The Role of Occupational Therapy in Refugee Resettlement
Written by Julia Leone, Communications Intern
“ACC’s goal is to help our refugee community members become self-sufficient. As an Occupational Therapist, our goal is to help people be more independent in order to improve their quality of life and wellbeing. Those values go together really well.”
I sat down with ACC staff member Hayley O’Shields to talk about her unique background as an Occupational Therapist and the role that Occupational Therapy (OT) can play in providing more robust and effective refugee resettlement.
Hayley currently works as part of the ‘Preferred Communities Program’ at ACC- a program that works to give extra care and support to some of our most vulnerable community members, like single parents, elderly couples, individuals with mental health struggles, etc. Her job is different every day, while some days are spent in the office case noting and writing reports, most of Hayley’s days are spent out in the community. These days in the community also vary, depending on the specific and unique needs of her caseload.
For example, one day might involve teaching a refugee community member how to ride the bus and learn more about Colorado’s public transportation system. Hayley would model the entire process, walking with them from their house to the bus stop, actually getting on the bus, using Google Maps/RTD app, arriving at their destination and of course, getting back home. A second example could be grocery shopping and explaining how public benefits like EBT(food stamps) and WIC can help pay for certain items.
Hayley’s passion for OT originated during her undergrad at Elon University. After graduating, she considered pursuing a career in physical therapy or public health but wasn’t sure which path was right for her. Hayley instead decided to join the Peace Corps, living as a health education volunteer in Cambodia for two years. During that time, she learned more about OT, realizing that it blended a lot of her interests working with people one-on-one but also promoting overall health and wellbeing. Occupational Therapy, as Hayley will go on to further explain, is a holistic profession that treats every person in a unique way, striving to help individuals achieve individual goals and gain independence. OT can take place within multiple spheres of life, Hayley describes, including both the ‘physical body’ as well as the ‘physical and social environment’ one lives in.
The following interview has been edited for readability and clarity.
Hayley presenting at the Occupational Therapy Association of Colorado (OTAC) Conference held in Parker, CO in October 2022
Q: What is Occupational Therapy?
Hayley: That’s a good question. Occupational Therapy is a holistic profession with the end goal being to help individuals achieve their unique goals and gain more independence. OT is different from other professions; we’re not as focused on rehabilitating people. There’s portions of that in helping a person learn skills, but we also incorporate the environment and what we call the occupation, which is any meaningful activity that they have, need, or want to do in their daily life. It’s asking how we can possibly modify these other pieces so that it all comes together as a cohesive whole that works together and helps that person slowly gain independence.
So, in a traditional sense, if you think about OT in a hospital-based or rehab-based setting, we might help someone with a broken leg get out of bed, take a shower, or get dressed. We link their goals to tasks of daily living, but we might have to modify the tasks a little so they can still be independent with the activity as they heal.
It translates really well into refugee resettlement, because we’re helping people who have experienced what we call ‘occupational deprivation.’ Our clients are coming from a country or culture where they had certain roles, routines, habits and occupations that they valued and all of that has been disrupted. Now some of those roles are no longer present, so they have to learn what their new role, new identity, and new occupation(s) are.
Q: Where do you see the intersections with refugee resettlement?
H: When you think of these individuals who are coming from a different country and culture, they’re coming with specific roles, routines, habits, occupations and meaningful activities. Then, they come to this entirely new country and culture, and everything they came with gets completely disrupted. Their entire world can be turned upside down. That’s when they may experience what I mentioned, ‘occupational deprivation.’
This new identity and new role can make it confusing to understand where they fit into this new culture. There’s so many new things to learn. Simple things that they used to do without thinking in their home country suddenly become much more difficult. They have to learn how to navigate a new transportation system, public benefits system, rules and laws and regulations, not to mention learn a new language. That’s where my work comes in. I work with individuals one-on-one and identify their unique goals. We work collaboratively, and I encourage learning by doing. ACC's goal is to help our refugee community members become self-sufficient. As an Occupational Therapist, our goal is to help people be more independent in order to improve their quality of life and wellbeing. Those values go together really well.
Q: How do you think ACC could include OT practices or knowledge into its work with refugees?
H: I think there’s already a lot of overlap between OT practices and what we do at ACC. Several weeks ago I was asked to lead a training about ‘Smart Goals’ for our integration coaches and team leads, and that is something that is common in different fields: to set goals for clients or individuals. That is a framework we use all the time in OT and something I learned to do in my graduate program, so I think having that background really helped being able to train co-workers and develop our skills as a team.
Another key premise of OT is being able to see the whole person and the holistic picture of not just who they are, but where they live, who their family members are, what their background is, and what skills they already have. This helps us understand why they may have some barriers and limitations to their activities of daily living. I think that OT brings a really nice holistic picture to the refugee community members we serve.
I would love to get more Occupational Therapists hired here at ACC, and I think the Preferred Communities team would be a great place for them to land. We have a much smaller case load, only 20 people, but they are the most vulnerable, so they need more help integrating. I would love to be able to talk to other colleagues in the field and work with ACC to see if we can expand the team. Realistically, OT’s could fit anywhere, not just Preferred Communities, but I am partial to my team.
I’d also like to continue offering fieldwork opportunities to students, showing them a potential place and setting to work in. Even if they ended up working at another agency or in another state, just showing them that it’s a potential career opportunity and making it a more prominent field in the world of OT would be fulfilling.
Q: Do you have anything else you want to add?
H: I’m really excited about the development of Occupational Therapy in refugee resettlement. I’ve been fortunate to attend a couple conferences last year, one being the World Federation of Occupational Therapy in Paris. I was also able to mentor two Level One OT students for 20 hours each of observation and learning. Opening up the field as an option to students is really going to help develop the field.
I also presented at the Occupational Therapy Association of Colorado, specifically on the role of OT in refugee resettlement, and I think the word is getting out within the Colorado community. My next steps are talking with our State Board about what it would look like to start billing OT services. That would involve discussions with Medicaid, as all of our refugee community members initially have Medicaid. That’s the direction I can see Occupational Therapy going and how we’re going to make it more prominent and show its value here!