How Occupational Therapists Help Youth Move Toward a Bright Future


When Morgan* started working with Covenant House occupational therapist Amy Weisner, they were feeling overwhelmed financially by how many expenses they had. Amy sat down with Morgan to look at where all their money was going and noticed a lot was being spent on cab rides – why?

It turns out Morgan, a youth now living out in the community, was not comfortable taking public transit in a large busy city, a much more affordable way to get around. So, Amy accompanied them on the subway, streetcar and bus and helped Morgan learn how to navigate the transit routes – how to tell when their stop was coming up, and how to ask for help if they didn’t know where to go.

There came a day when Morgan missed an appointment with Amy because they got lost taking transit to Covenant House.

“They called me and said they knew exactly what happened,” Amy said. “I told them that in itself was just as valuable as the appointment they would’ve had with me – they were problem-solving and using other life skills we’d helped them build as part of the foundation we created for working together.”

“Once a youth like Morgan who has experienced homelessness moves into shelter many of their basic needs can be met like food, access to health care and a safe place to stay. While this can bring a sense of relief, it can also raise new challenges: How do they fill their days?” How do they learn basic skills that will help them live independently? And, quite significantly, how do they develop the tools they need to deal with the impacts of the trauma they experienced – things like dealing with their emotional triggers, or getting a good night’s sleep?

This is why Covenant House is one of the only youth shelters in the city to have a team of occupational therapists on site –health care professionals who are trained to help youth build structure into their days and the skills, confidence and self-awareness to make daily life a little easier. They also help youth find ways to understand themselves better, navigate stressful situations.

“Our goal is to work closely with the youth to understand their unique needs and figure out what’s getting in the way of their daily function, and leading productive independent lives,” said Jordan Higa, another occupational therapist on staff. Some barriers for youth might be a lack of opportunity or safe environment in which to learn basic life skills. Some youth have underlying mental health challenges and learning disabilities.

“Every single person has what’s known as a “window of tolerance” which represents the amount of stressors a person can cope with at any given time”, said Amy. “For many youth who’ve experienced trauma, homelessness, abuse or mental health challenges, that window is quite small, reducing the amount of stress they can experience without feeling dysregulated”.

Jordan and Amy work with youth to develop strategies to help them navigate these challenges and recover in those moments. Helping them recognize what is happening and implementing coping skills accordingly. For example, taking deep breaths; or if they are shutting down, drinking some cold water to help alert their senses.

Many youth also arrive at our shelter with a condition that may or may not have been identified in their earlier life that are making their current circumstances more difficult. One of the ways that an occupational therapist helps a youth to manage their chronic conditions includes using different types of tools and equipment that support them in adapting to their current circumstance.

If chronic pain is keeping the youth from functioning, Amy and Jordan would help them to figure out ways to do things that would help limit the pain they are experiencing. Amy recalled working with a youth who had chronic pain and really long hair. She got them a long-handled hairbrush so they could brush their hair without having to move their arm as far. A lot of youth who have sensory processing differences can be bothered by the noise of the city, or glaring light. Amy and Jordan offered these youth noise canceling earbuds and photosensitivity glasses to wear – small yet impactful adjustments that allow youth to move through the world with greater ease.

Jordan and Amy will often help youth build routines to help give their days structure and protect things like a good night’s sleep, which can impact a youth’s ability to focus at school or work and help regulate their emotions.

Sometimes basic tasks like doing laundry can feel like a mountain to climb. Jordan likes to help youth break the tasks down into manageable pieces and finds that helps them build confidence and manage their energy to move forward and tackle these activities.

“I’ve often said to youth, ‘Ok only tell yourself you have to take the first step.’ The first step was turning all their clothes right side out,” she said. “They told me that’s what they did and then they were able to do their laundry three times last week. “It’s just being able to give the youth tiny little pieces of advice or action tweaks until all of a sudden, they say ‘Oh! I can do this!’”

Progress is not always linear and immediate: a large part of the work is just showing up and gaining those building blocks to use later, Amy and Jordan said. “We often see this after working with someone for a while. We feel very privileged to be a part of this work and these youth’s journeys.”