure Housing in Montréal Canada

The objective of this study was to explore housing insecurity among women newcomers to Montreal, Canada. Semi-structured interviews were conducted with 26 newcomer women who had experienced housing insecurity and five women’s shelter service providers. The primary cause of housing insecurity for newcomer women was inadequate income in the face of rapidly rising housing costs, coupled with unfamiliarity with the dominant culture and the local housing system. Specific events often served as tipping points for immigrant women—incidents that forced women into less secure housing. To avoid absolute homelessness, most women stayed with family, couch surfed, used women’s or educational residences, shared a room or an apartment, lived in hotels, single rented rooms, or transitional housing. These arrangements were often problematic, as crowded conditions, financial dependency, differing expectations and interpersonal conflicts made for stressful or exploitive relationships, which sometimes ended abruptly. Only two of the 26 women interviewed described their current living situation as stable. Based on the findings on the study, we recommend training for housing and immigration service providers, wrap-around services in terms of health, housing and immigration settlement programs that take into account a broad range of immigration statuses and transitional housing that caters to the specific needs of migrant women.     

Transitioning from congregate care: Preparation and outcomes

Of particular concern to child welfare professionals working with youth in foster care is the quality of services rendered to youth in foster care who are imminently making the transition to adulthood and independence, i.e., those at risk for aging out of foster care, many of whom live in congregate care facilities. This qualitative study focuses on the experiences of youth in congregate care in New York City's foster care system, the effectiveness of efforts to prepare youth for life after foster care, and post-discharge outcomes for youth, particularly when discharged to independent living. The study included interviews with professionals as well as young adults who had exited foster care after placements in congregate care settings. Results indicated that professionals and young adults were concerned about the quality of independent living preparation, viewed housing as a serious issue for youth exiting foster care, attributed youth's lack of employment to poor pre-discharge educational and work preparation services, and emphasized the importance of personal connections after youth leave care.     

employment or economic success: the experience of individuals with disabilities in transition from school to work

This research explores the mediating effects of severity of disability on the employment outcomes of participants with disabilities, taking into account their perception of interest‐job match. Participants were 115 high school students with disabilities who took part in an intensive school‐to‐work transition program that explored occupational interests in relation‐to‐work opportunities. Results of a 1‐way analysis of covariance indicated that severity of disability had a significant effect on the employment outcomes of participants despite interest‐job matching. Although participants experienced positive employment outcomes in terms of job entry, these outcomes may not necessarily translate into higher earnings.     

The Effectiveness of a Consultation Model in Community Mental Health

This one-year study explored the impact of an occupational therapy consultation model on housing status and goal attainment among 57 people with severe mental illness who were homeless or at risk of homelessness. A repeated-measure experimental design was used. Although results were mixed, the significant improvement in housing stability and goal attainment six months into the study supports the value of continued research on the effects of both direct and consultative occupational therapy intervention on client goal attainment.     

Prototype matching: a strategy for social decision making

College students responded to a series of questionnaires while they were in the process of selecting housing from a choice of seven available options for the coming fall. Questionnaires concerned their self-concepts, their housing prototypes, their preferences in housing, and their goals in housing selection. Overall analyses of the self-to-prototype matching strategy suggest that most students indeed prefer the type of housing for which their prototype of the "representative" resident most closely matches their self-perceptions. More important, we obtained individual differences in attention to self-fit in situations. Of individuals who reported that they had interpersonal goals in the housing selection task, those who reported that many personality characteristics (both positive and negative) were untrue of self were more systematic in their use of the self-to-prototype matching rule, this was also true of low self-monitors. Neither pattern of individual differences obtained for students with practical goals in the housing decision.     

Understanding the Mental Health Travails of Custodial Grandparents

Grandcarers are at-risk of poor mental health outcomes. Current knowledge of the support needs of grandcarers is fragmented. To help fill this knowledge gap qualitative analysis was undertaken on 49 interviews conducted with custodial grandparents. The findings reveal that conflicted occupational roles coupled with the complexity of the stressors facing grandcarers both contribute to their social isolation and to their self-doubts about their ability to adequately attend to their grandchildren’s needs. Greater awareness among occupational therapists (OTs) of custodial grandparents’ mental health travails and an increased understanding of key occupational therapy (OT) practice initiatives are central to addressing grandcarers’ mental health travails.     

A Social Ecological Approach to Investigating Relationships Between Housing and Adaptive Functioning for Persons with Serious Mental Illness

This paper seeks to advance mental health—housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health—housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health—housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework—physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing—allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings—survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.     

