July 10, 2024 • 66 mins
On this episode of Inside Rehabilitation Counseling, Sarah Price Hancock joins us to discuss her journey as a Certified Rehabilitation Counselor. Following a misdiagnosis of “treatment resistant” mental illness, Sarah received 116 bilateral electroconvulsive therapy (ECT) treatments resulting in Delayed Electrical Injury’s Myoneural Disorder.
Sarah joins us to share her journey to becoming a CRC and provides important insights into treatment for ECT recipients as well as why frameworks like Emotional Self Reliance can be transformative for individuals with disabilities.
Show Notes:
Sarah's San Diego Union-Tribune Op-Ed
The Neuro-Optometric Rehabilitation Providers
Daring to Dream: Essential tools to find employment (Workbook)
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Hello and welcome to Inside Rehabilitation
Counseling, presented by theCommission on Rehabilitation
Counselor Certification. I'mTaylor Bauer with CRCC, and
we're so glad to have you herefor another conversation on the
art and science ofrehabilitation counseling.
There are many certifiedrehabilitation counselors who
first encounter the field as aclient. The perspective of
(00:26):
having a disability can offerprofound insights and
considerations into providingservices for people with
disabilities. Sarah PriceHancock is a CRC and advocate
for electroconvulsive therapyrecipients, having received 116
bilateral ECT treatmentsherself, Sarah became a CRC
after receiving services andlearning about the role of a
(00:48):
rehabilitation counselor. Youmay have read Sarah's op-Ed in
the San Diego Union Tribunelast fall about how employers
can ensure that people withdisabilities are set up for
success in the workplace. Inour conversation, Sarah dives
into this topic further andalso shares her work on ECT
assessments, the importance ofemotional self-reliance for
people with disabilities, and acandid look at her
(01:11):
transformative journey as acertified rehabilitation
counselor. Sarah , thank you somuch for making time , uh, to
be on inside rehabilitationcounseling with us today. We
like to start all of theseconversations kind of in the
same place, you know, yourbeginning with , um, your time
in the profession. So when didyou first learn about , uh,
certified RehabilitationCounselors? And if you're
(01:33):
comfortable, can you explain abit of the story behind your
disability and the journey thatled you to the career that you
have today?
Speaker 2 (01:39):
Oh , certainly . Thank you so much for
this opportunity. Well, Iremember learning about
certified Rehabilitationcounselors in 2009 from a
community college disabilityservices counselor. She was
helping me get academicaccommodations after I'd
finished , uh,electroconvulsive Therapy,
which is also known as ECT. Um,and , um, the colloquial name,
(02:05):
I guess people call it ShockTreatment. I went to her
because the ECT had erased allof my memory of my prior work
experience and my educationalexperience. And I knew that in
order to become a candidate fora competitive job, I'd need to
go back and get completelyretrained. So I went to the
(02:26):
local Community College'sDisability Office because I
knew that it was a diagnosedillness that had caused the
referral for the shocktreatment. And in the
appointment, the DisabilitySupport Services counselor
asked me, if you could doanything in the world, what
would you want to do? And Itold her that I wanted to help
(02:48):
people like me get back ontheir feet after
electroconvulsive therapy, justlike she was helping me. And
she smiled and she said, well,in that case, you need to
become a certifiedrehabilitation counselor.
. Basically in thesummer of 2009, my life was in
chaos. Um, I just escaped anabusive mental health
(03:10):
residential facility, which hadbeen facilitating my receiving
the electroconvulsive therapy.
Unlike , like I mentionedbefore , um, after my
treatment, I had no job, but Iwanted to return to work. But
the problem was I had no memoryof anything required to do what
(03:31):
I'd done in my previous career. Before treatment, I'd been an
editor of faculty papers forthe humanities department as a
student at Brigham YoungUniversity. And I'd also been
an a SL , uh, interpreter incollege and university settings
for several years. But I had nomemory of my training and no
(03:53):
memory of my work experience. Ionly knew that I had the
experience, actually becauseI'd read about it in my own
journals. And also because ofwhat my family and friends had
told me. Uh , I was determinedto get a job. I was determined
to pay rent. I was determinedto live independently. I was
determined to start my lifeover , um, rise from the ashes,
(04:18):
if you will . Um , it wasdifficult because I'd suffered
dense and pervasive amnesiafrom the shock treatments. But
in my desire to become aprotective member of society as
soon as possible, I had a lotof deaf friends who were
helping me to relearn myAmerican sign language. And at
one point, my high school, a SLteacher who was deaf, invited
(04:42):
me to just take his a SL fourclass. He said that I needed
more practice and that I wouldbe the only student that
actually understood what he wassaying in the class. 'cause I'd
known him at that point, I'dknown him for more than a
decade. And he was concernedthat the students who had taken
(05:03):
the earlier classes from otherteachers didn't have the skills
to understand the deaf personwho spoke strictly in American
Sign Language. So he actuallyinvited me so that I could kind
of be a liaison between thestudents when they didn't
understand. I could help themrecognize what he was saying so
(05:24):
that he could better teach themhow to speak incorrect American
sign language, not like piggedin sign language. When I went
back to class, we had readingassignments and I realized, you
know, I really, I could hardlyread. And so he suggested that
I needed some academicaccommodations. And so I hit
(05:46):
over to the Campus DisabilityServices and Support Office. I
walked into her office wearingmy dark sunglasses, ,
and she asked me why I waswearing sunglasses in her
office. And I explained thatthe light just hurt too much.
And she asked if I was having amigraine, but I didn't really
know what that meant. I mean,I'd grown so used to the
(06:08):
perpetual headache from theshock treatments that she asked
me when I started havingproblems with light. And I told
her it started during ECT andshe said she thought I had a
brain injury. Well, I laughedbecause I had no history of car
accident. I had no history oflike a fall or like hitting my
(06:30):
head. I had no history of likebeing in sports or getting
knocked out. And so I just kindof laughed at that. And she
listened and she politelynodded. And I, I just told her
I knew I didn't have a braininjury, but she asked if I was
sensitive to noise. And I waslike , uh, yeah. And then she
(06:56):
asked, well, I told her thatnot only was I sensitive to
noise, it was stressful to tryand process sound. And that a
hearing test right after my ECTshowed that I had perfect
hearing, but that I had delayedunderstanding of what I was
hearing. So I'd actuallystarted using closed captioning
(07:19):
during the shock treatmentsbecause I couldn't follow what
was happening on TV shows. Icouldn't follow what was
happening in conversations. Andit was really, it was a delayed
understanding, delayedprocessing problem. And so
first she asked if I had anyother problems, and I explained
to her that I kept running intowalls, particularly like when I
(07:43):
say walls, like door jams, I'dgo, like, I thought I was going
through a door jam and I'dalways slam my shoulder into
the door jamb . It was like Ihadn't oriented myself in the
middle of the doorway to walkthrough, so I was always
slamming myself into the walls.
It was just really weird. And Itold her also that , um, I'd
have a lot of problems, likewith the coordination for
(08:07):
walking, which was kind ofweird. I'd like, especially
when I'd get tired, I'd stepoff a curb and land on my ankle
instead of landing on my foot.
And I did that all the time. Somuch so that my doctor had
prescribed those orthotic bootsfor , uh, like if you'd broken
(08:28):
your ankle, he'd prescribedthem for both of my legs,
expecting me to use them. So Iwas walking around rather than
having like a , like an anklefoot orthotic. They didn't
prescribe me that. Theyprescribed me two boots, like
as if I'd just had foot surgeryor something. So I was walking
(08:50):
around looking likeFrankenstein. It was just
terrible. But that's whathappens. Anyway , so I told her
that the reason I was reallythere was because I had lost my
ability to read. I was reallystruggling to read. I could
read a line, but then Icouldn't recognize which line.
