Management and Administration of Rehabilitation Programmes

Roy I. Brown

• Publisher: Routledge
• Year: 2021
• Print ISBN: 9780367627249
• eBook ISBN: 9781000225877
• Edition: 1
• Topic: Education
• Subtopic: Education Administration

First published in 1984, Management and Administration of Rehabilitation Programmes addresses issues in management and administration across a wide range of areas relating to the education, welfare, and quality of life of those with disabilities.

The book covers a variety of topics, including employment, the establishment of service priorities, and the evaluation of services and promotion of innovation. In each case, problems in management and administration are highlighted and explored.

Management and Administration of Rehabilitation Programmes will be of interest to administrators and students of the history of special education.

Chapter One MANAGEMENT AND ADMINISTRATION IN REHABILITATION: AN INTRODUCTION

Roy I. Brown and Peter R. Johnson

INTRODUCTION

As indicated in the first volume of this series, rehabilitation education refers to the broad range of programmes which, from behavioural, educational, and social points of view, enable children and adults to function increasingly effectively within society. Such programmes attempt to apply the philosophy of social role valorization (Wolfensberger, 1983). Social role valorization is a development and advance on the often misunderstood and abused Principle of Normalization. Social role valorization refers to the esteem associated with many of the roles in our society. Thus when people with special needs adopt a positively valued persona, such as that of a skilled worker, musician, or parent, they benefit from the role's image enhancing properties.

The authors believe that the basic principles and rules put forward in this chapter apply to all prograrmes dealing with people of various ages who have many different types of handicap. But our interests are wider than this, for we also believe the principles, if not the levels of application, apply in different countries despite the fact that philosophy and management style may differ. The terms that we use in this chapter are intended to be generic. The chapter is concerned with management and administration. It should be recognized that, although precisely the same board and management organization or structure may not exist in each agency, because of different terms of governance, the concepts discussed apply generally. If the component structures are not present in any form, then the agency, and, therefore, the consumers and the staff are likely to encounter particular difficulties.

In Canada the field of rehabilitation is dominated by a range of agencies which are designated for the most part, as private structures with their own philosophies and independent boards of management. They receive their funding from government, but have charitable status and receive donations and support from a number of other sources. In Britain the agencies are often government structures, relating to local health and social authorities and receiving their funding directly from these bodies. They frequently do not have boards responsible for their direction and running. Yet within the structure of the local authorities are systems which relate to authority and responsibility.

This book discusses a variety of issues concerned with the interface between management and programme development in a range of rehabilitation services. The particular agencies may be associated with government departments or boards of education, health and social services. Some are private foundations or charitable associations. Some may have components which deal with research and hopefully others are recognized as demonstration centres. However, most of them are concerned with the delivery of day-to-day services for people living with one handicap or another.

Education services may be viewed by some as rather different since, in several countries, education of children is required by law, or community school boards generally assume education should be supplied to all children regardless of handicap. We suggest that the majority of recommendations within this book apply equally to educational authorities, private centres, and agencies dealing with children, adolescents and adults. Indeed one of our concerns is that the bureaucratic classification system separating people by age and condition is an administrative convenience which restricts the delivery of effective service to disabled persons, and profoundly influences our ability to apply demonstration and research knowledge to general practice.

It is suggested that the various managements, boards and allied structures, developed within the field of rehabilitation over the past decades, have not adjusted to the knowledge now existing in the behavioural, social and educational sciences and that we have therefore reached a crisis in relation to the management of agencies working in the rehabilitation field. If we are to unravel this problem and come up with helpful recommendations, then it is first necessary to discuss the role of boards, management, and equivalent bodies responsible for overall philosophy.

One problem commonly experienced is that board members or advisory personnel lack an understanding of the role of committees in general and, more specifically, the aims and responsibilities that they may be taking on in relation to the rehabilitation field. Board members should obtain a general knowledge of agency functioning and direction and develop a philosophy in relation to their agency, and their intentions for clients they are serving.

For example Brown and Hughson (1980) have pointed out that problems arise at both conceptual and practical levels in terms of the function of sheltered workshops and vocational training agencies. In theory the programmes for each should be entirely different because the philosophy of the two types of agencies are entirely different, but most members of boards do not recognize this, nor do the agency staff. Unless functions are clarified, problems occur at the frontline level, at board level and, frequently, at the funding level; the latter often represented by government departments. Furthermore, personnel hired to work in a sheltered workshop, activity centre or training agency should differ markedly.

Such a situation occurs in Canada where many government agencies provide funds for day programmes. The funding for the most part ignores whether training or shelter workshop functions are carried on. As a result many individuals or their parents expect to receive a particular type of service, but do not do so because resources are not available. This is very different from saying that resources do not exist, either in terms of knowledge or funding.

