Typical, Generic, In Vivo, In Situ, Granola, Voodoo, Normal, Informal, (a.k.a. Natural) Supports

By Cary Griffin, Director of Training, The Rural Institute

EVERY SO OFTEN a concept creeps into the rehabilitation psyche and fundamentally changes the way we forever view our world. The concept of natural supports holds great promise to those of us who provide work site training and support to people in jobs and who thus understand how being an outsider feels. Indeed, anyone recalling their first day in any unfamiliar setting or job knows the discomfort and anxiety associated with being new or different. Correctly facilitated, natural supports can minimize the anxiety and problems commonly associated with assimilation into new environments.

The implementation of natural supports involves the identification and subsequent use of typical training, assistance, socializing, and supervision as support tactics. This is much more difficult and time consuming than simply analyzing the capacity of the work site for such opportunities. However, once the change in thinking was proffered—illuminating such incredible potential for consumer success, community integration, and reduced expenditures—the momentum of the quick-fix bandwagon became difficult to control. Soon after professionals and others began reading the new literature on natural supports, employment specialists demanded specific training, parents expected an end to stigma, and administrators conjured visions of captured investment capital. Some rehabilitation funders soon put severe restrictions on job coaching allowances and reimbursements by invoking natural supports without bothering to understand the process of work site inclusion.

This circumstance conjures up the historical concept of the “Revolution of Rising Expectations.” Briefly, this theory holds that revolutions occur only when things are getting better, not when they are getting worse. Periods of economic or political change and uncertainty lead citizens to hoard what they possess, to look toward old or comfortable ways of behavior, or to maintain the status quo. When people are shown the promise of a new day, however, the specter of not getting one’s share and the need for rapid gratification also comes into play. Certainly former Soviet Premiere Gorbachev now realizes that once they were promised democracy and free market competition, the people of Russia, predictably, demanded jobs, bread, and an end to bureaucracy. People poised for change do not tolerate the time it takes to develop implementation technology and infrastructure. The same can be said as we discuss the facilitation of natural supports.

Developing natural supports demands the studied approach to job match that includes: 1) the critical understanding of consumer desire and ability, 2) a keen sense of work site challenge circumvention and innovation, and, 3) a clear understanding of how corporate cultures either facilitate or poison acceptance of the individual. We live in a do-it-now society that has flourished based on consumerism. We want what we want, and we are not willing to wait for it. The advertising industry is richer by 130 billion dollars per annum because of this material thirst. A major cause for the decline of the U.S. economy in the preceding decade was that American business had for years equated quality with better marketing, not with better products. The rehabilitation field is making the same mistakes in its posturing of natural supports. The package is seductive: empowerment, reduced stigma, reduced costs, happy employers and co-workers. If we implement correctly, we will probably all lose weight as well.

The competence of the field does not live up to the promise of natural supports as yet. Most front line staff, such as Employment Specialists, turnover too quickly to be trained or to benefit from acquired personal experience. Management in community rehabilitation has yet to value up-front investment in community employment development that will yield long-term positive results. The people who first articulated the concepts of natural supports are certainly not to be blamed. Indeed, we should thank them for making an unfocused postulate more clear. Rather, our hell-bent, acquisitive, breach-filling approach must be supported with planful implementation, or we stand to continue the practice of putting people with disabilities at risk. Natural supports will not cure real human and economic problems; it is another tactic that moves us farther from the practice of “place and pray,” and closer to true professionalism in our conduct, fostering the realization of inclusion and cultural diversity.

Not long ago I received a call from a teacher who had attended an in-service training on her high school’s new transition project. She was clearly excited about using the new forms, but had no concept of employment or support strategy. She had managed to get an appointment with the personnel director of a local Fortune 100 company. She asked me what she should say when she got there. I asked if she had someone in mind for a particular job or was she simply introducing herself and prospecting; did she know anything about the company? She answered that she just knew there had to be a job available somewhere in that big building and that by next week she was going to get one for one of her students.

Eventually she was persuaded to take a more systematic and person-focused approach. Then, she said, “Oh, by the way, we don’t have any job coaches, so I’m going to have to find some natural supports out there, too.” Natural supports are not One-Size-Fits-All. One does not simply choose the color that looks best. Experience in developing natural supports reveals that complex social and organizational forces in business settings must be respected. Further, it is much easier to utilize natural supports if an inventory of worker activities is done on-site, over time, prior to placement; if a good job match is written; and, of course, if the prospective employee has seen the site, and clearly has a desire to work there.

There appear to be at least five phases of natural support development and utilization. The phases include:

1. Inventory Phase: This stage involves on-site assessment of work-related and off-task interactions, unwritten and formal rules and roles, supervisory patterns and practices, etc. In short, this is a study of work processes, visible corporate culture, and the attendant behaviors of co-workers who are immediately or incidentally in contact with the target job position.

2. Initiation Phase: The point when an individual enters the job and begins to interact with other workers (probably with Employment Specialist or mentor facilitation). Typical interactions occur regarding work instructions, assisting another co-worker in performing a task, sharing or being present during lunch or break time discussions and informal rituals. This phase continues the process of uncovering less visible or less obvious traits of the corporate culture. Co-workers are often taught how to teach the new worker during this phase.

3. Transfer Phase: The point when the paid facilitator fades for short and long periods, knowing that the supported employee will get direction and assistance within the workplace. Trust is built on-site among the co-workers, supervisors, employee, and employment specialist. The employment specialist realizes an increasingly consultative role to the interacting parties.

4. Contribution Phase: This point is reached once the new employee is valued by immediate co-workers as a vital or essential member of the work culture. This does not mean that the employee is either the most productive or the highest quality producer. Often, a person’s contributions, regardless of the presence of disability, are based more upon social competence, attitude, dress, humor, tenacity. People with disabilities have long been represented as takers rather than as givers. Supported employment and properly facilitated natural supports can change that image.

5. Co-Worker Phase: At this point, the employee is no longer viewed as someone earning their right to be employed. This person may assist in initiating new employees. Certainly, the commonality of experience with others, at least in the work side of life, diminishes references by others regarding their disability as an individual descriptor.

The most significant hurdle faced in moving to or through the upper phases is time. Professionals must have time to analyze support needs and availability. There must be time for consumers, parents, and employers to explore options and consider career choice. There must be time for work site assimilation. This does not mean that individuals with disabilities should once again be put on hold while we study and control employment avenues. Rather, job development and support processes must be sophisticated enough to reduce job loss and risk. This can be done by learning from the mistakes we have all already made, improving, and more important, using the job match process, and by implementing it correctly the first time.

The phases described here are not necessarily developmental in nature. Individuality and environment will dictate levels of entrance and attainment. Our careful understanding, coupled with a desire to connect people, may help move individuals, communities, and businesses up to, and whatever is beyond, Phase Five. It is clear that consumers, families, employers, and others represent tremendous resources as civil and economic rights are returned. The rehabilitation professional must remember that while natural supports is a pretty package, some assembly is still required.