Braille Monitor                                                    February 2008

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Messages to Take Away: Final Reflections on Residential Rehabilitation

by Allen C. Harris

Allen HarrisFrom Dan Frye: Allen Harris is the executive director of the Iowa Department for the Blind, the entity currently providing rehabilitation to blind residents of Iowa. His is the agency that Kenneth Jernigan formerly administered and from which many of the principles and practices highlighted in this conference originated. It seemed appropriate, then, to invite Allen Harris, a respected rehabilitation professional in his own right and a longtime Federationist, to close the Dare to Be Remarkable conference on a high note. Here is what he said:

I am honored to have the opportunity to offer my perspective on the topic of residential rehabilitation-center training for blind adults. This week we have discussed the difference between the remarkable and the ordinary. We have talked about the elements that make training effective in transforming our students´┐Ż lives. Surely by now we know the difference between the effective and the ineffective. What will we take away from this conference? Will we leave with the attitudes we came with, or will we leave with new information and a renewed commitment to making a difference?

You have just heard from five individuals, each with his or her own life story, yet all five spoke to the importance of center training in helping them change their own attitudes about blindness. They all spoke about how their confidence and hopes for the future had been beaten down by society's beliefs about blindness and the overwhelmingly negative impact public attitudes about blindness had had on their lives prior to training. Three of these people attended orientation center programs operated by the National Federation of the Blind: BLIND Incorporated in Minneapolis; the Colorado Center for the Blind in Denver; and the Louisiana Center for the Blind in Ruston, Louisiana. The other two speakers participated in training programs operated by state rehabilitation agencies: the Iowa Department for the Blind and the Nebraska Commission for the Blind and Visually Impaired. What do the Iowa and the Nebraska programs have in common with NFB centers? Each has incorporated the Federation's philosophy into its training; both agencies recognize that the Federation philosophy of high expectations is the key to effective rehabilitation. Today we call it the structured discovery model, but it is the Federation model. It is the gold standard, a model rooted in high expectations and an absolute belief in the fundamental equality of the blind.

Yet the future of comprehensive residential training is threatened. There have always been complaints that specialized services are duplicative and too expensive. But just because these complaints have been with us forever does not mean we can afford to ignore the widespread bias against categorical services. Earlier this fall I participated in a meeting of the National Council of State Agencies for the Blind (NCSAB) in San Antonio, Texas. While there, representatives from the Rehabilitation Services Administration (RSA) presented information about the effectiveness and efficiency of the vocational rehabilitation (VR) program. As is so often the case, they focused on cost. They talked about how much agencies for the blind spend on each consumer and the length of time we spend preparing them for jobs. Predictably their conclusion was that we should be doing it faster and cheaper.

The push toward generic services is a familiar one in the states. State legislatures are constantly looking for ways of saving money. Over the years this has made consolidation of state programs attractive as a way of saving dollars. Now the federal agency charged with administering the VR program has jumped on the bandwagon. Two years ago RSA eliminated its Division for the Blind. According to RSA leadership, specialized expertise is not needed. They tell us that all of their staff have the knowledge to assist agencies working with the blind. It is no wonder that RSA is pushing for quicker, cheaper rehabilitation services for blind consumers.

The quality of our training has much more impact on an individual's life than simply equipping him or her with a competent mastery of skills. Once a person finishes training, his or her beliefs and attitudes about blindness are pretty much shaped. That means that center training is the most concentrated time we will have to help our students develop their blindness skills and goals for life. We know the gold standard, and we must stick to it.

We must resist the temptation to compromise quality. We cannot shorten our training or lessen its intensity and still expect to achieve the life-changing results our consumers need and deserve. We cannot move from six months to four months or four weeks and expect the same results. We also cannot dodge our responsibility to operate the most effective training programs we can by hiding behind the concept of consumer choice.

Of course blind consumers have the right to make choices, but they must be informed choices. When a person first becomes blind, he or she does not yet have the knowledge or experience to know what he or she needs. Offering students the opportunity to decide whether they will or will not wear sleepshades or whether they will or will not take particular classes is irresponsible if we know they have no way of making informed choices and when they do not yet possess a thorough understanding of blindness or fully grasp their own unrealized capacity as blind people. We must operate the best programs we can and make no apology for doing so. If a person wants a Harvard MBA, he or she has to go to Harvard. There are no shortcuts. We know what works. We know the gold standard, and it is our job to make sure we deliver it.