(09:10):
I'd just read to know whichline to read next, which makes
reading very difficult. And myeyes would jump all over the
page. And I had reallydifficult time with headaches.
The more I read then thestronger the headache would
get, it would just, it was justexhausting. And I'd started
(09:32):
reading when I was three. I wasreading chapter books at the
time, I was in kindergarten. Sothis was a huge change from my
previous ability. She is like,I hate to tell you this, but
those were all symptoms oftraumatic brain injury. Sarah ,
your shock treatment hurt you.
(09:53):
And I told her that my doctortold me if my parents, that it
was safe and that the only realproblem was memory. And they'd
never mentioned any of theseother things as part of the
consequence of the treatment.
And then she's like, well, thenwhy are you going to community
college if you already have abachelor's degree? And I said ,
well, I wanna work, but I can'tremember all of the rules to
(10:14):
edit, so I can't be an editoragain. And I told her that I'd
been an a SL interpreter. Andthe reason I was on campus was
, 'cause again, my deaf friendhad invited me to come into his
fourth year a SL class, kind oflike as a teacher's assistant.
And he invited me to justenroll. That way I could like
have ASL four on my transcript, um, because I'd become an
(10:38):
interpreter at the universitylevel in the early nineties. So
at that time, they hadn'trequired, they'd only required
like proficiency testing , notlike a formal transcript. Well,
anyway, so my friend had , allof my deaf friends had told me,
if you wanna get a job fast,you just need to relearn and
repolish your interpretingskills, and then you'll be able
(11:02):
to get right back into work.
And, you know, that was likethe fastest route to earn
gainful employment. But shesaid I needed to address my
brain injury first. And again,I laughed and she listed
everything back to me that Ijust said and explained again
that they were all symptoms ofbrain injury. And she said, I
(11:24):
know you feel interpreting isyour fastest option to get a
competitive job, but what doyou really want to do? And I
explained that I really wantedto do what she was doing and
help people with disabilitiesachieve their fullest
potential. I wanted to helppeople like me get back on our
feet after we've been sidelinedby an acquired disability. And
(11:47):
her eyes just lit up .
And she told me that she knewwhat I needed to do. She said
that I needed to get mymaster's in rehabilitation
counseling and that locallyhere at San Diego State
University right here in town,we had one of the top programs
in the nation. And she gave meall the information about the
(12:10):
California Department ofRehabilitation explaining that
they had funding to helpqualified candidates get into
graduate school, or, I mean,not get in, but you know,
basically funding to pay, helppay for the tuition and the
books and whatnot. 'cause Ididn't have any, any money at
all. And she's like, then you'dbe able to graduate and then
(12:32):
you'd be able to give back tosociety by working in the
field. And I was like, that'sexactly what I want to do. And
so she explained that because Ialready had a , a great, great
transcript, good grades , uh,from BYU . Um, and I already
(12:54):
had my bachelor's degree.
Basically the only otherprerequisite would be taking
the GRE. And so she told me whoto contact at San Diego State,
and she really sent me on mypath path and all the way home
on the bus. Like I processedthat conversation. It took me
even longer to process hersuspicions about my plausible
(13:17):
brain injury. But withinmonths, I was accepted to San
Diego State RehabilitationCounseling program, and I was
absolutely floor that I wasaccepted because I, even though
I had been editor on facultypapers, I had lost most of my
(13:39):
vocabulary. And just to giveyou a perspective, I scored in
the bottom third percentile for, uh, on the GRE and
vocabulary, which means 97% ofthe people that took it scored
better than I did, even thoughI had been faculty and editor
(14:01):
of faculty papers . And my, thedear woman that interviewed me,
Karen Sachs, she looked throughall of my transcripts. We had a
good conversation about myinterests, my abilities, and
the diagnoses that I've beenlabeled with and whatnot. And
(14:22):
she is like, well, Sarah ,given your your lived
experience and your personalresilience and determination, I
really feel like our programwould be a good fit for you.
And I was like, well, whatabout my GRE score? And she is
like, well, the good news isyou have a great grasp of
(14:43):
vocabulary, so we're just goingto ignore that score because
you have all of therequirements. You've met all of
the requirements necessary tobe a good rehabilitation
counselor. Sorry. She changedmy life by , invited me into
the rehab counseling program.
(15:04):
And , um, while I was there, Iwas basically set up for
success because the faculty atSan Diego State University
understood how to work withstudents who have disabilities,
and they understood how to seepeople as individuals with
(15:24):
unique strengths and uniquecapacities. And so I had spent
12 years in a mental healthsystem that had always looked
at me from a deficit-basedmodel. And suddenly I was
surrounded by people who werelooking at me through a
(15:44):
strength-based model. And allof the students in my cohort
are part of the reason that Iwas able to graduate. And that
is because every time they hadany class projects that
involved assessments and usingthe results of assessments to
(16:06):
identify accommodations, everysingle class for assessment and
, uh, assistive technology,there was typically at least
one group that asked if theycan use me as their person. And
so gradually, each of thosepeople in that cohort, many of
(16:26):
them helped me identify mystrengths, and they helped me
identify appropriateaccommodations. And then I was
able to take theirdocumentations in their term
papers, justifying theappropriate accommodations back
to the Department ofRehabilitation, which had
(16:47):
never, before, previouslyfunded many of the things that
these students had identified,like, for example, an iPad to
help schedule, you know, help a, a student under , uh, keep
their schedule in place andtrack and use , uh, use the
alternative communic oralternative , uh, text, you
(17:11):
know, access to accesstextbooks and whatnot. They'd,
at that time, they'd neverbefore funded an iPad for that.
But because the students in mycohort had worked so hard to do
comprehensive assessments andthey could justify each of the
accommodations that we wererequesting, the Department of
(17:32):
Rehabilitation agreed. Andsuddenly I had, I had ergonomic
chairs, I had, and I've had tohelp with the scheduling and
coordination of my schedule andreading my materials. I had all
kinds of things that Ipreviously had no access to,
(17:55):
didn't even know I could askfor. And I think that is the
case for many people withacquired disabilities because
we grow up without an IEP , uh,we don't know that there are
even systems in place to helpus learn about what we can use
to circumvent the problems thatare causing barriers in our
(18:20):
life, whether it's in ouractivities of daily living or
in our employment settings.
That program changed my life,not only my life as a
individual with a disability,but also my life as an
individual striving to helpother people with disabilities.
Speaker 1 (18:38):
Thank you so much for sharing that. It's always
encouraging and empowering tohear those stories because I ,
I , I've spoken to other folkswho, you know, haven't acquired
disability, where just havingsomeone like as you mentioned,
come from a , a strength-basedperspective of what's the path
forward is such an empoweringexperience and , and hearing
(19:00):
you share that , um, is somoving and, and , um,
motivational, and I'm sure alot of people who have entered
the field the way that youhave, you know, from the point
of a , a client first, youknow, seeking services for a
disability and then becoming a, a certified rehabilitation
counselor yourself. Thatperspective and that journey,
we, we know CRCs are alreadymotivated, passionate people,
(19:23):
but , um, to go from client tocounselor, that, that brings a
whole nother perspective to thetable that really drives, as
you said, a lot of meaningprofessionally and personally.
