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Development of the Social Service Department at the Woodlands School : a review and assessment of developments… Sampson, Leonard Stanley 1954

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DEVELOPMENT OF THE SOCIAL SERVICE DEPARTMENT AT THE WOODLANDS SCHOOL A review and assessment o f developments i n The Woodlands S c h o o l , New Westminster, B. C,  (1931 - 1953)  by LEONARD STANLEY SAMPSON  T h e s i s Submitted i n P a r t i a l F u l f i l m e n t of the Requirements f o r the Degree o f MASTER OF SOCIAL WORK i n the School o f S o c i a l Work  Accepted as conforming t o the s t a n d a r d r e q u i r e d f o r the degree o f Master o f S o c i a l Work  School of S o c i a l worK  1954 The U n i v e r s i t y o f B r i t i s h  Columbia  iii ABSTRACT T h i s study makes an examination o f a t r a i n i n g p r o gramme i n an i n s t i t u t i o n f o r the m e n t a l l y handicapped. I t o u t l i n e s the h i s t o r y o f t h i s i n s t i t u t i o n and t r a c e s the development o f the t r a i n i n g programme through i t s v a r i o u s s t a g e s , with s p e c i a l r e f e r e n c e to the c o n t r i b u t i o n which s o c i a l work has made t o the r e h a b i l i t a t i v e programme. The study makes an a p p r a i s a l o f t h i s i n s t i t u t i o n ' s e x i s t i n g programme i n l i g h t o f accepted p r i n c i p l e s and s t a n dards o f p r a c t i c e , d e r i v e d from an examination o f r e l e v a n t p r o f e s s i o n a l medical and s o c i a l m a t e r i a l i n the f i e l d . Mate r i a l s t u d i e d i n c l u d e d r e p o r t s o f the medical d i r e c t o r o f The Woodlands S c h o o l , r e p o r t s o f the P r o v i n c i a l S u p e r v i s o r o f P s y c h i a t r i c S o c i a l Work, and a r t i c l e s w r i t t e n i n p r o f e s s i o n a l p e r i o d i c a l s and books on the s u b j e c t . Other' m a t e r i a l was obtained by p e r s o n a l o b s e r v a t i o n o f The Woodlands School's programme and by p e r s o n a l i n t e r v i e w s with v a r i o u s s t a f f members. The case m a t e r i a l was o b t a i n e d from the case r e c o r d s o f the S o c i a l S e r v i c e Department o f The Woodlands S c h o o l . These r e c o r d s cover a two-year p e r i o d , 1951 through 1953. The c o n c l u s i o n s o f t h i s study i n d i c a t e that the s e r v i c e s f o r the t r a i n i n g and e d u c a t i o n o f the m e n t a l l y handicapped a r e s e r i o u s l y l a c k i n g i n B r i t i s h Columbia with p a r t i c u l a r r e f e r e n c e to s o c i a l s e r v i c e s . I t i s recommended that both l a y and p r o f e s s i o n a l groups i n B r i t i s h Columbia r e a s s e s s t h e i r c u r r e n t programmes f o r the ment a l l y handicapped i n l i g h t o f e x i s t i n g standards s o t h a t a more adequate understanding o f needs i n t h i s a r e a may be a t t h e i r d i s p o s a l . The need f o r g r e a t e r expans i o n o f r e h a b i l i t a t i o n s e r v i c e s f o r the m e n t a l l y h a n d i capped i s s t r e s s e d .  * *»  iv  ACKNOWLEDGEMENTS I wish t o acknowledge indebtedness to the s t a f f i n the v a r i o u s departments  a t The Woodlands School f o r  t h e i r i n t e r e s t and c o - o p e r a t i o n i n the p r e p a r a t i o n o f t h i s thesis. Acknowledgement i s a l s o made o f the d i r e c t i o n o f Miss A. C a r r o l l , P r o v i n c i a l S u p e r v i s o r o f P s y c h i a t r i c S o c i a l Work, Dr. Leonard C. Marsh, Miss M u r i e l C u n l i f f e and Mr. W i l l i a m Dixon of the School o f S o c i a l Work without whose h e l p t h i s t h e s i s would not have been  * * #  completed.  ii TABLE OF CONTENTS Page Chapter 1.  The Problem o f Mental  Retardation.  Mental d e f i c i e n c y and mental r e t a r d a t i o n . Standards f o r I n s t i t u t i o n s f o r the mentally r e t a r d e d . A d a p t a t i o n o f S o c i a l Work to the f i e l d o f mental retardation. C o n t r i b u t i o n o f S o c i a l Work to the f i e l d of mental r e t a r d a t i o n . Method o f the present study Chapter  2.  1  The Development of the I n s t i t u t i o n a l Programme f o r the M e n t a l l y Retarded i n B r i t i s h ColnmbiaT !  P u b l i c concern f o r the m e n t a l l y r e t a r d e d . Admission Procedure. The Woodlands School Today. Formal Academic Programme o f The Woodlands S c h o o l . Psychology Department. N u r s i n g Department. Occup a t i o n a l Therapy Department. L i n e n and C l o t h i n g Department. Other F a c i l i t i e s Chapter  3.  The Movement of S o c i a l S e r v i c e i n t o The Woodlands S c h o o l .  Beginnings and development o f the S o c i a l S e r v i c e Department. Present o r g a n i z a t i o n o f S o c i a l S e r v i c e Department. F u n c t i o n s o f the S o c i a l S e r v i c e Department. Intake and Reception. C o n t i n u i n g Serv i c e . R e h a b i l i t a t i o n and Community I n t e r p r e t a t i o n Chapter 4.  43  Conclusions.  I n t r o d u c t i o n . S k i l l s o f the s o c i a l worker. The Treatment Team Approach. C o n t r i b u t i o n s o f the S o c i a l S e r v i c e Department. The need f o r r e s e a r c h . Physical f a c i l i t i e s . Staff training. Administrative procedure. PUblic i n t e r p r e t a t i o n . Other c o n s i d e r a tions. Appendix: A.  22  Bibliography.  * **  5  8  V  DEVELOPMENT OF THE SOCIAL  SERVICE  DEPARTMENT AT THE WOODLANDS SCHOOL A Review and Assessment o f Developments i n The Woodlands S c h o o l , New Westminster, B.C.  (1931 - 1953)  CHAPTER I  MENTAL RETARDATION IH GENERAL  The f i e l d of t r a i n i n g , education and r e h a b i l i t a t i o n of the mentally retarded has been r e c e i v i n g an increasing amount of attention i n recent years.  With the r a p i d expan-  sion of mental health services has come an ever-Increasing concern f o r the mentally retarded c h i l d .  Professional s k i l l s  i n the areas of medicine, psychiatry, psychology,  education,  s o c i a l work and sociology have contributed much to the r i s e of t h i s present day concern about programmes f o r the ment a l l y retarded. In order to study e f f e c t i v e l y present day programmes f o r the mentally retarded, i t w i l l be necessary to c l e a r up some of the prevalent confused thinking on t h i s subject. What i s mental retardation? ness?  Is i t comparable to mental i l l -  Are there any hopes f o r the mentally retarded person?  I f there are - what are they? Unfortunately, there i s no clear-cut u n i v e r s a l l y acceptable d e f i n i t i o n of "Mental Retardation. * 1  However, the  d e f i n i t i o n s which have been formulated on the subject give one many clues so that an i n t e l l i g e n t understanding of the d i f f i c u l t i e s encountered i n defining such a complex subject may be obtained.  England's Mental D e f i c i e n c y A c t o f 1927 s t a t e s that "mental d e f e c t i v e n e s s means a c o n d i t i o n o f a r r e s t e d o r in« complete development  o f mind e x i s t i n g b e f o r e the age o f e i g h -  teen y e a r s , whether a r i s i n g from i n h e r e n t causes o r induced by d i s e a s e o r i n j u r y . "  1  Or. George A. J e r v i s , w r i t i n g on the m e d i c a l a s p e c t s o f mental d e f i c i e n c y , s t a t e s that "Mental d e f i c i e n c y may be d e f i n e d , from a m e d i c a l p o i n t o f view, a s a c o n d i t i o n o f a r r e s t e d o r incomplete mental development  i n d u c e d by d i s e a s e 2  or i n j u r y before a d o l e s c e n c e , o r a r i s i n g from g e n e t i c c a u s e s . " I t i s n e c e s s a r y t o note a t t h i s p o i n t t h a t  "mental  r e t a r d a t i o n " and "mental d e f i c i e n c y " a r e n o t , and s h o u l d n o t be, synonymous terms.  The former suggests slowness o f d e v e l -  opment, whereas the l a t t e r suggests a c o n d i t i o n produced by a c o n s t i t u t i o n a l o r organic  deficit.  "The s o c i a l i m p l i c a t i o n s o f •mental r e t a r d a t i o n ' are p r i m a r i l y e d u c a t i o n a l and may extend t o the v o c a t i o n a l adjustment i n a d u l t h o o d .  The term 'mental d e f i c i e n c y , ' on  the o t h e r hand, s h o u l d be r e s t r i c t e d f o r a c o n d i t i o n o f ment a l a r r e s t r e s u l t i n g i n s o c i a l inadequacy which i s n o t amena b l e t o fundamental improvement through e d u c a t i o n and exper-  3  i e n c e and any known treatment." ; : , ; e T r e d g o l d , A.P., Mental D e f i c i e n c y . B a i l l u r e , London, Engl a n d , 1952, p. 3. D i M i c h a e l , G. S a l v a t o r e , V o c a t i o n a l R e h a b i l i t a t i o n o f the M e n t a l l y Retarded. Washington, D . C , U.S. Government, p. 1. 2  Myers, C. Rogers, Toward Mental H e a l t h i n S c h o o l . U. o f Toronto P r e s s , 1947, p. 38. 3  - 3~ Both the concept and d i a g n o s i s o f mental  deficiency  were w e l l developed b e f o r e the advent o f i n t e l l i g e n c e and other psychological t e s t s .  However, the concept and d i a g n o s i s  of mental r e t a r d a t i o n were n o t developed u n t i l a f t e r the v a l i dation of i n t e l l i g e n c e t e s t s .  Therefore, i n order to describe  mental r e t a r d a t i o n adequately, i t i s n e c e s s a r y t o have the s c o r e s of mental and e d u c a t i o n a l t e s t s which the m e n t a l l y r e t a r d e d person has completed.  T e t d i f f i c u l t y i s encoun-  t e r e d i n t h i s a r e a because t e s t s c o r e s do not show the underl y i n g modes o f i n t e l l e c t u a l  functioning.  There can be no u n i v e r s a l l y v a l i d s i n g l e concept o f mental r e t a r d a t i o n , a c c o r d i n g t o Dr. T h o r l e i f G. Hegge, because such a concept must c o n t a i n a l l the s u i t a b l e  1  educa-  t i o n a l , p s y c h o l o g i c a l , v o c a t i o n a l and s o c i a l c r i t e r i a necess a r y i n such a concept.  Dr. Hegge goes on t o s t a t e t h a t the  a c t u a l f o r m u l a t i o n o f the concept w i l l v a r y somewhat with the circumstances and with t h e purposes which i t must s e r v e . Consequently, d e f i n i t i o n o f mental r e t a r d a t i o n would v a r y f o r the purposes o f e d u c a t i o n , medicine, s o c i a l work, psychology and v o c a t i o n a l r e h a b i l i t a t i o n . I s mental r e t a r d a t i o n comparable  t o mental  The answer t o t h i s q u e s t i o n i s , d e f i n i t e l y n o t . ill  illness?  The m e n t a l l y  a r e not n e c e s s a r i l y m e n t a l l y r e t a r d e d , and t h e m e n t a l l y  r e t a r d e d a r e not n e c e s s a r i l y m e n t a l l y i l l .  I n many cases the  Hegge, T h o r l e i f , P s y c h o l o g i c a l A s p e c t s of Mental R e t a r d a t i o n , V o c a t i o n a l R e h a b i l i t a t i o n o f the M e n t a l l y Retarded. U. S. Government, 1950, p. i s . 1  - 4 = m e n t a l l y r e t a r d e d a r e p e r f e c t l y h e a l t h y , both p h y s i c a l l y and mentally.  They a r e s i m p l y below the average i n mental s t a t u r e ,  and they make up o n l y a s m a l l percentage o f the p a t i e n t s i n our mental h o s p i t a l s . I t must be remembered, however, that a l l m e n t a l l y r e t a r d e d persons do not show the same degree o f mental retardation.  Feebleminded persons do not c o n s t i t u t e a d i s -  t i n c t group, and t h e y do not r e p r e s e n t a d i f f e r e n t k i n d o r type o f human b e i n g .  M e n t a l l y r e t a r d e d persons range a l l  the  way from the almost completely h e l p l e s s . i d i o t t o the h i g h grade moron who may have p e r f e c t l y normal appearance and,  who  may be a b l e t o c a r r y on as a normal I n d i v i d u a l and be a useful  citizen. The d i s t i n c t i o n between the m e n t a l l y r e t a r d e d and  the m e n t a l l y d e f i c i e n t i s an important one, f o r the m e n t a l l y r e t a r d e d person i s amenable t o the e d u c a t i o n a l and t r a i n i n g programme whereas the m e n t a l l y d e f i c i e n t person has not the mental c a p a c i t y t o p r o f i t from such programmes.  F o r the  purpose o f t h i s s t u d y t h e terms " m e n t a l l y r e t a r d e d " w i l l r e f e r to those persons who may  b e n e f i t from an adequate  e d u c a t i o n a l and t r a i n i n g programme.  The term "mentally h a n d i -  capped" w i l l be used a s a g e n e r a l term c o v e r i n g both the "ment a l l y r e t a r d e d " and the "mentally d e f i c i e n t " but not i n c l u d i n g the "mentally i l l . " the m e n t a l l y handicapped may be d i v i d e d r o u g h l y i n t o three groups.  F i r s t t h e r e a r e the m e n t a l l y handicapped  persons o f v e r y low-grade i n t e l l i g e n c e who a r e almost e n t i r e l y  dependent upon others f o r physical care and well being. Secondly there are those who require only s o c i a l protection rather than physical care from parents and the community. L a s t l y , there are those who under ordinary circumstances and appropriate education, can lead f a i r l y independent l i v e s i n the community. A large number of the f i r s t group may have to be given permanent custodial care, whereas many i n the other two groups may p r o f i t by a combination of i n s t i t u t i o n a l t r a i n i n g and supervision of t h e i r l i v e s i n the community.  Others, pos»  s i b l y a very large proportion, may l i v e happy and u s e f u l l y normal l i v e s within t h e i r own family spheres or i n the community. Are there any hopes f o r the mentally retarded person?  One would only have to look around to see the number  of i n s t i t u t i o n s which are based on hope f o r helping the men* t a l l y retarded.  The modern approach to the problem of mental  retardation consists of special education and community supervision.  I t i s now known that there i s d e f i n i t e hope and i t  must never be thought that the s p e c i f i c t r a i n i n g of the ment a l l y retarded i s a hopeless o r worthless procedure.  "The  feebleminded, no matter how defective, are never ineducable."' ' 1  The success of present day programs f o r the mentally retarded proves conclusively that they can and are being made both happy and more useful to society through special t r a i n i n g . 1  Kvers. C. Rogers, op. c i t . . p. 39.  The i m p l i c a t i o n s of mental r e t a r d a t i o n pose a p r o blem to the community.  E s t i m a t e s a t the p r e s e n t time p l a c e  one per cent o f the p o p u l a t i o n i n the m e n t a l l y r e t a r d e d range.  Another t h i r t e e n per cent o f the p o p u l a t i o n a r e  1  estimated t o have an " i n t e l l e c t u a l equipment that i s so marg i n a l t h a t unusual s o c i a l p r e s s u r e o r temperamental i n s t a b i l i t y i s l i k e l y t o p r e c i p i t a t e the i n d i v i d u a l i n t o  insuffi-  2 eiency.*  With so l a r g e a group f a l l i n g i n t o the m e n t a l l y  r e t a r d e d range, and i n view o f the former o u t l a y s o f p u b l i c expenditures f o r i n s t i t u t i o n a l i z a t i o n with l i t t l e o r no worthw h i l e r e t u r n , i t i s l i t t l e wonder t h a t p u b l i c concern been aroused i n the a r e a of e d u c a t i o n , t r a i n i n g and t a t i o n of the m e n t a l l y r e t a r d e d .  Consequently,  has  rehabili-  with the dev-  elopment of g r e a t e r s k i l l s i n d i a g n o s i n g cases o f mental r e t a r d a t i o n has come a sharp r i s e i n the admission r a t e s t o v a r i o u s s c h o o l s f o r the m e n t a l l y  handicapped.  The t r a i n i n g and e d u c a t i o n a l f u n c t i o n s o f the s c h o o l s f o r the m e n t a l l y handicapped themselves.  a r e almost a s t o r y i n  A c t i v i t i e s c a r r i e d on by these s c h o o l s range  from the s i m p l e s t of o c c u p a t i o n a l therapy t o the u n d e r t a k i n g of  preliminary training f o r industry.  I t i s now  recognized  that no p h i l o s o p h y i s v a l i d f o r the education o f the m e n t a l l y Gibson, Robert, Mental D e f i c i e n c y as a B a s i c D i s c i p l i n e i n the T r a i n i n g of a P s y c h i a t r i s t , Mental H e a l t h . N a t i o n a l A s s o c i a t i o n o f Mental H e a l t h , Summer, 1952, p. 272. 1  2 Mental Hygiene, S o c i a l Work Tear Book. 1945,  p.  272.  - 7 =  r e t a r d e d which i s not b e n e f i c i a l to t h e r e t a r d e d themselves. Such a philosophy  would n a t u r a l l y have t o be based on a r e a l -  i s t i c assessment o f the s t r e n g t h s and weaknesses o f the r e t a r d e d as w e l l as on t h e p l a c e they may e v e n t u a l l y occupy in  society.  " I t i s now b e l i e v e d that the r e t a r d e d have a  p o t e n t i a l c o n t r i b u t i o n t o make t o the world i n which they l i v e , and t h a t i t i s a primary f u n c t i o n o f s p e c i a l to  education  h e l p the r e t a r d e d to r e a l i z e such p o t e n t i a l i t i e s . *  1  As  e a r l y a s 1931 the White House Conference s t a t e d : S e r i o u s c o n s i d e r a t i o n must be g i v e n t o the c u r r i c u l u m best s u i t e d t o the needs o f subnormal ( r e t a r d e d ) c h i l d r e n . Tbe aim i s t o develop the c h i l d ' s mental c a p a c i t i e s and the c o n t r o l o f b i s emotions t o t h e p o i n t o f adequate s o c i a l adjustment and t h e c u r r i c u l u m must n e c e s s a r i l y be determined i n p a r t by a d u l t r e q u i s i t e s . Tbe f i r s t p o i n t to c o n s i d e r i s what work these sub-normals ( r e t a r d e d ) w i l l e v e n t u a l l y be a b l e t o d o . 