Over the past 50 years there has been a considerable growth of knowledge in the rehabilitation field. It is generally recognized (Clarke, 1979) that if we applied our knowledge within our agencies, the amount and degree of handicap, particularly mental handicap, would be much decreased by the end of the century. We recognize that this will not happen, but submit that one of the crucial limitations relates to the structure and management of agencies. We have not yet developed mechanisms for incorporating successful change from demonstration programmes to general agency function. Nor do we have proven structures to move research knowledge to formal agency practice, although in subsequent chapters some possible examples are given. The incorporation of such structures involves changes in staff knowledge and flexibility, the job expectations by and of staff, a clear management philosophy which is client centred and a board which is directly concerned with agency direction.

we will attempt to look at some of the administrative and management qualities which make for the success or failure of a particular agency or centre. In doing so it is necessary to outline some major agency functions.

PHILOSOPHY AND GOALS

Most agencies and organizations have a constitution and a philosophy. Yet, when we have looked at the range of agencies in a variety of countries we find staff are frequently not aware of them and in some cases a written philosophy and constitution does not formally exist!

The constitution is a means of describing an agency's purpose and reflects a basic philosophy. It is the basic description of its aim from which all of its activities must be derived. Variations in philosophies and goals can have profound effects on the types of service offered. For example, an agency might be designated as a non-profit making organization whose resources of funding are directed to the care and treatment of individuals with handicaps. Sometimes the principal goals may be quite broad, at other times they are narrow and relate to only one specific type of condition or disability. For example, an agency may be concerned with care or treatment, home living or vocational training, cerebral palsied or mentally handicapped persons, adult accident victims or childhood disabilities, or to a combination of these and other attributes.

An agency might have a goal to rehabilitate handicapped individuals. On the other hand it might have a goal which is directed towards the care and protection of such individuals. It may be much broader and involve integrated programmes covering residencies, home care, leisure time and social education as well as vocational training.

Coordinated programming with a view to integrating people into the community represents a philosophy of social role valorization, and indicates the areas in which environments are to be normalized. But obviously this philosophy can only be effective if it is put into practice by agency personnel.

Although we agree that both agency personnel and boards of directors should be involved in the development of philosophy, the prime responsibility for saying what an agency is about must reside within the latter. Obviously philosophy is not a static function and we recommend that it is looked at continuously. A full appraisal is desirable every one to two years, with a view to ensuring the philosophy is consistent with the most modern knowledge available for rehabilitation purposes. This means a coherent policy, based on discussion involving all facets of staff and board personnel and often involving outside advisory consultants, rather than arbitrary action by the board, manager or executive director.

Many boards do not know the purpose of their agency and, furthermore, staff frequently disagree with one another on the major aims and how the agency should function.

We have reached a time where it is unacceptable for board and staff to belong to an agency on the one hand but have different views and aims at a macro level from the stated philosophy and goals of the centre. For example, it is of little help if personnel in a residential unit do not believe in a normalization philosophy when an individual from this unit is attending a day programme which does believe in integration. Handicapped people are often placed in difficult positions when different approaches are applied to them at different times of the day. This is hard for non-disabled human beings; it is quite intolerable when it is applied to those who have restricted abilities in one field or another.

Prospective staff should be given the constitution and goals to read on application. Disparity or disharmony between these and their own views should be explored and, if crucial, the applicant should be rejected. This is an important aspect of interviewing procedures.

The staff, including the executive director and manager, are responsible for the day-to-day running of the operation. That is their major role. They are also responsible, particularly the senior staff, for the design of programmes and for seeing that the philosophy pervades the programme at a practical level. The arguments above suggest different roles for board and staff, but in many countries the managerial staff are also separated clearly from mid management and frontline staff. There is a clear-cut hierarchical model imposed, with levels of function and responsibility clearly defined. We argue that this is not effective in the running of rehabilitation agencies (see Chapter Five). There is a continuum of activity which involves all levels of staff and board, and although there may be a preponderance of certain types of activity among certain members at particular levels of the continuum, the vast majority of members share functions to a lesser or greater degree. If this line of argument is accepted, it must follow that the board and senior management must be knowledgeable about staff, and agency aims, and the effects the agency is having at a practical level. Without such knowledge they cannot support the effective operation of the agency. Likewise, it is only when the staff understands the philosophy and its programme implications that the delivery of service to specific individuals is likely to be effective.

If a philosophy is to be a dynamic and changing structure, staff and board alike must consciously ensure that it is effectively evaluated on a group basis and changes are made after ratification by senior management and board. Agency reviews are often done by outside personnel. We do not totally concur with this view, although the process may be helpful. It alone can be quite damaging, particularly if the outside consultants are not knowledgeable about the field. This may seem an odd statement, but our experience suggests consultants are not always selected by boards or government departments on a knowledge basis. Other social and political pressures hold sway.

