Leadership and Change in Human Services

Selected Readings from Wolf Wolfensberger

David Race

• Publisher: Routledge
• Year: 2003
• Print ISBN: 9780415305624
• eBook ISBN: 9781134404421
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

For over forty years Wolf Wolfensberger has been a significant figure in the world of human services, especially in the field of learning disability. His work on normalization and citizen advocacy in the late 1960s and early 1970s has been acknowledged by supporters and critics alike to have been fundamental to developments in a number of countries, most notably his adopted country, and the USA, Canada, Australasia, and the UK. His further work in developing the theory of social role valorization, the successor to normalisation, and as a commentator on broader trends in society and their effects on vulnerable people and services for them has ensured his place as a major voice for values and the human worth of all people. Never afraid of controversy, his views have brought him into conflict with institutional vested interests and radical groups alike.In Leadership and Change in Human Services David Race introduces the reader to Wolfensberger's key ideas through a series of extracts, with commentary, from his published work. Throughout the edited selection, the emphasis is on placing Wolfensburger's work in contemporary context and examining its continuing relevance today. Including a comprehensive bibliography of Wolfensburger's written output, this text offers an invaluable source of reference to all those concerned with the recent history of the human services.

Chapter 1

The analysis of devaluation and wounding

Introduction

In the hundreds of publications that Wolf Wolfensberger has produced over the years, one theme recurs, sometimes in a small portion of the paper concerned, sometimes dominating it, but always around in one form or another. Whether in the early days as a psychologist, in the height of his influence in the early 1970s, in his controversial later works and workshops – whether on the subject of service organization, planning, advocacy, normalization, social role valorization, relationships between people or lessons from history – the way we as humans think about certain groups of people and what we then, as collections of humans, do about that is the basis of this recurring theme. As the extract in the Introduction above reveals, the basis for our thoughts and actions are, Wolfensberger believes, grounded in values. As the years have passed, his views on the content and/or relative weight of those values may have changed, as we shall see in later chapters. Overall, however, the result of our values and subsequent actions, in terms of the creation and perpetuation of devalued groups, has not changed. The groups themselves may also have changed, though Wolfensberger’s origins in the mental retardation field have kept that group as a constant in his work (just as they remain the most consistently devalued group, at least in so-called developed countries). The process, however, does not change.

As we shall see, greater refinement of analysis has added some new words to describe this process, from ‘treatment of deviancy’ to devaluation, with the incorporation, via contact with Vanier and L’Arche, of the descriptive term ‘wounding’. Other authors and groups (e.g. Oliver, 1990; Morris, 1993) have described the process in different terms, and with different emphases on causes and responses, but appear to be talking about much the same thing (much though some of them would not be prepared to acknowledge such a view). At its root, however, the process would seem to this editor to be so clearly set out in so much of Wolfensberger’s work, and to produce in those who read and hear his account of the process such strong reactions, emotional as well as intellectual, that it represents what he would call a ‘true universal’.

All of us can recognize, at the level of our most basic instincts (some would say deep in our soul), and identify with, this process of devaluation and wounding. We may then deny it, try to pick small or large holes in it, try to attack the man proposing it, or close our ears because of the language in which it expressed, but the underlying truth remains.

This opening chapter, therefore, goes straight to the heart of the matter; in fact, subsequent chapters can be said to summarize the many aspects of Wolfensberger’s response to, or refinement of, the central theme of devaluation and wounding that these opening extracts present.

2 From: ‘General observations on European Programs’, 1965, Mental Retardation, 3(1), 8–11.

One of Wolfensberger’s earliest published thoughts on the issue was encountered in the third of three articles, written for the journal Mental Retardation, on his 1962 European trip discussed in the Introduction. It represents, for its time, very radical thoughts about the link between the way services are carried out, and the view of the service system, and society, about the people for whom they are provided. The articles make a number of comparisons favourable to the European services, especially in terms of their developmental and community orientation, and in his conclusion, Wolfensberger first of all dismisses the simplistic belief of services that more money could make US services better, then points to the lack of a community base for those services. Finally, and in terms of the theme of this chapter, Wolfensberger speculates on the ‘complex and profound’ questions of why different societies treat similar groups of people in significantly different ways.