2  Dr. E l s i e Martens, C h i e f , E x c e p t i o n a l C h i l d r e n and Youth, a department i n tbe U n i t e d S t a t e s O f f i c e o f E d u c a t i o n , has  stated: E d u c a t i o n f o r the m e n t a l l y r e t a r d e d i s n o t d i f f e r e n t i a i t s aim from e d u c a t i o n f o r any group o f c h i l d r e n . T h i s aim i s t o teach t h e i n d i v i d u a l how t o l i v e b e t t e r ; t o teach him t o use a l l o f h i s c a p a c i t i e s ; t o teach him t o become a u s e f u l and a contented member o f the s o c i a l group. Whether be i s i n a day s c h o o l o r i n a r e s i d e n t i a l s c h o o l , the g e n e r a l purpose i s t h e same. The s o c i a l group o f which he i s a member may be t h e community a t l a r g e o r i t may i n v o l v e t b e more c i r c u m s c r i b e d l i f e o f the i n s t i t u t i o n . T e t the aim i s always t o make him a b e t t e r and more e f f i c i e n t member o f t h e group i n which he l i v e s . T h i s i s t h e p h i l o s o p h y u n d e r l y i n g every c u r r i c u l u m a d justment . 3  Hungerford, R.H., C. De Prospo, L . Rosenzwig, E d u c a t i o n of the M e n t a l l y Handicapped i n Childhood and Adolescence, V o c a t i o n a l R e h a b i l i t a t i o n o f the M e n t a l l y Retarded. U. S. Government, 1950, p. 54. Loc. c i t . 3  Loc. c i t .  - 8 -  Dr. C h a r l e s S c o t t B a r r y , w r i t i n g i n a b u l l e t i n o f the Michigan S t a t e Department of E d u c a t i o n , s t a t e s : There has been much time, money, and e f f o r t wasted i n the e d u c a t i o n of subnormal ( r e t a r d e d ) c h i l d r e n through f a i l u r e t o r e c o g n i z e c l e a r l y the p r o p e r aim o f e d u c a t i o n i n the case o f t h i s type of c h i l d . S i n c e about 20 per cent of the a d u l t p o p u l a t i o n a r e engaged i n u n s k i l l e d l a b o r the f o l l y o f attempting t o prepare c h i l d r e n o f the most I n f e r i o r i n t e l l i g e n c e f o r s k i l l e d l a b o r o r f o r e l e c t r i c a l work i s s e l f - e v i d e n t . The aim of the t e a c h e r , a f t e r a thorough t r i a l i n the s p e c i a l c l a s s had demons t r a t e d the i m p o s s i b i l i t y o f the p u p i l s ever s u c c e s s f u l l y d o i n g r e g u l a r grade work, should be t o prepare him t o become a l a w - a b i d i n g , s e l f - s u p p o r t i n g c i t i z e n , i n the s i m p l e s t occupations.1 Thus, many educators have come to the c o n c l u s i o n that i f the r e t a r d e d a r e to r e a l i z e f u l l y t h e i r p o t e n t i a l i t i e s they must be g i v e n a d i f f e r e n t developmental programme r a t h e r than a r e m e d i a l o r i m p r a c t i c a l a d a p t a t i o n of a normal  programme.  In o r d e r to meet s u c c e s s f u l l y the needs o f the r e t a r d e d such a programme s h o u l d g i v e to each c h i l d competency i n the f o l l o w ing: (1) The technique of measuring and knowing o n e s e l f . (2)  A b a s i c understanding o f the j o b f a m i l i e s and  social  requirements which one i s s u i t e d t o meet. (3)  The technique of meshing a b i l i t i e s with v o c a t i o n a l and s o c i a l requirements.  (4)  The  " d r i v e " or desire f o r s o c i a l  contribution.  T h e r e f o r e , the e n t i r e program f o r the e d u c a t i o n of the m e n t a l l y r e t a r d e d must be c o n s t r u c t e d around  achievement  i n the a r e a s o f v o c a t i o n a l and s o c i a l competency, f o r i n these Hungerford, R.H.,  Loc. c i t .  a r e a s , i f i n no o t h e r s , the r e t a r d e d w i l l most n e a r l y reach normalcy.  I n Hew  gram i s c a l l e d  York C i t y t h i s d i f f e r e n t developmental  •Occupational E d u c a t i o n . *  1  pro-  T h i s program i n -  c l u d e s the f o l l o w i n g f i v e major a r e a s : (1) O c c u p a t i o n a l i n f o r m a t i o n - g i v i n g the p u p i l I n f o r m a t i o n c o n c e r n i n g the work a v a i l a b l e to him: how  t h i s work  i s done ( j o b a n a l y s i s ) ; and what i t s importance to  is  the world.  (2) V o c a t i o n a l guidance-guiding tbe p u p i l t o measure h i s own  a b i l i t i e s a g a i n s t the requirements  of the j o b i n  which he i s i n t e r e s t e d ; showing o t h e r jobs i n the same work a r e a . (3) V o c a t i o n a l t r a i n i n g - g i v i n g the p u p i l t r a i n i n g i n the manual s k i l l s found i n tbe work a r e a (25 per c e n t ) ; t r a i n i n g i n the nonmanual s k i l l s n e c e s s a r y i n the work a r e a (25 per c e n t ) ; t r a i n i n g i n g e n e r a l h a b i t s , a t t i t u d e s , and s k i l l s common t o a l l good i n d i v i d u a l i t y , workmanship, and c i t i z e n s h i p (50 per c e n t ) . (4) V o c a t i o n a l p l a c e m e n t - p r o v i d i n g the i n d i v i d u a l with a c t u a l j o b placement i n c o o p e r a t i o n w i t h o t h e r agencies. (5) S o c i a l p l a c e m e n t - a d j u s t i n g the a d u l t on the job and i n tbe freedom o f h i s f i r s t independence f o r as l o n g a p e r i o d as may  be n e c e s s a r y , a g a i n i n c o o p e r a t i o n  with o t h e r a g e n c i e s . Hungerford, R.H., C. De Prospo, L. Rosenzwig, E d u c a t i o n the M e n t a l l y Handicapped i n Childhood and Adolescence, p.55. 1  of  - 10 Occupational Education i s an i n c l u s i v e programme Which prepares the retarded c h i l d f o r many possible l i f e situations.  This programme seeks to give the retarded c h i l d  s u f f i c i e n t freedom to enable him to develop h i s c a p a b i l i t i e s f o r self-support and yet s u f f i c i e n t protection from rigorous competition to keep him from being too hopelessly discouraged to u t i l i z e these c a p a b i l i t i e s . pational-social  I t provides a number of occu-  s k i l l s leading toward a s o c i a l maturity that  includes occupational adjustment as a part of t o t a l adjustment.  As such i t provides a good example of present day  trends i n tbe education and t r a i n i n g of the retarded. I t must be kept i n mind, however, that there i s no known method of changing the degree of a person's native i n t e l l i g e n c e . Such i n t e l l i g e n c e i s f i x e d at b i r t h and remains constant throughout  life.  Therefore mentally retarded persons cannot  be made more i n t e l l i g e n t by present educational methods.  They  can, however, through t r a i n i n g and education, develop greater p o t e n t i a l i t i e s and a more e f f i c i e n t approach to t h e i r l i f e situation. Standards of Practice The American Association on Mental Deficiency bel i e v e s that the underlying objective of every i n s t i t u t i o n f o r the mentally retarded i s : To provide sheltering protection f o r the retarded i n d i v i d u a l , to provide opportunity f o r him to grow phys i c a l l y , mentally, emotionally, and s o c i a l l y to b i s f u l l l i m i t s of growth, to restore and r e h a b i l i t a t e him both within h i s l i m i t a t i o n s and the l i m i t a t i o n s of the  - 11  -  knowledge and c u l t u r e of h i s times, and t o t r a i n and educate him i n s o f a r as h i s c a p a c i t i e s permit, with the goal i n mind o f p e r m i t t i n g him t o l i v e h i s l i f e , whether i n the i n s t i t u t i o n o r r e t u r n e d to the communi t y , with as much d i g n i t y , happiness and u s e f u l n e s s as may he i n h e r e n t t o him.l The  f o l l o w i n g p r i n c i p l e s were e v o l v e d  by t h i s Asso-  ciation: (1) A modern p h y s i c a l p l a n t , f r e e from hazards and p r o p e r l y equipped f o r the comfort and s c i e n t i f i c care o f the p a t ient . . (2) A competent, w e l l t r a i n e d e x e c u t i v e o f f i c e r o r adminis t r a t o r with a u t h o r i t y and r e s p o n s i b i l i t y to c a r r y out the p o l i c i e s o f the i n s t i t u t i o n as a u t h o r i z e d by the governing l e g i s l a t i o n c o n c e r n i n g mental d e f i c i e n c y i n the s t a t e i n which the i n s t i t u t i o n o p e r a t e s and without hazard of p o l i t i c a l i n terference or r e t r i b u t i o n . (3) An adequate number of e f f i c i e n t p e r s o n n e l , competent i n t h e i r r e s p e c t i v e d u t i e s and conforming t o p r o p e r p h y s i c a l , mental, e d u c a t i o n a l and c h a r a c t e r standards f o r the d u t i e s they perform, and under competent s u p e r v i s i o n , (4) An adequate medical s t a f f o f e t h i c a l , Competent phys i c i a n s f o r the e f f i c i e n t care o f the p a t i e n t s and f o r c a r r y i n g out the p r o f e s s i o n a l p o l i c i e s o f the i n s t i t u t i o n i n keepi n g with the accepted minimum t h e r a p e u t i c standards as e s t a b l i s h e d by the American M e d i c a l A s s o c i a t i o n and competent, w e l l t r a i n e d s t a f f i n the f i e l d s of psychology, e d u c a t i o n , d i e t e t i c s , and s o c i a l s e r v i c e t o a s s u r e adequate d i a g n o s i s , study, t r a i n i n g , s u p e r v i s i o n and r e h a b i l i t a t i o n of the p a t i e n t by contemporary standards i n these v a r i o u s d i s c i p l i n e s . (5) A s y s t e m a t i c program o f p r e p a r i n g p a t i e n t s f o r r e t u r n t o the community when a d v i s a b l e , o r s u p e r v i s i n g them i n the community, and of c o l l a b o r a t i o n with community s e r v i c e s i n connection therewith. (6) A c c u r a t e d i a g n o s i s and t h e r a p e u t i c f a c i l i t i e s with e f f i c i e n t t e c h n i c a l s e r v i c e under competent m e d i c a l s u p e r v i s i o n . (7) A c c u r a t e and complete r e c o r d s promptly f i l e d i n an a c c e s s i b l e manner so a s to be a v a i l a b l e f o r study, r e f e r e n c e , follow-up and r e s e a r c h . American A s s o c i a t i o n on Mental D e f i c i e n c y Standards Brochure, American A s s o c i a t i o n on Mental D e f i c i e n c y , 1952, p. 1.  - 12 (8) An o r g a n i z e d formal i n - s e r v i c e t r a i n i n g program f o r i n s t i t u t i o n a l p e r s o n n e l adequate t o i n s u r e tbe maintenance o f a high standard o f p a t i e n t c a r e , t r a i n i n g , s u p e r v i s i o n and opportunity. (9) Group c o n f e r e n c e s of the a d m i n i s t r a t i v e and p r o f e s s i o n a l s t a f f s t o review r e g u l a r l y and t h o r o u g h l y t h e i r r e s p e c t i v e a c t i v i t i e s i n o r d e r to keep the s e r v i c e and the s c i e n t i f i c work i n the h i g h e s t plane of e f f i c i e n c y . (10) A humanitarian s p i r i t i n which the b e s t c a r e o f the p a t i e n t i s always the primary c o n s i d e r a t i o n . (11) The a v a i l a b i l i t y of p r o f e s s i o n a l s k i l l s i n the I n s t i t u t i o n f o r o u t - p a t i e n t s e r v i c e and o t h e r problems. I t i s important t h a t each s e r v i c e o f the i n s t i t u t i o n , w i t h i n the l i m i t s o f i t s need and the demand o f tbe l o c a l c o n d i t i o n s , have c e r t a i n f e a t u r e s i n common as f o l l o w s : (1) A d m i n i s t r a t i o n and S u p e r v i s i o n Competent t r a i n e d head with s u f f i c i e n t e x e c u t i v e a b i l i t y and an adequate number of a s s i s t a n t s and o t h e r p e r s o n n e l t o c a r r y on the work of the s e r v i c e e f f i c i e n t l y . (2) C o o r d i n a t i o n The c o o r d i n a t i o n o f e f f o r t among members o f each s e r v i c e with the o t h e r p e r s o n n e l o f the i n s t i t u t i o n t o promote d e s i r a b l e teamwork and a h i g h l y e f f i c i e n t s e r v i c e o f the i n s t i t u t i o n as a whole. (3)  Location Each department o r s e r v i c e s h o u l d have adequate space and l o c a t e d i n t h a t a r e a of the i n s t i t u t i o n which w i l l most c o n v e n i e n t l y permit e f f i c i e n t s e r v i c e . (4)  Equipment The equipment s h o u l d be s u f f i c i e n t and adequate t o p e r mit s a t i s f a c t o r y performance o f the u s u a l scope o f work w i t h out undue h a r d s h i p . (5)  P r o t e c t i o n and S a f e t y , Proper p r o t e c t i o n of the worker and p a t i e n t a g a i n s t the u s u a l hazard of the o p e r a t i o n . (6) Records A complete system o f a c c u r a t e r e c o r d s on c a r e f u l l y developed forms to permit day by day e f f i c i e n t o p e r a t i o n and t o p r o v i d e means of t a b u l a t i o n and e v a l u a t i o n a t a l a t e r date. (7) T r a i n i n g Opportunity f o r r e p e a t e d attendance a t conferences and i n c o n s u l t a t i o n t o i n s u r e continued p r o f e s s i o n a l growth o f tbe p e r s o n n e l and t e c h n i c a l advancement.  13 -  Therefore, the quality of the t r a i n i n g f a c i l i t i e s w i l l l a r g e l y determine to what degree the p o t e n t i a l i t i e s of the mentally retarded are e f f e c t i v e l y developed.  Present  day schools f o r the mentally retarded are now making more prov i s i o n f o r such t r a i n i n g of the mentally retarded, and society i s beginning to see such t r a i n i n g as an inalienable r i g h t of each retarded c h i l d . The Adaptation of S o c i a l Work to the F i e l d of Mental Retardation when the f i r s t school f o r the mentally handicapped was established over 100 years ago, the best s k i l l s from both the educational and medical professions were brought into play to help provide custody f o r these deprived c h i l d r e n .  With the  gradual change i n focus of these schools f o r the mentally handicapped from custody to t r a i n i n g and r e h a b i l i t a t i o n , came an Invitation from educators and physicians to the s o c i a l work profession to j o i n i n the administration of these i n s t i t u t i o n s . The profession of s o c i a l work found f e r t i l e  soil  for growth i n the mentally retarded f i e l d , f o r s o c i a l work's two major objectives of well being (or a healthy and  decent  standard of l i v i n g ) , and s a t i s f y i n g s o c i a l r e l a t i o n s h i p s f o r a l l human beings, applied meaningfully to the s i t u a t i o n i n which the mentally retarded person found himself.  The s o c i a l  worker's e f f e c t i v e use of s o c i a l casework enabled him to understand the many s o c i a l implications of mental retardation and how such implications affected the c h i l d and h i s family. Such  - 14 understanding by the worker could be c a r e f u l l y interpreted to the other d i s c i p l i n e s so that the many forces acting on the retarded were able to be c l e a r l y seen. Before the contributions of the s o c i a l worker i n the f i e l d of mental retardation are discussed, i t w i l l be necessary to outline b r i e f l y what s o c i a l casework i s . The following d e f i n i t i o n of s o c i a l work and s o c i a l casework was evolved i n 1953 by second year s o c i a l work students completing f i e l d work at the Provincial Mental Hospit a l , Essondale, B.C. This d e f i n i t i o n was evolved a f t e r the group f e l t a general d i s s a t i s f a c t i o n with current and past d e f i n i t i o n s of s o c i a l casework. Soeial work i s an enabling process of helping the i n d i v i d u a l , the group, and the community to cope with the stresses which prevent t h e i r best possible adjustment to society. Its philosophy i s rooted i n democratic p r i n c i p l e s and i n the s o c i a l worker's beliefsand conv i c t i o n i n man's d i g n i t y , worth, and self-determining r i g h t s , i n i t s s p e c i f i c professional sense, s o c i a l casework embodies an integrated, dynamic understanding of the i n t e r - r e l a t i n g factors ( s o c i a l , economic, developmental and psychological, c u l t u r a l and r e l i g i o u s ) . Simultaneously, the easework method employs a d i s c i plined, integrated use of the client-worker r e l a t i o n ship, the agency services, and community resources. Thus, the c l i e n t i s enabled to mobilize h i s i n t e r n a l strengths and external resources so that he can reach his optimum adjustment. Casework has been defined by many s o c i a l workers i n i t s r e l a t i v e l y short h i s t o r y .  However, there i s a d e f i n i t e  lack of d e f i n i t e concepts and precise terminology i n s o c i a l casework and t h i s may again be attributed to s o c i a l casework's r e l a t i v e l y short h i s t o r y . In spite of the lack of concise terminology, there  15 are p r i n c i p l e s upon which s o c i a l casework i s founded and which may he adequately applied to any s e t t i n g f o r the mentally retarded.  The caseworker believes that a l l behaviour i s pur-  poseful and that i t i s Important to understand the manner i n which an i n d i v i d u a l attempts to adjust to h i s s i t u a t i o n .  What  may appear to be a bizarre, extreme, unsocial adjustment of behaviour i n l i g h t of e x i s t i n g standards and s o e i a l norms, may r e a l l y be a struggle f o r equilibrium on the individual's part.  