Speaker 2 (19:32):
Can I just share one additional experience with
that? Yeah. So I just, just tomake example of one of the
students that helped me , um,and how that help went on to
basically form my career. Sowhen I very first entered the
rehabilitation and counselingprogram, I met a third year
(19:52):
student and we were talking andI told her, you know, about my
problems reading. And I toldher about my, my difficulties
organizing my thoughts. Andshe's like, well, you know, you
just recently finished your ect, so let's just assume you do
have a brain injury, and as youcontinue working on things, it
(20:13):
will become easier for you. AndI was like, okay. And she said,
I said, well, do you have anyhints for someone like me? And
oh, dear Lisa , shesaid that , uh, because it took
me so long to read, shesuggested that if I chose one
topic to pursue for the entirethree years of the program ,
(20:37):
not only would I save timebecause I'd gradually approve
like a familiarity with whatI'd read, and gradually with
the repetitive reading of it,I'd be able to remember what
I'd read. She also said that Iwould have read articles on
that topic that I would use forlike research papers in
(20:57):
different classes. And so shesmiled and she said, I've got a
few articles you could use justlike 12 or 15 articles that she
had used in her papers. And soI got to work reading those and
that she gave me a really goodhead start . And now 15 years
(21:19):
later, my library has more than500 books, journal articles,
court transcripts, user devicemanuals. It's so much for , so
like her advice was the bestever. It really set me on a
successful path to help peoplewith a history of
electroconvulsive therapy. Ithink it really speaks to her
(21:43):
understanding of my passion.
You know, as an individual weso strive to help recognize an
individual's strengths, but wealso have to recognize their
passions. And when we can tapinto someone's passion, then
their efforts becomesynergistic. When they're using
(22:05):
their strengths to help fueltheir passion, then that that
effort becomes synergistic.
Speaker 1 (22:14):
Yeah. And you know, that really speaks to the, the
difference of working with theCRC, right? That expertise of
disability coupled with thecounseling skills, makes it so
you're not just looking to workwith an individual with a
disability and say, let's findyou any job, right ? Something
nearby, something you can getas fast as possible. And then
we send you on your way, A CRC's going to approach that and
(22:36):
say, what's going to fulfillyou? Um, what's, what's going
to put you in a place where youlook back however long a month,
a year, you know, years downthe road and say, I did all of
these things to make thisdream. I have come through. And
the CRC is there to put you onthat path. And it sounds like
from the story you just shared,you know, you start with , uh,
(22:57):
a handful of journal articlesand , um, that's a library that
, uh, dwarfs mine , uh, forsure of , of all those
, uh, things you just listed.
Um, so yeah, it's, it's alwaysgreat to hear , um, that extra
emphasis and knowledge thatCRCs bring to that experience ,
um, manifest itself in such animpactful, you know, outcome.
Speaker 2 (23:19):
You know, I think you're right. I think one of
the unique capacities that CRCshave in terms of not only, you
know, the , like we discussedstrength-based model and the
counseling skills. I mean, whenyou can take an individual and
identify their strengths,identify appropriate
(23:39):
accommodations to circumventwhat could plausibly be a
weaknesses or deficit, and thenhelp them , uh, focus on their
passion, then you've basicallyempowered an indi an individual
to , uh, prevent burnout intheir career. So longevity is
(24:01):
there . They're not going tojust be going into a job that
they don't really have aninterest in or aren't
passionate about. And I , it'sso easy to get burnt out when
you are not passionate aboutyour job or when you're
passionate about your job, butyou don't have the counseling
skills and wellness tools inorder to sustain that passion.
(24:22):
That's a , that's a recipe forburnout. And I think all of us
, uh, could probably benefitfrom speaking with a
rehabilitation counselorspecifically for that reason,
because good rehabilitationcounselors understand ,
understand the tools andwellness tools necessary to
(24:44):
prevent burnout or to workthrough burnout, to work around
burnout, and to find joy in thejourney again.
Speaker 1 (24:52):
So after obviously becoming a CRC yourself , um,
you mentioned that , um, a lotof your work in research has
been related to ECT. And , um,if people aren't aware of your
work , um, you have someincredible stuff on your
website that people can , uh,check out. We'll have it in the
notes for the podcast episode,so they can check that out.
But, you know, a lot of yourresearch that I was going
(25:12):
through discusses communicationdisorders that come from ECT
for , for other CRCs who, whomight be working with a client
who has experienced , um, ECT.
What are the unique needs orconsiderations that you've
identified as being, you know ,um, considerations that CRC
should take with these sorts ofclients?
Speaker 2 (25:32):
I think to best understand how ECT impacts an
individual, you have to look atit from the perspective of a
neuropathologist whounderstands brain injury. And
so , um, I would just referthem to , uh, Dr. Bennett Amala
(25:53):
, who during the Department ofRehabilitation in Californians
during their traumatic braininjury advisory board meeting,
he was explaining that peoplewho have a history of
electroconvulsive therapy,while their MRI standard MRI
(26:13):
might not show anything wrongwith their brain. It is a
functional injury akin to arepetitive traumatic brain
injury because it's not justone ECT treatment, the
individual receives, it'smultiple, it's an entire series
or multiple series oftreatments. And so he
(26:35):
recommended that we view ECTrecipients through two lenses,
both the lens of a repetitivetraumatic brain injury and the
lens of repetitive electricaltrauma. Keeping that in mind,
it's important that werecognize the long-term
consequences of, of repetitivetraumatic brain injury. And we
(27:00):
recognize the long-termconsequences of a repeated
electrical trauma or even asingle electrical trauma. And
so in terms of communication,assessing your client for, for
problems, so you'd want to askthem like, why , person asked
me, do you have any problemswith bounds? Do you have any
(27:20):
problems with lightsensitivity? Do you have any
problems with motion ? When youbegin getting tired , does your
voice begin to slur? Did yourspeech begin to slur? Do you
have difficulty finding yourwords? Um, do you have
difficulty organizing yourthoughts? Do you have
(27:42):
difficulty planning andcarrying out tasks and then
contingent on that person'sanswers, you know, they could
even go into further. Do youhave difficulty with
coordination? You know, can youstill type at the level you
used to be able to type? Canyou still read and enjoy
(28:05):
reading the level that youpreviously did? Those kinds of
things are very basic skillsthat many individuals have
never been assessed for . Andso routing that person for a
comprehensive speech assessmentfor a comprehensive
occupational therapyassessment, looking at a hand
(28:27):
eye coordination, looking atmotor coordination, because one
of the, one of the recognizedproblems , uh, identified in
the manufacturer's user manualfor , uh, electroconvulsive
therapy is, well , brain injuryis one of the official serious
(28:48):
adverse events, but alsogeneral motor dysfunction is
another , uh, recognized , uh,problem. So I would
specifically refer them if itwere me with a new ECT
recipient, I would refer themto ACE pH therapist for
(29:12):
assessment to evaluate forcognitive communication
disorder. I would also referthem for a visual assessment
with a neuro optometricrehabilitation , uh, provider
through the Nora network. Um,because the neuro optometric
(29:35):
rehabilitation providers areoptometrists who are trained in
brain injury or developmentalvisual problems, who can see
whether or not the person'seyes are aligning correctly. If
your eyes cannot aligncorrectly, which is most common
consequence of ease of braininjury, then you are going to
(29:56):
fatigue faster. Because as youread, as you look at life, your
eyes are struggling to maintaintheir alignment, I guess is
what you'd say. Um, and so thatis gonna be tiring. And so you
want to set your client up forsuccess. And a comprehensive, a
assessment will be able tobreak down barriers to
(30:18):
accessing not only thevocational rehabilitation
necessary, but the physicalrehabilitation necessary after,
after an injury of this nature.