Individual Pathways Through the Junior-to-Senior Transition: Narratives of Two Swedish Team Sport Athletes

Athletes frequently describe the junior-to-senior transition (JST) as the most difficult within-career transition, and many athletes have acknowledged that they failed to cope well with it. Athletes’ development in the JST is influenced by narratives existing within relevant contexts and settings. This study served as a follow-up to the quantitative longitudinal study to gain a deeper understanding of individual JST paths through a qualitative narrative approach. The aim was to explore 2 team sport athletes’ (John, the football player, and Anna, the basketball player) JST pathways, emphasizing psychosocial factors that were perceived as facilitating and debilitating the process. Narrative type interviews were conducted, and the holistic-form structural analysis was used. Through their narratives, John and Anna reconstructed their JST paths, attaching meanings to certain events, recounting the people involved, and making personal reflections. John had a performance and family narrative and Anna had an enjoyment and relationship narrative. They perceived their key facilitating persons to be their family members and teammates. The debilitating factors were some coaches’ behaviors. At the time of this study, John and Anna had already terminated their athletic careers and had refocused on getting an education. Although they did not reach elite senior levels in their sports, they found their athletic careers to be meaningful life experiences.

Lay Summary: The aim was to explore two team sport athletes’ junior-to-senior transition (JST) pathways, emphasizing psychosocial factors involved in the transition process. The findings revealed two narratives. John (football player) storied his JST as a performance and family narrative and Anna (basketball player) as an enjoyment and relationship narrative.     

Growing Up Too Soon: Parental Status,Concern for Youth,and Attitudes Toward Sexual Morality

Sociological research on the control of elite crime has focused primarily on two groups: corporate whistle-blowers and informants within the criminal justice system. Few studies examine the internal social control of occupational misconduct, particularly in organizations that rely on the self-regulation of their members. This paper summarizes the findings of a case study of reactions to occupational misconduct within an elite military institution: the U.S. Naval Academy. Data from three sources are analyzed: official statistics on occupational misconduct, survey data collected from midshipmen attending the Academy, and semi-structured interviews with graduates. Findings reveal that few midshipmen are reported for occupational misconduct primarily because informal norms about peer loyalty typically override official norms that require midshipmen to control the misconduct of their peers. Furthermore, the Academy's system of mandatory self-regulation produces two marginalized groups: those reported for violating rules and those who rigidly enforce the rules.     

A Mixed Methods Study of the Re-Animation Approach Within a Forensic Mental Health Setting

This mixed-methods study investigated the impact of the Re-Animation Approach, a creative occupational therapy, on the well-being and occupational performance of three male patients in a forensic mental health setting. Quantitative data were gathered through goal attainment scaling (GAS) and qualitative data using semi-structured interviews. GAS t-scores demonstrated an over-achievement of expected outcomes in goals related to improving skills, well-being, and time use. Issues emerging from thematic analysis of the interviews are consistent with the GAS results. The Re-Animation Approach had a positive impact on participants’ health and well-being, addressed a range of occupational needs, and can be graded.     

How We Define Success: A Qualitative Study of What Matters Most to Women and Men

In this article we explore how women and men define success and how their definition of success affects their career progress. Qualitative analysis of data from 40 interviews with successful women and men suggest that gender differences do exist. Women highlight the importance of balance and relationships. Men focus more on material success. Similar numbers of women and men thought that their definitions of success had limited their career progress, but the tradeoffs they reported making were distinctly different. Our results suggest that gender differences in the meaning of success exist even when occupational attainments are similar.     

The Impact of Social Anxiety on Occupational Participation in College Life

Social anxiety is a reality for many college students. This study explored the impact of social anxiety on the occupational participation in daily life of six Irish students. Semi-structured interviews were used to explore participants’ daily routines, coping mechanisms, and interaction with the environment. The study aims to inform occupational therapists, academics, and other healthcare professionals of the impact of the condition on the daily life of college students. Qualitative data analysis showed that participants described negative beliefs about themselves and had concerns about how they were perceived by others. This affected their ability to fully participate in the student role.     

A nuanced look into youth journeys of gender transition and detransition

Some media have suggested that many youths who have previously completed a gender transition are “detransitioning”. Their experience is often framed around the idea of regrets but rare are the articles that provide a nuanced examination of their journey. This article presents the perspectives of youths who have detransitioned or discontinued a transition regarding their experiences and feelings on their journey from transition to detransition. Semi-structured interviews were conducted with 20 youths between the age of 16 and 25 years who were recruited on social media and who transitioned and detransitioned or discontinued their transition. Data were analysed according to thematic analysis. Regrets and feelings of satisfaction can both coexist. The processes of transition and discontinuation or detransition appear to be non-linear and participants do not necessarily return to a cisgender identity. Ambiguous loss theory is applied to frame youth experiences and feelings and to suggest way forward for intervention.

Highlights

• This paper examines the experiences and feelings of youth on their journey from transition to detransition.
• Their journey is experienced as non-linear, and often comprised mixed feelings and experiences about transition and detransition steps.
• Ambiguous loss theory allows a nuanced understanding of feelings and experiences of their journey from transition to detransition.