Intervention in the occupational identity of homeless populations: changes through occupational therapy

Abstract

Although often overlooked, Occupational Therapy interventions with people experiencing homelessness represent an opportunity for personal and social reconstruction. This study aimed to analyze the changes in occupational identity among individuals living on the streets after participating in Occupational Therapy intervention processes. A quantitative-explanatory approach with a quasi-experimental design was applied, using the Occupational Performance History Interview-II (OPHI-II) as the main instrument with a group of 18 individuals undergoing rehabilitation in a foundation in Bucaramanga, Colombia. Initial results showed that 78% (n=14) presented “extreme occupational dysfunction,” while 22% (n=4) presented “some occupational dysfunction” across the different occupational identity items evaluated. Based on these findings, a nine-week Occupational Therapy intervention was designed and implemented, resulting in 78% of participants transitioning from “extreme occupational dysfunction” to “some occupational dysfunction,” with reductions ranging from 50% to 60% across the various occupational identity indicators. These results highlight the effectiveness of Occupational Therapy in restoring occupational identity in contexts of social exclusion. However, structural limitations were identified, such as the absence of interdisciplinary teams in institutions, lack of continuity in public policies, and limited social and labor inclusion for this population. The study concludes that it is essential to strengthen intervention processes through a comprehensive and intersectoral approach—one that includes the occupational therapist—to address homelessness as a public health issue.