Sarah Blake LaRose (3kitties) wrote,
Sarah Blake LaRose
3kitties

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today update, pictures, and thoughts about rehab services


Getting up at 6:00 wouldn't be so bad if I could breathe well at night... I made it up, had breakfast, took meds, wrote something substantial (posted below), and mapped out what I hope will be a reasonable schedule for finishing my work on the CD. It won't all happen today, but I think a good bit of it can. I am in desperate need of a nap for pain control--my hand is hurting and I have a nasty sinus headache. I picked songs that need vocals and minimal instrumentation to work on today, and I took my new nose meds and am going to allow myself a nap to see if that will help me get a bit more energy. C doesn't come until 6:30 tonight, so that gives me a bit of extra time to work on the project this afternoon. Then again, maybe I will flip-flop the CD work with things I can do in spite of pain and do CD work tomorrow, when I don't have to juggle C coming.



I forgot to mention that Mom was very pleased with the picture results. That is meaningful to me. I didn't expect her to be satisfied with these pictures, and I was prepared to use them as test pictures to see how the home set up would work for the idea and have to repeat the shoot after getting my hair done professionally. This is definitely going to be a unique product; but I'm glad it's turning out this way. I've been able to stay "me" throughout the process and do things that enhance who I am instead of recreating me. More and more, I'm realizing that I'm not a concert hall kind of singer. I'm a small to mid-size church singer, and that's really all I ever want to be. I like intimacy and simplicity, freedom to be reflective and worship openly. That's something I'm trying to capture in the music. I don't really know how to capture it in a picture. I don't know how to worship with my body; and I think that if I tried to figure it out, I would stop focusing on God and start focusing on what to do with my body. Worship would no longer be worship for me. I worship with my music and my mind and my notebook... I wanted a picture of me at a keyboard playing... We took some at the piano, but I was sitting at unusual angles, not the way I would be sitting if I was really playing. I don't know if a picture with a keyboard would be a good thing. I do think it might capture more of a relaxed, peaceful attitude.



The discussion about unemployment on ACB-L goes on...




I discuss the topic of rehabilitation regularly with job seekers around the country. The experiences with VR counselors vary; but often clients feel intimidated by their counselors rather than encouraged. I suspect that a lot of this has to do with the fact that early in life blind children are inundated with professionals who are teaching, facilitating, and often pointing out deficits compared to sighted peers. Certainly those deficits need to be pointed out and corrected; but how do we deal with the issue of people feeling intimidated? It can make or break the VR relationship. How those deficits are addressed can make the difference in whether a person feels defective or that she could be more successful if she presented herself more effectively. Most people I speak with about their stereotypical behaviors are actually receptive to the idea of change but don't know how to accomplish it because the habits are so deeply ingrained that they aren't even aware they're doing them.



Sometimes I think the solution to the intimidation problem might be as simple as getting the answer to a question directly. My first frustration with Indiana's VR system in 1998 was the fact that no one could answer the question, "What types of services does your agency provide to a person who has recently graduated from college?" I was trying to assess the question of whether I wanted to open a case or not. My question was never answered. Instead, I was scheduled for a meeting with the supervisor since there was at the time no counselor on staff serving my area. Things went downhill from there. At the meeting, which took place in October, I was asked to sign some forms, including releases for medical information, and was given a recording of general information about the agency. I asked whether the agency could assist with payment for eye surgeries not covered by Medicaid because I was scheduled for surgery in December for a detached retina and cornea transplant. The question was evaded;. I mentioned an interest in working in a ministry setting. The supervisor said to me in what I interpreted as a disbelieving tone, "But you are blind." He seemed concerned about my ability to visit sick paritioners and was not persuaded by any of my proposals for handling the situation in the same ways that blind people handle any other job that requires travel.



In January, a new counselor was hired. She called and set up a meeting with me, and I asked again about assistance with paying off the surgery as well as services for new college graduate with psych degrees. She tole me that payment for the surgery would have been possible if I had a rehabilitation plan. I had no idea that I didn't already have one because no one had clearly explained the process to me at that initial meeting. When the plan was finally in place, the counselor questioned whether the surgery had really been necessary and wanted another medical opinion despite the three already on record. I paid off the surgery myself. That was the beginning of a very tenuous relationship with the counselor in which I felt that every proposal I made would be negated and she was working against me rather than for me. The relationship could have gotten off to a much better start if she had told me that we just didn't get the paperwork trail started in time and she was sorry but the agency couldn't help me with this particular request since the surgery had already been done.



I spent the next five years trying to work with a counselor who did not provide job leads, told me that I "wasn't trying hard enough," refused to refer me to agencies offering job placement or job search assistance services, openly discouraged me from pursuing self-employment, and refused any possibility of graduate school funding on the basis of the fact that I should be able to get a job with my current qualifications.



Perhaps part of the difference lies in the fact that Indiana's VR system is not blindness-specific; but I'm not sure--I've spoken with people with otherdisabilities who felt that they were similarly underserved by the particular counselor. She presents herself as a person who is unhappy and has little interest in doing her job actively. She is the only counselor who serves this area. I could contact the CAP program, but I'm not very certain what my options are in a situation where there are no other counselors who serve the area. Obviously the supervisor is not a great option either, and I can't request that they make her smile and speak cheerfully!