It is also important for staff to evaluate their own programmes so that they can become aware of deficiencies and be provided with the authority and direction to eradicate problems. Without this responsibility, agency personnel often blame other authorities for inadequacies and inaccuracies. They also argue that change cannot occur because of rigid bureaucratic authority. Many agencies are stagnant or deteriorate because the agency structure is not such that senior personnel can second authority or permit directional and controlled change to take place. Some of the reasons for this are discussed later.

Simple diagrams, which outline the procedures involved in committee structures, are often helpful to all those involved and give a visual impression not only of philosophy but of line authority and committee requirements. Other aids that can be employed are the recording of interviews with clients about programme and programme needs and the impact that the programme has had on the individual. An example of this was recorded by Brown (1985). Such input is not just important in terms of agency structure but also adds to programme effectiveness. If, for example, one of the aims is social role valorization, it makes sense for clients to be encouraged to make recommendations.

The Voluntary Society

In many countries, it was the parents of handicapped children who established the first community agencies. Many did not wish to send their children to large institutions, but found that local educational services were not available to them. Consequently, groups of parents organized themselves to provide basic schooling for their offspring. Some approached local ministers regarding the use of church basements, while others complained to their elected representatives about the lack of services. While these parents knowingly became the first service providers in many communities, they had perhaps unwittingly embarked upon their most powerful role as advocates for people who live with a handicapping condition (Sarason & Doris, 1979). To this day, service delivery and advocacy remain the dual roles of these voluntary societies.

Over the last 30 years in Australasia, the British Isles, and North America, parent-directed associations, sometimes named for a specific disability, have grown enormously in number and political power, and have provided a range of sophisticated programmes. In some countries, such as Canada, the relationship between societies is that of a grass roots movement. Power resides in local groups rather than in any national body. In each geographical area, these locals combine to elect and direct members of a regional body. The regional associations in turn sponsor a national society for handicapped people.

Advisory Boards

It is recognized that many agencies will not have boards as such, or that these boards are remote within some government authority and have very little direct contact with agencies. We advise that such agencies form their own advisory committees which make recommendations directly to local or other government authorities, that they are formally constituted and represent a knowledge base. The following chapter relates to these advisory committees as well as governing boards.

A board of directors is responsible to the general membership for the functioning of the agency and may be responsible to government for the application of funds. It is a means of developing a specific framework for promoting the philosophy and programme base of an agency. Individual board members should recognize that they are on the board for the better functioning of the agency, not to represent personal concerns. Parents sometimes have this conflict and need to recognize their different roles, one as parents of students in the agency and the other as impartial board members. The selection of members to advisory committees is critical. The staffing of an agency and how it develops a board has been described by Brown & Hughson (1980), also Nemeth, Brown and Hughson (1981). However, whether it is a new board or new...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Table of Contents
• PREFACE
• ACKNOWLEDGEMENT
• 1. MANAGEMENT AND ADMINISTRATION IN REHABILITATION: AN INTRODUCTION
• 2. MANAGEMENT AND ADMINISTRATION IN REHABILITATION: ROLE OF VOLUNTARY AGENCIES AND THEIR BOARDS
• 3. MANAGEMENT AND ADMINISTRATION IN REHABILITATION: IMPACT ON PROGRAMMES AND PERSONNEL
• 4. MANAGING CHANGE IN REHABILITATION SERVICES
• 5. IMPACT OF AND ALTERNATES TO CORPORATE BUSINESS MODELS IN REHABILITATION
• 6. CONJOINT EVALUATION AS A PROGRAMME DEVELOPMENT STRATEGY
• 7. A DEVELOPMENTAL SYSTEMS APPROACH TO PLANNING AND EVALUATING SERVICES FOR PERSONS WITH HANDICAPS
• 8. VOCATIONAL REHABILITATION SYSTEMS AND STRUCTURES: A BI-NATIONAL LOOK
• 9. ADMINISTRATION AND MANAGEMENT OF LEISURE SERVICES FOR DISABLED PERSONS: ONE EXAMPLE
• 10. ENHANCING EMPLOYMENT OPPORTUNITIES BY INVOLVING BUSINESS AND INDUSTRY IN REHABILITATION PROGRAMMES
• 11. SERVICE PRIORITIES FROM A RESEARCH PERSPECTIVE: A PRACTICAL APPROACH
• 12. STRESS AND BURNOUT IN REHABILITATIVE SETTINGS
• INDEX
• AUTHOR INDEX