copyright 2008 Cheryl K. Hosken, BSN, MS Psych.
Rehabilitation facilities are places that have programs to help handicapped people overcome or adjust to their functional and mental limitations. In general, all rehabilitation facilities are characterized by the following features:
- A protected environment where handicapped persons can obtain skills, support, and supervision for their complete development mentally and physically without distractions and tensions of regular society.
- A team approach by specialists who work together in their individual areas of expertise to meet the needs of clients as they are rehabilitated.
- A rehabilitation goal for each client established by the team together with the client.
- An overall goal of helping each person from dependence to a more independent role.
Meditate Word By Word On These Verses:
Mat. 9:35-38.
Rehabilitation Workshops
Rehabilitation workshops have developed in response to a need to provide employment, assessment, training and other rehabilitative services to handicapped people. The workshop offers a controlled working environment with individualized goals that help persons with disabilities to work at their own capacity and to be paid accordingly.
Rehabilitation workshops are mostly operated by private, nonprofit corporations to serve handicapped people. A workshop operates as a rehabilitation agency and a business. As a business, the shop makes money through sales of the products it makes. It also pays wages to the regular staff and the client workers through the sales of its products. As a rehabilitation agency, the shop provides a place where handicapped persons can learn how to work at a job and to work with other people. The handicapped persons who work well are also gradually moved from the workshop to a regular job.
1. Why were rehabilitation workshops established?
(Only one of the following answers is correct.)
a) to occupy the time of a handicapped person so that his parents get rest from him,
b) to make money by selling its products,
c) to teach a handicapped person how to work.
There are two different types of workshops based on the goals they may have. The transitional workshop has an emphasis on working with a person to learn job new skills and adjust to working in a new job situation. The program of the transitional workshop concentrates on bringing disabled persons who want economic independence to the highest level of functioning they can achieve. When a client reaches this level, he must be moved into an employment situation. This can be in the community or in a sheltered workshop. Those who cannot work are referred to a facility that offers constructive use of time. This is called an activity center. A transitional workshop is not a final destination for a handicapped person.
A transitional workshop has programs for two types of clients. They are:
Client A - This client is a severely disabled person who is capable of understanding and using intensive training and work experience. He can and does adjust to the disciplines expected in a work situation. He develops an acceptable level of skill and productivity. Ultimately, he enters the open labor market working with others.
Client B - This client is also a severely disabled person who has received rehabilitation services identical to client A. He accepts responsibility for work and develops skill and productivity. However, he is unable to face working in the open labor market for reasons that are beyond his control. Perhaps he has uncontrolled seizures or just cannot work with others.
The term transition means that a client must move to somewhere and is specifically structured as a vocational rehabilitation agency. It offers vocational exploration - trying various types of jobs and intensive work training - learning how to tolerate a work day of 8 hours, learning good work habits, and doing acceptable work. The focus is on vocational readjustment so that a person can move out of the transitional workshop to somewhere else for work.
Transitional workshop clients move through the transitional process quickly compared to those who are in sheltered work centers. Usually, the objectives that the client needs to meet can be achieved in a fairly short period of time - 6-8 weeks.
2. The term transitional workshop means:
(Only one of the following answers is correct.)
a) a person is there for a limited amount of time,
b) a person is moving from one place to another,
c) a person works slowly at his job tasks.
The objectives of a transitional workshop are:
- Assessment of work potential - Such an evaluation shows whether a person can work in the competitive market or in a sheltered workshop. It also helps the staff to determine what practice is needed by the client - he may need help in getting to work on time, learn to do his work on an hourly basis without breaks, or increase his speed of working.
- Preparation for employment - This means the goal is to employ the person. The primary purpose is to get them ready for working, to help them adjust to the demands of a work environment, and give them skills that will help them get a job.
- In the development of work readiness, the person must meet the work requirements of competitive employment. Unsatisfactory levels of performance result from a variety of factors - lack of motivation, lack of preparation, limitation in body functioning, etc. The development of work readiness through work experience is probably the most frequent short-term objective in workshops.
