Understanding homelessness through an occupational therapy lens is essential for both the exam and ethical practice. This topic challenges you to apply concepts like trauma-informed care, occupational deprivation, and social determinants of health to real-world client situations—particularly with unhoused individuals (also referred to as people experiencing homelessness).
In our study chart, we help you connect these core OT principles to how homelessness affects engagement, performance, and access to care—equipping you with reasoning tools to approach test scenarios with clarity and confidence.
What the Exam Expects You to Understand
This topic appears across several exam domains—ethics, intervention planning, mental health, and social participation. You’ll be expected to:
- Identify barriers to ADLs, IADLs, and health management due to unstable housing
- Apply trauma-informed care principles within shelter or outreach settings
- Interpret the impact of social determinants of health (SDOH) on occupational engagement
- Prioritize client-centered strategies for those facing stigma, trauma, or discrimination
- Recognize systemic issues such as poverty, lack of access to care, and unemployment
- Analyze case scenarios involving veterans, LGBTQ+ youth, or individuals with mental illness experiencing homelessness
Sample Exam Scenarios
- A veteran with PTSD and substance use disorder has been living in a car. What’s your best OT approach to establishing safety and routine?
- A youth who has aged out of foster care is now unhoused and engaging in high-risk behaviors. How do you integrate trauma-informed care into your intervention?
- A client in transitional housing cannot maintain a medication schedule due to lack of storage. How should you modify the intervention plan?
Key Concepts to Master
Social determinants of health (SDOH): Non-medical factors like housing, income, and discrimination that directly affect health and occupational access.
Trauma-informed care: Based on the five pillars—safety, trust, choice, collaboration, and empowerment. Required in working with PEH.
Occupational deprivation: A loss of meaningful occupations due to housing instability and systemic barriers.
Cycle of Homelessness: Understand how systemic factors create recurring housing instability, and how OT can interrupt this pattern.
OT Strategies for Working with the Unhoused
In our study chart, we outline best practices OTPs use in shelter and street settings:
- Education on ADLs, hygiene, and health self-management
- Creating realistic routines based on community access
- Simplifying health management plans based on client context
- Using advocacy to reduce stigma and adjust discharge plans
- Building partnerships with housing, legal, and health resources
Tips for Exam Prep
- Know how mental illness and substance use intersect with housing loss
- Review real examples of trauma-informed interventions
- Learn how to assess and support clients with limited access to ADLs
- Understand how to document using strengths-based, non-stigmatizing language
Ready to strengthen your reasoning with real-world scenarios?
Enroll now and get access to practical examples and test-ready content in our full study program.
What does ‘unhoused’ mean in occupational therapy?
In occupational therapy, the term ‘unhoused’ refers to individuals experiencing housing instability or homelessness. OTPs must assess how this status affects occupational engagement, safety, and daily routines.
How does being unhoused affect a person’s life and health?
Unhoused individuals experience high rates of illness, trauma, and mental health challenges. In the exam, be prepared to explain how these issues impact access to care, routines, and occupational roles.
What are common reasons people become unhoused?
These include poverty, domestic violence, mental illness, unemployment, and discrimination. Understanding these risk factors is essential for identifying intervention opportunities.
What is occupational therapy’s role with the unhoused population?
OTPs support clients by developing routines, teaching life skills, supporting mental health, and coordinating with housing and health services. Advocacy and trauma-informed care are key.
Why is trauma-informed care important when working with unhoused clients?
Most unhoused clients have experienced trauma or stigma. OTPs use trauma-informed care to avoid re-traumatization, build trust, and offer meaningful, safe intervention.
What is occupational deprivation in the context of homelessness?
It’s the inability to access or engage in meaningful occupations due to environmental or social barriers. It often appears in exam questions involving shelter settings, stigma, or health disparities.
How does social stigma affect people experiencing homelessness?
Stigma can impact self-esteem, health outcomes, and willingness to seek services. The exam may ask you how OTPs can use strengths-based documentation and language to reduce harm.
