Adolescents Experiencing Homelessness and Substance Misuse

Speaker:

• Kylie Widhelm, OTD, OTR/L, BCPR

Learner Outcomes:

1. Describe the impact of homelessness and substance use on occupational participation, health, and development among youth
2. Explain the role of occupational therapy in supporting harm reduction, recovery, resilience, and community integration
3. Identify OT assessments and interventions that support housing, harm reduction, and participation

Abstract:

Adolescent homelessness and substance misuse are closely interconnected challenges that significantly affect health, development, and participation in meaningful daily activities. An estimated 4.2 million youth experience homelessness annually in the United States, and rates of substance misuse among this population far exceed those of housed peers. Factors such as trauma, mental health challenges, educational disruption, and social instability contribute to poor outcomes and increased barriers to participation in school, work, relationships, and community life.

This presentation explores the bidirectional relationship between homelessness and substance misuse among adolescents and examines the resulting impact on occupational performance and well-being. Participants will review current trends and risk factors, including trauma exposure, mental health concerns, and reduced access to supportive resources. The presentation will highlight the unique role of occupational therapy in promoting resilience, recovery, and occupational justice through trauma-informed and strengths-based practice.

Attendees will be introduced to assessment tools and evidence-informed interventions that address occupational participation, executive functioning, self-regulation, life skills, health management, and substance use recovery. Practical strategies for supporting routine development, school engagement, community integration, and harm reduction will be discussed. Through community-based examples, participants will gain a deeper understanding of how occupational therapy can help adolescents experiencing homelessness build skills, access resources, and engage in meaningful occupations that support long-term health, stability, and independence.

 

 

Biography of speaker(s):

Kylie Widhelm, OTD, OTR/L, BCPR is an occupational therapist, educator, and advocate whose work focuses on homelessness, substance use recovery, mental health, and community-based practice. She currently serves as faculty in the Creighton University Doctor of Occupational Therapy (OTD) Program, where she is committed to preparing future practitioners to address complex health and social challenges through evidence-based, client-centered care.

Dr. Widhelm is board certified in physical rehabilitation and has extensive experience working with individuals facing physical, cognitive, psychosocial, and environmental barriers to participation. Her professional interests include trauma-informed care, occupational justice, social determinants of health, and supporting vulnerable and underserved populations.

In addition to her academic role, Dr. Widhelm developed and led a pro bono occupational therapy clinic at the Stephen Center in Omaha, Nebraska, providing services within both a homeless shelter and an addiction recovery program. Through this work, she has supported individuals experiencing housing instability, substance use disorders, and other barriers to health and community participation. Her efforts emphasize helping clients build skills, routines, and supports that promote recovery, resilience, independence, and meaningful engagement in daily life.

Dr. Widhelm is passionate about advancing the role of occupational therapy in community health settings and enjoys sharing innovative approaches that empower individuals and strengthen communities.

 

References to Support Evidence-Based Practice:

Liu, M., Koh, K. A., Hwang, S. W., & Wadhera, R. K. (2022). Mental health and substance use among homeless adolescents in the US. JAMA, 327(18), 1820-1822. https://doi.org/10.1001/jama.2022.4422