Reaching Out to the Marginalized

Reaching Out to the Marginalized

“I wanted to challenge my prejudice against homeless people. The COTS program helped me see them as real human beings, not as panhandlers asking for change. In fact, I learned that real homeless people don’t even beg.”

Kathleen Malloy may sound like a social worker, but she’s not. She’s a master’s student in occupational therapy at Cleveland State University in Ohio. Malloy came to the UT Health Science Center in Memphis to complete a fieldwork requirement at the Community Occupational Therapy Services program–COTS for short.

For Malloy and other students, this is a one-of-a-kind experience. The COTS programs have affiliations with more than 65 colleges and universities throughout the U.S. and the United Kingdom. As a result, graduate students come from far and wide to Memphis to participate in 12 weeks of intensive fieldwork.

Occupational therapy is one of the fastest-growing professions in the healthcare field. The need for OT professionals is expected to increase faster than the average rate for all occupations through 2012. With a long-range goal of helping their patients achieve independence in all facets of their lives, OT students work with a variety of people. Some have learning or developmental disabilities, a few are recovering from major surgery, and others have suffered burns, spinal-cord injuries, or amputations. Many OT patients have mental health or behavioral problems varying from Alzheimer’s, schizophrenia, and substance-abuse disorders to post-traumatic stress. Students in UT’s COTS program get real-world experience working with people who are homeless and have a wide range of social, economic, and emotional complications.

While these students are meeting a degree requirement at UTHSC, they are also providing a much-needed community service–87,200 hours to more than 900 clients since the program’s inception in 2001, to be exact. The program’s clients are referred to as “consumers,” not “patients,” in an effort to lessen the stigma of a “you need help” label. But these consumers do need help of the most basic kind. Most are trying to fight their way back from incredibly difficult life situations–mental illness, domestic abuse, post-traumatic stress syndrome, jail, poverty, or prostitution.

“They are the disenfranchised of society,” says Lisa Tekell, COTS program director. “Most of our consumers need to build their self-esteem from the ground up. So our students learn to help them work on such life skills as self-care, coping, anger management, and relationship skills in general. Our students learn a new way to look at the people we serve–with respect and dignity.”

Most COTS consumers live in transitional housing facilities throughout Memphis and participate in the COTS program free of charge. The UTHSC COTS program has contracts with six community programs in Memphis:

1. Alpha Omega Veterans Services’ Transitional Supported Housing is a facility for homeless veterans.

2. War Memorial Permanent Housing facility provides permanent supported housing for veterans who have been homeless and have a diagnosis of at least two of the following–a mental illness, a physical disability, or a substance-abuse disorder.

3. Catholic Charities’ Genesis House serves consumers who have a dual diagnosis of mental illness and substance abuse.

4. Catholic Charities’ Dozier House is a transitional facility for men and women recovering from substance abuse.

5. The Salvation Army’s Renewal Place houses homeless women and children.

6. The Cocaine and Alcohol Awareness Program houses men recovering from substance abuse.

In these diverse settings, COTS students help people restart their lives by setting the most basic of goals: affirming oneself as a human being, developing positive self-esteem, and gaining self-respect. Some simply have to learn to trust another person.

On a more practical note, the COTS students, under the supervision of a registered licensed occupational therapist, help consumers build bookshelves, use a computer, develop a realistic budget, improve job interview skills, learn how to navigate the Memphis bus system, or identify fun and affordable leisure activities. On a social outing to Peabody Place, a business and entertainment area in the heart of Memphis, a consumer said this was the first time he had felt “normal.”

“Students must problem-solve with a minimum of resources and be creative,” says Ann Nolen, chair of the Occupational Therapy Department.

“We learn to think outside the box to find fun ways to get people to meet their goals,” says Malloy, who reported she was “nervous at the thought of running a group of 20 men older than I. But now I really look forward to working with them and coming up with ideas to help them become more independent, like check-writing and monthly budgeting.”

“We have to be flexible and be ready for anything that comes up,” says Ravyn Murden, a UTHSC master’s degree candidate. When her consumers at Genesis House had some downtime, she gave them woodwork to sand, stain, or paint. “Once they had something to do in their free time, they seemed to feel more productive,” she says.

