Nicole Cohen, Human Services and Sociology

Lifespire, Brooklyn, NY

Therapy Aide IV

SPRING 2018 CO-OP

◼Company: Lifespire, Inc.

▪ Park Slope Day Program in Brooklyn,

NY

▪ Lifespire runs 12 day programs and 118

residences throughout NY state for

adults aged 22 on with intellectual

disabilities

◼Title: Therapy Aide IV

◼Dates: Jan 8-June 29

◼Pay: $13/hour (NYC minimum wage)

◼Self-developed by a Psychology

student the previous cycle

BASIC CO-OP INFO

◼ Job description ▪ “As a Therapy Aide IV, student will be a valuable member of the psychology team

for the day program. She will provide psychology services which will include

behavioral intervention and planning, crisis intervention, participating in team

meetings, working with front line staff and reporting to the lead psychology staff

in the building who may assign other tasks.”

▪ “Serving populations: Adults with Development and Intellectual Disabilities with

serious behavioral challenges. Previous experience in mental health preferred.”

◼Sufficient description? ▪ Vague, but not inaccurate

▪ Still unsure what “team meetings” refers to; attended person-centered meetings

for each individual and regularly consulted with the psych “team” of 2 people

BREAKING DOWN THE CO-OP

◼How I spent the day (really depends!)

▪ 10-80%: Covering for direct support staff during their breaks and if understaffed (to maintain ratio of 8 individuals to 1 staff member)

▪ 0-30%: Participating in each individual’s biannual person-centered meetings to discuss goals, skills, behaviors, satisfaction, preferences, etc.; consulting with other psych staff, drawing up/editing as-needed behavior plans

▪ 0-20%: De-escalating behaviors and counseling, handling anything from mild stress to aggressive physical outbursts

▪ 0-50%: Creating fliers for events or meetings, doing research to plan trips, formatting weekly and monthly calendars, decorating for events

▪ 0-40%: Accompanying groups of individuals on trips into the community (ex. 99 Cent Plus Store, art exhibits, Michaels, bowling, circus, etc.)

BREAKING DOWN THE CO-OP PT. 2

Flier I made for the All White

Affair

TRIP TO THE BROOKLYN BOTANIC GARDEN!

I wish I could’ve captured how much the guys loved this trip, but taking pictures of them isn’t allowed.

OUR CENTER’S CONTRIBUTIONS TO THE AGENCY-WIDE MOTHER’S DAY CRAFT FAIR

A coworker of mine who has an art degree ran these projects, while myself and some other staff helped out. A couple individuals and staff took a trip to main office to help sell our crafts. People were fighting to claim them!

◼Around 100 day program attendees come from 9 AM to 3 PM, range of functionalities

◼Diagnostic criteria of adults with intellectual disabilities (ID)

▪ IQ under 70

▪ ID developed by age 25 and expected to continue throughout lifespan

▪ Limited skills in activities of daily living (ADL), money management, communication

◼Really enjoyed working with the population: all different personalities, perspectives, ability nuances, interests

◼Worked in the psych department

▪ Solved complications caused by behavior

▪ Wrote guidelines for staff best practices with various behaviors

▪ Identified mental illness-based issues that needed attention

THE INDIVIDUALS

◼ The management ▪ Director, two asst. directors

▪ Due to nature of position, sometimes faced poor communication patterns and limited encouragement

◼ My coworkers ▪ Developmental Aides (DA) = classroom staff

▪ Habilitation Practitioners (HP) = verify that DAs have completed daily write-ups on individuals’ goals, complete monthly write-ups

▪ Habilitation Specialists (HS) = schedule/run biannual meetings, communicate with individuals’ coordinators and residence staff/families, solve clothing/home/safety problems of caseloads

▪ Some wonderful and compassionate staff, some rude and/or lazy staff ▪ Education and experience not needed for the field, which is not necessarily the cause of some

staff being under par, but allows for that to happen

▪ Not enough money or motivation in the field to ensure everyone’s competent and caring ...sad

THE COWORKERS

◼Professionalism

▪ Email writing

▪ Verbal communication

▪ Understanding position hierarchies and what information goes to whom

◼Field experience

▪ Language of the ID field

▪ Jobs within the field

▪ Coordinating nuances of the various facets of the individuals’ lives

▪ Understanding the mental health/psychiatric side of the field

◼Handling a full-time job

▪ Time management during the 40 hours

▪ Making meaningful decisions for what to do in that coveted after-work free time

WHAT I HOPED TO LEARN

◼ Work style ▪ Can become frustrated if others in my team aren’t aligned with my goals/pace, might

work better alone

▪ Love task-based work, like writing up a guideline or designing a flier; often frustrated with vague or poorly outlined assignments

▪ If the tasks are attainable, I can thrive multi-tasking using lists, etc.