If nothing else, it would have been nice if the counselor had looked at my resume and made the effort to understand why I have difficulty narrowing my job search instead of making condemning statements because I couldn't decide what kind of job I wanted. I have a disparity between the type of jobs I have held, the volunteer experience I have, and my educational background which creates a very confusing situation and makes it very hard to determine what kind of job is best. A bit of in-depth career counseling would have been very helpful for me; but in her thinking it was a matter of me making a choice and figuring out "what I really want to do." In a chronic unemployment situation, it's easy to lose sight completely of what one wants to do and even to lose sight of the fact that one has desires of one's own. Sometimes desires compete when a person has multiple skill areas; and sometimes the desire simply becomes "to be self-supporting," which is not a viable career goal. (Too bad! A lot of people would have million-dollar jobs!)



While VR counselors certainly don't have responsibility to find jobs for clients, it was a real eye opener for me to work with counselors in Florida who actually sent me job leads and partnered with me in the job search. Instead of feeling intimidated by both the counselor and the interviewers, I felt that the counselor was working with me. I called in every time I sent out a resume, every time I had an interview. I did not find a job in the two years that I lived there, but at least the experience with VR was positive and I was able to get some additional services that were badly needed. If I needed something that wasn't normally provided, I was encouraged to write a proposal and demonstrate how it would assist me. I tried it and included information about how the proposed item would assist me in a potential job setting, which I was actively trying to obtain; and I discovered that this process works in a system where counselors listen to and work with their clients.



I chose not to reopen a case after moving back to Indiana last fall. I've done all the same things without the case open that I would have done with it open. I've found ways to provide myself the services I would have wanted from the VR system. I went to therapy for general mental health issues related to hurricane stress, and in the process we have also begun discussing my career options. O&M was only provided once a month pre-Florida; and it was very difficult to maintain knowledge of new environments at that frequency. I've done just as well locating volunteers to walk with me and plan my own routes. This works for me, but there are many people who do not have the skills to do this kind of planning for themselves. They need much more intensive O&M and daily living skills services. I am seeing a lot of this with the elderly clients in my community who are not eligible for residential rehab but who do not get adequate O&M and rehab teaching services. This is a bit of a tangent, but it's a peek at the realities of rehab in a non-specialized state and in an area where the population of blind people is spread out geographically.



The down side of not having a case open with VR is that if I do get a job, I have no means of getting equipment paid for if necessary; but I don't see the point in leaving my case open for years and enduring the additional stress associated with meeting with a counselor who is not supportive while I'm doing exactly what I'm doing now. Using up energy to manage the negative emotions that well up after those meetings takes away from the energy that I need for managing my employment situation, whatever it is. It may be that I come to a point where I am able to open the case and tell that counselor that all I want from her is assistance with accommodations once I get a job; but something inside me is at odds with the idea of this kind of solution because it doesn't seem to be how VR is supposed to work. It makes VR seem like a waste of tax payer money to me, and it makes me angry that the counselor would get credit for assisting me in getting a job that she had absolutely nothing to do with because I did all the work. I know that I won't open a case again without some exceedingly specific plans and requests and a whole lot of emotional strength.




Someone brought up the issue of lack of "people skills" on the part of VR counselors and the fact that more counselors are needed and recruitment is difficult because salaries are low.




Part of the problem is ambiguity in understanding the job expectations. When I discussed the concept of career counseling with the VR counselor in Indiana, she told me that this was not her job. I think she felt that her job was something more along the lines of casework, which actually does require only a bachelor's degree if you do it for a mental health agency. The problem is that VR agencies are hiring people to act as both counselors and caseworkers and paying them caseworkers' salaries. Back in the 1980s, when I was a client of the Texas Commission for the Blind, they were called caseworkers. I don't know what they are called now; but I suspect the salaries haven't changed very much.



What are successful counselors doing to build that rapport with their clients? What can clients do to build rapport with a counselor who presents him/herself badly? With all this training, is there attention given at all to self-presentation, people skills, similar things that customer service professionals have to listen to? Perhaps it should be required in-service stuff. There isn't really a way to police it in the field, but should there be a way to review performance beyond evaluating the number of satisfactory case closures: perhaps sitting in on occasional meetings to evaluate the quality of interactions in the same way that call centers are monitored for quality and accuracy?



I have thought about adding some content to my web site addressing ways to build partnerships between clients and professionals. Sometimes a basic understanding of how the rehab system works can help significantly when a person feels intimidated by employees of that system. Even people who have been working with the system all their livesoften don't know how it works. That was one reason why the experience in Florida was so helpful for me: things were communicated to me very clearly and consistently, without the kindergarten teacher tone of voice. I knew what I needed to do in order to get something accomplished, and the decision of whether to do it was mine to make. No statement was made to me about the difficulty level--that was left to me to evaluate for myself and choose to do or not do. This alone lessened my frustration level significantly.


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