His manner of adjustment, even i f a l i e n to others, may  be the only adjustment he i s able to make, with the capacities he has at h i s disposal. In the f i e l d of mental retardation, the s o c i a l worker must ask himself what i s the retarded person's response to h i s l i f e s i t u a t i o n , and what i s the meaning of h i s l i m i t a t i o n s to him, and what he has done or what does he want to do about his  situation.  Secondly, the worker must c a r e f u l l y assess the  extent of the mentally retarded person's a b i l i t y to enter successfully into a casework r e l a t i o n s h i p .  Therefore, know-  ledge of the retarded person's past behaviour and r e l a t i o n ships would be a necessity before the worker could understand f u l l y the retarded person's reactions to h i s present s i t u a t i o n . In order to help the mentally retarded c l i e n t adequately, the s o c i a l caseworker must use three basic s o c i a l casework tenets: (1) That there i s a cause-and-effect r e l a t i o n s h i p i n human behaviour; (2) That behaviour i s emotionally determined; (3) That behaviour may be consciously or unconsciously determined.  - 16 Mary Richmond points ont i n her book, What i s S o c i a l Casework, that: Human beings are not dependent and domestic animals. This fact of man's difference from other animals establishes the need of h i s p a r t i c i p a t i o n i n making and carrying out plans f o r h i s welfare. Individuals have w i l l s and purposes of t h e i r own and are not f i t t e d to play a passive part i n the world; they deteriorate when they do.l This quotation would seem to apply most a p t l y to tbe f i e l d of mental retardation. Such a short discussion of s o c i a l work and more s p e c i f i c a l l y s o c i a l casework leaves untouched much of the tremendous s k i l l contained  under the o r b i t of s o c i a l work.  S o c i a l work i s a professional body of knowledge which i s constantly undergoing growth and change.  Its horizon of know-  ledge and s k i l l s i s being continually broadened by the newest developments i n the sciences with which i t i s intimately associated, namely, psychiatry, psychology, education, sociology, and c u l t u r a l anthropology.  As s o c i a l work has as i t s  basic purpose the helping of people i n need, i t must constantly adjust i t s s k i l l s to meet tbe ever-changing s o c i a l and economic problems of the world.  This a b i l i t y to adjust has  greatly  helped s o c i a l work's widespread acceptance i n many d i v e r s i f i e d settings. The Contribution of S o c i a l Work to the F i e l d of Mental Retardation The contribution which the s o c i a l worker i s able to Richmond, Mary E., What Is S o c i a l Case Work. Russell Sage Foundation, Hew York, 1922, p. 258.  - 17 make i n any programme f o r the mentally retarded i s immense. The Soeial Service Department performs a valuable function as a l i n k between the i n s t i t u t i o n and the pati e n t , the family and the community. I t interprets the i n s t i t u t i o n and i t s program to the family and seeks to maintain continuity of r e s p o n s i b i l i t y of family and community f o r the patient. I t a s s i s t s the family with problems a r i s i n g from admission and discharge of the patient to and from the i n s t i t u t i o n . It can i n c e r t a i n s i t u a t i o n s a s s i s t the patient i n h i s inter-personal r e l a t i o n s h i p s with the i n s t i t u t i o n a l s t a f f and h i s fellow patient. The f i e l d of opportunity f o r the s o c i a l service department may include the spheres of the p s y c h i a t r i c s o c i a l worker, medical s o c i a l worker and the group s o c i a l worker. With h i s understanding of the dynamics of human behaviour, knowledge of family, c u l t u r a l group and community i n t e r r e l a t i o n s h i p s the worker i s able to pool h i s s k i l l s with those of the other helping professions, i n order that a more adequate understanding of the mentally retarded person i n the r e s i d e n t i a l school-setting may be reached.  Helping the parents  or r e l a t i v e s to consider possible placement of the mentally retarded c h i l d i s another s k i l l which the s o c i a l worker brings to any programme f o r the mentally retarded.  This requires  patient and s k i l l f u l meeting of parents* f e e l i n g s about having a defective c h i l d and through the medium of a c a r e f u l l y planned orientation to the sehool-setting, the parents or r e l a t i v e s are able to prepare properly the c h i l d f o r the essent i a l separation from the family sphere.  Feelings of g u i l t and  r e j e c t i o n which the parents or r e l a t i v e s may have can thus be worked through with the supporting, helping r e l a t i o n s h i p which American Association on Mental Deficiency Standards Brochure, op. c i t . . p. 12.  -  18  the worker i s able to o f f e r .  -  Once these feelings are worked  through the parents or r e l a t i v e s are able to p a r t i c i p a t e more f o l l y daring the residents' educational period and l a t e r during the important stage of h i s r e h a b i l i t a t i o n . Work with the c h i l d during t h i s educational period i s another important contribution which the s o c i a l worker i s able to make.  The c h i l d must learn to adapt himself to an  e n t i r e l y new experience.  He must adjust to the group s i t u a -  t i o n and t h i s requires the a c q u i s i t i o n of new regarding himself and others.  responsibilities  Tbe s o c i a l worker must stand  behind him as he makes each new step i n the i n s t i t u t i o n a l program, be i t backward or forward.  Frequent interviews bet-  ween the worker and the c h i l d are therefore necessary i f such a relationship i s to grow. Interpretation to the parents of tbe resident's progress i n the School i s another contribution which the s o c i a l worker i s able to make.  Thus the parents' i n t e r e s t i n the  child's education and t r a i n i n g i s kept keen and a l i v e . Through tbe medium of a close r e l a t i o n s h i p with the s o c i a l worker the parents are able to accept many decisions of the School which may be to the best interests of the resident but which may misunderstood by the parents.  be  Thus many d i f f i c u l t i e s which  might arise through such misinterpretations are avoided. Working cooperatively with tbe other d i s c i p l i n e s i n order that more e f f e c t i v e help may be given to the resident i s another function which the s o c i a l worker i s q u a l i f i e d to carry out.  The s o c i a l worker, through h i s study of the r e s i -  - 19 dent as an i n d i v i d u a l , and of the resident's home, community and parents, i s able to share t h i s valuable information with the other d i s c i p l i n e s . to the understanding  This sharing of knowledge adds greatly  which each d i s c i p l i n e should have of the  resident. Rehabilitation i s an area to which the s o c i a l worker brings his greatest s k i l l s .  The s o c i a l worker should be res-  ponsible f o r intensive casework services i n t h i s f i e l d .  He  must assess the community s i t u a t i o n , the readiness of the parents, and the readiness of the resident to move i n t o the r e h a b i l i t a t i o n process.  This involves proper preparation of  the resident, the parents, and various community resources for the resident's return t o the community.  Often employment  opportunities must be uncovered by the s o c i a l worker who acts i n close cooperation with the national Employment Service. The resident i s i n need of much support both before and during the r e h a b i l i t a t i o n process.  Through the close  understanding  relationship which i s established between the worker and the resident t h i s support i s able to be e f f e c t i v e l y used i n helping the resident i n h i s adjustment. The s o c i a l worker must also use h i s s k i l l i n i n t e r preting to the community what the School i s doing and planning. What the School i s able to accomplish  i n i t s educational pro-  gram w i l l l a r g e l y depend on the support i t receives from the community.  I f there i s a well-integrated program f o r the men-  t a l l y retarded i n the community, the benefits received by the resident during the t r a i n i n g period w i l l have l a s t i n g e f f e c t s  - 20 and w i l l continue  to grow.  -  A g r e a t e r i n t e r e s t i n and  under-  s t a n d i n g o f the problems c r e a t e d by mental r e t a r d a t i o n i s needed by the community.  P r o f e s s i o n a l and l a y groups  should  have t h e i r i n t e r e s t s awakened so that they too w i l l see need f o r an adequate community programme f o r the  the  mentally  retarded. Miss A.K.  C a r r o l l , w r i t i n g on the f u n c t i o n s of  s o c i a l worker i n the School  the  setting, states:  The important c o n t r i b u t i o n of s o c i a l workers i n a programme geared to the understanding, education, t r a i n i n g and r e h a b i l i t a t i o n of the m e n t a l l y r e t a r d e d i s t h a t of forming a l i n k between the i n s t i t u t i o n a l S c h o o l , the p u p i l - p a t i e n t , the f a m i l y and the community. T h i s l i n k i s f o r g e d by p u r p o s e f u l h e l p i n g and i n t e r p r e t a t i o n undertaken by the s o c i a l workers. Such help and i n t e r p r e t a t i o n i s d i r e c t e d toward the development, maintenance and f u r t h e r a n c e of the r e s p o n s i b i l i t y of f a m i l y and community i n the p r o v i s i o n of s e r v i c e s geared to the c o n t i n u i n g s o c i a l adjustment of the m e n t a l l y r e t a r d e d both w i t h i n the School and the community. 1 The and complexity  f o r e g o i n g m a t e r i a l p o i n t s out the g e n e r a l  problem  o f mental r e t a r d a t i o n and mental d e f i c i e n c y .  T h i s m a t e r i a l a l s o i l l u s t r a t e s the gradual  e x t e n t i o n of  r i g h t s of c h i l d r e n to i n c l u d e the m e n t a l l y handicapped the i n c r e a s i n g study and  the and  emphasis which i s being devoted to  t h i s problem by p r o f e s s i o n a l groups and  the g e n e r a l p u b l i c .  A set of p r o f e s s i o n a l r e h a b i l i t a t i v e standards f o r the a d m i n i s t r a t i o n and a c t u a l programming i n present  day  i n s t i t u t i o n s f o r the m e n t a l l y  criteria  handicapped i s used as  a g a i n s t which a s p e c i f i c i n s t i t u t i o n a l programme of the k i n d The Woodlands School S o c i a l S e r v i c e Department, Annual Report (1952-53), p. 1.  21 is  evaluated. The method of the study i s to examine i n d e t a i l  the actual inner workings of The Woodlands School with  par-  t i c u l a r reference to the r o l e which the s o c i a l service worker i s able to play.  An examination i s made of the extent to  which a t o t a l r e h a b i l i t a t i v e programme has been i n s t i t u t e d i n The Woodlands School and an assessment made of i t s present operation. The method of assessment used includes the review of i n s t i t u t i o n a l records and reports, the study of numerous S o c i a l service f i l e s , interviews with the Medical Director, the P r o v i n c i a l Supervisor of Psychiatric S o c i a l Work, the supervisor of the S o c i a l Service Department and with the beads of Departments, and by conversations and discussions with other members of s t a f f , supplemented by personal observation of the programme i n operation. Background material includes various a r t i c l e s , studies and reviews appearing i n the current l i t e r a t u r e i n t h i s f i e l d , a l l of which are enumerated i n the bibliography. F i n a l l y , an assessment i s made of the adequacy of the e x i s t i n g services i n meeting the s o c i a l and emotional needs of the residents and t h e i r f a m i l i e s .  CHAPTER 2  THE DEVELOPMENT OP THE INSTITUTIONAL PROGRAMME FOR THE MENTALLY HANDICAPPED IN BRITISH COLUMBIA  The h i s t o r y of public concern f o r the mentally retarded began over 100 years ago with the development of special i n s t i t u t i o n s f o r t h e i r care.  Changes had to be  made i n the punitive l e g i s l a t i o n r e l a t i n g to the insane and the mentally retarded, both i n penal law and i n laws deal =• ing with t r a i n i n g and custodial care, f o r such laws were outmoded by modern treatment methods.  Within recent de-  cades, the concept of standards of i n t e l l i g e n c e and t h e i r bearing on educational and occupational planning became recognized as having p r a c t i c a l s i g n i f i c a n c e .  The decade  of the World War I , and the decade following t h i s , saw the use of i n t e l l i g e n c e tests by schools, colleges, armed services and vocational t r a i n i n g .  Research on pathological  and abnormal phenomena threw much l i g h t on normal and superior intelligence. Studies on such problems as feeblemindedness l e d to the use of i n t e l l i g e n c e tests i n planning f o r children and adults of normal i n t e l l i g e n c e .  Psychometric methods  improved and psychometric concepts flowed into the other f i e l d s of behaviour, such as personality, temperament, emo-  - 23 tional maturity, and i n t e l l e c t u a l and s o c i a l aspects of a b i l i t y and behaviour. As time passed, various studies showed beyond doubt that the e a r l i e r emphasis upon i d e n t i f y i n g  and l a b e l l i n g men-  tal- retardation, upon setting up r i g i d c l a s s i f i c a t i o n s , upon i s o l a t i n g and i n s t i t u t i o n a l i z i n g persons so c l a s s i f i e d , was being pushed beyond l i m i t s that were s c i e n t i f i c a l l y sound or s o c i a l l y useful.  They saw the mentally handicapped  not as a  score on a populative test but as people belonging to famil i e s and society.  Soon i t became apparent that some persons  suffered from mental l i m i t a t i o n s rather than mental deficiency, and that suitable employment and appropriate education was f r e quently the treatment f o r such persons. In B r i t i s h Columbia, concern f o r the mentally retarded has been mainly centered around developments i n the P r o v i n c i a l Government i n s t i t u t i o n located at the corner of Columbia Street and McBride Boulevard i n the c i t y of New Westminster.  This i n s t i t u t i o n , formerly c a l l e d the P r o v i n c i a l  Hospital f o r the Insane and l a t e r the Provincial Mental Hosp i t a l (New Westminster), had i t s name changed i n recent years to The Woodlands School.  Such changes i n name i l l u s t r a t e  society's various approaches to the subjects of mental d e f i ciency and mental retardation.  To begin with, society asso-  ciated the mentally handicapped  with, the criminal tendencies  of the "insane."  With the scrapping of t h i s punitive approach  came the medical emphasis i n which the mentally  handicapped  - 24 were seen as "mental c a s e s " which r e q u i r e d medical  treatment.  T h i s approach t o the m e n t a l l y handicapped was r e p l a c e d by the modern day programmes which emphasize t r a i n i n g and e d u c a t i o n geared  t o the p a r t i c u l a r a b i l i t i e s  o f the m e n t a l l y handicapped  person. Early History The  P r o v i n c i a l Mental H o s p i t a l , Hew Westminster,  (The Woodlands S c h o o l ) , had a s m a l l beginning. c o n s i s t i n g o f twenty-eight  A building  small rooms i n u n i t s o f seven,  intended f o r m e n t a l l y i l l persons, was c o n s t r u c t e d and opened i n 1878.  As the years passed, more b u i l d i n g s were c o n s t r u c t e d  and r e m o d e l l i n g o f a l l b u i l d i n g s took p l a c e .  From 1930-45  t h i s r e m o d e l l i n g programme continued, so t h a t a t the present time a l l o l d e r b u i l d i n g s a r e s a t i s f a c t o r y and up t o date. 1945  In  the A d m i n i s t r a t i v e b u i l d i n g was ready f o r o c c u p a t i o n ,  a f t e r an e x t e n s i v e r e m o d e l l i n g programme.  Also during t h i s  y e a r a new s c h o o l b u i l d i n g was completed and occupied. P r o v i s i o n f o r female n u r s i n g s t a f f r e s i d e n c e s on the i n s t i t u t i o n a l grounds was a l s o made.  The y e a r 1920 saw  the completion o f a Nurses' Home f o r 32 nurses.  In 1948  a second Nurses* Home was completed f o r 51 nurses. r e c e n t l y , i n January for  1953,  More  a t h i r d Nurses* Home was ready  100 nurses t o occupy. In February 1950,  The Woodlands S c h o o l , was f i t t e d  with the a d d i t i o n o f a f i r e p r o o f , r e i n f o r c e d s t e e l , b u i l d i n g (Cedar Cottage) f o r the r e s i d e n t s .  concrete  This b u i l d i n g  - 25 c o n t a i n s no s t a i r s o r ramps and has c a p a c i t y f o r 112 and 65 a d u l t beds.  cribs  Playrooms a r e l o c a t e d i n t h i s new  building  as w e l l as d o r m i t o r i e s , k i t c h e n s , sunporches and a combination room f o r m e d i c a l examinations and minor s u r g e r y . At the present time t h r e e other b u i l d i n g s s i m i l a r to Cedar Cottage have been completed and o c c u p i e d .  These were  named Pine, Beech and Willow Cottages, r e s p e c t i v e l y .  These  t h r e e c o t t a g e s c o n t a i n a t o t a l of 404 c r i b s with a p o t e n t i a l i t y of 60 more beds.  P l a n s are b e i n g l a i d f o r a new  dispen-  s a r y i n the Pine b u i l d i n g as w e l l as a modern l a b o r a t o r y and autopsy room. Admission  Procedures The g r a d u a l change from a d m i t t i n g the m e n t a l l y  ill  person to tbe a d m i t t i n g of the m e n t a l l y r e t a r d e d c h i l d i s an i n t e r e s t i n g phase i n the development of The P r o v i n c i a l Mental H o s p i t a l , New  Westminster,  s i o n s of tbe m e n t a l l y i l l H o s p i t a l , New  Westminster,  (The Woodlands S c h o o l ) .  