- Work adjustment means that a person is coached about his behavior on the job. Many people have ability to do a job working a normal productivity, but behavior is a problem. Exposure to work is not sufficient to help them be employed. It is necessary to assess the deficiencies they have and correct their problems. The deficiencies most commonly corrected are: cooperation with supervisors, work organization and rhythms, understanding of instructions, responsibility, emotional and physical stamina, honesty, punctuality, cooperation with co-workers, adherence to safety rules, adaptation to new work situations, consistency and perseverance, and attention to the task to be done.
- There may also be a need for vocational skills training. This involves learning to use various tools or equipment for a job.
- Related services may be offered to the client as well. Employment is used as an attraction to get persons interested in services that might help them. For example, a work program may be offered to a mentally retarded person, but other goals may be added to the work program. Perhaps the person needs social interaction with others, which the work environment provides. He may need some medical treatment that can be offered to him because he is working. If he were not working, he may have rejected medical treatment. For example, a person with poor eyesight may reject seeing a doctor for glasses or eye treatment, but if he cannot do his job in a workshop due to poor eyesight, he may be convinced to see an eye doctor.
3. A transitional workshop helps a person in many ways except:
(Only one of the following answers is correct.)
a) work-related behavioral problems,
b) assessing his potential for work,
c) assessing his spiritual needs,
d) learning new skills.
As an example, one of my clients was injured when she worked in a nursing home for older people. She hurt her back and was given limitations by the doctor that prevented her from returning to her former job. I was able to send her to a transitional workshop. She was placed in a program that lasted for 8 weeks. The focus was learning secretarial skills. She learned typing, basic bookkeeping, transcription from a dictation machine, filing, and office procedures. She also learned how to answer the telephone properly and take messages. An emphasis was placed on dressing appropriately for work in an office. Another important part of the program was learning how to search for a job - filling out applications, practicing how to interview with an employer, and writing a resume.
I was invited to check her progress in the program every 2 weeks. Her rehabilitation teacher gave me the results of her typing tests and other subjects. At the end of 8 weeks, her scores were better than average. The rehabilitation teacher helped her to approach our state government employment office where she applied for a job. She was offered a job as a beginning level secretary. In the next two years, I heard from her every few months. She was delighted with her new job, and with good work she was promoted.
Sheltered Workshop
The sheltered workshop is for those persons who cannot return to the regular labor market due to their mental or physical limitations. These people get paid for the work they do on an hourly basis and they are encouraged to work at their maximum level of potential. Wages and production levels in a sheltered workshop are somewhat lower than the competitive business levels. The workers are substandard, but they can and do make a contribution through their work. They may not earn enough to fully support themselves, but with a little government subsidy, they can live independently. If they continue to live at home, they contribute to the family household expenses. Over a period of a few years, these persons may eventually be able to work in the regular competitive market.
A person is usually recommended for extended employment in a sheltered workshop because he has multiple problems that will take a long period of time to resolve. A client needs to be in a transitional workshop for a long period of time to be evaluated before it is decided that he needs sheltered work.
Such persons have regular workdays and are expected to get to work on time. They have coffee breaks and lunch breaks. Oftentimes the jobs they do are assembling small pieces of a larger product. For example, they may assemble the wheel section of a piece of furniture that rolls. They may package small office items such as paper clips or staples.
4. A person may be recommended for a sheltered workshop because:
(elect the best answer.)
a) he has behavior problems,
b) he has limited intelligence,
c) he has multiple problems,
d) he cannot work a regular day.
There are some newer programs in the U.S. and in Russia now. Several large retail companies such as Ramstore inMoscow have hired handicapped persons. These people are trained to do one job all day. The jobs are simple and with training, they understand what to do. They learn when to speak to and not to speak to customers. They usually prepare items for display. Most often, they put clothing on shelves, hang clothing, open packages of products and put them on shelves. Through their work, they have contact with the normal world and they are a part of the employee group at the store. Their work hours depend on their energy levels and disabilities. In the U.S. and in Russia, these companies pay reduced taxes to the government because they hire and train handicapped persons.
