Gainesville - Robin Underwood's clients face a gamut of problems - fear, loneliness, broken bones, attentiondeficit disorder, parenting issues, a lack of life skills - that share a common origin: domestic abuse.

They come to the Gateway House, an emergency shelter for battered women and children, for refuge from abusive boyfriends or husbands. It's here where Underwood, an occupational therapist, and her peers, Kristen Sipe, MS/OTR/L, and Marcy Simpson, MS/OTR/L, help heal broken spirits and boost self esteem through life-skills training.

Begun in 2000, the occupational therapy program is the only one in Georgia focusing on women, children and teens in a shelter, Underwood said.

Four years ago, Underwood, an assistant professor and field coordinator for occupational therapy students at Brenau University, approached Gateway's administration to volunteer. She was interested, partly "because Brenau is a women's college and I was interested in women's issues," but also because she was exploring avenues for her students to gain practical occupational therapy experience.

Working with the shelter's family advocate and other staff members, Underwood began developing a program for the women and children. The director and staff soon realized that the job called for more than volunteer time and applied for a grant from the Atlanta Women's Foundation to continue their efforts on a more regular schedule. The three therapists now split a 12-hours-a-week stipend provided by a grant from the Department of Human Resources, but they put in many more unpaid hours.

"We found that the residents were able to do more, faster, with occupational therapists here," said shelter Executive Director Brenda Cook.

The therapists' efforts start after the women and children get settled in the shelter. "Our main concern is to make them feel comfortable and safe," Cook said.

Residents who flee abusive situations often bring no more than the clothes they're wearing; many have children suffering from the effects of abuse. Besides dealing with physical scars, the women often lack life skills, such as balancing a check book, grocery shopping, dealing with their children's behavior problems or how to interview for jobs.

"As occupational therapists, we are trained to work with anyone that has a barrier to independence . . . for whatever reason," said Underwood, who works primarily with the mothers.

Simpson is trained to deal with teens, while Sipe works with toddlers and elementary-age children.

"We assist guests who have disruptions to their lives to develop, improve or restore skills," Sipe said. Some of the things the therapists address include grooming, oral hygiene, dressing, medication management, health maintenance, home management, job performance and meal preparation.

Family advocates at the shelter help the women develop goals to get out of the shelter and get on with their lives. The occupational therapists begin their work when it is recognized that "for whatever reason, a woman is unable to meet those goals," Underwood said.

Sometimes, the problem is truly physical, such as an unrecognized head injury that prevents clear thinking. Other times it may be the effects of post-traumatic stress disorder after years of abuse, or even attention-deficit disorder.

These factors "may have led to poor judgment and decision-making in their lives," Underwood said.

Many women doubt their parenting skills and don't know what to do with children who seem to be out of control. Others may think they are handling their children well, but evidence may show otherwise, Underwood said.

Underwood never judges her clients.

"We don't ever confront them; we're here as advocates," she said.

Sipe, who did her field work at Gateway when she was a student at Brenau, works four hours a week with the children at the shelter.

The job dovetails with her position at Fulton County Schools as an occupational therapist, but there is a difference, she said. "We see changes fairly rapidly with the children once they realize their environment is safe."

When it opened in 1982, Gateway House, a private, nonprofit center, was the first of its kind for battered women and children in Georgia, offering not only emergency shelter, but crisis intervention and support services, Cook said.

Built to house 25 women and children whose stay can be up to a month, the shelter remains full at all times. A transitional shelter adjacent to Gateway is available for women and children who are moving toward financial independence, but need to save money for utility deposits.

In 2003, the shelter served more than 1,300 women and children - all first-time clients.

"There is nothing better than seeing someone succeed and be able to go on," Underwood said.

For information on Gateway House, call Cook at 770-539-9080.

For information about the OT program, call Underwood at 770-534-6129.