…

Conclusion

Since my return to the United States, I have spoken to a number of parent and professional groups, frequently showing slides and pictures I brought back. One point often made from the audience is that if we only had more money we would be able to provide more or better services, too. This is a fallacious and even dangerous argument. First of all, money alone cannot assure quality of service. Over and over, I observed that the better endowed programs were not always the best, or, to the contrary, that they were often very ineffective. Secondly, many states provide considerable financing for institutions but little in terms of community services. For the same amount of money it takes to provide one place in an institution, one could maintain from three to five retardates in the community by means of day care services, home visitors, parent counseling, mother’s helpers and sheltered workshops. Yet even though this is now known, several states are presently in the process of enlarging, building, or planning traditional, large, uneconomical omnibus type institutions, often far removed from the area of greatest need. It would appear that there is a lot of money available even now, but that it is being spent uneconomically and not in the best interest of the retarded. …

In this series of articles a number of programs and issues have been discussed which are not likely to leave us feeling content and happy with what we have been doing. Our programs and attitudes have come a long way in the last decade, but many of us, while verbalizing the fashionable watchwords, do not appreciate how much could actually be done. … there are enough publications in our literature which glorify the achievements of this or that program, and too few which point to conditions which are unsatisfactory or which, in some institutions or states, are outright scandalous.

Particularly, I see one almost inexplicable paradox in the contrast of care and training the retardate receives here and in Europe. Ours is a society based on democratic and idealistic principles. We voice beliefs in self-sufficiency, hard work, human dignity, freedom of movement, minimal controls and equality of opportunity. Furthermore, we are affluent while European countries either are not or much less so. Also, they have been traditionally restrictive of human rights and opportunities, and more class conscious. For example, Germany, even today, is a country where the police has vast power, where the state keeps up with the whereabouts of every individual; where every resident age 14 and over must have his passport if he goes out upon the street; where you must give your wife’s maiden name, place of birth, and your own passport number, place, and date of issuance if you wish to register in a hotel; and where a man can be held in prison for months without a public charge. Yet, when it comes to providing programs for the retarded, the Europeans are both wise and generous where we have been careless and stingy; they grant rights which we so often take away; they provide opportunities we deny; they educate for independence where we prefer to give meager charity; they permit open movement of retardates where we yet have innumerable locks and fences; they tackle problems we prefer to repress.

Why this reversal of traditional modes of behavior when it comes to mental retardation? Is it because our Protestant ethic rejects individuals we believe to be idle, unproductive and unfavored by God? Is it that in our striving for ascendancy, independence and strength, the retardate reminds us of what we might be, and we thus proceed to repress his needs or even his existence? Or, in our affluence, are we gratified to have an object of charity, and to maintain the retardate in a state of well-fed dependency? The answer is probably complex and profound, and the questions keep nagging. But regardless of past and present paradoxes, the time has come to demand that the best of ideas from everywhere be combined with the material resources of our society in order to produce better solutions to the problem.