Admis-  took p l a c e i n the P r o v i n c i a l from 1878  u n t i l 1925,  A d m i t t i n g B u i l d i n g a t Essondale was completed. admissions took p l a c e at the P r o v i n c i a l Mental E s s o n d a l e , f o r both the m e n t a l l y i l l  Mental  when the From 1925 a l l  Hospital,  and the m e n t a l l y r e t a r d e d  person, with t r a n s f e r s from Essondale to New  Westminster  or  vice versa.  Westminster  con-  T r a n s f e r of p s y c h o t i c s from New  t i n u e d , g e n e r a l l y speaking, u n t i l the s p r i n g of 1931.  For  s e v e r a l y e a r s p r i o r t o 1951 a s m a l l u n i t of approximately 85 p u p i l s ( s m a l l e r r e t a r d e d boys and g i r l s ) were d o m i c i l e d a t  - 26 Essondale  i n a t w o - s t o r i e d wooden frame s t r u c t u r e . T h i s group was  H o s p i t a l , New  t r a n s f e r r e d to the P r o v i n c i a l Mental  Westminster, (The Woodlands S c h o o l ) and a num-  ber of m e n t a l l y i l l male and female p a t i e n t s were t r a n s f e r r e d from New  Westminster to Essondale.  d i r e c t i o n s are s t i l l  These t r a n s f e r s i n both  i n p r o c e s s , and today The Woodlands  School i s almost e x c l u s i v e l y f o r the m e n t a l l y  retarded.  T r a i n i n g Programme Development In the summer of 1931,  Dr. L.C.  S a u r i o l began o r -  g a n i z i n g the t r a i n i n g s c h o o l which i s found a t The Woodlands School today. for of  At t h i s time there were no modern  the c a r r y i n g on o f the s c h o o l c l a s s e s .  facilities  With the vacancy  a physician's o f f i c e , a nucleus f o r school c l a s s e s  formed.  In 1936  the f i r s t  was  q u a l i f i e d s c h o o l teacher assumed  her d u t i e s at the i n s t i t u t i o n . Soon a f t e r t h i s , two  teachers  were engaged and Manual A r t s i n s t r u c t i o n , c a r r i e d on p r e v i o u s l y by i n d i v i d u a l a t t e n d a n t s from the s t a f f ,  (now  named P s y c h i a -  t r i c Nurses), received a q u a l i f i e d i n s t r u c t o r . S c i e n c e c l a s s was ing  of the new  pointed.  begun, and i n the year 1945,  A Domestic with the open-  s c h o o l b u i l d i n g , f i v e s c h o o l t e a c h e r s were ap-  L a t e r a q u a l i f i e d Manual A r t s i n s t r u c t o r and  R e c r e a t i o n a l i n s t r u c t o r were added to the s c h o o l In the f a l l of 1950  staff.  the s c h o o l had e i g h t  qualified  academic s c h o o l t e a c h e r s on i t s s t a f f , one of whom was principal. had  a  a school  The Women's Occupational Therapy department, which  been a f u n c t i o n of the h o s p i t a l f o r many y e a r s , was  later  - 27 reorganized under the d i r e c t i o n of a q u a l i f i e d  Occupational  Therapist. The month of September, 1950,  saw the addition of a  modern classroom i n the new Cedar Cottage b u i l d i n g .  Since  t h i s time there has been a steady r i s e i n both the number of s t a f f and i n better q u a l i f i e d s t a f f . The Woodlands School Today Today The Woodlands School i s a r e s i d e n t i a l t r a i n i n g school f o r the mentally retarded.  Making up the population  of t h i s School are residents of the lower, the medium and the higher l e v e l of i n t e l l e c t u a l accomplishment.  In t h i s s e t t -  ing special teaching and other f a c i l i t i e s such as nursing care and medical attention, are given during twelve months of the year, so that the resident's numerous needs f i n d s a t i s f a c t i o n . The p s y c h i a t r i s t , psychologist, s o c i a l worker, academic teacher, d i e t i c i a n , manual a r t s i n s t r u c t o r , r e c r e a t i o n a l i n s t r u c t o r , women's occupational therapist and the s t a f f of the i n d u s t r i a l departments have t r i e d to keep one goal i n m i n d that of helping each resident to reach h i s best possible adjustment to l i f e with the capacities which he has at h i s disposal. Formal Academic Programme of The Woodlands School The schoolroom i s one of the most important  educa-  t i o n a l t r a i n i n g areas i n t h i s r e s i d e n t i a l school f o r the ment a l l y retarded person.  As many as possible of the residents  attend the school classes.  I f some are unable to attend  classes, provision i s made f o r lessons to be conducted i n the  - 28 various cottages.  Thus the p h y s i c a l l y handicapped are able  to enjoy the attention given to them; they are able to f e e l that they are learning as the others do, and not being neglected. Most educators now f e e l that the majority of ment a l l y retarded children do have a contribution to make to the world i n which they l i v e , and that i t i s a primary respons i b i l i t y of special education to help them a t t a i n such responsibilities.  The aim of Education should be to meet the needs  of a l l mentally retarded children i n the areas of s e l f r e a l i z a t i o n , s o c i a l r e l a t i o n s h i p s , c i v i c r e s p o n s i b i l i t y and economic e f f i c i e n c y * The need ofor favourable recognition, s o c i a l approval and prestige gives the mentally retarded c h i l d a f e e l i n g of belonging and a sense of personal worth, both of which are so important to t h e i r personality adjustment.  They must be given  a chance to succeed i n an educational programme based on r e a l i t y and not upon fantasy. Throughout the t r a i n i n g process the mentally retarded c h i l d benefits from the a f f e c t i o n of friends, companions and loved ones, as well as from understanding and sympathetic ance from a l l of those who come i n contact with them.  guid-  This  philosophy seems to have been adequately incorporated into the Formal Academic Programme of The Woodlands School. Consequently,  owing to the fact that the mentally  retarded person has l i m i t e d powers of concentration, only two hours a day i n the schoolroom are a l l o t t e d f o r academic  29 -  work.  The student spends the rest of the day doing some, var-  i e t y of occupational work such as manual a r t s , cooking, handwork or physical t r a i n i n g .  Pupils are placed i n a classroom  according to t h e i r mental age and s o c i a l adequacy.  Informa-  tion from both the Psychology and S o c i a l Service Departments provide the basis f o r the decision as to what class a c h i l d w i l l be placed i n . A t y p i c a l mentally retarded c h i l d of s i x years of age would undergo the following procedure as he moved into the school and gradually progressed through i t .  He would  s t a r t i n a Pre-School Class, which i s conducted i n either Pine or Cedar cottages.  Such a c l a s s would accommodate approxim-  ately s i x t y children.  In t h i s class the c h i l d learns to share  toys and obey simple commands, and the beginnings of sense t r a i n i n g and other t r a i n i n g necessary f o r classroom behaviour are i n s t i t u t e d . take.  In the group s i t u a t i o n he learns to give and  To begin with, he may not be able to adjust to others,  but i n time he learns to become more sociable. A f t e r f i n i s h i n g with the pre-school classes, the c h i l d would come to the school building where he would enter one of the three Kindergarten Classes of approximately t h i r t y s i x children each.  Here the c h i l d would continue with the  t r a i n i n g i n s t i t u t e d i n the pre-school classes with the teacher expecting better r e s u l t s .  Word recognition, counting and  rhythm games are also introduced to him.  Much patience i s  needed by teacher, f o r she must repeat many things to the  - 30 -  mentally retarded c h i l d Which would be almost automatic to children of average i n t e l l i g e n c e . The c h i l d would next move i n t o one of the two P r i mary Academic Classes which cover grades one and two. Here rhythm games and exercises are conducted, using the piano. Development of sand table projects i s encouraged and a toy store has been constructed i n the classroom which i s used by a l l academic classes.  Both older and younger c h i l d r e n are  combined, and while the younger children w i l l l i k e l y move on to higher academic classes, the older children w i l l reach their level i n this class. If he completes t h i s c l a s s , the c h i l d would enter the Junior Academic Class covering grades one to four.  This  class covers the regular academic work of these grades with the exception of h i s t o r y , science and geography.  In many  cases the boys at t h i s grade l e v e l are able to s t a r t attending manual a r t s classes and the g i r l s w i l l be able to attend cooking classes. From the Junior Academic Class the p u p i l would a t tend the Senior Academic Class which covers grades four to eight.  The Senior Academic Class covers a l l academic work.  However, because of the l i m i t e d time, h i s t o r y and science are not stressed as much as the other subjects. I f a p u p i l has attained h i s academic optimum before attending a l l a v a i l a b l e classes he i s encouraged to f i t into some other department of the t r a i n i n g school.  Consequently,  - 31 he may or may not attend school f o r some type of occupational work.  However, i f he has reached the age l i m i t , which may  be  eighteen or twenty-one, and he i s i n need of academic t r a i n ing, he would f i t into one of the three Opportunity Classes and continue h i s t r a i n i n g i n some other department f o r the rest of the day. For those students confined to wheelchairs, f o r one reason or another, there i s a teacher who v i s i t s the wards every morning.  Daring these v i s i t s , classes are held ranging  from the pre-school to the grade seven period.  In Beech Cot-  tage, a q u a l i f i e d teacher also conducts l i p reading classes for the deaf residents every morning. Each year a Christmas concert i s put on by the students attending the academic classes.  Acting, singing and  rhythm band numbers are presented to both the residents and the parents who are i n v i t e d to attend these  performances.  Through the medium of educational f i l m s received each week from the Department of V i s u a l education, tbe c h i l dren are able to see l i f e outside of t h e i r l i m i t e d environment. School broadcasts have also proved b e n e f i c i a l to the school's educational programme. Under the school's programme, occupational work includes cooking, manual a r t s , and a l l forms of handwork. Cooking classes are held each afternoon with seven Or eight g i r l s i n each c l a s s .  Approximately one-third of these g i r l s  are able to follow a recipe unsupervised, but the other g i r l s  - 32 need constant supervision.  Each Friday afternoon, two or  three of the g i r l s from each group prepare a complete meal and have one of the members of s t a f f as guest.  In these  classes the teacher i s able to teach the g i r l s the correct way to set the table, to say grace, and to learn correct and acceptable behaviour at the table.  The cooking classes  are very popular and a great deal of benefit i s derived from them. Handwork classes are also held each afternoon. Four such classes are i n operation and the g i r l s are assigned to each of the classes according to the g i r l s ' p a r t i c u l a r a b i lities.  The g i r l s begin with sewing cards and a simple design.  As t h e i r a b i l i t y grows they w i l l work up to more complicated designs.  K n i t t i n g , shellwork and rugmaking are carried on by  the more capable g i r l s .  Once a year a sale of a l l handwork  done by the students i s held. Manual Arts Classes are conducted i n the mornings for the older boys who work i n some other department i n the afternoon, and who  do not attend the school.  The school  boys, however, attend the Manual Arts Classes i n the a f t e r noon.  Classes are kept small because of the l i m i t e d space  and because of the need f o r constant supervision by the teacher. Recreational Classes are conducted from ten i n the morning u n t i l e i g h t - t h i r t y i n the evening.  Morning classes  are intended mostly f o r the boys and g i r l s , who,  because of  t h e i r l i m i t e d capacity, are not able to attend academic classes.  - 33 These c h i l d r e n spend t h e i r time p l a y i n g with whatever equipsent  they wish.  One hour i s a l l o t t e d f o r each o f the j u n i o r  boys, the j u n i o r g i r l s and the t i n y t o t s .  I n t h e evening  there i s r e c r e a t i o n f o r a d u l t r e s i d e n t s with a weekly dance. A gymnastic d i s p l a y i s a l s o put on each s p r i n g by the s t u d e n t s . Such a d i s p l a y i n c l u d e s d r i l l s , games, f o l k dancing and square dancing. In Tbe Woodlands School i t i s w e l l r e c o g n i z e d  that  the t e a c h i n g a b i l i t i e s o f the s c h o o l teacher must be above average.  She must have knowledge of s p e c i a l e d u c a t i o n a l  methods used i n t h e t r a i n i n g o f the m e n t a l l y would n a t u r a l l y r e q u i r e a teacher and mature i n her outlook. and  of h e r own.  who was e m o t i o n a l l y  In order  such s t a b i l i t y , the teacher  retarded.  This stable  t o have such an o u t l o o k  must not have t o o many problems  She must l e a r n that the m e n t a l l y  retarded  person  l e a r n s i n h i s own l i m i t e d way, and with h i s own p a r t i c u l a r speed.  The m e n t a l l y  Therefore,  r e t a r d e d person may a l s o l a c k i n t e r e s t .  i t i s up t o the teacher  t o make h e r t e a c h i n g i n -  t e r e s t i n g , so that the p u p i l ' s a t t e n t i o n and i n t e r e s t i s maintained.  In s h o r t , a sound i n s t i t u t i o n a l programme f o r the  mentally  r e t a r d e d must have as i t s b a s i s a good academic p r o -  gramme conducted by w e l l - q u a l i f i e d t e a c h e r s . Psychology Department L i k e the p r o f e s s i o n of S o c i a l Work, the p r o f e s s i o n o f Psychology has had t o adapt i t s e l f t o a r e l a t i v e l y new s e t t i n g , as i s found i n The Woodlands School.  As an i n t e -  g r a l member o f t h e treatment team, the p s y c h o l o g i s t  i n The  Woodlands School has important f u n c t i o n s t o f u l f i l .  Per-  - 34 haps the most notable f u n c t i o n o f the p s y c h o l o g i s t i s . t h e performance o f p s y c h o l o g i c a l e v a l u a t i o n s on v a r i o u s r e s i d e n t s . Through the medium of v a r i o u s t e s t s o f p e r s o n a l i t y , v o c a t i o n a l and manual d e x t e r i t y , an assessment i s made o f the r e s i d e n t ' s s t r e n g t h s and l i m i t a t i o n s .  Thus s c h o o l c h i l d r e n c a n be  graded before a t t e n d i n g s c h o o l and p l a c e d a c c o r d i n g l y .  Such  assessments can be u s e f u l i n s e l e c t i n g those r e s i d e n t s which w i l l p r o f i t from o c c u p a t i o n a l therapy c l a s s e s .  L a t e l y , the  p s y c h o l o g i s t has i n s t i t u t e d p l a y therapy i n t e r v i e w s f o r the young c h i l d r e n . P r e l i m i n a r y assessment of p o t e n t i a l r e h a b i l i t a t i o n cases, i n c o n s u l t a t i o n with the S o c i a l S e r v i c e Department, i s another f u n c t i o n o f the p s y c h o l o g i s t . Here, the f o c u s i s upon l o c a t i n g and a s s e s s i n g those r e s i d e n t s who would best seem to adapt themselves t o community l i v i n g and a l l i t s p r e s s u r e s . The  p s y c h o l o g i s t a l s o i n t e r v i e w s r e s i d e n t s , with the o b j e c t  of h e l p i n g them work out any problems which may a r i s e d u r i n g any  such adjustment.  had  assessed  Up u n t i l May 6th, 1953, the p s y c h o l o g i s t  130 r e s i d e n t s .  t e s t s were a d m i n i s t e r e d The  To these 130 r e s i d e n t s , 1550  over a f o u r o r f i v e months' p e r i o d .  p s y c h o l o g i s t has been r e c o g n i z e d  as an i n v a l -  uable member o f t h e treatment team and o f The Woodlands School's s t a f f i n g e n e r a l .  H i s assessments add g r e a t l y t o  the t o t a l understanding which the treatment team must have of the m e n t a l l y r e t a r d e d r e s i d e n t .  1  In J u l y , 1953 t h i s department became t e m p o r a r i l y vacated by the r e s i g n a t i o n o f t h e P s y c h o l o g i s t . 1  - 35 Nursing  Department The  profession of P s y c h i a t r i c Nursing,  i n the s e t t -  i n g o f The Woodlands S c h o o l , c a r r i e s out s p e c i f i c r e l a t e d t o the p r o f e s s i o n .  functions  Being the c l o s e s t o f any o f t h e  d i s c i p l i n e s to the r e s i d e n t n a t u r a l l y i n v o l v e s many r e s p o n sibilities.  Through the process o f person t o person  the p s y c h i a t r i c nurses t r y t o • s o c i a l i z e ' as they can.  1  contact,  the p u p i l s as much  Help i s needed by the r e s i d e n t i n h i s a d j u s t -  ment t o the group.  P s y c h i a t r i c n u r s i n g t r i e s t o teach and  h e l p the c h i l d t o l i v e with h i s l i m i t a t i o n s and t o develop h i s c a p a b i l i t i e s as a m e n t a l l y r e t a r d e d  person.  