Developing the Bridging the Transition Framework
The Bridging the Transition Framework was developed in 2018 after it was identified that there was a need to inform the practice and research of occupational therapists working in the area of homelessness. In response, we developed the Bridging the Transition Framework to draw together knowledge about existing practice, research and policy on homelessness prevention from a functional and participation perspective. That is, acknowledging homelessness as a problem that arises when individuals are denied the right to the necessary structural and service supports that enable function and participation in daily life. Problems in our society such as growing income inequality, a rising wealth gap, and a lack of investment in deeply affordable social housing are the underlying causes of homelessness [1,2]. These structural trends disproportionately affect individuals living with disabilities emerging from mental health, cognitive, and physical health conditions [3]. To inform the initial development of the Bridging the Transition Framework, we conducted three foundational studies. Each of these is presented below:
Study 1: Identifying Daily Living Needs From Unhoused to Housing
In this first study, we interviewed 36 individuals who were unhoused, housed 1-3 months following homelessness, and 3-24 months following homelessness. We asked participants to describe their daily living needs at these different time frames. Using Sen and Nussbaum's Capabilities Approach, we identified how individuals with experiences of homelessness were able to gain access to activities that supported tenancy sustainment and well-being. To access this article, click on the article image or at the button below.
Study 2: Developing the Initial Framework
In this study, we used our findings from our empirical research presented above to inform a consultation with 17 international occupational therapy researchers and practitioners who were recognized for the depth of their expertise in the area of homelessness. We developed an initial framework, and using a participatory process, we requested the input of these experts on revisions to our draft framework using a confidential online survey. To access the article, click on the article image, or on the button below.
Study 3: Identifying the Competencies Needed to Support Individuals Experiencing Homelessness
To identify the competencies needed for occupational therapists to support individuals across the trajectory of unhoused to housing, we conducted a Delphi study. This research was meant to provide guidance to occupational therapists on professional development and to educators on the competencies they may consider incorporating in curricula to prepare occupational therapists in work with individuals during and following homelessness. While this study was designed to inform the field of occupational therapy, it could also be used to guide training and competency development in other fields. Access the article by clicking on the article image or the button below.
Development of the Framework Since its Initial Inception
After developing and refining the framework, we developed a one-day workshop to train occupational therapists in using the Bridging the Transition Framework to inform their research and practice. When we held workshops and when organizations requested that we deliver these workshops, we found that there was interest from a range of health and social care professions. In some of these workshops, more than 90% of the registrants represented other professions. To date, we have delivered the Bridging the Transition Framework workshop with 300-400 individuals representing a range of health and social care professions including occupational therapy, psychotherapy, social work, social service work, child and youth work, peer support, and individuals who are not health and social care providers, but perform an advocacy role in their communities. Participants in our workshops represent practitioners, researchers, policymakers and advocates. The current version of the Bridging the Transition Workshop is a two-day, interactive event that focuses on equipping practitioners, researchers and policymakers with the skills needed to work towards homelessness prevention at individual, community and population levels. If you are interested in a workshop for your own community, you can request one here.
Moving Towards an Interdisciplinary Approach
In 2024, we were approached by Routledge to develop a book in the Bridging the Transition Framework. Our experiences in delivering workshops helped our team to recognize that the framework had relevance for a range of professions. For this reason, we decided to broaden the focus of the Bridging the Transition Framework book so that it would be welcoming of a range of health and social care professions interested in taking a functional and participation approach to homelessness prevention. Instead of writing the book for an occupational therapy audience, we retained the focus on function and participation, and wrote the chapters in ways that would ensure their relevance for people from a range of professions. As an edited book, we decided to approach authors from different professional backgrounds to contribute chapters based on their expertise in homelessness prevention. In November, 2025, we published our book entitled Bridging the Transition to Housing: A Homelessness Prevention Framework. This development represents an important turning point in the development of the framework, and one that will enable us to offer our learning beyond the profession of occupational therapy.
Next Steps
In the future, our team will continue to refine the Bridging the Transition Framework, and evaluate the ways in which individuals are using the framework to inform their health and social care practice, research and policymaking.
Learn About the Framework and its Components
To learn more about the Bridging the Transition Framework and its various components, click here or on the image below.
References
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Statistics Canada (2023). Homelessness: How does it happen? https://www.statcan.gc.ca/o1/en/plus/5170-homelessness-how-does-it-happen
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Statistics Canada (2026). Distributions of household economic accounts for income, consumption, saving and wealth of Canadian households, fourth quarter 2025. https://www150.statcan.gc.ca/n1/daily-quotidien/260413/dq260413a-eng.htm
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Maybee, J. E. (2020). Homelessness, disability, and oppression. The ethics of homelessness: philosophical perspectives. Leiden: Brill, 357-87. https://doi.org/10.1163/9789004420366_025
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Marshall, C. A., Gewurtz, R., Ross, C., Becker, A., Cooke, A., Roy, L., ... & Kirsh, B. (2024). Beyond securing a tenancy: Using the capabilities approach to identify the daily living needs of individuals during and following homelessness. Journal of Social Distress and Homelessness, 33(1), 81-95. https://doi.org/10.1080/10530789.2022.2070098
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Marshall, C. A., Cooke, A., Gewurtz, R., Barbic, S., Roy, L., Ross, C., ... & Kirsh, B. (2023). Bridging the transition from homelessness: Developing an occupational therapy framework. Scandinavian journal of occupational therapy, 30(7), 953-969. https://doi.org/10.1080/11038128.2021.1962970
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Marshall, C. A., Cooke, A., Gewurtz, R., Barbic, S., Roy, L., Lysaght, R., & Kirsh, B. (2023). Competencies for occupational therapy practice in homelessness: A Delphi study. Scandinavian Journal of Occupational Therapy, 30(7), 924-938. https://www.tandfonline.com/doi/full/10.1080/11038128.2021.2002404