And so it wasn't until like Iwent through my entire program
with alternative text andpeople taking notes for me. And
(30:39):
I mean, I had a lot of, I hadextra time on tests 'cause I
qualified for all of that, butthey never , uh, recognized
that, gee, you know, visionrehabilitation could really
improve your quality of lifeand vision. Rehabilitation has
improved my memory. Visionrehabilitation has improved my
(31:02):
ability to create sequence. And, uh, so vision rehabilitation
is probably something that notmany rehabilitation counselors
had considered because wetypically think in terms of
speech, occupational therapy,physical therapy, and mental
health therapy. Um, andneuropsych testing does not go
(31:26):
into like vision , uh, andvisual processing. But you'd
want visual processingassessment. And also, I also ,
uh, benefited from getting anauditory processing, you know ,
like a central auditoryprocessing assessment because
then they were able torecognize, oh, okay, she can,
(31:48):
like I scored off the charts inone-on-one conversation. My
hearing, I got 99% of myhearing. But when they started
putting all the other peoplenoise in my head and I had to
focus on the one voice, mycomprehension dropped to
profoundly disabled. It waslike the 23rd percent being
(32:10):
able to understand the worldaround me in a conversation ,
uh, or in a room, you know ,like in a meeting. And so they
were recommending things like,you need, you know, real time
captioning you need, and youcan use an a SL interpreter
'cause you understand a SL youknow, those kinds of things
because you need those kinds ofthings to work and survive in
(32:35):
an employment environment. Soyes, the central auditory
testing and the basically theneuro optometric rehabilitation
provider, that's a basically acentral visual processing
assessment. And so that'swonderful. Thank you so much.
If I could see me again as anindividual back in 2009, this
(32:55):
is what you need. One lastthing. Mm-Hmm.
you've mentioned , um, youknow, what do we know? What,
what would you do? Well, it'swonderful that you can ask me
that, but not everyone has muchof an understanding of what has
happened to people withelectroconvulsive therapy. And
to that end, I'm actuallyworking on a project with a
(33:16):
colleague of mine and severalother ECT recipients and
psychologists. We currentlyhave a survey that is open
right now, and the survey isopen for any ECT recipient and
their family member or closefriends who understand how ECT
impacted them. And it'sbasically functioning as a
(33:38):
needs assessment. And thatsurvey will likely be open
through the end of August,maybe September. But we're
basically doing a needsassessment so that we can
better understand whatindividuals with history of ECT
need in order to move onthrough life after ECT. So I
can give you that information.
(33:59):
If you could share in your shownotes, that would be fabulous.
'cause we've really, we really,this is a gap in our
understanding in general inhelping people who have severe
mental illness, many e ct, manyec , many CRCs don't even know
that if they have someone whohas a history of a mental
health diagnosis, we really,and even these days, we need to
(34:23):
look also at people who have ahistory of autism or who who
are autistic , um, people who ,uh, have any kind of
developmental disability. Weneed to begin asking on our
intake forms if they have ahistory of electroconvulsive
therapy. Because a lot of timeswe won't understand why the
(34:45):
individual isn't thriving inthe situation that we've put
them in or in their, in theirplan, in their treatment plan.
And it's because we haven'tcompletely understood , uh,
some of the problems that theyare dealing with. And I , so
for that reason, I wouldencourage everyone to include,
do you have a history ofelectroconvulsive therapy on
(35:07):
your intake form? Becauseyou'll be surprised at how many
people will be able to check.
Yes. One of the things aboutbrain injury is that the
symptoms of brain injury willwax and wane depending on the
individual's level of cognitivefatigue and the individual's
(35:31):
level of , um, sensoryoverload. And so, for example,
we purposefully scheduled thisappointment in the morning
because in the morning I havespeech that people can
understand, but I really onlyhave functional speech because
(35:53):
I am advanced in my delayedelectrical injury. I really
only have functional speechabout two to four hours a day.
And so I actually use a speechdevice to communicate , um, as
my speech becomes so slurredthat people cannot understand
(36:15):
what I say. That was not aproblem when I very first began
this journey. And it willlikely crop up at different
periods of time for individualswith a history of ECT simply
because of the nature ofdelayed electrical injury that
(36:36):
typically develops between sixmonths to more than a decade
after ECT or after electricalinjury. In general, it's
referred to as delayedelectrical injury. Right? Now,
I don't need an alternativecommunication device to speak
with you, but I do have oneprescribed, and it was
(36:59):
prescribed because as I gettired, I lose my speech. And
when I am surrounded by sensoryinput, I cannot coordinate the
muscles required to speak within a way that people can
understand me. And so I do usea speech generating device. So
(37:19):
I just wanted to put that outthere because if anyone wanted
to look at me, they might lookat me today in this interview
and say, well , she could talk. But we need to understand
that disabilities, a lot ofpeople that live with
disabilities, their symptomswax and wane . And so we need
(37:40):
to ask people, you know, nottreat people as like their
symptoms are static. They'llnever get better, they'll never
get worse. A lot ofindividuals, depending on the
disability, will have an ebband flow of their capacity,
another ebb and flow of theirability. And so keeping that in
mind when you do yourassessments for individuals
(38:03):
with a history of brain injury, especially keeping in mind
the , how the environmentimpacts the person. For
example, one of the things thatwe discovered with my personal
injuries , that because theelectrodes are placed on the
trigeminal nerve, thetrigeminal nerve goes right
(38:26):
into the brainstem, and thatgoes right into all of the
other parental nerves. It goesall the way down your spine.
And so all of my ability toprocess sensory input with my
eyes and with my ears, and withmy touch, that has been
compromised with my motoroutput because that nerve, the
(38:48):
trigeminal nerve, does bothsensory input and motor output.
And so , um, that's critical tounderstand because when they
referred me for centralauditory processing assessment,
and they discovered that Icould not understand the world
around me when I was floodedwith too much auditory
(39:11):
stimulation, they actuallyprescribed basically their
musician's earplugs. Theyfilter out 25 decibels of
sensory input so that I canfocus on just the person
sitting in front of me and itwill get rid of all of the
(39:32):
external, you know, the typingor the other people con , um,
conversations in the phone orin the , in the work
environment. And so being ableto be aware of how sensory
input, input impacts not onlystress levels, but ability to
process the world around youwould be really critical for ,
(39:53):
uh, someone doing an assessmentfor an individual who had a
history of electroconvulsivetherapy or any brain injury.
Speaker 1 (39:59):
And I think, you know, it's really telling, like
you mentioned, scheduling thiscall earlier in the day , um,
as opposed to maybe theafternoon or something like
that was a, a type of, youknow, a , a accommodation to,
to scheduling this that like anemployer, if they have somebody
who maybe throughout theafternoon starts to lose speech
function, maybe schedulemeetings with them in the
(40:21):
morning or, you know, it , it'sthose little, those, those
tweaks to what is consideredmaybe like the norm with a
business that can be sotransformative for an
individual with a disability.
And those accommodations a lotof times are just rescheduling
the way that the day's gonnaflow, you know, and we always
hear from CRCs that a lot ofaccommodations don't even cost
(40:41):
a business anything. It's justallowing a little bit of
flexibility to the way that theday usually plays out for
everyone to be able to functionat their, you know, their,
their maximum potential. And Ithink that was a great example
that you pointed out.
