in the job market. Developing flexible working conditions including shorter workweeks, flexible hours, intermittent work, will provide means of meeting some problems of the chronic and severely disabled. Problems and goals VIII. COUNSELING AND EVALUATION The process of vocational counseling represents the outcome of most of the research in vocational rehabilitation. Increased knowledge and improved procedures facilitating the achievement of optimal performance in handicapped persons lead to improved counseling procedures and better services to clients of State agencies. To improve assessment of clients, devices must be developed for evaluating abilities and personality characteristics in relation to success in training, in employment, and in community activities. The counseling relationship itself must also be made more meaningful, since this process involves complex problems of interpersonal perception, communications and emotional response which are just beginning to be studied effectively. Research, therefore, needs to be devoted to problems of: (1) Devices assessing the facilities and motivations of the client; (2) methods of obtaining occupational information including not only job duties and conditions but attitudes of potential employers and coworkers; (3) analysis of the counselor-counseling interaction; (4) selection, training, and professional development of counselors and related personnel. Accomplishments Several scales or test batteries have been or are being developed for predicting trainability and employability of retardates and of mental patients. These include tests of abilities and vocational interests. Further studies of the predictive value of these scales are in progress. Scales for measuring attitudes toward mental patients, retardates and toward the physically handicapped have been completed. One of these is being used in several other projects. A more extensive scale of attitudes toward the physically handicapped is at present undergoing factor analysis to determine components of this attitude such as nature of handicap and severity of handicap, as well as relation of attitude to age, sex, and other characteristics of the respondent. One of the important elements in the counseling process is the client's perception of his own physical and mental characteristics in relation to what he can do in employment situations. In order to understand such perceptions better, a study recently completed analyzed handicapped persons' conceptualization of parts of their bodies. Another study determined sources of anxiety in the handicapped person concerning his personal characteristics and the situation in which he finds himself. Work evaluation of the handicapped while on the job is a complex and continuing problem. A project completed this year has made intensive studies of physiological and psychological functioning of handicapped persons while performing tasks which have been analyzed into elements also found in many job situations. Group counseling methods are increasingly being developed as a means of extending personal counseling to as many clients as possible. Two projects have devised methods of enabling clients to conduct some counseling sessions under their own direction. Proposed 1967 program In 1967, an amount of $1,010,000 is requested to support 25 projects in this area. This will permit an increase over 1966 of two projects at a cost of $80,000. There will be continuing work on evaluation of work capacity and employability and on the measurement of attitudes of potential employers and coworkers toward handicapped persons. The counselor-counselee relationship will be explored in greater depth in order to determine and reduce barriers to communication. There will be intensified study of the professional role of the rehabilitation counselor, methods of recruitment of counselor trainees, and devices for improving the training and professional development of counselors; for example, programed teaching materials. Problems and goals IX. NEW PATTERNS OF SERVICE Previous studies and demonstrations have pointed to the fact that large numbers of handicapped persons are not being reached by existing rehabilitation services because of certain barriers between the professional personnel and rehabilitation facilities and the handicapped they are intended to serve. In the past, geographic distances have created a major obstacle. With the increase in the number of facilities available, other obstacles have been identified. Many of the poverty stricken who are eligible for those services appear to reject them. Workers on demonstration projects attempting to serve a population not previously served report a reluctance to participate on the part of potential clients. Approaches that have been developed in recent years include the use of subprofessional personnel recruited from the ranks of the population to be served, thus providing a "go-between" for the professional worker. Another approach is to house the "service" in the local low-income housing area in close proximity to those being served. This brings the service to the ones who need it. In spite of these measures, there is difficulty still in breaking down barriers to successfully serving the selective service rejectee, the public offender, the public assistance and OASDI applicant, and other groups, especially those seriously deprived of education and other social benefits. A major goal of research and demonstration projects delivering new patterns of service should be to analyze further the obstacles which prevent effective delivery of service to certain specific populations. Another problem which has become widespread in our economy is the lack of professional personnel to serve the large numbers of persons needing health, education, and welfare services. In vocational rehabilitation there is a growing demand for the development of means for expanding the ability of available personnel to meet the needs. One of the solutions has been the experimentation with subprofessional personnel who assume small segments of the professional person's role under supervision. Group counseling has been and is being studied as an effective means of expanding the trained professional's ability to serve. More study is needed in the area of management of facilities and staff in order to design patterns of service and to draw up job specifications for delivering services. The aim is to increase the productivity of professionally trained persons through the restructuring of the method of delivering services. The development of regional facilities to provide research, training, and service in connection with heart disease, stroke, and cancer will require the development of rehabilitation units designed to do vocational rehabilitation research and training in a context of service, integrated with the other health and welfare services in the regions. Although there has been some experience in the development of vocational rehabilitation units integrated with medical facilities there is much experimentation necessary in developing a model for such integration. Accomplishments Recent research