Lillian Thoms, VR Counselor

Sometimes my caseload gets to the point where I feel overwhelmed. Then I will go and tell the supervisor and assistant supervisor, "Okay, I've had enough. We need to start divvying these up to the other people because I can't take anymore." I did that last summer, because I was up to about 165. At that point I did not feel like I was able to make monthly contacts with everybody successfully, because by the time I got through all the numbers, it was the next month and time to start over.

I strictly deal with severely disabled as in mentally retarded, people that have cerebral palsy, some people that have combinations of CP (cerebral palsy) and MR (mental retardation), some individuals that have MR, drug/alcohol, and MI (mental illness). And I work with the high school kids, which they're needy as well, but they're not as needy as my individuals that have all those dual diagnosis.

My referrals come from lots of different places. I get them from the high schools. Davis County group homes, the Central State Regional Center, sometimes from local care providers. There are self-referrals, and, of course, all the counselors have different referral sources.

Specializing

As far as my specialty area, when I first started I had a general caseload, which means that I had, you know, back injury, vision, hearing loss, everything. But my bosses learned that I liked to work with individuals that were severely disabled as in MR, dual diagnosis, BD (behavior disorder) - that was me. So they started shifting stuff around and giving other people the more - I won't say the easier ones, because nobody's necessarily easy when they have a disability - but the individuals that weren't so needy. Maybe they just wanted to go to college, which - that's important, too , but when you talk about having to take a person and sometimes give them a shower or practice other personal hygiene things with them - it's a more challenging case to handle.

I discovered I was more apt to really enjoy doing that, so that's how I ended up getting my caseload. And, as far as the schools, my background's in juvenile delinquency and gangs, so that's how I got the schools.

I've got one client whom the high school really did not want to deal with. They tried to transfer him to an alternative school, and that school basically gave him the run around. He had an interview to get in there, which I thought was odd, because that's a school for individuals that are high-risk and ready to drop out of high school - BD (Behavior Disorder), severely BD, you know, criminal record and all.And, basically, between the case manager and myself, we worked really hard getting him in there, and he's finally in there, but he has some serious issues that I think, if this hadn't worked, he would've easily ended up in a gang. Just because he would have felt accepted, where as, at school, nobody wanted to deal with him.

I have to work with residential counselors, case managers, parents, guardians, etc. - more than most VR counselors. And I've got to deal a lot with public administrators, because a lot of the public administrators are guardians for my clients. Which means, I can't open a case, can't even start them on employment without permission. Sometimes that takes a lot of footwork that I don't feel like I could ask anybody else to do, because who else knows my client but me?

There are only three other counselors that do supported employment - I do primary supported employment where I have the individuals with severe disabilities. The other counselors are doing more standard vocational guidance, placement sort of things, but not the intensive supported employment that I deal with. So it's hard for me to go and talk with other counselors because they'll say, "Lillian, I don't have a clue what you're saying." Of course, when I try to explain the disability and how would they help, some have told me, "I'd close them, because there's nothing you can do for them." But I'm hard-headed, or determined, whatever you want to call it. I believe there's a job for everybody. We just have to find it.

Advice to new VR staff

One thing I'd tell new VR staff - they have to be extremely flexible. Sometimes I do have a set schedule and I might have somebody scheduled every half-hour out of an eight-hour day. But then issues will come up that you need to deal with right now, which means then, you have to juggle. So you have to be flexible. And, yeah, our schedule says 7:30 to 4:00, but sometimes you have to stay later. It's not written in stone that VR says that you have to stay, but you have to really care for your individuals. And you have to express that in order for them to really trust you and believe that you're trying to help them.

So there's a lot of times that I'm mumbling "I don't want to stay late. But it's not an option because I know these people, and it's not just a job. I'm trying to make a difference, and so as a result, sometimes I've been here till 7:30, 8:00 at night and then have to drive back to the town where I live.

So be flexible. Don't be afraid to ask questions because you know how they tell you in high school no question is a dumb question - and that's true. Especially when you start working with individuals and things that you say and authorize are going to affect their life. If you don't ask a question when you're really not sure, you could be fouling them up for the rest of their lives instead of making a drastic, positive difference. So I would say definitely ask questions.

You need to know when your better time for doing paperwork is. If you are a morning person, do it in the morning. Some individuals like doing it at night. You can flex your schedule up as far as 9:00 until 6:00 or 9:00 until 5:30. Also be able to accept a challenge and also be able to accept criticism, because sometimes you'll get it - not necessarily from your clients or the guardians, but from providers, case managers. It will be things like: "I really don't like how you handled this. Could you do it different?" And when that happens, first I'll explain why I did it the way I did it. And then I'll say, "Well, how would you have handled it sitting in my shoes?" I think that's how we've built so much of a relationship with all the case managers and providers. I can pretty well call any of them - doesn't matter if it's work-related or not - and if I say, "I need help," they'll come and help because they know they can tell me if I'm doing something wrong. So I would say definitely be open to criticism.