Speaker 2 (40:54):
Well, to your point, I think Covid has taught us the
value of remote working. Andyou know , for me, as someone
with a brain injury who liveswith a form of mild neuro
disorder, my body shuts down asit becomes fatigued. But when I
rest, I take a nap, all of asudden my speech will come
(41:16):
back, my ability tocommunicate, my ability to work
will return , my ability tofunction will return. And so
when you have flexiblescheduling in an employment
setting, having the opportunityto log out, take a nap, and
then log back in to continue,you know, getting your, your
(41:37):
hours in, you'll be a much moreproductive person. I'm a much
more productive person when I'mwell rested . And especially
with my, my own neuraldisorder, people can understand
me better when I speak clearly,and I can only speak clearly
what I'm very well listed . Sojust, I think that was actually
(41:59):
one of the good things thatcame out of Covid was that now
employers recognize thatemployees can still be
productive when they are athome in quiet , secluded
environments. They can stillmeet , uh, employment
expectations in terms of, ofmaking, you know, achieving
(42:20):
their job responsibilities. Andthey know that now from a
personal perspective, becausethey were the ones working from
home striving to be productive.
And I think before then,employers really had no concept
of how productive people can beif they're stuck at home. And
now we know that you can evenbe productive at two in the
(42:43):
morning because you, you know,your sleep got schedule messed
up, but guess what? You canstill respond to emails or you
do, you know, jobresponsibilities at, at, at
times that would not typicallybe between the typical nine to
five. And I think that was veryvaluable experience. Probably
the one valuable thing thatcame out of the covid shutdown
(43:05):
was opening employers eyes tothe possibilities of what can
be done from home, what can bedone in quiet work
environments, how productivepeople can be at their own
schedule.
Speaker 1 (43:19):
Thank you for adding that, and we will absolutely ,
uh, link that survey into theshow notes. There was another
interview you did where youmentioned the phrase employment
as a treatment plan. And we've,we've heard that from other
CRCs as well, that, you know,employment has a profound
impact on, on , on a clientbeyond just being able for that
individual to say, I now have ajob. Can you, can you talk a
(43:42):
little bit about your view ofemployment as a way for people
with disabilities to feel , um,active and integrated into
society and their community?
Well,
Speaker 2 (43:51):
Employment in a job or career you love is
empowering. And until peoplefeel empowered, they do not
recognize that they are agentsof change. Many people who live
with a variety of disabilitiesacquired or developmental
congenital disabilities we'reoften surrounded by people who
(44:13):
have looked at us through adeficit based model for so long
that they routinely tell us, Iknow, they told me what I can't
do, what I can't do, what Ishouldn't try, what I can't
even try. I mean, little bylittle, our circle of influence
(44:34):
feels smaller and smaller andsmaller and little by little,
especially people like me whoare diagnosed with what they
said was treatment resistedmental illness, we begin to
develop learned helplessnessbecause it didn't matter how,
how compliant I was with mymedical treatment, I was not
(44:56):
getting better. In fact, I wasgetting worse. And so , um,
people who live with theseexperiences so many times,
because we've been told what wecan't do so much, we gradually
learn not to try. And so interms of looking at employment
as a treatment plan,especially, I mean, even pre
(45:21):
pre-employment as a treatmentplan, right? Basically my
doctors told me that I wastreatment resistant. And after
12 years of faithful treatmentcompliance without improvement,
I believed them. Andessentially I turned my power
over to my doctors and mycounselors who were telling me
and my family that I cannot dowhat I cannot do or what I
(45:43):
shouldn't even try to dobecause it might make me worse.
But finally I realized if mydoctors couldn't make me
better, I had two choices. Icould either just give up and
die or I could make myselfbetter. And so I began learning
from people diagnosed withsevere mental illness, what
their strategies were. Forexample, I enrolled in a class
(46:07):
developed by Mary EllenCopeland, who lives with
bipolar disorder diagnosis.
That class is a wellnessrecovery action plan class. And
in that class I learned how,you know, to develop a wellness
toolbox, which is basically allof the strategies and skills
that I would need to use in mydaily life. And the more tools
(46:32):
I had in that wellness toolbox,the more capable I became. And
when I wasn't having success inmanaging my illness, you know,
I would I went , I waslike, I'm determined to go back
to work. I went back to work.
This is actually even before Iwent to the community college,
(46:53):
I'd actually gone back to work.
And I was like, the only thingI know how to do for sure , for
sure is answer a phone answer .
And so I applied for a job as areceptionist, and I did so
well. And my interactions withpeople at the regional manager
actually recognized my skillswithin three weeks, and she
(47:17):
hired me to be her advaadministrative assistant. So
here I was in my physicalhealth, my mental health,
running up against wall afterwall after wall. And yet at
work, because I had personalityon the phone that sounded,
well, clearly I didn't havethis voice, but even if I had
(47:41):
this voice, I'm a very good perpeople person. And I was able
to communicate with , withpeople in such a way that I was
getting padded on the back allthe time for what I was capable
of doing. And that is whyemployment as a treatment plan,
(48:04):
if you want to help someonefeel empowered, help them find
a job they can really do, andtheir environment will become
empowering and be by feelingempowered, they will be more
likely to try and explore newthings to stretch their
capacity.
Speaker 1 (48:25):
Yeah, rehabilitation counseling has such a deep
history , um, over a centurynow. It has existed and , um,
has, has deep ties obviously tothe vocational aspect of, of
that disability counselingexperience. And, you know, we
know that the knowledge of a ,of a certified rehabilitation
counselor can be utilized in ,uh, several different practice
(48:46):
settings and fields. We keepseeing CRCs , um, join
organizations or, or, or , uh,service providers and
industries that we don't see alot of CRCs. And then suddenly
a couple years later, there'smore of them. And it's kind of
like a good, good news thatspreads, right? Like if you
hire one CRC, you see their ,uh, impact and the potential
they have to, to aid yourorganization and then you want
(49:08):
more of 'em, which is what welove to see here at CR ccc .
Yeah . You know, based on, youknow, your experience as a CRC,
where would you like to seecertified rehabilitation
counselors working or making animpact , uh, given their unique
expertise and disability?
Speaker 2 (49:23):
I would like to see CRCs in two places that I
typically don't see them. Iwould like to see them in HR
departments because one of themost important things an HR
person in HR can do is to takethe strengths and all of the
(49:45):
training that an an employeehas invested, an employer has
invested in an individual anduse them in , if they come back
and they can no longer do Xportion of their job
description, the employer knowshow much they've invested in
that individual and that theystill have these abilities. And
(50:05):
being able, as an hr, you wouldbe person, you'd be able to job
carve , create job specificallyfor those job responsibilities
for, you know, and pay forthose specific job
responsibilities. And without,you know, without the one thing
or two things or five thingsthat the person can no longer
(50:27):
do, they still have this entireskillset . Um, and so I think,
I think a good example of that, uh, I mean in a major
corporation would be Boeing.
I've done a training forBoeing. Boeing actually employs
CRCs. And because the Boeinghas such a dynamic, you know,
it's a ginormous corporation,right? And they invest in their
(50:50):
employees years of training.