Kathy Miller, another graduate student from Cleveland State, chose the COTS program because she wanted to do her required fieldwork in mental health. “This program is totally unique. You can’t get this kind of community experience at any other place.”

“Our students go away from COTS understanding that homeless people are just that–people,” Tekell says. “They learn that recovery is possible and that community support is essential. When people feel part of a community, they realize they can make a difference. They gain ownership of their own lives, responsibility, and empowerment.”

The program participants aren’t the only ones who benefit.

“Students usually reflect at the end of their fieldwork that COTS provided them with the ability to see life through the eyes of a person who has an illness,” Tekell says. “For instance, one student expressed an overwhelming sense of understanding after she had the opportunity to work on parenting skills with a mother who was in recovery from mental illness and substance abuse. This was a life-altering experience for the student, as well as the consumer.”

As Miller puts it, “When I first came to the program, I was nervous. Why would these people care? After knowing them and working so closely with them, my own self-esteem got a boost along with theirs.”

Murden agrees. “In my entire graduate school experience, I’ve grown the most through COTS.”

The COTS program has received funding from the UT Health Science Center and HUD since its inception in 2001. This funding will end February 28, 2008. COTS is looking for alternative funding to maintain its services. Interested donors may contact Lisa Tekell at or 901-448-8072.

Homeless No More: A COTS Success Story

By the year 2000, Rick Haney had pretty much hit bottom. Out of work for nearly 20 years, homeless, a hardened substance abuser with legal issues pending, he had just been charged with abandonment of his children. That final blow sent him for help to the Alpha Omega rehabilitation program, a transitional facility for homeless veterans in Memphis.

After several months, the Alpha Omega staff urged Haney to get a job, but he was apprehensive. Would anybody hire him? Would he be able to deal with people in a work environment again? Anxiety plagued him. He felt angry and totally negative about the whole idea.

Then he encountered students from Community Occupational Therapy Services.

“To be honest, I was put off at first,” Haney says. “What did they know about life?” He remembers one of the students, a young woman named Austin, “walking through the door with a big smile on her face. I thought What’s her problem? Nobody’s that happy.” But he smiled back. And that was the beginning of a beautiful relationship.

At first the students played bingo with the men at Alpha Omega.

“We were a bunch of disgruntled, angry old men, and bingo seemed like a waste of time,” he says. But as it turned out, the games taught him and the other guys a few things, like coping skills, better communication, and how to be sociable. “There’s a big difference between being told what to do and experiencing it,” he says.

“I found it was a trade-off. The students learned from me about life, but they gave me a whole lot more.” Austin helped Haney develop a resume that landed him a job in a Memphis warehouse. At the end of his first month, he was asked to present a productivity report to management. “I panicked,” he recalls. “I had no idea where to start, what questions to ask, how to make a business presentation. I figured they were going to fire me.”

Once again, Austin kicked into gear and helped Haney prepare a presentation. They rehearsed it over and over.

“I couldn’t believe how confident I felt giving that report,” Haney says. “I found it hard to believe it was me.”

But it was, and the “new” Haney was offered a permanent job with the company. Unfortunately, he was unable to accept it because the new job location was across town and he had no way to get there. But on the basis of a strong recommendation from the warehouse job, ServiceMaster hired Haney and sent him to Washington, D.C., to help clean up the Pentagon after the September 11 attack.

Encouraged, he saved his money and decided to fight to get his children back. The court was planning to place his kids in foster care unless he could prove that he was fit to be a parent. The then–student coordinator of the COTS program told him her students could help. Haney participated in student-led groups on anger and stress management. Students worked with him to budget his paycheck and stick to it. They taught him to balance a checkbook, and they took him horseback riding: “One of the greatest days I ever had in my life,” he admits, smiling. “It was the first time I ever rode a horse.”

His days were about to get a whole lot better. The court awarded him his children in 2002 and now Haney is attempting to buy his first home in Memphis. His children are on the honor roll.

Today a confident and outgoing Haney works as a peer counselor at Alpha Omega, helping the COTS students break the ice with new guys entering the transitional facility. “We’re seeing a huge difference with COTS–fewer relapses, more guys moving on to jobs,” Haney says.

“No words can truly express how I feel about the COTS program,” he adds. “The students helped me put my life back together. They made me accountable for my life.”