My First Level 1 Fieldwork in Permanent Supportive Housing

September 17, 2020
by Liz

Fieldwork

The mental health immersion has been by far one of my favorites! Before grad school I had zero experience in this type of setting and I didn’t know what OT in mental health looked like. So, I was excited to learn all about it! A couple of weeks into my first fall semester, I learned that I would be completing my first level 1 fieldwork experience at a permanent supportive housing facility. The residents at this facility were all individuals who were transitioning from homelessness to permanent housing. This is one of the settings that you’ll get a chance to learn about in the immersion.

To my surprise there wasn’t an OT at my site, but I learned SO much. This was because there’s already a smaller representation of occupational therapists working in mental health settings. Fortunately, there were a couple of case managers and an event coordinator present who collaborated with each other to best support the residents. At first it made me really nervous that there wasn’t an OT at my site. I already didn’t know what OT looked like in a mental health context and the fact that it was my first fieldwork experience felt intimidating. However, I will say it was comforting to have one of my colleagues at the same site with me!

The site was relatively new, and most of the residents didn’t really know each other. However, a few of them did from seeing each other at some of the same shelters prior to obtaining housing. On our first day, we knocked on every single resident’s door to introduce ourselves. Even after we introduced ourselves, at first it was difficult for my colleague and I to interact with a lot of the residents. They preferred to stay in their rooms and only came down to the main lobby for coffee or snacks. So, my colleague and I asked ourselves: what would our goal be while we were there? We broke down some of what we had learned in class so far and decided that we wanted to establish a sense of community among the residents. We hoped to promote social engagement and wanted the site to feel like home. And of course we also wanted to encourage the residents to engage in meaningful occupations!

We discussed our ideas with the case managers and event coordinator to make sure it was okay to move forward and they were on board! After receiving the green light, we designed a monthly calendar full of different groups/activities the residents could attend which included gardening, bingo, cooking groups, exercise groups, and computer classes. We also got to use some of the money available in the budget to order some yoga mats, light weights, coloring supplies, and raffle gift cards for bingo.

Every week we would make a new flyer to promote the groups we would be hosting for the day, knock on people’s doors, and invite them to join us. What started with one person attending our first couple of groups turned into more than 10 people joining us! I had the chance to work with one resident who wanted to learn how to use a computer to type up his own songs. He loved music, and I showed him how to use Microsoft Word to type them up. I taught him how to use the internet to search up websites that help you practice typing on the keyboard. I also helped another resident type up a resume. She wanted to go back to work and wanted to get a resume ready. Being able to support these residents engage in activities they found meaningful was amazing.

Over time, some residents felt more comfortable coming down to the lobby even during hours when we weren’t hosting any group sessions. It was an amazing experience also serving as social support for them. Several residents didn’t have any family or friends, while some had simply lost touch with them. On some days we would just sit in the lobby, listen to music and just talk. We were able to order a speaker for bingo that had an aux, so I was able to take some song requests. Billie Jean was a HIT! But, hearing their stories was the best part.

My professional boundaries were also tested while I was at this site. I am a very petite woman, and one of the residents who was also around my size wanted to give me a USC sweater she said no longer fit her. We had talked about this in class and how we may have to make ethical decisions when at fieldwork and in practice. But, I didn’t know making those decisions would come so soon! This woman whom I had established wonderful rapport with wanted to gift me a sweater. How could I decline? I definitely didn’t want her to think it was because I didn’t like it or because it wasn’t brand new. Would this affect our therapeutic relationship? I knew the right thing to do was to decline the gift. So, I explained that I was not allowed to accept any gifts, but that I would take a picture with it and keep that instead. I could tell she was disappointed at first, but she was happy to see that I took a picture with it! This was definitely a difficult decision to make, but an important part of my learning experience.

Overall, I had a great time and learned a lot! As I am writing this blog post I can’t help but think about all of the wonderful residents I met at this site. I am hoping they are all doing well and full of health! If you are a student in the program who hasn’t taken the mental health immersion, I am certain you’ll have a wonderful experience too. And, if you’re a future Trojan you also have some exciting experiences to look forward to!

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