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BACKGROUND: Occupational therapists have a long history of addressing community performance and participation challenges faced by individuals with complex, chronic conditions, including those with serious mental illnesses (SMI) and cognitive issues that present with a traumatic brain injury (TBI). Healthcare reform has shifted incentives to support practices that promote successful community life for people with complex medical conditions. Community based care models emphasizing integrated primary care, such as Federally Qualified Health Centers (FQHC) are emerging, and a generalist role for occupational therapy is being defined. Those with complex comorbid conditions such as mental illness, substance abuse and traumatic brain injury are at risk for negative health outcomes that are further compounded by homelessness. There is a critical need to understand effective treatment options for this population to reduce the negative effects of chronic health conditions. As occupational therapists further define a role serving traditional clients in less traditional settings, such as the FQHC, it is helpful to explore the perceptions of the utility of OT services on the part of provider referrers. OBJECTIVE: This study explored provider referrer perceptions of a new occupational therapy service for homeless adults in an FQHC to assist effective allocation of scarce resources. METHODS: Twelve provider referrers at an FQHC were interviewed regarding their perception of the role and utility of occupational therapy in this setting. Interviews were then coded for themes. RESULTS: Providers identified the unique value of occupational therapy, emphasizing critical information gleaned from the performance-based assessment of functional cognition, and the positive impact on team interactions and subsequent care decisions. CONCLUSION: Occupational therapy provides a distinct perspective on client performance in FQHC settings indicating benefit for inclusion of services.

Background: Current health care policy supports occupational therapy services with individuals experiencing homelessness in primary care settings. Research on the impact of interventions is needed to support this emerging practice area. Method: : A retrospective, descriptive study was completed following the initiation of full-time occupational therapy services in an integrated primary setting and Federally Qualified Health Center (FQHC) for clients experiencing homelessness. This study evaluated: (a) percentage of referred clients who engaged in ongoing intervention; (b) diagnostic demographics of those referred; (c) functional goal types and frequency; (d) a comparison of preintervention Canadian Occupational Performance Measure (COPM) scores with postintervention scores. Results: : Analysis of data revealed clients referred for occupational therapy services present with complex co-morbidities. t tests for matched pairs (p < .05) revealed that participants had a statistically significant improvement in COPM performance scores (69%) and in COPM satisfaction scores (73%) between baseline and postintervention. Diagnostic subgroups had a similar rate of improvement. Analysis of client identified COPM goals revealed a high rate of instrumental activity of daily living focused goals. Conclusion: : Integration of full-time occupational therapy services into FQHC settings increases client access to functional-based rehabilitation services that address physical and behavioral health. Individuals experiencing homelessness demonstrate improvement toward functional goals using client-centered goal setting processes and interventions. Comments The authors report no potential conflicts of interest.

This study aimed to identify the effectiveness of occupational therapy utilizing Recovery Model principles from the consumer perspective within an inpatient psychiatric unit. Clients engaged in recovery-based occupational therapy while admitted, and feedback was collected using a survey regarding the benefit of occupational therapy sessions, as well as perceived ease=difficulty of their personal recovery plans. Consumers overall viewed occupational therapy as beneficial to recovery process and identified specific areas that were of most benefit. Consumers' responses indicated occupational therapy enhanced the recovery process during inpatient admission, supporting the role of occupational therapy and the Recovery Model in these settings.