▪ Sometimes spent too long on somewhat menial tasks to achieve perfection, but ultimately could’ve managed time more effectively

◼ Preferred managerial style ▪ Transparent communication, respect

▪ Competence in tech basics/communication/empathy

◼ Capacity for human service skills ▪ Compassion, focus, perspective, effective communication in meetings and mundane

tasks, quick problem-solving, flexibility, reflective listening

◼ Sensitivity ▪ Can take criticism hard

▪ Very concerned with coworkers’ opinions of me

WHAT I LEARNED ABOUT MYSELF

◼Morning relaxation, 9:30-10 AM

▪ Daily activity carried out by the TA IV (me) in the cafeteria with beanbag chairs

▪ Hadn’t been running for years until I started it back up

▪ Supported by binder of research detailing the psychological benefits of mediation in an under-stimulating environment

▪ Played slow, calming music and tried to limit conversation

◼5-10 participants, 1-3 staff

▪ Typically the more high-energy individuals

▪ Found that it helped them calm down for the rest of the day vs. days without morning relaxation

▪ In my opinion, everyone should do this! All ability/energy levels

◼Additional relaxation as needed

▪ Implemented at other points in the day if a behavior needed de-escalation

MEANINGFUL ACTIVITY: RELAXATION

◼ Many types of food modifications (for reasons such as: some people with cerebral palsy have trouble swallowing because of underdeveloped throat muscles) ▪ 1” cut up, ½” cut up, ¼” cut up, ground, puréed

◼ Specific ways to cut or serve certain foods ▪ Hotdog cut long ways

▪ Make it as appetizing as possible

▪ No ground wild rice

▪ Maintain moisture and keep foods separate

◼ How I felt ▪ Guilty about and sympathetic to their missing out on whole/diverse foods

▪ Understanding of the fact that this is an adjustment they’re used to and apparently content with

▪ Despite the blended contents being normal food, ground or puréed foods seemed more pungent, and all of the smells mixed together at once was challenging

▪ Felt increasingly natural with practice and with watching other staff members incorporate it into the normal daily routine

SOMETHING I’D NEVER DONE BEFORE: FEEDING PEOPLE BLENDED FOOD

◼Communication /process issues?

▪ Lifespire wasn’t aware they had to take steps to acquire their next co-op, so nearly ignored the résumés

▪ So I emailed Lisa to ask why Lifespire hadn’t gotten to me, and she called them and I got an interview

◼The value of experience in the field

▪ Serving this population might be an adjustment for some

▪ Feeding, toileting, physically assisting, creating appropriate activities come with practice – can learn on the job, but easier to already be comfortable with these things

▪ Compassion and patience VERY important!

◼Once on the job: long, elaborate orientation

▪ Training on patience, skills, reporting abuse, diagnosis characteristics, person-first language, policies, reinforcements, etc.

▪ 8 hours of SCIP training: de-escalation and self-protection techniques

PREPARATION

◼Could see myself in this field

▪ Possibly not direct support, but rather coordination or administration

▪ Interested in corporate and/or curriculum development-type work

◼Hoping to delve into other human services fields

▪ Substance abuse

▪ Homelessness

▪ Immigration

▪ Hunger

◼Add computer science?

▪ Taking Fundamentals of Computer Science 1 in the Fall to see if I like it and to develop some basic CS skills

▪ Could turn into possible human-centered tech career

FUTURE PLANS

◼Governing body in NY state: Office for People with Developmental Disabilities (OPWDD)

▪ Sets guidelines such as: treatment of individuals, reporting abuse, which activities and events are billable, how much funding comes in

▪ Staff must submit daily and monthly records of billable activities for each individual, stating progress on goals

DISABILITY SUPPORT POLICY AND STRUCTURE

◼Will do anything for funding ▪ In the nonprofit world, it sometimes feels like organizations play up their

performance when an auditor/observer comes around, for (legitimate) fear they may lose funding if they don’t meet certain standards

▪ Even if unobserved performance is low and the population is in reality underserved, management ensures the auditor sees an ideal story

◼But is the policy really serving the people it’s intended to protect? ▪ Guidelines in this field are often set by people with little understanding of the

population and limited compassion

▪ Some activities are not allowed because they are “childish” (because we serve adults), e.g. we couldn’t do puzzles or many types of art, watch movies, etc. – seems unnecessarily limiting; very frustrating!

PUBLIC POLICY NUANCES AND ISSUES

EXPLORATION IN NYC

My best friend, a former Philadelphian, was able to move in with me.

Here’s me and an NEU exchange student friend from New Zealand at the Whitney.

I started climbing at a gym near me called Brooklyn Boulders, and now hope to make NEU’s climbing team.

I tried walking my cat, Bruce Willis, to his apparent dismay.

EXPLORATION PT. 2

I found a fantastic role model in a friend through volunteering to help immigrants learn computer basics. Here are 2/3 of her cats that I took care of while she was away one weekend.

My brother and I explored a huge flea market in Brooklyn called Smorgasburg; pictured are fried cookie dough balls.

After a food tour, my sister and I went to a famous cupcake place designed after a classroom.

EXPLORATION PT. 3

I signed up for an intro coding class and a few tech-related talks at this place called General Assembly, and developed newfound interests.

The Brooklyn Museum is incredible, and I was able to see the David Bowie Is exhibit that was only up for a couple months there.

Here’s an old train that visitors can walk through at the Transit Museum. NYC has the biggest system in the world!

At the Brooklyn Public Library, I watched Nelson Mandela’s grandson, Ndaba Mandela, discuss his new book, Going to the Mountain, which shares his experiences being raised by one of the world’s greatest humanitarians.