And there's sometimes that I might say something and I really didn't mean it the way it came out. And then, of course, they'll pull me aside afterwards and say, "Lillian, you know, that really sounded mean. You sounded as if you didn't give a sh-- about anything." And then I'll say, "Oh, my God, I didn't mean that." So I'll try to go back and talk with the client to make sure that they understood the way I wanted it to come out. And the parents, most of the time, say, "Oh, yeah, we understood what you were trying to say."

Relationships With Clients and Parents

Sometimes I've had to tell parents things they do not want to hear. If they really wanted their son or daughter to have a particular job and, based on the assessment, I really did not think it was appropriate. I had to try to figure out how could I say this to the parents so it didn't sound like I'm saying, "You're kid's stupid. They can't do this." Because I would never classify anybody as being stupid - everybody has a place in society somewhere. We just have to find it. That's really a touchy subject. You never know if you're going to get parents that are agreeable and will listen to what you're saying, or if you're going to get parents that will go to central office, then go to Protection and Advocacy. So you have to kind of tread lightly. That's why, in the beginning, you have to build rapport with the parents, or the guardian. Then they know that you're not going to misguide that individual. They can be real defensive at first.

Initially, when they first come in for interviews, everybody, of course, is real stand-offish. They're only answering what I ask, they're not going to give me anything extra. I can start talking about my dogs, my daughter, anything - but they're not giving me anything extra. Then, gradually, we start building some rapport because I'm good on meetings - meaning that I will call meetings. I don't care if it's 7:30 in the morning. I'll say, "We need to be at such-and-such place at 7:30 because we have some issues we need to resolve." If I know that they're really sensitive or scared about coming to a state office, I'll go to their house. I'll go to the mall and meet them. I'll go to the park and meet them. Wherever they want to meet, I'll meet. And after about two or three of those meetings, they discover, "Oh, she's not so bad."

My clients all know I'm a morning person. So by the time I get here at 7:15, they're calling me. Because they know if they call after 9:00, I'm not likely to be here. I'm likely to be out in the community, popping in on sites, talking to employers.

Keeping Up With Paperwork

I also function better with paperwork in the morning. Once 1:30 comes, I do better talking because I can jot down what I said and then keep talking. But as far as paperwork, it will be wrong in every shape if I try to do it in the afternoon. So I think the first thing is to decide whether or not you're a morning or afternoon person and then fit your work schedule around that. Then you pretty well have to know the time span it takes you to do certain things. Like if I'm doing a plan, I know that it probably takes maybe five or ten minutes and I can have ten of them and have them done in an hour. Report of contacts are a little different you have to make sure that every detail is in the report. You guys might have talked about something, but if it's not in the report of contact, and if an appeal comes up and they say, "Okay, well, you told me I could do so-and-so." And you say, "No, remember I told you this other thing." If they go and look in the file say, "No. It just says that you made contact with them, but it didn't say specifically what was said." Then, you're leaving yourself open for whatever kind of criticism …. It's always the client's right : the customer's always right. If you don't cover your backside, looks like you just dropped the ball and the client's going to get whatever they want. It's crucial that you have the comments in your reports.

So on a daily basis we have to type in or dictate our reported contacts from the previous day on individuals we've met with. We definitely have to do that on a day-to-day basis because we need to have those contacts in the files so if anybody pulled the files while we're not in the office or they have questions, everybody knows what's going on. So that's a day-to-day basis thing. I would say probably at least 70 percent of my job is shuffling paperwork

I hate the paperwork. And that computer screen. Of course, we've had people from central office come and say we should look at paperwork as a way for us to give, to help our clients get what they wants. I've tried to look at it that way, but I keep thinking, "It's just something keeping me from talking to these individuals." So I don't like the paperwork.

Of course, you also have secretaries that you can utilize, to whom you can dictate the report of contacts, but they're trying to get us more into the computers where we do them ourselves. Right now the only thing that I've had my secretary doing is the authorizations, like if we're authorizing a payment for something, she'll do that.

I've got a feeling that in about a year or two they'll discover, "Okay, this computer thing isn't working because our counselors are actually sitting in the office doing more paperwork than contacts." There's been sometimes where I've had to take two days to try to catch up because I had a day that was just swamped. For instance, if we have an emergency meeting, I have to basically juggle then and decide, "Okay, now what's more important?" or can I move this one back or can I move it up further? So it's not much fun sometimes.

Things People Misunderstand About VR

The biggest misunderstanding I see in parents is that they misunderstand services overall because schools tell them, "If you go to Voc Rehab and you have a disability and you're declared eligible, they can pay for you to go to school." So they expect us to pay instantly. They don't know that we have to go through financial guidelines, looking at their income, for instance. Although I try to avoid that if I know they're wanting to go to school. I'll say, you know, "Let me tell you what the financial guidelines are, you tell me if your family falls below this amount. If so, complete the form enclosed and provide me a copy of your income taxes." If they don't, then I can safely say we can't assist you financially. But I don't like to get in people's financial business. That's personal and if I can't help you, I don't want all your financial history.