Work Activity Centers
Work activity centers are for those persons who are not prepared to enter a sheltered workshop, but can get benefit from exposure to work activity. The focus of the center is to help a person develop into a more mature person. The person learns to cope with stress in daily life, learn decision-making processes, learn to live alone or in a group home, and begin to learn about work. This type of facility is for those persons who are severely limited mainly due to long term mental and emotional trauma and past the age of a high school student. People who are clients in this facility are introduced to limited types of work - it is a beginning point of rehabilitation for this group of clients.
From the research of these facilities, the people who are referred to them usually have excessive dependence on others, limited motivation about themselves because they have not had the chance to mature, and they are vocationally inept. They require instructions and experiences to compensate for years of under-development and over protection by family or a social system. They cannot be responsible, live up to adult expectations, and don't have standards for behavior. They are naive about the real meaning of work activities.
Avocational Activity Centers
These centers were first begun in the 1950's as an alternative for children who were ineligible for any workshop programs. Parents were active in trying to keep their severely disabled children out of institutional care. People who come to the centers are low in maturation and they have delayed physical and emotional/mental limitations. This is mainly due to institutionalization.
The center's program focuses on exposing the clients to various experiences that will help them understand the world around them. An individual program may begin with teaching the child or adult how to answer questions, learn numbers and letters, learn to eat, and stand independently. The program resembles those we discussed in the lecture on cerebral palsy.
5. The difference between a work activity center and an avocational center is that:
(Only one of the following answers is correct.)
a) the work activity center helps a person mature mentally and an avocational center teaches to interact with the normal world,
b) the work activity center trains people to work and the avocational center does not,
c) they are both the same in goals.
Centers also exist for the elderly. By taking an elderly person to an activity center daily, his caregivers can do their ordinary jobs during the daytime. Sometimes the activity centers for the elderly are funded by the government, and sometimes by churches. Elderly severely disabled persons are helped at the centers by various types of therapy.
One of our friends had a stroke that confined her to a wheelchair. At home, she had a person who lived with her and her husband to give care. The caregiver got our friend out of bed every morning, washed her, and gave her breakfast. Then a van came to pick our friend up and take her to the center. Her daily activities included exercise, playing the piano (she was a pianist before the stroke), and learning to use adaptive equipment for daily life. Since she could not stand independently, the physical therapist helped her learn how to stand and use a turning plate so that she could turn to use the toilet or get into bed. Other activities included discussions of her experiences in life (she had been a missionary to Brazil), games, singing, and preparing food.
This program helped her husband. He was elderly and could not do the physical care she required. When she was at the activity center, he worked part-time in a local store and did household chores such as shopping, cooking, and cleaning. The center provided him with peace of mind about his wife and she came home at the end of every day with new ideas she shared with her husband. She was also tired from all the activities so that she rested well at night instead of calling out for his assistance.
The above rehabilitation facilities help persons to mature and begin to understand the world of work. They are helpful in teaching disabled people to make decisions and live as independently as possible. Not everyone can work in the labor market, but they can be taught to help at home, consider themselves as worthy persons, and learn how to communicate with others.
6. Centers for the elderly are helpful because:
(One or more of the following answers may be correct.)
a) they provide activities for the elderly so that they can keep as active as possible,
b) they give respite for the caregiver at home,
c) they help to stimulate their minds.
You may wonder why I have talked about these facilities since there are few of them in Russia. I want to expose you to ideas about helping persons live independently. Also, through this lecture, perhaps you can help someone become a more independent person. It will require that you observe this person, his interests, his abilities, his behavior and then decide what needs to be changed and how to change it. You do not have a specialized education for this, but you do have observational skills and a desire to help and you can write a small plan of what you are going to do.
If you have disabled persons in your church, perhaps they can learn to work by helping in the church with you as a guide to teach them what is expected of a worker. It requires patience and love, but God can give that to us. The job may be as simple as straightening the chairs for the morning service or cleaning the church after service. These simple jobs can help a disabled person feel that his life is of worth to the church and to God. God does not throw away persons who are not perfect. He gives them to us to love and teach and by doing that we bring the kingdom of God to earth.