3 From: ‘Models of Mental Retardation’, 1970, New Society, 15(380), 51–3.

In the period between the series of articles mentioned earlier and the next article in this chapter, a considerable amount of activity took place in the mental retardation field in the USA and certain European countries. In relation to the development of normalization, this is outlined in Wolfensberger’s own account at the start of Chapter 2. In terms of the analysis of devaluation and the experiences of vulnerable individuals and groups in Wolfensberger’s writings, however, the early reflections above now go on to consideration of the ‘models’ of service that characterized the field at the time. The next extract is from an English journal, New Society, which was not an academic journal, but more a journal for the intelligent lay reader (mainly of a ‘soft left’ persuasion – it has subsequently merged with the more famous journal of the left, the New Statesman). It was adapted from a key chapter in the famous report for the President’s Commission on Mental Retardation, published as Changing Patterns of Residential Services for the Mentally Retarded (Kugel and Wolfensberger 1969 – see extract 6 for greater detail). The chapter, entitled ‘The origins and nature of our institutional models’, was also summarized in the journal Mental Retardation (White and Wolfensberger, 1969) and later edited to form a best-selling monograph with photographic illustrations (Wolfensberger, 1975). It also sees one of the earliest references to the ‘historic roles’ of devalued (especially impaired) people, the link between those perceptions, and the reinforcement of such perceptions in the ‘settings’ of human services, by the physical environment, the social environment, and the language used about people. The article itself, of course, uses then contemporary sociological and social psychological language, that of ‘deviancy theory’ which, as we have discussed and shall see below, also informed elements of normalization ideas and has had its critics, both from within sociology and outside. As with much of Wolfensberger’s writing, however, the article has a broader historical referential sweep, and in addition acknowledges some of the key influences and contemporaries on his thinking. (N.B. As an article in a non-academic journal, referencing was not made in the ordinary way, but with a list being given in the margins, rather than references in the text. To aid readers of this book, the basic citations are given after the extract, with the full references in the main list at the back of the book.)

Man’s attempts to deal with deviance can be classified into three categories: destroying the deviant, making him undeviant, or segregating him. Segregation can take two forms: protecting the deviant from society, or protecting society from the deviant. Apparently, it is difficult to the point of impossibility for society at the same time to view people as deviants and interact normally with them. A good example of the three main reactions to deviancy is the treatment of the Jews in Europe. During early Christianity, efforts aimed at converting them; in the Middle Ages, they were segregated by banishment or ghettoes; in the recent past, they were first segregated in concentration camps and then destroyed.

Another important fact about deviancy is that although it can take many forms, these tend to be treated in very similar ways at a given time. When Hitler destroyed the Jews, he also destroyed the mentally disordered and the retarded, the aged, habitual criminals, gypsies and vagabonds. The history of the treatment of the mentally retarded over the past 100 years illustrates very well the changing ways in which society can “manage” deviancy. Here, too, there were remarkable parallels in the handling of the retarded, the disordered, the epileptic, the blind and deaf and even criminal offenders. …

There is, obviously, a clear link between the way a deviant is perceived, and the way he is treated. On studying the history of mental retardation, you find seven chief social roles in which people have been cast at different times and places. The retardate has been seen as subhuman (an animal or vegetable), as a sick person, as a menace, as an object of pity, as a burden of charity, as a holy innocent, and as a developing person. By their very nature, it appears that all but the last of these seven perceptions leads directly or indirectly to treatment which “dehumanises”.

In a research programme I have confirmed – by the factor analysis of attitude statements put to various groups of people – that several of these “role perceptions” of the retarded are still identifiable in American society. When we create a human management “setting” (agencies, institutions, …) for the handicapped, the dominant perceptions – in society as well as among specialists – will result in a building, a staffing hierarchy, and rules and procedures which add up to a consistent model.

An institution based on the view that a retardate is “sick” – the “medical” model – will have certain characteristics. It will be called a hospital, and its director will be a physician. The hierarchy and daily schedule resemble those of a hospital. Non-medical staff sport white coats. Resident care is called nursing care; residents are called patients, and their retardation is referred to as an illness or disease. Assessment of their problems is called diagnosis, and all “management procedures” are called therapy or treatment, even to the point where education, work and recreation become educational, industrial and recreational therapy. Those who “administer” such therapy (perhaps in “doses” rather than lessons) may be called therapists. Finally, there may be a preoccupation with the issue of the curability versus incurability of retardation, and a decided pessimism – despite occasional “convalescent leaves” for patients – because of the “chronicity” of the condition.