A lot of people think if one counselor says no to something, another counselor is going to say yes. I don't think they realize that we all go by the policy. So I think they think we're saying no just because some of us have soft hearts and some of us don't have hearts at all. They fail to realize we're following policy and procedure as a guideline. I mean, there's a lot of ways that we can work with it until eventually we can get a person declared eligible if it's kind of questionable- but it ultimately has to be based on what is in the Rehab Act. So people come and say, "Well, so-and-so had me declared eligible, you know, previously." But if they've got a job and they're maintaining it, and there're no problems, under the federal policy they do not to have any vocational impediment. And they don't understand all the hoops we have to jump through to get services or to get them declared eligible. They don't have a clue about what we have to do as far as policy and procedure.

I would say most clients pretty well know what we do. They might not have a clear perception of the depth that we have to go into, but overall I think they know that our primary goal is to get an individual who's got a disability into employment where they can be successful. I don't know if various referring agencies always tell the individuals when they make the referral, because people will say, "I am getting food stamps, social security, I do not want a job." And I say, "okay." Where do you go from there?

VR Burnout

I would say - and this is going to sound bad - when a counselor gets to the point where they don't want to help, or they gripe about everything and nothing is good and they don't want to provide services or they don't like what the client is doing - it's time for them to retire. If life doesn't look good and you don't want to help or you don't see the reason in why you're doing what you're doing, then you're in the wrong job.

I have always told everybody in the office, if I get to the point where my clients get on my nerves, the case managers get on my nerves, the group home staff, everybody involved, tell me to switch jobs. Tell me I am not doing my job. Because this is a people job, this is a helping job. If we're not doing that, and we're just sitting in the office pushing a pen and shuffling some papers, then we're not doing our job. If I get to that stage, then push me out. Just tell me. I wouldn't want to sit here taking up a space."

I think a lot of the image we portray bounces off on the individuals, and sometimes... it's not that you don't care, you're just so overwhelmed with your own personal life.

Separating Work And Home

Which is another thing - you have to be able to cut off your own personal life once you get to work. And that's hard to do sometimes unless you're rare. My father died unexpectedly a few years ago, and so I took a week off. But when I came back, every half hour I had something scheduled because that's the only way I could function and deal with it - I had to keep moving, constantly moving. When I could talk and actually see somebody else's disability or hear about their disability, it made me appreciate that I was making a difference. I knew if I sat here in this office I would drive myself bonkers. That was the way I could cut if off and leave it at the back door when I walked in.

On the other hand, I am not good at leaving work problems at the office. I'll worry at home about work problems. I've even called providers in the middle of the night and say, "Did we try this?" And they're thinking, "Who is this?" Or I'll page them and leave a message such as "9-1-1, 9-1-1." And they're looking at the phone number and they're thinking, "Who is this?" So, of course, they're going to call back.

In general I would say you probably shouldn't do that. When I was married, I used to go home and my husband would look at me and say, "Okay, you're stressing. What's wrong?" And I couldn't tell him at that point because it's confidential information. "Maybe you can just tell me the situation." "No, I can't." So I think he felt like he was blocked out because I put up a shield. And that isn't good. But now, since I'm divorced, I can take it home with me. Yeah, sure. I can talk to my daughter about it, but she's only two. So what does she understand at this point?

The Good Things About Working For VR

What I love most about this job is talking to people - just trying to make a difference. It's a challenge. There's never a day that goes by that there's not a challenging situation somewhere in those eight hours.

And there's a lot of cases where we've dealt with something similar before so we know how to deal with it, but then there comes individuals that we don't have a clue. That's when it's fun. We say, "We need to figure this out, and do it in the right way". So that's fun. And I like talking.

It isn't always a workable situation. Sometimes a case manager or staff person makes a totally inappropriate referral. For instance, a person is working at their workshop, they're having severe difficulties in the workshop for whatever reason - attitude problems, behavioral problems, whatever - and they'll make the referral for supported employment. Which means they want a job in the community - without addressing the real reason for the difficulty. Of course, we will try - I will not tell any individual "No," even though I know that they're having problems in the workshop. I'll say, "Okay, let's give it a shot." But when we start, sometimes you can see difficulties coming.

And I'll talk to everybody in the office, "What would you do about this?" And a lot of people will say, "Well, I wouldn't even open it." Nope, I will open the case. Then we'll start the assessment, on-site assessment. If we're having serious problems then, of course, we'll have to have an emergency meeting and everybody's mad because I called an emergency meeting. But I have to tell them, "This is not appropriate. If he can't or she can't work in the workshop, we can't put them in the community expecting that things are going to be better."

On the flip side of that, we've had cases where someone just didn't want to be in the workshop and they do fine in the community. So that's why I try not to refuse to open anybody's case because, if they're burned out on what they're doing or they don't like what they're doing in the workshop, a job in the community may be just right for them.

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