We cannot cut corners. We know what makes center training work, and whether or not it is easy to do, we must hold fast to those foundational principles. That means having our students take the full curriculum, having them wear sleepshades all day, and having them participate in the program for six-plus months; and it means pushing them to confront their fears through activities like taking wood shop and participating in outside experiences that challenge their skills and thinking. It also means pushing our students to examine their own attitudes about blindness through open and honest discussions. And we must do one more thing. We must connect our students with other blind people through consumer organizations.

This is not a point that can be ignored. We know the consumer organizations, and it is our responsibility to make sure our students get connected with them. It is not enough to hand them a brochure or tell them about a Website. We must insist on their getting involved. They need other blind people to help broaden their perspective and to give them a source of support and encouragement that will last beyond training. We are determined that our students be successful. Some are determined not to be, and this is why involvement with other blind people is essential.

We must understand that, no matter how hard we work, we will not reach nirvana. A program does not reach a pinnacle of quality at a particular moment. The process is ongoing, and, if we do not continually push ourselves to become more challenging, we are acting irresponsibly. This means that, while we should take pride in our achievements, we must acknowledge that we will always have more to learn. And in order to keep learning and keep growing, we must have an ongoing way of comparing our training with other effective programs.

The National Blindness Professional Certification Board (NBPCB) has developed a process for recognizing programs that use the structured discovery approach to blindness training. In other words, I am referring to comprehensive programs that embody NFB philosophy in the structure and rigor of their orientation-center training. Our goal is not to recognize programs that are just barely good enough to pass. This process is intended to identify programs that have demonstrated that they are dedicated to the principles of the structured discovery approach to blindness training and that are serious about continued development and improvement. The recognition will help programs, no matter how experienced and effective, identify ways of doing better and becoming stronger. We believe in the gold standard, and we are committed to upholding it. We are happy to offer it to you and happy to charge you for the privilege.

For many state agencies, finding the money to support effective orientation-center training, training reflecting the gold standard, is not easy. My agency operates a residential training center. I know what it costs. It is expensive, and for most of you finding the resources to create the intensive training programs we have been discussing this week is impractical. That does not mean you and your consumers have to settle for second best.

Fortunately there are three NFB training centers in the country. They represent the most cost-effective way of getting comprehensive training for your consumers. This is not to say that you shouldn't try to run the very best program you can. But operating a first-rate residential program within a state system is very costly, and, if you are facing tight budgets, contracting for services from one of the NFB centers is a much less expensive alternative. If you decide to run a program of your own, insist on excellence. If you send your students out of state, have it be to a program that reflects the very best in orientation-center training. Whether it is your own program or a private center, make sure it meets the gold standard. This is our responsibility to our consumers.

In conclusion, the process of changing our students' attitudes is as important as helping them gain the skills of blindness. It has been the principle that has driven effective orientation-center programs since the model was first conceived in Iowa in the 1960s. We are about changing people's lives, changing them by showing them that with training and a new way of thinking about blindness, blind people can compete in whatever they wish to do. It is the model based on integrating NFB philosophy into our training programs. It means pushing people, sometimes more than they want. We push them because we care and because we know that a rigorous program of training is the best way of preparing them for the future.

To make a lasting impact, we must help our students face their own beliefs about blindness. That means learning to view themselves as blind people. It means showing them that nonvisual techniques are efficient and effective. This is why we insist on having our students wear sleepshades, having our students use a cane all day, having them take the full complement of classes, and connecting them with other blind people.

We cannot hide behind the principle of consumer choice. We cannot let choice become an excuse for avoiding making our students confront their own beliefs about blindness. We know what works, and we should insist that our programs or those we contract with embody this philosophy. Perhaps you can develop such a program in your state, but, even if you can, we must insure that students know about and have access to training from one of the Federation centers.

Your being here this week tells me that you are serious and committed. Make use of the information you have received and the contacts you have made. This is something that is important and something that takes our collective best thinking, imagination, and hard work.

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