Some institutions combine perceptions. The subhuman and the menace model are often mixed. Usually, such institutions have features like these: strong fences and windowguards; locked doors, rigid segregation of the sexes; little or no use of knives and forks; unbreakable windows, dishware and furniture; staff looking at residents from protected stations rather than interacting in their midst; an open view of residents’ beds, toilets, lavatories and bathrooms; prohibition of the carrying of matches, lighters and pocket knives; and rigid control and censorship over incoming and outgoing mail, parcels and telephone calls.

It was in the middle of the 19th century that enthusiastic educational pioneers launched on concerted efforts to reverse the deviancy of the retarded. They intended to make the deviant undeviant, but their goal was not so much to make the retarded person “normal” as to make him productive, adjusted and independent. It was during this period of optimism that institutions for the retarded were founded throughout the western world. The “perception” was the humane one – of the retarded as developing persons.

In America and other countries, these early institutions based on the development model were defined as residential schools. It was believed to be very important for the residents to have many contacts in the outside community and to have other experiences which today would be called “normalising”. One of the first American institutions was, we are told, “organised on the family plan; the pupils all sat at the same table with the principal … It was the belief of the managers that only a relatively small number of inmates could be successfully cared for in our institutions.” To be in the public eye, these early institutions were, in America, sited in the principal or capital cities of their states. A large family residence in a crowded neighbourhood of Boston was the first public institution for the retarded in the United States. …

One of the early pioneers in the United States, Samuel Howe, was an internationally renowned social and political activist. In 1866 he said: “All great establishments in the nature of boarding schools, where the sexes must be separated; where there must be boarding in common and sleeping in congregate dormitories; where there must be routine, formality, restraint and repression of individuality; where the charms and refining influences of the true family relation cannot be had – all such institutions are unnatural, undesirable and very liable to abuse. We should have as few of them as is possible … Witness the old nunneries and monasteries, darkened and saddened by lack of the sunlight of affection and love … soured by crushed hopes and yearnings … Witness soldiers in detached garrisons; sailors on long voyages; prisoners under long sentences. Wherever there must be separation of the sexes, isolation from society, absence of true family relation, and monotony of life, there must come evils of various kinds which no watchfulness can prevent nor physician cure.”

In his book, Asylums, published in 1961, Erving Goffman also pointed out the similarity between mental hospitals, prisons, monasteries, boarding schools and army camps, calling them “total institutions”. Under the direction of Professor Jack Tizard of the University of London Institute of Education, researchers have used Goffman’s work to devise a scale for measuring the quality of residential service given to children. Interestingly, this scale includes such items as whether the staff and children eat together.

The reason why Goffman and Tizard can still be concerned about this problem is because, unfortunately, what intervened between Samuel Howe and the other pioneers, and the present day, makes ghastly reading. If more people knew this tragic history, it might prevent a recurrence of the kind of dehumanisation of the deviant which was at its most common and most extreme between about 1910 and 1960.

First by about 1870, the “developmental” attitude changed, and a “pity” model took its place. This occurred because the early institutions, although remarkably successful, were not as successful as many people expected them to be. One expression of the pity model was the view that the deviant should be segregated from society in order to protect and shelter him. So institutions were moved into the purportedly bucolic and Eden-like setting of the countryside, with fences around them to keep out the predations of a cold and vicious world.

But a successful human management model must be based on respect, not pity. Pity may be benevolent, but it contains an element of regarding those who are pitied as not so fully human as he who is doing the pitying. This pity model was only transitional (perhaps this is always the function of pity). It only lasted for 20 or 30 years, reaching a peak in the Unite...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• Foreword
• Preface
• Acknowledgements
• Introduction: Wolf Wolfensberger – changing leadership and leading change
• 1 The analysis of devaluation and wounding
• 2 Normalization
• 3 Social Role Valorization
• 4 Advocacy
• 5 Possibilities, limitations, and ethical issues raised by Human Services
• 6 Threats to vulnerable people
• 7 Relationships with, and lessons from, vulnerable people
• References
• Appendix: Full bibliography of Wolf Wolfensberger
• Index