And when an employee develops adisability for any reason, they
work hard to tap into thatemployee's strengths and assign
them to a different job withinthe community, within their,
within their company. So , um,I think HR departments
(51:16):
definitely could use , uh,CRCs, but I also think that we
really need , uh, certifiedrehabilitation counselors in
rehabilitation settings. Iwould love to see certified
rehabilitation counselors inthe clinic with the brain
(51:36):
injury. Uh, people, you know,in these rehabilitation
facilities, these long-termcare facilities that are, you
know, rehabilitation nursingfacilities, like the transition
between hospital discharge andback into the community, lots
of people go to theserehabilitation facilities or
they go to outpatientrehabilitation programs for
(51:56):
speech, physical therapy,occupational therapy, et
cetera. I mean, thosetherapists are designed like
physical therapy, occupationaltherapy, speech therapy.
They're designed to help themwith activities of daily
living. But until they have aconcept of the job that the
(52:17):
person's going to be going backinto, you know, CRC has a
unique perspective becausethey'll already understand the
job responsibilities of thatindividual's job, whatever that
job might be, and then know howto help them identify
reasonable accommodations sothat they, when they want to go
back to work because they'refinally physically capable of
(52:40):
returning to work, then they'llbe able to say, and, you know,
to their HR department, theseare the accommodations that
will allow me to maintain myproductivity, or these are the
accommodations that arereasonable that would allow me
to maintain not only myproductivity, but my longevity
so that you do not lose me as askilled employee. So that's why
(53:03):
I really think thatrehabilitation settings in
general would be extremelybeneficial. I think that we
should really, as a groupadvocate for Medicare
reimbursement, because oncecertified rehabilitation
counselors can be reimbursedthrough Medicare, it sets
(53:25):
precedent. We can build in waysthat will allow us to be able
to get , get into these medicalsettings, and we will be able
to augment the rehabilitationalready ave available in
rehabilitation settings becauseessentially we are helping
people get back to work. So, Imean, not only are we going to
(53:47):
be alleviating the tax burdenon people, you know, taxpayers,
you know, because we're gonnabe able to keep people employed
because we recognize theirskills, we recognize their
abilities, we recognize theircapacities , we recognize the
accommodations that need to beput into place so that they can
continue in their preferredcareer as A-C-R-C-C, I think we
(54:11):
should really work on helpingget our CRCs into medical
settings by advocating throughMedicare for reimbursement.
Because in the long run, Imean, they've talked about
wanting to get people back towork, but there's really a
disconnect between wantingpeople to work and getting them
(54:33):
back to work. And the CRC iswhat's going to branch that if
they want to get people off thedisability and off of social
security and they want to getthem back to work, they need to
facilitate that by not siloingcertified rehabilitation
counselors into just staterehabilitation, vocational
(54:55):
rehabilitation departments orinto , uh, university or, you
know, community collegesettings. We need to have them
in all settings so that we canactually facilitate the
rehabilitation of individualswho can work and can get and
(55:15):
maintain competitiveemployment.
Speaker 1 (55:18):
The rehabilitation settings in the HR settings are
similar in that when I comeacross job listings , um, for
a, a disability specialist oran accommodations coordinator,
things like that, and I seethat they're under
requirements, they're notlooking for a rehabilitation
counselor or even better A CRC,they're looking for people,
maybe like you said,traditional HR backgrounds ,
(55:40):
um, social work, other fieldsthat are related, but that
skillset of A CRC is gonna havethe most impact. I always wanna
message the hiring manager andbe like, man, do I have a field
of professionals for you? Youknow? Um, so hopefully we
continue to see CRCs , uh, inthose spaces more often.
Speaker 2 (55:58):
I think also in our push to help people get
competitive integrativeemployment, I would like to see
CRCs in schools, in schooldistricts because, you know, we
want to start young in thesepre-employment trainings. And
if we're actually going to helppeople find work after they
(56:19):
leave schools, we need to havethem already understanding the
kind of , uh, employmentaccommodations that they need
to request. We also need tohelp educate employers to
understand, you know, if youcan find a talented individual
that might do things didifferently, but who is a has
(56:42):
superhero powers for theirpassion, you want to be able to
work with their reasonableaccommodations.
Speaker 1 (56:50):
Uh, if you're listening and you work in a
school setting or arehabilitation setting or, or
in hr, and you , um, want toshare with us at CRCC how
you've broken into that fieldso we can help advocate for
more folks , um, like yourselfjoining those fields, please
reach out to us on our websiteor social media. Um, we've
spoken to people who work ininsurance or at companies like
(57:11):
Amazon in the past and have hadsuccess helping them build, you
know, advocacy resources to beable to try to get their , uh,
hiring managers or, you know,district managers to hire more
CRCs. So if that's, if that'syou listening today , uh, we're
happy to partner with you onthat. You know, we're, we're so
happy that you're on ourpodcast today, Sarah , but you
have a podcast yourself calledEmotional Self-Reliance. Um,
(57:32):
and I, I really liked that termwhen I was researching a little
bit about it , um, in , inpreparation for speaking with
you today. Um, can you tell usa little bit about emotional
self-reliance as a wellnesstool and how it's used in
practice?
Speaker 2 (57:45):
Well, in terms of wellness tools , uh, we've
already talked about how thereskills and strategies , um,
that we use to improve ourquality of life physically and
emotionally. Um, but I believethat together our wellness
tools create like an emotionalself-reliance toolbox. And so
basically the more wellnesstools we gather, the more
(58:08):
resilient we become asindividuals, and we can depend
on ourselves to work throughour problems and not look
outward for other people tosolve our problems. So I think
more of emotionalself-reliance, more of, you
know, as self-exploration toidentify as many tools as
(58:30):
possible to facilitatewellness. And so I kind of look
at my emotional self-reliance,like as the , the label on my
wellness toolbox..
Speaker 1 (58:44):
Yeah, I love that.
Um, you wrote a book , uh,called Daring to Dream
Essential Tools to findEmployment , uh, which helps
people find a job that, aswe've talked about in this
conversation, that they'lltruly love. Right? Um, where,
where do you think employersneed to do the most catching up
in regards to the way that theyunderstand inclusive and
(59:05):
accessible employment?
Speaker 2 (59:07):
Well, that book's actually a workbook. Um, and it
really, it's really thepre-employment blueprint, I
guess, for individuals. And Ideci I designed it to
facilitate my job club, and itwas so successful that many
people employ, many peopleenroll , they found jobs, and
then the club spread by word ofmouth. But once all of these
(59:27):
people began developing theirpre-employment skills, at times
they were met by employers whocouldn't see the bigger
picture, which was, if youemploy people with diverse life
experiences, it's better forthe bottom line. So people with
living with disabilities, Imean, if you're an employer and
(59:48):
you want to better understandinclusive and accessible
employment, you really need tounderstand that individuals
with disabilities, I'm justgonna say humans, humans need
to be seen through astrength-based model. And when
looking at individuals withdisabilities, we are quite
(01:00:11):
creative problem solvers. Wemight not do things the way
other people can, but wefigured out how to do them
anyway. And often when everyoneelse told us what we couldn't
do and that we'd never be ableto do what we're presently
doing. So overcoming thatamount of opposition in our
lives, it takes creativity, ittakes determination, and it
(01:00:33):
takes resilience. So inclusiveand accessible employment means
created an environment where anindividual can use whatever
appropriate combinationnecessary for them to get the
job done. Um , many of us learnto streamline our daily tasks
to conserve energy, and thishelps us learn how to
(01:00:55):
streamline other tasks, right?
It's a transferable skill, soit helps us learn how to
streamline other work tasks tobecome more efficient. And I
mean, many of us, I'm justgonna say we're superheroes
within our own skillsets thatus it sounds really prideful.