Such an approach n a t u r a l l y i n v o l v e s much p e r s e r verance on the p a r t o f the n u r s i n g s t a f f . perserverance  However, t h i s  pays o f f i n t h e l o n g run, f o r such s t a f f time,  which would n o r m a l l y  go i n t o h e l p i n g one r e s i d e n t , c o u l d  then  be expended on b e h a l f o f another r e s i d e n t , who a l s o r e q u i r e d c o n s i d e r a b l e a t t e n t i o n , but who was not r e c e i v i n g i t owing to the l a c k o f s t a f f  time.  As of October, 1951, a l l p s y c h i a t r i c nurses were trained a t Essondale.  At the present  time the p r o f e s s i o n o f  p s y c h i a t r i c n u r s i n g a t The Woodlands School two  i s divided into  s e c t i o n s — F e m a l e and M a l e — e a c h s e c t i o n b e i n g under a  Chief PsychiatrictNurse. The  Male s e c t i o n employs 84 p s y c h i a t r i c nurses and  79 p s y c h i a t r i c a i d e s . to the School plan.  S i x student  nurses a r e a l s o  assigned  f o r a three month p e r i o d under the Essondale  T h i s t o t a l group i s r e s p o n s i b l e f o r g i v i n g 24 hour  - 36 n u r s i n g s e r v i c e c a r e t o approximately 525 men r e s i d e n t s . The Women's s e c t i o n employs f o u r r e g i s t e r e d n u r s e s , 49 p s y c h i a t r i c graduates, 42 n u r s e s - i n * t r a i n i n g , 16 student nurses and 96 a i d e s .  Female nurses p r o v i d e n u r s i n g c a r e t o  both women and men r e s i d e n t s . However, as soon as a boy i s f e l t t o be o l d enough to make h i s own way on t h e men's wards he may be t r a n s f e r r e d , a f t e r c o n s u l t a t i o n between the n u r s i n g departments, t o a men's ward. Whereas male nurses tend t o l o o k upon p s y c h i a t r i c n u r s i n g as a l i f e ' s p r o f e s s i o n , the m a j o r i t y o f female tend t o r e g a r d i t as a s h o r t - t e r m employment f i e l d .  nurses  Thus  t h e r e has been a l a r g e turnover beset by many d i f f i c u l t i e s i n the women's s e c t i o n , and a r e l a t i v e l y s t a b l e s t a f f with minute turnover i n the men's s e c t i o n .  The m a j o r i t y of the male nur-  ses and o n e - t h i r d o f the female nurses l i v e o u t s i d e the School.  With the l i c e n s i n g o f P s y c h i a t r i c N u r s i n g i n B.C. has  come a r e c o g n i t i o n o f t h e p r o f e s s i o n a l i s m r e q u i r e d i n t h i s type o f work.  P s y c h i a t r i c N u r s i n g , i n such a s e t t i n g as The  Woodlands S c h o o l , must have h i g h standards i f t h e t o t a l p r o gramme i s t o be e f f e c t u a l .  1  O c c u p a t i o n a l Therapy Department S t i l l another v e r y important  t r a i n i n g area f o r the  m e n t a l l y r e t a r d e d i s the O c c u p a t i o n a l Therapy Department. Under the d i r e c t i o n o f an Occupational T h e r a p i s t the r e s i d e n t s Number o f nurses quoted a r e approximate t o t a l s as o f Angust 3, 1953.  -  37  -  are able to learn to use t h e i r spare time to the best of their a b i l i t y .  To the disturbed person occupational therapy  often has a soothing e f f e c t .  Residents with behaviour pro-  blems also seem to receive benefit from occupational  therapy.  Referrals to the occupational therapy department are made by the medical doctor.  A f t e r such a r e f e r r a l i s made,  a discussion i s held between the doctor and the psychologist and between the psychologist and the occupational therapist. Such discussions assess the number of hours of active occupat i o n a l therapy which would prove of the utmost benefit to the referred resident.  Once a resident has been selected f o r  occupational therapy he may  receive such therapy f o r an inde-  f i n i t e period of time. At the present time occupational therapy classes are held f o r f i f t y g i r l s .  T h i r t y of these g i r l s come to the occu-  pational therapy c l a s s on t h e i r own,  whereas the remaining  twenty receive occupational therapy i n s t r u c t i o n on the ward, owing to t h e i r i n a b i l i t y to come to the occupational classroom on t h e i r  therapy  own.  1  The o v e r a l l aim of occupational therapy i n t h i s s e t t i n g i s to help the residents receive emotional benefit from tbe work i t s e l f , and not s o l e l y from the f i n i s h e d product. However, once the product i s finished encouragement i s given to the resident's receiving pleasure from completing such a product. Subject to periodic assessments of medical d i r e c t o r , psychologist and occupational therapist. 1  38 As i n the other departments, d i f f i c u l t i e s are encountered i n handling the residents and i n maintaining their interest.  Helping the residents to get along with  each other i s one of the major d i f f i c u l t i e s .  Other d i f f i -  c u l t i e s are encountered i n the scaling of work which a r e s i dent i s given.  The resident must learn to move on to more  d i f f i c u l t work gradually.  I f pressed too f a r beyond h i s or  her a b i l i t i e s only f r u s t r a t i o n and confusion r e s u l t . Occupational Therapy can therefore be seen as having a great deal to contribute to any programme designed f o r the t r a i n i n g of the mentally retarded.  It not only provides  amusement and r e l a x a t i o n f o r the resident, but i t also provides invaluable t r a i n i n g f o r the resident 's future rehabilitation. Linen and Clothing Department A Linen and Clothing Department i s responsible f o r the p r a c t i c a l work which i s required by the various wards of the School.  Towels, bags, nurses' uniforms are among the pro-  ducts which t h i s Department turns out.  In addition to pro-  ducing such items, t h i s department also contains a mending annex which i n turn i s responsible f o r the t o t a l mending requirements  of the School.  The s t a f f of two, made up of one supervisor and her assistant, supervise a number of women residents, who  are  employed i n what might be r e f e r r e d to as i n d u s t r i a l t r a i n i n g . Only s i x to eight g i r l s are engaged i n t h i s i n d u s t r i a l t r a i n -  -  39  -  ing, owing to the l i m i t e d trained s t a f f and space a v a i l able.  Training the women f o r positions outside the School i s "  a prime consideration of the s t a f f , as several women residents have been successfully r e h a b i l i t a t e d a f t e r having worked i n t h i s department. On the whole the women residents who are selected f o r t h i s department are of the School's higher i n t e l l i g e n c e group.  Patients must be able to recognize  the front and back  of uniforms i f they are to benefit from t h i s department. I f a woman i s unable to run one of the department's sewing machines, she may be able to hand sew and consequently she may receive some emotional benefit from thus contributing to the work of the department.  Unfortunately,  however, the primary  focus of t h i s department i s d e f i n i t e l y not therapeutic.  This  arrangement i s due to the number of emergency situations which t h i s department has to meet. Referrals to t h i s department are made by the doctor.  Such a r e f e r r a l might be made when a woman resident ex-  pressed an i n t e r e s t i n working i n the Linen and Clothing Department. Other F a c i l i t i e s The Public Works Department i s responsible f o r the t o t a l maintenance of the buildings making up The Woodlands School.  Such a c t i v i t i e s as replacing windows, plumbing r e -  pairs, and repairing f i x t u r e s , are c a r r i e d on by t h i s department.  On request by the Superintendent of Public Works at The  -  40  -  Woodlands School, several hoys are p e r i o d i c a l l y recommended and u t i l i z e d by t h i s department.  Valuable t r a i n i n g i s there-  fore given to the boys so recommended and several within t h i s r e h a b i l i t a t i v e t r a i n i n g programme have returned to the community and have secured employment i n these l i n e s . The Shoe Department i s responsible f o r the r e p a i r ing of a l l shoes worn by the resident population of the Woodlands School.  In c e r t a i n cases, s p e c i a l shoes, which may  be  required by a resident, are turned out i n t h i s f a i r l y wellequipped shoe r e p a i r i n g department.  However, such work i s  on a very minute scale owing to the pressures of other work. Several men residents are retained i n t h i s department and they have i n many cases become quite s k i l l e d i n the area of shoe r e p a i r i n g .  Host of the men  have been i n t h i s  department f o r years, and are i n need of constant supervision because of their l i m i t e d i n t e l l i g e n c e and i n order that the heavy demands made upon the department, can be  met.  The carpentry and painting shops carry out the t o t a l carpentry and painting duties as are required i n such a large s e t t i n g as The Woodlands School.  Each of these  shops i s under i t s own foreman and each shop employs i t s own p a r t i c u l a r men.  Hale residents are permanently u t i l i z e d  within these shops. The gardening department under the supervision of an experienced gardener grows the flowers and shrubbery of which The Woodlands School i s so proud.  Such flowers and  shrub-  - 41 -  bery greatly add to the beauty of the grounds and add to the resident's comfort.  Flowers and potted plants, while i n sea-  son, are delivered to the wards and are i n turn changed every few days.  The gardening department of The Woodlands  School also grows the flowers and small shrubs f o r the Prov i n c i a l Mental Hospital grounds located at Essondale, B.C. As well as flowers and shrubs t h i s department has the r e s p o n s i b i l i t y of growing the vegetable requirements consumed i n the summer months by the School's large population. Men residents are u t i l i z e d extensively i n t h i s department. A l l of the laundry needs, with the exception of dry cleaning, f o r both The Woodlands School and The P r o v i n c i a l Mental Hospital are met through the Laundry department at the Woodlands School.  Located i n a very old brick building d i r -  e c t l y behind the Administration building, the laundry uses mostly resident help to carry out i t s work. On the ground f l o o r of the laundry building men r e s i dents convey the s o i l e d clothing and l i n e n to the various laundry machines which wash and dry the a r t i c l e s .  These  a r t i c l e s are then sent upstairs, where women residents machine or hand i r o n the a r t i c l e s . This department provides an invaluable t r a i n i n g ground f o r both men and women residents who are about to move into the r e h a b i l i t a t i o n process.  Under close super-  v i s i o n many residents are able to learn a great deal about the laundry  trade.  - 42 PATIENTS EMPLOYED IH VARIOUS DEPARTMENTS AT TBE WOODLANDS SCHOOL Laundry . 23 P a i n t Shop 4 Carpenter Shop . . . . . . 2 Kitchen 10 Sewing Room 6 T a i l o r & L i n e n Shop . . . . 6 Vegetable) Greenhouse) - Garden . . . 10 Cemetery 6 Shoe Shop 7 2 Grass Gangs 20 School Chores 4 Electrician 1 Stores . . . . . . . . . . 1 Centre Desk 3 messengers 9 Gangs - B o i l e r room Outside Heavy 2 hall & stairs ). . . 36 2 wax Food Office N u r s e s ' Home P l u s Ward Workers Each of the departments which we have d e s c r i b e d i n t h i s chapter c o n t r i b u t e t o t h e t o t a l t r a i n i n g The Woodlands School o f f e r s  programme which  t o the m e n t a l l y r e t a r d e d r e s i d e n t .  The r e s i d e n t s may come i n t o c o n t a c t with any member o f the School's s t a f f , whether he be a c a r p e n t e r o r the m e d i c a l d i r ector.  T h e r e f o r e , each s t a f f member i s encouraged to c o n s i d e r  h i m s e l f a s a h e l p i n g person.  Numbers v a r y i n a l l departments from day t o day. As workers a r e r e q u i r e d they a r e a s s i g n e d by C h i e f Male and F e male Nurses O f f i c e , No r e c o r d s maintained. Approximate numb e r s a s o f August 3, 1953.  1  CHAPTER 3 MOVEMENT OP SOCIAL SERVICE INTO THE WOODLANDS SCHOOL On September  the 19th, 1951, the beginnings o f a  S o c i a l S e r v i c e Department were s t a r t e d a t The Woodlands School i n the appointment of two s o c i a l workers with one year t r a i n i n g each.  These two workers became i n v o l v e d i n  d i r e c t work with the c h i l d r e n , whereas f o r m e r l y a v e r y l i m i t e d i n f o r m a t i o n - g i v i n g s e r v i c e had been extended to the School by the S o c i a l S e r v i c e Department o f the P r o v i n c i a l Mental Hosp i t a l and Crease C l i n i c . Such a l i m i t e d s e r v i c e was not due t o a f a i l u r e t o r e c o g n i z e the c o n t r i b u t i o n which a s o c i a l worker c o u l d make i n any programme f o r the m e n t a l l y r e t a r d e d but r a t h e r i t was due t o a s e r i o u s u n d e r s t a f f i n g o f workers a t the P r o v i n c i a l Mental H o s p i t a l and Crease C l i n i c and t o a g e n e r a l l a c k o f workers a v a i l a b l e f o r appointment.  In t r u t h there had never  been an e s t a b l i s h m e n t s e t up f o r the appointment o f s o c i a l workers i n The Woodlands S c h o o l . " S o c i a l S e r v i c e was faced immediately with the d i f f i c u l t t a s k o f choosing an a r e a i n which the l i m i t e d casework s e r v i c e s which two s o c i a l workers would b r i n g t o the School*s a l r e a d y well-advanced i n s t i t u t i o n a l care programme c o u l d be used most e f f e c t i v e l y .  1 , 1  The q u a l i t y o f s e r v i c e  The Woodlands School S o c i a l S e r v i c e Department, Annual Report (1951-52), p . l . 1  -  44  -  which could be given to both residents and to r e l a t i v e s  was  of paramount importance i n considering t h i s problem. After c a r e f u l consideration, i t was  f e l t that the  S o c i a l Service Department should l i m i t i t s services to four main areas, the f i r s t of which would be casework services to children and r e l a t i v e s during the admission period.  It was  r e a l i z e d that t h i s service would involve the process of intake and reception then developed.  Such an area would also include  s o c i a l service during the reception of the c h i l d into the School. The second of these areas included continuing soci a l service to the c h i l d once he had become a resident of the School.  Both of these services were to be on a s e l e c t i v e  basis, owing to the shortage of s o c i a l service s t a f f . Rehabilitation of the residents and the casework services involved i n such a process were f e l t to be the t h i r d area i n which s o c i a l service could be most e f f e c t i v e .  This  too was to be on a s e l e c t i v e basis. L a s t l y , s o c i a l service was  seen as being responsible  f o r a programme of community education and i n t e r p r e t a t i o n . Such a programme was to include the r e s p o n s i b i l i t y of the community i n helping the mentally retarded person adjust to the community. In order to assess the extent to which the aforementioned functions have been i n s t i t u t e d , i t w i l l be necessary to examine i n d e t a i l the workings of the S o c i a l Service Department at The Woodlands School.  - 45 Under the present plan of organization, the S o c i a l Service Department, made up of two trained s o c i a l workers and a supervisor who has had many years of experience i n the psyc h i a t r i c f i e l d , has one hundred per cent coverage of a l l admission cases.  This means that every c h i l d entering the School  has an intake interview with the s o c i a l worker.  During the  intake process the parents also p a r t i c i p a t e . S o c i a l workers now r e a l i z e that the parents often require the utmost s k i l l , patience and understanding which the worker i s able to give. Often such parents are torn between the b i t t e r l y c o n f l i c t i n g opinions of r e l a t i v e s and f r i e n d s .  Often they are crushed  by the immense pressure of t h e i r own neighbourhood's judgments.  These external pressures coexist with pressures from  within, such as f e e l i n g s of fear, f r u s t r a t i o n and deep pain over having such a thing happen to them. Since both the intake and s o c i a l h i s t o r y interviews are often the c h i l d ' s f i r s t d i r e c t contact with the School, the s o c i a l worker has an early opportunity to l a y the groundwork e f f e c t i v e l y f o r l a t e r services.  The s o c i a l history becomes  not only a diagnostic tool but also an opportunity f o r the beginning of a r e l a t i o n s h i p between the. worker, the c h i l d and the parents. The case of Susan Sadler, a f i v e year old spastic mentally retarded c h i l d , i l l u s t r a t e s how the s o c i a l service worker helped a mother to come to a decision about placing her c h i l d i n The Woodlands School.  