When Grace* found herself without a safe, stable place to stay, she turned to Covenant House Toronto, Canada’s largest shelter serving youth experiencing homelessness or sex trafficking.  

Youth at Covenant House, whether they are there to access short term shelter or the community drop-in programs, have access to a team of professionals to support them. Like other shelters and agencies, youth are assigned a caseworker and have access to mental health counselling, education and employment programs. Unlike at other youth shelters, Grace was given the opportunity to work with an occupational therapist. 

Jordan Higa and Amy Weisner (MScOT Class of ’22) are in-house occupational therapists at Covenant House, which established their roles after a previous student from our MScOT program completed a LEAP (Leadership, Emerging, Advocacy, Program Planning and Evaluation) placement at the shelter. Since then, the program has expanded into two roles: Higa works as the residential occupational therapist and Weisner is the community occupational therapist. 

Young people who come to Covenant House, like Grace, need caring support in order to transition from shelter to independent living. Youth who have experienced abuse and neglect often lack the necessary life skills to thrive on their own. When Higa and Weisner work with youth, their focus is on function — looking at their clients as whole people to help them figure out their goals and what it means for them to be functioning well. 

“The main need that we notice when youth are experiencing homelessness and crisis is that they are in survival mode, just trying to get to the next safe place,” says Weisner. “Once youth come here and their basic needs like food and shelter are met, we start asking ‘What does the rest of the day look like for you? How do you want to fill your time?’” 

“A lot of the youth that we work with have never really had the opportunity to sit down and ask themselves what they want to do, because they’ve been in crisis for so long,” Weisner adds. 

 

Residential occupational therapist  

When Grace came to Covenant House, she was given a bright, clean bedroom in the short-term crisis shelter — a place she could stay temporarily while she looked for long-term housing. Here, her physical needs were being met — a warm shower, daily meals, and a caseworker to help her navigate social assistance applications. But Higa, as her occupational therapist, also asked her: “What else can I help you with? What are the goals you want to work on?” 

“The goals I help my clients with are very much youth-led and based on whatever they feel is most helpful for them at that time. Our assessment and intake is really a lot of occupational interviewing and asking about different areas or life skills, and figuring out which ones are most important for them to use.” 

For Grace, a part-time college student, this meant managing a schedule and working on emotional regulation. Higa worked with Grace to build a daily schedule that incorporated her classes, mealtimes and routine sleep. She also offered Grace tools for managing emotions and setting healthy boundaries – both skills that Grace hadn’t been able to develop after years in a stressful living situation. 

 

Occupational therapy in the community 

Support from Covenant House doesn’t end when youth move out of the shelter. Weisner, as an occupational therapist, is available to support youth through this transition. “It’s so wonderful when our youth, who have been through a lot, move out into the community and into safe, reliable housing,” she says 

But in the transition from shelter to housing, clients have to figure out many things, she adds. At the shelter, their meals are all provided. So when clients secure a new home, Weisner asks if they know how to cook and grocery shop – tasks they may never have had the opportunity to practice. 

“When clients are in the shelter, there are a lot of activities that are planned throughout the day,” Weisner says. “So when they suddenly have a whole day to fill for themselves, I help them figure out what they want to spend their time doing and help them figure out how to do it.” 

For one of Weisner’s clients, Jesse,* everything seemed to be falling into place. Jesse had found a roommate to share a small apartment with and was about to start a new retail job downtown. But Jesse’s sensory issues meant that the subway, with its loud noises and overcrowded trains, was not an option for traveling to and from work.  

During one of their sessions, Weisner worked with Jesse on route navigation. Together, they took a trip on public transit, starting from Jesse’s apartment and going to the new workplace, following a route that could be taken without a subway. Weisner even secured a pair of noise-cancelling headphones so Jesse could block out surrounding noise and have a more peaceful, less overwhelming commute. 

 

Setting them up for success 

Covenant House was one of the first youth shelters to include occupational therapy as a service. “We are lucky to have a team here of wrap-around supports including case management, transition services, harm reduction, counselling, psychiatry and primary care services” says Higa.  

“What’s unique about our role is that we focus on the fun and function. We get to sit down with our clients to learn about what they want to do, and help them build these foundational skills to set them up for success.”   

*names have been changed for confidentiality 

Note: Weisner left her role at Covenant House in August, 2023 and is currently working as an occupational therapist at a complex care housing team in another province. 

Image courtesy of Covenant House Toronto.