I'll just say I take pride inmy humility,,
Speaker 1 (01:01:17):
I think it's accurate,
Speaker 2 (01:01:18):
, but I mean,
all of us are superheroes in a
certain aspect of ourexperience because we have
unique experience that nobodyelse does. And so , um, we
might, you know, I know I, Istruggle with things that are
outside of my skillset , but ifmo , if more businesses could
(01:01:41):
be trained in job carving,those member , again, and HR
departments that have acertified rehabilitation
counselor to help split up anddivide job responsibilities and
assign them to individuals withthe skills to perform that task
at or above expectations, Ireally believe employers and
(01:02:02):
businesses will love whathappens to their employee
morale. And consequently thereare productivity.
Speaker 1 (01:02:11):
I have one more question for you, which, if
anyone listening today listensto the podcast regularly, this
is a question we love to askeverybody who comes to speak
with us, we often hear thatCRCs say that this job, this
profession, this, this fieldthat they've pursued is, is a
calling that they've answered.
What brings you joy in the workthat you do as a CRC? Hmm .
Speaker 2 (01:02:33):
Sorry, I'm gonna get emotional. Um, until I studied
rehabilitation counseling,there is not a single other
person in the research onelectroconvulsive therapy that
has addressed improving qualityof life after ECT. And by my
(01:03:01):
learning about appropriatecomprehensive assessments and
then sharing that indiviinformation with individuals
who have a history of ECTI amfor the first time, I am
facilitating the breaking ofbarriers for accessing
(01:03:21):
assessments even , uh, forpeople who previously had no
access to assessments. And weknow that once you have
assessments, appropriateassessments, then the results
can drive appropriaterehabilitation interventions.
And it brings me suchtremendous joy to hear from
(01:03:48):
people and their families, orpeople who've had history of
ECT tell me that my assessmentrecommendations helped them
gain access to therehabilitation necessary to
improve their quality of lifeafter ECT and to move beyond
(01:04:08):
the tragic circumstances oftheir, their life had become
after they'd been abandoned,after their injuries and
hearing about their newlydiscovered interests and
exploring employment in fieldsthat they'd never previously
considered hearing them say, Ithought my life was over, but
(01:04:29):
now I realize there's more tolife after ECT, that that is
what brings me joy. And yes, Ido see it as a calling.
Speaker 1 (01:04:40):
The work that you're doing is , um, is profound and
so impactful. Uh, I can't thankyou enough and we can't thank
you enough. Um, we reallyappreciate your time today ,
um, in speaking with us. We'llmake sure , um, as we've
mentioned throughout the show,that , uh, there'll be some
links in the show notes , um,so you can follow along with
Sarah's work. And , uh, thankyou so much , uh, for your time
and insight today.
Speaker 2 (01:05:01):
Thank you so much. I I'm really grateful for the
opportunity to do anything Ican to support certified
Rehabilitation counselorsbecause they've radically
improved my quality of life andI want to be able to help them
help others. You so much.
Speaker 1 (01:05:25):
Thanks again to Sarah Price Hancock for that
engaging conversation. You canfind links to Sarah's work, her
current research study for ECTpatients and their families,
and more resources in the shownotes. If you have any
takeaways or insights on topicscovered in this episode, email
us at contactus@crccertification.com. Be
(01:05:46):
sure to subscribe to this showon Apple Podcasts, Spotify, or
wherever you're listening to ustoday. You can find us on
Facebook, Twitter, and LinkedInat CRC Cert , and our website
is crc certification.com. Untilnext time, I'm Taylor Bauer.
Thank you for listening toInside Rehabilitation
Counseling.
Hello and welcome to Inside Rehabilitation
Counseling, presented by theCommission on Rehabilitation
Counselor Certification. I'mTaylor Bauer with CRCC, and
we're so glad to have you herefor another conversation on the
art and science ofrehabilitation counseling.
There are many certifiedrehabilitation counselors who
first encounter the field as aclient. The perspective of
(00:26):
having a disability can offerprofound insights and
considerations into providingservices for people with
disabilities. Sarah PriceHancock is a CRC and advocate
for electroconvulsive therapyrecipients, having received 116
bilateral ECT treatmentsherself, Sarah became a CRC
after receiving services andlearning about the role of a
(00:48):
rehabilitation counselor. Youmay have read Sarah's op-Ed in
the San Diego Union Tribunelast fall about how employers
can ensure that people withdisabilities are set up for
success in the workplace. Inour conversation, Sarah dives
into this topic further andalso shares her work on ECT
assessments, the importance ofemotional self-reliance for
people with disabilities, and acandid look at her
(01:11):
transformative journey as acertified rehabilitation
counselor. Sarah , thank you somuch for making time , uh, to
be on inside rehabilitationcounseling with us today. We
like to start all of theseconversations kind of in the
same place, you know, yourbeginning with , um, your time
in the profession. So when didyou first learn about , uh,
certified RehabilitationCounselors? And if you're
(01:33):
comfortable, can you explain abit of the story behind your
disability and the journey thatled you to the career that you
have today?
Speaker 2 (01:39):
Oh , certainly
this opportunity. Well, Iremember learning about
certified Rehabilitationcounselors in 2009 from a
community college disabilityservices counselor. She was
helping me get academicaccommodations after I'd
finished , uh,electroconvulsive Therapy,
which is also known as ECT. Um,and , um, the colloquial name,
(02:05):
I guess people call it ShockTreatment. I went to her
because the ECT had erased allof my memory of my prior work
experience and my educationalexperience. And I knew that in
order to become a candidate fora competitive job, I'd need to
go back and get completelyretrained. So I went to the
(02:26):
local Community College'sDisability Office because I
knew that it was a diagnosedillness that had caused the
referral for the shocktreatment. And in the
appointment, the DisabilitySupport Services counselor
asked me, if you could doanything in the world, what
would you want to do? And Itold her that I wanted to help
(02:48):
people like me get back ontheir feet after
electroconvulsive therapy, justlike she was helping me. And
she smiled and she said, well,in that case, you need to
become a certifiedrehabilitation counselor.
chaos. Um, I just escaped anabusive mental health
(03:10):
residential facility, which hadbeen facilitating my receiving
the electroconvulsive therapy.
Unlike , like I mentionedbefore , um, after my
treatment, I had no job, but Iwanted to return to work. But
the problem was I had no memoryof anything required to do what
(03:31):
I'd done in my previous career. Before treatment, I'd been an
editor of faculty papers forthe humanities department as a
student at Brigham YoungUniversity. And I'd also been
an a SL , uh, interpreter incollege and university settings
for several years. But I had nomemory of my training and no
(03:53):
memory of my work experience. Ionly knew that I had the
experience, actually becauseI'd read about it in my own
journals. And also because ofwhat my family and friends had
told me. Uh , I was determinedto get a job. I was determined
to pay rent. I was determinedto live independently. I was
determined to start my lifeover , um, rise from the ashes,
(04:18):
if you will . Um , it wasdifficult because I'd suffered
dense and pervasive amnesiafrom the shock treatments. But
in my desire to become aprotective member of society as
soon as possible, I had a lotof deaf friends who were
helping me to relearn myAmerican sign language. And at
one point, my high school, a SLteacher who was deaf, invited
(04:42):
me to just take his a SL fourclass. He said that I needed
more practice and that I wouldbe the only student that
actually understood what he wassaying in the class. 'cause I'd
known him at that point, I'dknown him for more than a
decade. And he was concernedthat the students who had taken
(05:03):
the earlier classes from otherteachers didn't have the skills
to understand the deaf personwho spoke strictly in American
Sign Language. So he actuallyinvited me so that I could kind
of be a liaison between thestudents when they didn't
understand. I could help themrecognize what he was saying so
(05:24):
that he could better teach themhow to speak incorrect American
sign language, not like piggedin sign language. When I went
back to class, we had readingassignments and I realized, you
know, I really, I could hardlyread. And so he suggested that
I needed some academicaccommodations. And so I hit
(05:46):
over to the Campus DisabilityServices and Support Office. I
walked into her office wearingmy dark sunglasses,
and she asked me why I waswearing sunglasses in her
office. And I explained thatthe light just hurt too much.