46  -  Susan was r e f e r r e d to the S c h o o l by a community s o c i a l agency. Her f a t h e r was r e p o r t e d as being a drug a d d i c t and at t h a t time was s e r v i n g a p r i s o n sentence. Susan had become, a problem i n the home because o f her need f o r constant a t t e n t i o n . Her younger b r o t h e r f e l t r e j e c t e d by t h i s a t t e n t i o n and he r e a c t e d by t u r n i n g t o a d e l i n q u e n t p a t t e r n of behaviour. The mother, who had j u s t r e c e n t l y accepted the mental r e t a r d a t i o n of h e r c h i l d as a f a c t , wanted to see the S c h o o l . The s o c i a l worker arranged t o show the mother the S c h o o l , and d u r i n g t h i s v i s i t the mother was v e r y much impressed by the c h i l d r e n themselves, by t h e i r f r i e n d l i n e s s to one another, and by t h e i r o v e r a l l happiness. Interviews with the mother were arranged by the worker, and i n the course o f these i n t e r v i e w s , the mother was helped to b r i n g out her f e e l i n g s about having a m e n t a l l y r e t a r d e d child. The mother*s o r i g i n a l hope f o r a m i r a c l e cure of the c h i l d ' s slowness was g r a d u a l l y r e p l a c e d by a more r e a l i s t i c acceptance of the c h i l d ' s permanent l i m i t a t i o n s . E v e n t u a l l y the c h i l d was admitted to the Woodland's School on the d e c i s i o n of the mother. C o n s i d e r a b l e support was given by the worker d u r i n g t h i s p e r i o d o f casework s e r vice. Thus through the s k i l f u l h e l p of the t r a i n e d  social  worker, both the parent and c h i l d a r e a b l e to work out many of  t h e i r f e e l i n g s about mental r e t a r d a t i o n and  treatment.  residential  Through the k i n d l y c o u n s e l of the s o c i a l worker  i n the r e c e p t i o n p r o c e s s the parent and c h i l d are a b l e t o move at  t h e i r own  speed i n a s s i m i l a t i n g and v e r b a l i z i n g t h e i r  ini-  t i a l and l a t e r r e a c t i o n s t o the r e s i d e n t i a l s c h o o l s e t t i n g . The worker h e l p s the parent t o see that her will  be an i n d i v i d u a l of worth i n t h i s s e t t i n g and not  child merely  an e n t i t y which soon becomes l o s t i n a cumbersome i n s t i t u t i o n a l arrangement.  Right from the b e g i n n i n g , the parent and  child  have the worker t o l e a n upon should they f e e l the need. The parent i s made to f e e l t h a t she, as a p a r e n t , has something worthwhile  to c o n t r i b u t e to the S c h o o l , which has as i t s b a s i c  - 47 o b l i g a t i o n t h e treatment place therein.  of the c h i l d which she may wish to  T h i s parent i s helped t o see that mental  r e t a r d a t i o n i s not h e r problem a l o n e .  As i n t h e case o f Susan  S. the parent i s not pressed to make a d e c i s i o n , but i s l e f t to make up h e r own mind a f t e r the f a c t s have been o u t l i n e d by tbe worker. I f the parent should decide to p l a c e h e r c h i l d i n the S c h o o l , the process o f i n t a k e enables the worker t o f u r t h e r e x p l o r e the p a r e n t a l f e e l i n g s about the c h i l d ' s tions.  limita-  I t i s i n t h e i n t a k e i n t e r v i e w that the parent needs  f u r t h e r support f o r the process o f b r e a k i n g the c h i l d away from t h e f a m i l y u n i t , even i f o n l y t e m p o r a r i l y , may produce various parental reactions.  I t i s i n t h i s a r e a t h a t the  worker must use h i s utmost s k i l l s , f o r with proper  interpre-  t a t i o n t o the p a r e n t s , the c h i l d may be adequately  prepared  f o r s e p a r a t i o n from h i s f a m i l y and from h i s f a m i l i a r p a t t e r n of l i f e .  The f e a s i b l e time t o prepare t h e c h i l d f o r s e p a r a -  t i o n would be between the r e c e p t i o n and the i n t a k e p r o c e s s e s , f o r i f the c h i l d i s p r o p e r l y prepared b e f o r e h i s i n i t i a l movement i n t o r e s i d e n c e i n t h e School he w i l l be a much h a p p i e r c h i l d , who w i l l be a b l e to accept t h e School's programme with a minimum o f d i f f i c u l t y . Once t h e c h i l d has been p r o p e r l y prepared f o r sepa r a t i o n from t h e home, both p a r e n t s and c h i l d a r e f r e e to d i r e c t t h e i r e n e r g i e s i n t o a c t i v e p a r t i c i p a t i o n i n the School's programme and e v e n t u a l l y i n t o f i n a l r e h a b i l i t a t i o n .  Careful  s c r e e n i n g o f a p p l i c a n t s f o r the School's s e r v i c e s i s e s s e n t i a l  - 48 so t h a t commitments which may n o t be i n the best i n t e r e s t s o f the f a m i l y o r c h i l d can be prevented. From January t o March 1953. 30 c h i l d r e n under the age of s i x , t o g e t h e r with t h e i r p a r e n t s and r e l a t i v e s were helped by the s o c i a l s e r v i c e s t a f f a t the time o f the c h i l d ' s admission t o the S c h o o l . I n a d d i t i o n t o t h i s , some 103 i n t e r views o f a h e l p i n g nature were g i v e n t o p a r e n t s . I n a l l , d u r i n g the f i s c a l year ( A p r i l , 1952 March, 1953) the s o c i a l s e r v i c e s t a f f helped t o r e c e i v e i n t o the S c h o o l , some 205 r e s i d e n t s as w e l l as 560 h e l p i n g i n t e r views to r e s i d e n t s and p a r e n t s .  I n summary, 1004 i n t e r v i e w s ,  aimed a t h e l p i n g the parent t o express and r e l i e v e h i s f e e l i n g s about the p o s s i b i l i t y o f committing  h i s mentally retarded  c h i l d , were h e l d by s o c i a l workers. During these i n t e r v i e w s the worker had as h i s g o a l the s e t t i n g up o f a r e l a t i o n s h i p with the parent which would enable the parent t o see the School not a s an i n s t i t u t i o n o f f e r i n g permanent c u s t o d i a l c a r e f o r t h e i r c h i l d but as a treatment a r e a with r e h a b i l i t a t i o n as i t s f i r s t g o a l . D u r i n g the f i s c a l year ( A p r i l , 1952 - March, 1953) 132 f a m i l i e s made e n q u i r y about the s e r v i c e o f f e r e d by the Woodland's S c h o o l f o r the m e n t a l l y r e t a r d e d .  A l l o f these  f a m i l i e s were seen and i n t e r v i e w e d by v a r i o u s members o f the S o c i a l S e r v i c e Department.  Of these 132 f a m i l i e s , 60 were  r e f e r r e d t o o t h e r s o c i a l agencies f o r h e l p with v a r i o u s i n a d e q u a c i e s , such a s m a r i t a l problems, which were f e l t  t o be the  b a s i s f o r the f a m i l y ' s i n a b i l i t y t o h e l p i t s m e n t a l l y r e t a r d e d member.  - 49 The s o c i a l s e r v i c e s t a f f a l s o p r o v i d e d d i r e c t v i c e t o 72 f a m i l i e s who sought i n f o r m a t i o n about services.  ser-  the School's  To t h i s end, some 264 i n t e r v i e w s were p r o v i d e d f o r  t h i s group, t o g e t h e r with 180 c o n s u l t a t i v e c o n f e r e n c e s with staff  psychiatrists. Pre-admissions i n t e r v i e w s o f a s c r e e n i n g nature  numbered 444.  These 444 i n t e r v i e w s helped 80 p a r e n t s become  o r i e n t a t e d to the School's programme. C o n t i n u i n g casework s e r v i c e s t o the c h i l d r e n a l r e a d y admitted t o the S c h o o l a r e on a h i g h l y s e l e c t i v e b a s i s .  Only  cases which would seem t o b e n e f i t m o s t l y from c o n t i n u i n g c a s e work s e r v i c e s axe c o n s i d e r e d .  R e f e r r a l s a r e commonly made by  members o f the o t h e r d i s c i p l i n e s , but f r e q u e n t l y the r e s i dents themselves, request such h e l p by sending a note to the worker o r by c a l l i n g i n person a t the s o c i a l worker's o f f i c e . Many times the worker h e r s e l f i n h e r v i s i t s t o the wards sees r e s i d e n t s who c o u l d p r o f i t from casework s e r v i c e s . In h i s adjustment  t o the S c h o o l , the c h i l d meets  many o b s t a c l e s some o f which he i s unable to s u c c e s s f u l l y handle a l o n e .  With the h e l p which he r e c e i v e s through the  process o f the casework r e l a t i o n s h i p he i s a b l e i n many cases to meet such  difficulties.  S u c c e s s f u l casework treatment on a c o n t i n u i n g b a s i s i s shown i n t h e f o l l o w i n g case  illustration:  Bobby James was a 14 year o l d f o s t e r c h i l d who was r e f e r r e d t o the S c h o o l by the C h i l d Guidance C l i n i c . He came from a l a r g e f a m i l y which c o n t a i n e d s e v e r a l o t h e r r e t a r d e d c h i l d r e n . H i s mother was r e p o r t e d a s b e i n g a promiscuous woman who n e g l e c t e d h e r c h i l d r e n s e r i o u s l y . A f t e r b e i n g adm i t t e d to the S c h o o l through the wish o f h i s f o s t e r mother he began t o develop problems i n a d j u s t i n g t o the t r a i n i n g  50 -  regime. A f t e r r e f e r r a l by b i s d o c t o r , Bobby was seen on the ward by h i s s o c i a l worker. He was thus a b l e to v o i c e h i s f e e l i n g s regarding h i s d i f f i c u l t i e s . Bobby's n a t u r a l mother began v i s i t i n g the h o s p i t a l and she became v e r y h o s t i l e t o the setting. T h i s h o s t i l e a t t i t u d e o f the mother g r e a t l y added to the d i s t u r b a n c e s which Bobby was f a c i n g . The s o c i a l worker was a b l e by frequent i n t e r v i e w s with both Bobby and h i s mother t o r e l i e v e t h e i r f e e l i n g s about the S c h o o l . As the r e l a t i o n s h i p developed both Bobby and the mother were a b l e to accept the t r a i n i n g program and to take an i n t e r e s t e d p a r t i n i t . I t i s the r e s p o n s i b i l i t y o f the s o c i a l worker t o d i r e c t h i s s k i l l s to the newly a r r i v e d r e s i d e n t so t h a t the best p o s s i b l e adjustment to the School's programme may e f f e c t e d by the r e s i d e n t .  be  The new a r r i v e e f i n d s h i m s e l f i n  a group s e t t i n g , a s e t t i n g which r e q u i r e s both g i v e and take on h i s p a r t .  With the h e l p o f the s t a f f and the casework  process as p r a c t i s e d by the s o c i a l worker, the c h i l d i s made to f e e l important.  T h i s f e e l i n g o f worth enables him to  b r i d g e the gap between f a m i l y and i n s t i t u t i o n a l  living.  I n Bobby's case he was a b l e t o t a l k to the s o c i a l worker as a f r i e n d who was g e n u i n e l y i n t e r e s t e d i n what happened to Bobby.  T h i s i n t e r e s t on the worker's p a r t gave  Bobby f a i t h i n h i m s e l f and he was a b l e through c a r e f u l p r e t a t i o n to take a b e t t e r p a r t i n the School's  inter-  programme.  Without the worker's i n t e r e s t i n him, Bobby c o u l d e a s i l y have turned i n t o a boy with many problems who would r e q u i r e much of the s t a f f ' s time t o handle him.  The worker's h a n d l i n g of  Bobby's mother i l l u s t r a t e s a s i t u a t i o n i n which the worker through understanding  and p a t i e n c e was a b l e to r e l i e v e  pot-  e n t i a l t e n s i o n s i n the mother's mind, thus f r e e i n g h e r t o take p a r t i n the School's  programme.  - 51 Daring the f i s c a l year ( A p r i l , 1952  - March  1953)  251 r e s i d e n t s were r e f e r r e d to the S o c i a l S e r v i c e Department. To these r e s i d e n t s some 1,244  i n t e r v i e w s were extended.  Hem-  hers of the s o c i a l s e r v i c e s t a f f , t o g e t h e r with members o f other d i s c i p l i n e s , p a r t i c i p a t e d i n 242 c l i n i c a l study s e s s i o n s which had as t h e i r o b j e c t i v e the f o r m u l a t i o n of t r a i n i n g and r e h a b i l i t a t i o n g o a l s f o r r e s i d e n t s .  Conferences  with  o t h e r s o c i a l agencies i n o r d e r to e f f e c t i v e l y p l a n f o r v a r i o u s r e s i d e n t s numbered  24.  R e h a b i l i t a t i o n i s perhaps the newest of the  respon-  s i b i l i t i e s which the s o c i a l worker has a c q u i r e d i n t h i s s e t t ing.  P r i o r to the entrance o f s o c i a l workers on the  r e h a b i l i t a t i o n was  p r a c t i c a l l y non-existent.  scene,  Today a rehab-  i l i t a t i o n programme has been s e t up which i s f a i r l y adequate when one c o n s i d e r s the l i m i t e d number of s o c i a l workers. Teamwork and c o o p e r a t i v e p l a n n i n g a r e the b a s i s f o r the many needs of the r e t a r d e d , i n o r d e r to a c h i e v e the mate o b j e c t i v e s of good v o c a t i o n a l and s o c i a l l i v i n g .  ultiIn  o r d e r f o r the r e t a r d e d to h o l d a j o b s u c c e s s f u l l y , he must a c q u i r e p o s i t i v e a t t i t u d e s i n the f o l l o w i n g a r e a s : (1) A s i n c e r e d e s i r e to a c q u i r e work. (2) A sense of r e s p o n s i b i l i t y once the j o b has been acquired. (3) Sound p e r s o n a l h a b i t s . (4) A b i l i t y t o work with o t h e r s . A thorough understanding p r o s p e c t i s t h e r e f o r e necessary.  of the r e h a b i l i t a t i o n The s o c i a l worker must know  - 52 about such areas as the resident's emotional and s o c i a l maturi t y and also the degree of development of h i s manual dexter-, ity.  Knowledge must also be acquired about the resident's  a b i l i t y to follow simple oral and written directions and to complete assigned tasks.  In p r a c t i c a l l y a l l cases the worker  w i l l need to know about the resident's a b i l i t y and i n i t i a t i v e i n handling machinery and handtools.  Only by c a r e f u l observa-  tion and teamwork can the best r e h a b i l i t a t i o n prospects be located and u t i l i z e d . In The Woodlands School, the prospective  rehabilita-  t i o n case i s referred through many mediums, such as the doctor,  the nurse or the resident himself.  A review of the pat-  ient's f i l e i s made by the s o c i a l worker, the doctor, and sometimes the psychologist.  The psychologist i s then con-  tacted i n order that a psychological assessment of the resident may be made.  Such an assessment adds greatly to  the t o t a l information which w i l l eventually be compiled as a background f o r the r e h a b i l i t a t i o n decision. A report i s also received from the school.  Such a  report contains d e t a i l s as to whether or not h i s teacher thinks that t h i s resident has reached h i s maximum i n the academic programme.  I f the resident has not reached h i s  maximum, then he may be allowed to continue with h i s academic education  u n t i l such a maximum i s reached.  In addition to the report from the teacher, the resident receives a f u l l medical and dental checkup.  Once  a l l these d e t a i l s are attended to, the resident's r e l a t i v e s  = 53 are n o t i f i e d that he i s being considered f o r r e h a b i l i t a t i o n . It i s then the s o c i a l worker's r e s p o n s i b i l i t y to assess the resident's home, h i s community, and h i s prospective employment opportunities.  A f t e r a c a r e f u l assessment of a l l the  f a c t s facing the resident i n r e h a b i l i t a t i o n , the s o c i a l worker makes a recommendation, keeping i n mind the resident's a b i l i t i e s at a l l times.  The f i n a l decision f o r or against the  return of the resident to the community r e s t s with the medical  superintendent. The complex area of r e h a b i l i t a t i o n i s brought out  i n the case of Margaret Bayer, who had come from a family whose parents had deserted her when she was a very young girl.  Margaret, a 26 year old g i r l , had been a resident i n  the School f o r the past twelve years.  During t h i s time she  had made frequent home v i s i t s to a cousin. Margaret was referred f o r possible r e h a b i l i t a t i o n to the psychologist. A mental assessment was made and Margaret, previously tested as a moron, now tested as a borderline mentally retarded person. Social Service was then requested to v i s i t the cousin regarding possible r e h a b i l i t a t i o n f o r Margaret. During such v i s i t s the worker was able to help the cousin to bring out her feelings of anxiety and g u i l t . I t soon became c l e a r to the s o c i a l worker that the cousin did not wish to have the r e s i dent stay with her permanently. Social service also worked with the resident during t h i s time. Margaret was able to voice her h o s t i l i t y and her f e e l ings about leaving the School. From here Margaret was able to move on to a frank discussion of her l i m i t a t i o n s and strengths. Discussions were held between the S o c i a l Service Department and the National Employment Service i n regards to employment p o s s i b i l i t i e s f o r Margaret. A housekeeping p o s i t i o n was secured i n an understanding home and the resident was moved out into the community under the supervision of the s o c i a l worker.  - 54 Margaret needed much support d u r i n g t h i s time and gradu a l l y the s o c i a l worker was a b l e t o p u l l away and l e a v e Margaret i n the c a r e o f a community s o c i a l agency which would make p e r i o d i c v i s i t s to Margaret. T h i s r e s i d e n t i s now a d j u s t i n g w e l l to the community and she now f e e l s that she i s making her own p a r t i c u l a r c o n t r i b u t i o n to community l i f e . Once a r e s i d e n t i s r e t u r n e d t o the community,  through  the process of r e h a b i l i t a t i o n , he or she i s p l a c e d under prob a t i o n f o r s i x months.  The S o c i a l S e r v i c e Department has  the  r e s p o n s i b i l i t y f o r v i s i t i n g and a s s e s s i n g the r e s i d e n t ' s adjustment d u r i n g t h i s There are two is ing  instituted.  time. forms o f c a r e under which p r o b a t i o n  These a r e f a m i l y c o n v a l e s c e n t care and work-  convalescent c a r e .  Under f a m i l y convalescent care the  r e l a t i v e s s i g n the p r o b a t i o n terms and agree t o s u p e r v i s e the r e s i d e n t when he l e a v e s the S c h o o l .  V i s i t s a r e made to the  home of the r e l a t i v e s once a month by the s o c i a l worker. A f t e r six  months the case i s reviewed  and the r e s i d e n t i s e i t h e r d i s -  charged i n f u l l by the medical superintendent  o r the p r o b a t i o n -  a r y p e r i o d i s renewed f o r another s i x months, a f t e r which the case i s reviewed  again.  