and demonstration projects have pointed the way to the formal planning and development of vocational rehabilitation services on a statewide basis. Methods and procedures have been developed which can serve as guidelines to the States in the development of coordinated programs to serve their needs. Also, metropolitan areas have conducted projects designed to coordinate existing services and introduce new services where they are lacking. These two types of planning and development projects have been completed in time to serve as prototype for a general nationwide move by the individual States to review their programs and design improvements. Other projects recently initiated are those studying programed instruction for counselors and volunteers, the development of a national recruitment and placement program for vocational rehabilitation counselors, a placement program for a metropolitan area using a computer to match up job openings with rehabilitated candidates. A new approach to serve quadriplegics is being attempted using assistive devices and workshop aids in a medically supervised residence-workshop. Proposed program An amount of $5,631,000 is requested for support of 99 projects in 1967. The program level would be increased over 1966 by two additional projects at a cost of $120,000. Of the total number of projects, seven are in the area of heart disease, cancer, and stroke. Special emphasis will continue in the development of new patterns of service to disabled youth, culturally deprived groups and socially maladjusted individuals such as public offenders. Also, there is need for further studies to expand the use of subprofessional workers to extend the service of trained professional personnel. Special emphasis will be placed on the development of techniques for breaking down barriers that exist to prevent delivery of rehabilitation services to those most in need of them. Problems and goals X. EXPERIMENTAL FACILITIES With the rapid growth of the workshop movement and the development of comprehensive rehabilitation centers over the country, there is an increasing demand for (1) experimentation with staffing patterns and physical arrangements for service to different populations; (2) exploration of means for obtaining contracts to provide work for workshop populations; (3) study of the functions of various units within a comprehensive center; (4) development of research programs within workshops and centers in order that they may study and evaluate their own programs. The new legislation providing for expansion of workshop activity increases the need for knowledge in all aspects of workshop management and operation. Within the workshop field there are special functions performed by special types of facilities. Investigations are therefore required in specialized areas of service such as activity centers which provide developmental services for clients moving to transitional workshops where work potential is evaluated. The evaluative functions of workshops and centers will be further extended by new legislation which provides special funds for evaluation of severely disabled individuals for periods of 6 months or up to 18 months (for mentally retarded and other specially designated groups). The ability of the vocational rehabilitation program to design effective services to the handicapped rests squarely on the capacity to evaluate the abilities and needs of the individual client. Facilities must be provided for long-term study and evaluation of clients in order to properly identify remedial procedures required. Accomplishments A recently completed project has established architectural guides for workshops which will be valuable in implementing new legislation for the construction and development of workshops. Another project has completed the development of standards for the operation of rehabilitation centers and facilities. Projects are underway to establish evaluation procedures for workshops and rehabilitation centers. A project to develop a systematic voluntary reporting procedure for rehabilitation centers and facilities has been completed. This system will make possible much better studies of the needs in various areas of the country. Another project has developed a major university as a regional facility with specialized services to meet the needs of severely handicapped college students. This project is providing information and guidelines to other institutions of higher learning for serving the needs of the handicapped. A project to demonstrate the value of a statewide network of sheltered workshops has resulted in State legislation to provide local tax support for those shops, which have been placed under the administrative supervision of the State vocational rehabilitation agency. Other projects are demonstrating the use of a central evaluation team to serve clients in satellite workshops. Proposed program An amount of $780,000 is requested for support of 12 projects in 1967. The program level would be increased over 1966 by one additional project at a cost of $68,000. Projects to test the use of central technical staffs to serve satellite shops should be broadened to include experts in industrial engineering and marketing in order to provide workshops with the technical ability to bid for and fulfill complex modern industrial jobs, both at the operator level and at the middle management level. An alternative that needs testing is the development of laboratory-workshops within an industry to provide training in the newer types of industrial jobs, the opportunity for the employer to observe handicapped workers performing these jobs and placement of the handicapped into permanent industrial positions when they have developed the necessary skills and work tolerance. Emphasis in these projects should be on heart, cancer, and stroke cases. Problems and goals XI. OTHER PROJECTS With an increasing number of completed projects each year, the dissemination of the findings of rehabilitation research is of paramount concern to the Vocational Rehabilitation Administration. Major problems include not only the need for the new techniques to be utilized in the field for the severely disabled, but that in some of our collaborative projects these new techniques be further enhanced by their use in conjunction with new and tested professional approaches in other rehabilitation fields. Accomplishments Several research conferences have been held. On explored the contribution of sociology to problems in rehabilitation. Others have been concerned with control and function of the neurogenic bladder, the bioengineering aspects of prosthetics and orthotics, group approaches to counseling the disabled, communication problems of the deaf, and neurological problems in the rehabilitation field. In relation to heart disease, cancer, and stroke, three conferences were held on each of the areas during the 1966 fiscal year covering current rehabilitation knowledge and gaps in information. Proposed 1967 program For 1967, a total of $191,000 is requested to fund nine projects. This will allow for support of the program at the same level as in 1966. |