Working convalescent c a r e i s much the same as f a m i l y convalescent c a r e with the e x c e p t i o n t h a t a n employer i s c o n t a c t e d and s h o u l d the r e s i d e n t be a c c e p t a b l e to him, i s asked  to s i g n the p r o b a t i o n a r y forms.  he  I f the r e s i d e n t  i s p l a c e d o u t s i d e the G r e a t e r Vancouver a r e a o r New  West-  m i n s t e r , the branch  i s asked  to  s o c i a l w e l f a r e o f f i c e concerned  s u p e r v i s e the r e s i d e n t d u r i n g the p r o b a t i o n a r y p e r i o d . During the f i s c a l y e a r ( A p r i l 1952  - March 1953),  f i v e r e s i d e n t s were r e h a b i l i t a t e d , f o u r i n t o working c o n v a l e s -  - 55 -  cent c a r e and one i n t o f a m i l y c o n v a l e s c e n t c a r e .  Of these  f i v e two were r e t u r n e d to the School before the e x p i r a t i o n o f the six-month p r o b a t i o n a r y p e r i o d .  In the s i t u a t i o n o f one  l o n g i n s t i t u t i o n a l i z e d r e s i d e n t , the employment s e l e c t e d was beyond h i s emotional m a t u r i t y and he was t h e r e f o r e unable to adapt h i m s e l f to the needs o f the j o b . The other r e s i d e n t was r e t u r n e d t o the School because he was not a b l e to cope with h i s employer's demands. tended  Lack o f p r a i s e i n h i s work a l s o  to make him q u e s t i o n h i s own a b i l i t y on the j o b . In p r e p a r i n g these f i v e r e s i d e n t s f o r r e h a b i l i t a t i o n ,  the s o c i a l s e r v i c e s t a f f conducted  205 i n t e r v i e w s aimed a t  p r e p a r i n g , s u p p o r t i n g and s u p e r v i s i n g the r e s i d e n t . ences with employment and agencies o f f e r i n g f i n a n c i a l tance were made on 33 o c c a s i o n s .  Conferassis-  Before the r e s i d e n t s were  moved out i n t o the community the p s y c h i a t r i s t s were c o n s u l t e d on 165 o c c a s i o n s , psychology  on 86, o c c u p a t i o n a l therapy on  19, r e c r e a t i o n and i n d u s t r i a l on 45, education on 81 occas i o n s and 15 study c l i n i c s were attended by s o c i a l  workers.  In order t o assess p o s s i b l e working home r e s o u r c e s some 45 v i s i t s were made by the workers.  Contacts with  agencies r e q u e s t i n g assessment o f homes numbered 21.  other  In a d d i -  t i o n to t h i s 68 f o l l o w - u p v i s i t s were made t o both r e s i d e n t s and employers d u r i n g the placement p e r i o d . One f o r t y y e a r o l d woman who had been deserted by both p a r e n t s on placement i n an orphanage was committed to The Woodlands School about t w e n t y - f i v e years ago. While i n the School her progress had been remarkable from the m e d i c a l , psyc h o l o g i c a l and s o c i o l o g i c a l a s p e c t s . When f i r s t admitted t o the School a t the age o f 15, she was d e s c r i b e d as i m b e c i l e given to h y s t e r i c a l a t t a c k s and f a i n t i n g . Pre-rehabilitation  - 56 study a f t e r her e d u c a t i o n and t r a i n i n g p e r i o d r e v e a l e d her to be of d u l l - n o r m a l i n t e l l i g e n c e . In A p r i l 1952, she approached the S o c i a l S e r v i c e Department and a f t e r numerous i n t e r v i e w s with the p u p i l and c o n t a c t with a d i s t a n t r e l a t i v e a programme f o r her i n i t i a l r e h a b i l i t a t i o n was i n i t i a t e d . There was, however, some doubt i n the p s y c h i a t r i s t s ' minds as t o t h i s p u p i l ' s a b i l i t y to a d j u s t to the o u t s i d e community h a v i n g r e g a r d to her l o n g r e s i d e n c e i n the School which had not p r e sented her with an o p p o r t u n i t y f o r c o m p e t i t i o n with i n d i v i d u a l s her own age. S o c i a l S e r v i c e , however, proceeded with the r e h a b i l i t a t i o n process working c l o s e l y with the p u p i l and i n i t i a t e d a programme geared to h e l p i n g her to f a c e the world with new c o n f i d e n c e and reassurance. The r e s u l t was a f i n e l y i n t e g r a t e d p e r s o n a l i t y , assured s i g n s of emotional and s o c i a l m a t u r i t y and most important of a l l , the p u p i l ' s d e s i r e to r e t u r n to the community. A f t e r f o u r months, the N a t i o n a l Employment S e r v i c e was contacted and a f t e r c a r e f u l s e l e c t i o n by N.E.S. and the School s o c i a l worker, a job on a c h i c k e n farm was i n v e s t i g a t e d and s e l e c t e d with the c o o p e r a t i o n of the p u p i l and o t h e r School staff. The employer was g i v e n a complete p i c t u r e p u p i l ' s emot i o n a l l e v e l and i t was e x p l a i n e d that she would need constant and c l o s e s u p e r v i s i o n and t h a t she would need to be t r a i n e d by s i m p l i f i e d methods i n order to l e a r n . A v i s i t to the working home was planned f o r the p u p i l and a s t a r t i n g wage of $50, monthly was o f f e r e d . S i n c e placement, an i n t e n s i v e f o l l o w - u p programme has been c a r r i e d out. Employer and employee were both seen from time to time and on each o c c a s i o n high s a t i s f a c t o r y r e p o r t s were r e c e i v e d . The p u p i l ' s enthusiasm and improvement i n both appearance and behaviour was such that when the s i x months' p r o b a t i o n a r y p e r i o d was about to e x p i r e the employers agreed v e r y r e a d i l y to an e x t e n t i o n of p r o b a t i o n as e v e r y t h i n g was working out w e l l . The p u p i l has been given i n c r e a s i n g respons i b i l i t i e s and has proved r e l i a b l e i n every r e s p e c t t o date. 1 A review of the p a r t which S o c i a l Work has  played  i n the r e h a b i l i t a t i v e process w i l l i n d i c a t e the l o n g , d e t a i l e d and s k i l l e d work i n v o l v e d . The S o c i a l S e r v i c e Department has a l s o assumed as one  of i t s f u n c t i o n s the education and t r a i n i n g of v a r i o u s p r o -  f e s s i o n a l and l a y groups which have v i s i t e d the S c h o o l . The Woodlands School S o c i a l S e r v i c e Department, Annual Report (1952-53), p. 6.  Such  work i s i n v a l u a b l e , f o r the School must r e l y on i n d i v i d u a l s and groups i n the community to make r e f e r r a l s and t o h e l p i n the important a r e a of r e h a b i l i t a t i o n . During the f i s c a l y e a r ( A p r i l 1952  - March 1953),  the s o c i a l s e r v i c e s t a f f p a r t i c i p a t e d i n a t e a c h i n g c l i n i c f o r 60 f i r s t year s t u d e n t s of the School of S o c i a l Work, U n i v e r s i t y o f B r i t i s h Columbia.  Three second year s t u d e n t s were  a l s o o r i e n t a t e d over a three-day p e r i o d . c l i n i c was  A s p e c i a l teaching  a l s o s e t up f o r a number of i n - s e r v i c e  trained  workers. In a l l ,  f i v e groups of p u b l i c h e a l t h n u r s e s , p o s t -  graduate nurses and n u r s i n g a f f i l i a t e s r e c e i v e d i n t e r p r e t a t i o n o f both the School's programme and the p a r t which the S o c i a l S e r v i c e Department p l a y s i n the e d u c a t i o n and  training  of the m e n t a l l y regarded. One  group of 35 t e a c h e r s and another group o f  kindergarten teachers studied education i n t h i s s e t t i n g  30 and  the p a r t y which s o c i a l s e r v i c e p l a y s i n r e l a t i o n t o e d u c a t i o n . The S o c i a l S e r v i c e Department a l s o p l a y e d host t o f o u r r e p r e s e n t a t i v e s of r e h a b i l i t a t i o n and s o c i a l work agenc i e s who  spent time i n the Department.  Members o f t h r e e S e r -  v i c e Clubs a l s o v i s i t e d to s t u d y the School's programme. I t has been shown i n t h i s chapter t h a t the work of the S o c i a l S e r v i c e Department c o n t a i n s many v a r i e d r e s p o n s i bilities.  Each of these r e s p o n s i b i l i t i e s has as i t s u l t i m a t e  g o a l the enhancement and e v e n t u a l w e l l - b e i n g of the r e s i d e n t . From the moment he e n t e r s the School u n t i l h i s movement back t o the community the s o c i a l worker stands ready t o h e l p him i n any way  i t can.  CHAPTER 4  CONCLUSIONS  Introduction In the p r e c e d i n g three chapters there has been some d i s c u s s i o n of the many c o m p l e x i t i e s  which must be  i n the understanding, e d u c a t i o n and  t r a i n i n g of the m e n t a l l y  retarded.  The  considered  i n c r e a s i n g amount of a t t e n t i o n which the  blem of mental r e t a r d a t i o n has f e s s i o n a l groups has  pro-  r e c e i v e d from both l a y and  pro-  r e s u l t e d i n a more d e t a i l e d assessment  of ways and means t o combat the e f f e c t s of the l i m i t a t i o n s brought on by mental r e t a r d a t i o n . S o c i a l work, i n s p i t e of i t s youth as a has  profession,  l o n g been i n t e r e s t e d i n the a r e a of mental r e t a r d a t i o n .  With the g e n e r i c  t r a i n i n g , which many s o c i a l workers r e c e i v e d  i n p r o f e s s i o n a l schools that s o c i a l work, and work and  of s o c i a l work, came the r e a l i z a t i o n  i t s two main components o f s o c i a l case-  s o c i a l groupwork, had  something to o f f e r to the  d e n t i a l t r a i n i n g programmes o f f e r e d by many schools mentally  resi-  f o r the  retarded. Being a c o n d i t i o n and  d a t i o n i t s e l f cannot be t r e a t e d .  not an i l l n e s s , mental r e t a r However, the s o c i a l  t i o n s of mental r e t a r d a t i o n can be t r e a t e d .  implica-  S o c i a l workers  are aware t h a t t h e i r p a r t i c u l a r a r e a of competence  includes  - 59 case work and group work s k i l l s i n the a l l e v i a t i o n of the impact of mental retardation. Social workers also understand that mental retardat i o n affects the whole community and not just the family of the mentally retarded person.  Therefore, the community becomes  a valuable partner i n any planning which the school makes f o r the mentally retarded person.  Any successful t r a i n i n g pro-  gramme f o r the mentally retarded has to have cooperation of the community from the moment of the mentally retarded child's admittance  to the r e s i d e n t i a l t r a i n i n g school u n t i l the time  of h i s eventual discharge back to the community. S k i l l s of the Social Worker It was also pointed out that i n any r e s i d e n t i a l t r a i n i n g programme f o r the mentally retarded the s o c i a l caseworker i s able to apply h i s s k i l l s i n f i v e major areas.  The  f i r s t of these areas i s the intake process, during which the worker helps both the c h i l d and r e l a t i v e to understand what the school has to o f f e r the mentally retarded person.  Through  such understanding and the help of the worker, the r e l a t i v e i s able to move at her own pace and to a r r i v e eventually at a decision regarding whether or not he wants h i s c h i l d to be a part of such a r e s i d e n t i a l programme.  Once a decision i s  reached to e n r o l l the c h i l d i n the School, the second of the s o c i a l work functions comes into being, namely, reception of the prospective resident into the school.  Because of the  p r e v i o u s c o n t a c t with the c h i l d , the worker i s a b l e to h e l p the c h i l d to break away from the parent and become a r e s i d e n t of  the s c h o o l .  The worker then becomes the l i n k between the  s c h o o l and the p a r e n t s . Another r e s p o n s i b i l i t y of the s o c i a l worker was to  seen  be i n the a r e a of h e l p i n g the r e s i d e n t to a d j u s t to the  s c h o o l regime.  In t h i s a r e a the caseworker uses h i s s k i l l i n  the understanding  of the dynamics of i n d i v i d u a l and group  be-  haviour i n order to h e l p the r e s i d e n t make the best p o s s i b l e adjustment to the s c h o o l .  Such work was  seen to be needed on  a continuing basis. The f o u r t h r e s p o n s i b i l i t y of the worker l i e s i n the complex a r e a of r e h a b i l i t a t i o n .  Here the worker uses h i s  s k i l l s to prepare the c h i l d , the r e l a t i v e s and the community for  the c h i l d ' s r e t u r n to s u p e r v i s e d community  life.  The l a s t f u n c t i o n of the s o c i a l worker i s i n the f i e l d of s t a f f t r a i n i n g and community i n t e r p r e t a t i o n .  Here  the s o c i a l worker i s a b l e to share h i s knowledge of s o c i a l behaviour and i t s many c o m p l e x i t i e s with groups o f s t a f f with community groups.  The use of the "case  h e l p s these groups to understand  and  illustration  0  the many s o c i a l s t r e s s e s  a c t i n g on the r e s i d e n t and h i s f a m i l y b e f o r e , d u r i n g and a f t e r d i s c h a r g e from the S c h o o l .  Being a p a r t n e r to the  S c h o o l , the community a l s o has to be aware o f the f a c t that not a l l m e n t a l l y r e t a r d e d r e s i d e n t s are a b l e to r e t u r n t o the community, owing to the extent of the r e t a r d a t i o n o r to  - 61 oar limited resources and knowledge. The Treatment Team Approach This study has shown that some of the mentally retarded are educable and can be helped i f placed i n the pro* per educational and t r a i n i n g programme.  Such a programme r e -  quires a team approach involving both group and i n d i v i d u a l cooperation between the professional and l a y l e v e l s . In t h i s regard the h i s t o r i c a l background of The Woodlands School shows a change of emphasis which has resulted i n a gradual expansion and improvement i n the services f o r B r i t i s h Columbia's mentally handicapped  children.  Such services  have grown i n order to meet the ever-increasing needs of the many provincial communities which The Woodlands School serves. Operating as a r e s i d e n t i a l t r a i n i n g and educational school f o r B r i t i s h Columbia's mentally handicapped  children,  The Woodlands School contains the many f a c i l i t i e s necessary f o r such education and t r a i n i n g , namely, academic education, nursing, medicine, occupational and i n d u s t r i a l therapy, manual a r t s , recreation, psychology, and s o c i a l service.  Every s t a f f  member of The Woodlands School i s therefore a potential i n structor, as a l l of the residents have various forms of contact with s t a f f members.  Selection and t r a i n i n g of s t a f f i s  therefore very important as the quality of s t a f f must be such as to enable the School to meet f u l l y i t s objectives of adequate education and t r a i n i n g .  - 62 C o n t r i b u t i o n s of the S o c i a l S e r v i c e Department The  S o c i a l S e r v i c e Department, which was  on September 19,  1951,  established  has made an important c o n t r i b u t i o n to  The Woodlands School's programme i n s p i t e of many l i m i t a t i o n s . With a s t a f f of o n l y one s u p e r v i s o r and  two  s o c i a l workers,  the S o c i a l S e r v i c e Department has been a b l e to l a y the ground work f o r more i n t e n s i v e s o c i a l s e r v i c e c o n t r i b u t i o n s to f i e l d of mental r e t a r d a t i o n i n B r i t i s h Columbia. ment now  c a r r i e s out one  e n t e r i n g the S c h o o l .  This  depart-  hundred per cent coverage of r e s i d e n t s  Such work covers  i n t a k e and  reception  i n t e r v i e w s with both the r e s i d e n t and h i s r e l a t i v e s .  Social  S e r v i c e a l s o c a r r i e s a s e l e c t i v e c a s e l o a d of c o n t i n u i n g Many c h i l d r e n , who the School  the  cases.  have been unable to respond s u c c e s s f u l l y to  regime, have thus been r e c e i v i n g h e l p i n t h e i r  ad-  justment from the s o c i a l worker. The  a r e a of r e h a b i l i t a t i o n has a l s o r e c e i v e d some a t -  t e n t i o n from the S o c i a l S e r v i c e Department of The Woodlands School.  S e v e r a l r e s i d e n t s , who  the S c h o o l , have now  p o s s i b l y would have remained i n  been s u c c e s s f u l l y r e h a b i l i t a t e d with  h e l p r e c e i v e d from the S o c i a l S e r v i c e Department.  the  Community  i n t e r p r e t a t i o n of The Woodlands School's f u n c t i o n s has  been  another f u n c t i o n which members of the S o c i a l S e r v i c e Department have c a r r i e d on.  Through such mediums as group d i s c u s -  s i o n s to o u t s i d e groups and p e r s o n a l r e p r e s e n t a t i o n i n prof e s s i o n a l groups, such a s the Canadian A s s o c i a t i o n of S o c i a l Workers, the S o c i a l S e r v i c e Department has been a b l e to i n t e r p r e t i t s own  unique f u n c t i o n s i n The Woodlands School s e t t i n g .  -  63  -  Perhaps one of S o c i a l S e r v i c e s * g r e a t e s t f u n c t i o n s i n The Woodlands School s e t t i n g i s the e f f e c t t h i s department has had on the v a r i o u s s t a f f groups.  S o c i a l S e r v i c e has been  a b l e to show these s t a f f groups j u s t what the o b j e c t i v e o f the t r a i n i n g programme i s , and, r e s i d e n t s are the same.  t h a t i n p e r s o n a l i t y makeup no  two  S t a f f members, t h e r e f o r e , f e e l t h a t  t h e i r c o n t r i b u t i o n , be i t ever so minute, when combined with the o v e r a l l t r a i n i n g and e d u c a t i o n a l programme, i s h e l p i n g the r e s i d e n t t o at l e a s t achieve some contentment. However, there i s s t i l l a l a c k of r e a l i z a t i o n i n some groups as to what they are t r y i n g to accomplish  as a s c h o o l .  There e x i s t s i n s t e a d a f e e l i n g of r i v a l r y between groups which impedes a r e a l teamwork approach.  I t i s hoped t h a t the  offi-  c i a l s a t The Woodlands School w i l l be a b l e to overcome t h i s b a s i c d i f f i c u l t y by f o r m a l s t a f f c o f e r e n c e s which would g i v e p e r s p e c t i v e on the present s i t u a t i o n . then give way  t o departmental  These conferences might  r e p o r t s and e v e n t u a l l y t o the  type of c o o p e r a t i o n a c h i e v e d when each team member knows and a c c e p t s the r o l e s o f the o t h e r s and uses them to the.best advantage. The Need f o r Research The phenomenal i n c r e a s e i n the p o p u l a t i o n s of  insti-  t u t i o n s f o r the m e n t a l l y r e t a r d e d has c r e a t e d many complex p r o blems i n the accommodation, f e e d i n g , education and t r a i n i n g of such persons.  There i s t h e r e f o r e a great need f o r a v i g o r o u s  programme of r e s e a r c h i n the areas of d e t e r m i n a t i o n and  pre-  v e n t i o n o f the causes of mental d e f i c i e n c y and mental r e t a r d a -  - 64 «  tion.  C o i n c i d e n t with such r e s e a r c h should he the working out  of more adequate programmes f o r the r e h a b i l i t a t i o n of the ment a l l y handicapped  person.  I t i s recommended that The Woodlands School  insti-  tute p e r i o d i c surveys and s t u d i e s o f i t s s e r v i c e s i n o r d e r to a s c e r t a i n where such s e r v i c e s may efficient. stood.  be improved and made more  In any study the goals should be thoroughly under-  Terms s h o u l d be d e f i n e d and i f p o s s i b l e a s m a l l s c a l e  t e s t should be i n s t i t u t e d before the study b e g i n s .  Analysis  of m a t e r i a l s h o u l d be planned i n advance o f the study. C o n t r o l s w i l l a l s o be needed where the e f f e c t of any a c t i o n i s to be measured.  Above a l l ,  s t a f f s h o u l d be  the c o o p e r a t i o n of The Woodlands School  assured.  To date there has been no l a r g e s c a l e assessment of the mental c a p a b i l i t i e s of the r e s i d e n t s a t The Woodlands S c h o o l . S e v e r a l attempts have been made a t such assessments, but each time these s t u d i e s have been stopped  i n the e a r l y stages owing  to v a r i o u s members o f the assessment team l e a v i n g The Woodl a n d s S c h o o l f o r other p o s i t i o n s . No e f f i c i e n t t r a i n i n g or e d u c a t i o n a l programme f o r the m e n t a l l y r e t a r d e d can operate u n l e s s i t knows the a p p r o x i mate c a p a b i l i t i e s o f i t s members.  As has been p o i n t e d out p r e -  v i o u s l y , o n l y the m e n t a l l y r e t a r d e d can p r o f i t from t r a i n i n g programme methods now  i n use.  I f m e n t a l l y d e f i c i e n t members  are e n r o l l e d i n such a programme t h e r e i s a l o s s of much s t a f f time which c o u l d have been much more p r o f i t a b l y used by  men-  - 65 t a l l y r e t a r d e d r e s i d e n t s who  would respond much more to such  training. There s h o u l d , t h e r e f o r e , be an immediate assessment made of the p o p u l a t i o n a t The Woodlands School so that r e s i d e n t s who  would p r o f i t best from an e d u c a t i o n a l and  i n g programme reach t h e i r r i g h t  those train-  to such a programme as soon as  possible. Physical F a c i l i t i e s Research s h o u l d a l s o decide whether the present phys i c a l setup of The Woodlands School i s too cumbersome f o r the a d m i n i s t r a t i o n of an e f f i c i e n t e d u c a t i o n a l and t r a i n i n g p r o gramme.  The f e a s i b i l i t y of s e t t i n g up s m a l l c o t t a g e - s t y l e  t r a i n i n g u n i t s throughout studied.  B r i t i s h Columbia should be  carefully  Thought a l s o s h o u l d be given to the p o s s i b i l i t y of a  t r a i n i n g s c h o o l s o l e l y f o r the m e n t a l l y r e t a r d e d p o p u l a t i o n of British  Columbia.  Staff Training Adequate care f o r the m e n t a l l y handicapped i n an i n s t i t u t i o n a l setting requires well-trained s t a f f i n s u f f i c i e n t numbers, e f f i c i e n t a d m i n i s t r a t i o n p r a c t i c e s , h i g h s t a n * dards of s e r v i c e and sound and economical facilities.  use of e x i s t i n g  Both p r o f e s s i o n a l and n o n - p r o f e s s i o n a l s t a f f must  be c a r e f u l l y t r a i n e d so as to enable them to serve the r e s i d e n t with understanding, must be concerned  knowledge and s k i l l .  Each s t a f f member  with the r e s i d e n t ' s p h y s i c a l ,  emotional,  - 66 -  s p i r i t u a l , s o c i a l and economic needs.  E f f i c i e n t use o f per-  sonnel i n t u r n depends upon adequate s u p e r v i s i o n and administ r a t i o n and upon good p e r s o n n e l p o l i c i e s . Any  programme f o r s t a f f development should  give the  i n d i v i d u a l s t a f f member a f u l l e r a p p r e c i a t i o n o f the importance of the team approach. team approach should  Case demonstrations i l l u s t r a t i n g the t h e r e f o r e be an important p a r t o f s t a f f  development t r a i n i n g .  Personnel members should  also attain a  g r e a t e r understanding o f the s i g n i f i c a n c e of the r e s i d e n t as a person and o f the importance o f the r e s i d e n t ' s s o c i a l  environ-  ment i n the c o n t r o l o f h i s r e a c t i o n s t o mental r e t a r d a t i o n and deficiency. team should  The s o c i a l worker as a member o f the treatment t h e r e f o r e assume a l e a d i n g r o l e i n t h e t r a i n i n g o f  s t a f f members i n The Woodlands S c h o o l . Administrative  Proceedings  In The Woodlands School, admission, discharge  there i s a need f o r sound  and r e f e r r a l p o l i c i e s and procedures.  There i s a l s o a d e f i n i t e need f o r an i n t e g r a t i o n o f f a c i l i t i e s so as t o enable a f r e e f l o w i n g of r e s i d e n t s and p e r t i n e n t i n r e l a t i o n t o the r e s i d e n t ' s needs.  data  As an i n s t i t u t i o n a l p r o -  gramme must be dynamic and meet the r e s i d e n t ' s needs, i t i s recommended that The Woodlands School s t a f f p e r i o d i c a l l y r e evaluate  the r e s i d e n t ' s s t a t u s and need f o r f u r t h e r s e r v i c e s .  T h i s s e r v i c e has been d e f i n i t e l y l a c k i n g i n The Woodlands School programme.  - 67 -  Public Interpretation A sound p u b l i c e d u c a t i o n a l programme on mental r e t a r d a t i o n and d e f i c i e n c y i s almost non-existent i n B r i t i s h Columbia.  The p u b l i c must be made aware o f the extent o f men-  t a l r e t a r d a t i o n and d e f i c i e n c y so that they w i l l  l a t e r be a b l e  to see that second c l a s s s e r v i c e to the m e n t a l l y handicapped i s uneconomical. I n t e r p r e t a t i v e m a t e r i a l should be d i s t r i b u t e d t o the p u b l i c and l o c a l surveys s h o u l d be made o f community needs and services.  The development o f p r i v a t e p h i l a n t h r o p i c funds f o r  r e s e a r c h i n t h i s f i e l d s h o u l d a l s o be encouraged. Good i n s t i t u t i o n a l care o f the m e n t a l l y handicapped i n B r i t i s h Columbia may be s a i d t o be a r e a l i t y o n l y when each and every one o f the f o l l o w i n g c o n d i t i o n s have been s u c c e s s fully  instituted:(1) When t h e p u b l i c i s made aware and a c c e p t s t h e need f o r the best p o s s i b l e care o f i t s m e n t a l l y handicapped. (2) When t h e r e i s c o o r d i n a t i o n o f p r o f e s s i o n a l s k i l l s and facilities. (3) When s e r v i c e s and f a c i l i t i e s keep pace with the demand for care. (4) When a l l r e s o u r c e s a r e used t o the optimum. (5) When r e s e a r c h uncovers the best methods o f p r o v i d i n g the utmost q u a l i t y of c a r e . (6) When s e r v i c e s a r e a v a i l a b l e f o r every m e n t a l l y capped person.  handi-  Thus f a r B r i t i s h Columbia i s l a g g i n g f a r behind i n any r e a l i z a t i o n o f such g o a l s .  Impetus t o reach t h e s e  goals  should come from both p r o f e s s i o n a l and l a y groups with the  - 68 s o c i a l worker p l a y i n g a major r o l e i n i n t e r p r e t a t i o n to the community a t l a r g e . Other C o n s i d e r a t i o n s The S o c i a l S e r v i c e Department at The Woodlands School i s s e r i o u s l y handicapped by l a c k of depth i n s t a f f .  T h i s nat-  u r a l l y means a c u r t a i l m e n t of casework s e r v i c e s to the r e s i d e n t s . However, casework s e r v i c e s s h o u l d be a n a t u r a l r i g h t of the r e s i d e n t , a r i g h t which he has e v e r y o p p o r t u n i t y to make use o f . I n c r e a s i n g the S o c i a l S e r v i c e Department a t The Woodl a n d s School to a b a s i c minimum of ten t r a i n e d s o c i a l workers, i n c l u d i n g two s e n i o r casework s u p e r v i s o r s , s h o u l d be as soon as p o s s i b l e .  instituted  This increase i n s o c i a l service s t a f f  would then b r i n g the r a t i o of s o c i a l workers to i n s t i t u t i o n a l p o p u l a t i o n more i n l i n e with the recommended standards o f s o c i a l worker to one hundred r e s i d e n t s f o r s i m i l a r  institutions.  C l o s e r c o o p e r a t i o n between the S o c i a l S e r v i c e ment and o t h e r departments should be maintained.  should be compiled  Depart-  There i s a  d e f i n i t e need f o r a manual o u t l i n i n g d e f i n i t i o n s and used i n the care of the m e n t a l l y handicapped.  one  principles  Such a manual  by a committee o r group chosen from pro-  f e s s i o n a l and n o n - p r o f e s s i o n a l r e p r e s e n t a t i v e s h a v i n g knowledge on the s u b j e c t . The whole a r e a o f r e h a b i l i t a t i o n i n The Woodlands School s h o u l d be r e a s s e s s e d .  R e h a b i l i t a t i o n should not  be  seen as being n e c e s s a r i l y synonymous with d i s c h a r g e or as a separate segment from admission  and i n s t i t u t i o n a l c a r e .  Rather,  i t s h o u l d be seen as a process which begins with the i n t a k e  - 69  i n t e r v i e w and continues  -  through the t r a i n i n g programme u n t i l  f u l f i l l m e n t i s reached i n the i n s t i t u t i o n or i n the community. During  the i n t a k e i n t e r v i e w the s o c i a l worker should  f o c u s h i s a t t e n t i o n on r e t u r n i n g the c h i l d to the community p r o v i d e d t h a t the c h i l d can p r o f i t s u f f i c i e n t l y from the e d u c a t i o n a l and t r a i n i n g programme.  School's  I f complete bed care f o r  an i m b e c i l e c h i l d i s the o n l y r e c o u r s e ,  then t h i s s h o u l d  be  seen as the f i n a l r e h a b i l i t a t i v e p l a n , pending p e r i o d i c r e a s sessments of the s i t u a t i o n , as the c h i l d w i l l have reached  the  l e v e l most s u i t e d to h i s c a p a b i l i t i e s a t t h a t time. Such an approach to r e h a b i l i t a t i o n would n a t u r a l l y take time to i n i t i a t e and would r e q u i r e c a r e f u l i n t e r p r e t a t i o n to s t a f f groups. open a whole new  However, once i t was  i n c o r p o r a t e d , i t would  f u t u r e f o r B r i t i s h Columbia's m e n t a l l y  retarded.  A programme of community f o s t e r homes and boarding homes f o r the m e n t a l l y r e t a r d e d c o u l d be i n s t i t u t e d . even f u r t h e r "The  Rights of C h i l d r e n  11  T h i s would extend  t o the m e n t a l l y  retarded.  L a s t l y , i n order to show the change i n emphasis from s c h o o l i n g to r e h a b i l i t a t i o n the name o f The Woodlands School might changed to 'The Woodlands School  be  for Rehabilitation.'  No programme f o r the education and m e n t a l l y r e t a r d e d can be completely  t r a i n i n g of  s u c c e s s f u l without  quate m a t e r i a l r e s o u r c e s i n the programme i t s e l f .  In  the  adeThe  Woodlands School there i s a d e f i n i t e need f o r more equipment such as r e c r e a t i o n a l equipment, t o y s , et c e t e r a .  Adequate  r e a d i n g m a t e r i a l and l i b r a r y f a c i l i t i e s s h o u l d a l s o be f o r the r e s i d e n t s .  As was  provided  p r e v i o u s l y mentioned, the p u b l i c must  - 70 be aware that second-class care i s not economical, i n the long run. This study has pointed out the need f o r further expansion of services to the mentally handicapped Columbia.  in British  The necessity of expanding such services, a f t e r  careful research has disclosed the actual needs i n t h i s area, must be c a r e f u l l y interpreted to the public so as to assure t h e i r f u l l support on both the community and i n s t i t u t i o n a l levels.  The s o c i a l worker must be prepared to assume a large  proportion of the r e s p o n s i b i l i t y f o r keeping the everincreasing needs of the mentally handicapped  before the pub-  l i c ' s eye, so that the best possible care may at some future time be available to every mentally handicapped  •ss- #  *  person.  - 71 -  APPENDIX A  BIBLIOGRAPHY  SPECIFIC REFERENCES Books D i M l c h a e l , G. S a l v a t o r e , V o c a t i o n a l R e h a b i l i t a t i o n o f the M e n t a l l y Retarded. U.S. Govt. P r i n t i n g O f f i c e , Washington, D.C., 1950. Myers, C. Rogers, Toward Mental H e a l t h onto P r e s s , Toronto, 1947.  i n S c h o o l . U. o f T o r -  A r t i c l e s . Reports and Other S t u d i e s American A s s o c i a t i o n on Mental D e f i c i e n c y Standards Brochure, American A s s o c i a t i o n on Mental D e f i c i e n c y , 1952. Dinsmore, Mayme, "Teaching S p e c i a l i z e d S u b j e c t s t o the Ment a l l y D e f e c t i v e , " American J o u r n a l of Mental D e f i c i e n c y . J u l y 1952. Gibson, Robert, "Mental D e f i c i e n c y a s a Basic D i s c i p l i n e i n the T r a i n i n g o f a P s y c h i a t r i s t , " Mental H e a l t h . N a t i o n a l A s s o c i a t i o n o f Mental H e a l t h , Summer 1952. Heilman, Ann E l i z a b e t h , " P a r e n t a l Adjustment t o the D u l l Handicapped C h i l d , " American J o u r n a l o f Mental D e f i c i e n c y . J u l y 1952. Meyer, Gladys A., "Twelve Years o f F a m i l y Care a t Belchertown S t a t e S c h o o l , " American J o u r n a l o f Mental D e f i c i e n c y , January 1951. P o t t s , Jane, " V o c a t i o n a l R e h a b i l i t a t i o n o f the M e n t a l l y Retarded i n M i c h i g a n , " American J o u r n a l o f Mental D e f i c i e n c y . October 1952. Richman, S o l , "The P u b l i c R e h a b i l i t a t i o n Program and E f f e c t i v e R e l a t i o n s h i p s with Other A g e n c i e s , " American J o u r n a l o f Mental D e f i c i e n c y . October 195V. Rogers, Jean, "Family Care School Program a t Newark S t a t e S c h o o l , " American J o u r n a l o f Mental D e f i c i e n c y . October 1951.  72 S i o n , A l v i n , "Casework with An A d o l e s c e n t Boy o f Moron ligence," A m e r i c a n J p u r n a l o f M ^ A p r i l 1953*1 '.  Intel-  The Woodlands School S o c i a l S e r v i c e Department Annual Report, (1951-1952). The Woodlands School S o c i a l S e r v i c e Department Annual Report, (1952-1953). T i z a r d , J . , "The E m p l o y a b i l i t y of High Grade Mental D e f e c t i v e s , " American J o u r n a l of Mental D e f i c i e n c y . A p r i l 1950. GENERAL REFERENCES Books Burt, C y r i l , The Backward C h i l d . U n i v e r s i t y of London P r e s s , London, England, 1937. Penrose, L.S., B i o l o g y of M e n t a l _ D e f e c t i v e s . S i d q u i c k and J a c k son, London, England, 1950. Richmond, Mary E., What I s S o c i a l Casework, R u s s e l l Sage Found a t i o n , New York, 1922. Sarasen, S.B., The Psychology o f Mental D e f i c i e n c y . Harper, New York, 1949. T r e d g o l d , A.F., Mental D e f i c i e n c y . B a i l l u r e , London, England, 1952. A r t i c l e s , Reports and Other S t u d i e s Buck, E l i z a b e t h W., "Developing the Community's R e s p o n s i b i l i t y f o r the Adjustment of the M e n t a l l y Retarded," American J o u r n a l o f Mental D e f i c i e n c y , February 1952. Coleman, James C., "Group Therapy with Parents of M e n t a l l y D e f i c i e n t C h i l d r e n , " American J o u r n a l of Mental D e f i c i e n c y . A p r i l 1950. G i l i b e r t y , Frank R., "The Role o f the S o c i a l Worker,* American J o u r n a l o f Mental D e f i c i e n c y , January 1951. Haasarvd, F l o r e n c e F., Moore, S a r a W., " V o c a t i o n a l R e h a b i l i t a t i o n and E d u c a t i o n f o r the M e n t a l l y Retarded i n M i n n e a p o l i s , " American J o u r n a l of Mental D e f i c i e n c y . October 1952.  - 73 -  Mental Hygiene. S o c i a l Work Year Book, 1945. Scholter, Bertha B . , "Social Training f o r Boys and G i r l s , " American Journal of Mental Deficiency. A p r i l 1950.  #* *  

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