And she asked if I was having amigraine, but I didn't really
know what that meant. I mean,I'd grown so used to the
(06:08):
perpetual headache from theshock treatments that she asked
me when I started havingproblems with light. And I told
her it started during ECT andshe said she thought I had a
brain injury. Well, I laughedbecause I had no history of car
accident. I had no history oflike a fall or like hitting my
(06:30):
head. I had no history of likebeing in sports or getting
knocked out. And so I just kindof laughed at that. And she
listened and she politelynodded. And I, I just told her
I knew I didn't have a braininjury, but she asked if I was
sensitive to noise. And I waslike , uh, yeah. And then she
(06:56):
asked, well, I told her thatnot only was I sensitive to
noise, it was stressful to tryand process sound. And that a
hearing test right after my ECTshowed that I had perfect
hearing, but that I had delayedunderstanding of what I was
hearing. So I'd actuallystarted using closed captioning
(07:19):
during the shock treatmentsbecause I couldn't follow what
was happening on TV shows. Icouldn't follow what was
happening in conversations. Andit was really, it was a delayed
understanding, delayedprocessing problem. And so
first she asked if I had anyother problems, and I explained
to her that I kept running intowalls, particularly like when I
(07:43):
say walls, like door jams, I'dgo, like, I thought I was going
through a door jam and I'dalways slam my shoulder into
the door jamb . It was like Ihadn't oriented myself in the
middle of the doorway to walkthrough, so I was always
slamming myself into the walls.
It was just really weird. And Itold her also that , um, I'd
have a lot of problems, likewith the coordination for
(08:07):
walking, which was kind ofweird. I'd like, especially
when I'd get tired, I'd stepoff a curb and land on my ankle
instead of landing on my foot.
And I did that all the time. Somuch so that my doctor had
prescribed those orthotic bootsfor , uh, like if you'd broken
(08:28):
your ankle, he'd prescribedthem for both of my legs,
expecting me to use them. So Iwas walking around rather than
having like a , like an anklefoot orthotic. They didn't
prescribe me that. Theyprescribed me two boots, like
as if I'd just had foot surgeryor something. So I was walking
(08:50):
around looking likeFrankenstein. It was just
terrible. But that's whathappens. Anyway , so I told her
that the reason I was reallythere was because I had lost my
ability to read. I was reallystruggling to read. I could
read a line, but then Icouldn't recognize which line.
(09:10):
I'd just read to know whichline to read next, which makes
reading very difficult. And myeyes would jump all over the
page. And I had reallydifficult time with headaches.
The more I read then thestronger the headache would
get, it would just, it was justexhausting. And I'd started
(09:32):
reading when I was three. I wasreading chapter books at the
time, I was in kindergarten. Sothis was a huge change from my
previous ability. She is like,I hate to tell you this, but
those were all symptoms oftraumatic brain injury. Sarah ,
your shock treatment hurt you.
(09:53):
And I told her that my doctortold me if my parents, that it
was safe and that the only realproblem was memory. And they'd
never mentioned any of theseother things as part of the
consequence of the treatment.
And then she's like, well, thenwhy are you going to community
college if you already have abachelor's degree? And I said ,
well, I wanna work, but I can'tremember all of the rules to
(10:14):
edit, so I can't be an editoragain. And I told her that I'd
been an a SL interpreter. Andthe reason I was on campus was
, 'cause again, my deaf friendhad invited me to come into his
fourth year a SL class, kind oflike as a teacher's assistant.
And he invited me to justenroll. That way I could like
have ASL four on my transcript, um, because I'd become an
(10:38):
interpreter at the universitylevel in the early nineties. So
at that time, they hadn'trequired, they'd only required
like proficiency testing , notlike a formal transcript. Well,
anyway, so my friend had , allof my deaf friends had told me,
if you wanna get a job fast,you just need to relearn and
repolish your interpretingskills, and then you'll be able
(11:02):
to get right back into work.
And, you know, that was likethe fastest route to earn
gainful employment. But shesaid I needed to address my
brain injury first. And again,I laughed and she listed
everything back to me that Ijust said and explained again
that they were all symptoms ofbrain injury. And she said, I
(11:24):
know you feel interpreting isyour fastest option to get a
competitive job, but what doyou really want to do? And I
explained that I really wantedto do what she was doing and
help people with disabilitiesachieve their fullest
potential. I wanted to helppeople like me get back on our
feet after we've been sidelinedby an acquired disability. And
(11:47):
her eyes just lit up
And she told me that she knewwhat I needed to do. She said
that I needed to get mymaster's in rehabilitation
counseling and that locallyhere at San Diego State
University right here in town,we had one of the top programs
in the nation. And she gave meall the information about the
(12:10):
California Department ofRehabilitation explaining that
they had funding to helpqualified candidates get into
graduate school, or, I mean,not get in, but you know,
basically funding to pay, helppay for the tuition and the
books and whatnot. 'cause Ididn't have any, any money at
all. And she's like, then you'dbe able to graduate and then
(12:32):
you'd be able to give back tosociety by working in the
field. And I was like, that'sexactly what I want to do. And
so she explained that because Ialready had a , a great, great
transcript, good grades , uh,from BYU . Um, and I already
(12:54):
had my bachelor's degree.
Basically the only otherprerequisite would be taking
the GRE. And so she told me whoto contact at San Diego State,
and she really sent me on mypath path and all the way home
on the bus. Like I processedthat conversation. It took me
even longer to process hersuspicions about my plausible
(13:17):
brain injury. But withinmonths, I was accepted to San
Diego State RehabilitationCounseling program, and I was
absolutely floor that I wasaccepted because I, even though
I had been editor on facultypapers, I had lost most of my
(13:39):
vocabulary. And just to giveyou a perspective, I scored in
the bottom third percentile for, uh, on the GRE and
vocabulary, which means 97% ofthe people that took it scored
better than I did, even thoughI had been faculty and editor
(14:01):
of faculty papers . And my, thedear woman that interviewed me,
Karen Sachs, she looked throughall of my transcripts. We had a
good conversation about myinterests, my abilities, and
the diagnoses that I've beenlabeled with and whatnot. And
(14:22):
she is like, well, Sarah ,given your your lived
experience and your personalresilience and determination, I
really feel like our programwould be a good fit for you.
And I was like, well, whatabout my GRE score? And she is
like, well, the good news isyou have a great grasp of
(14:43):
vocabulary, so we're just goingto ignore that score because
you have all of therequirements. You've met all of
the requirements necessary tobe a good rehabilitation
counselor. Sorry. She changedmy life by , invited me into
the rehab counseling program.
(15:04):
And , um, while I was there, Iwas basically set up for
success because the faculty atSan Diego State University
understood how to work withstudents who have disabilities,
and they understood how to seepeople as individuals with
(15:24):
unique strengths and uniquecapacities. And so I had spent
12 years in a mental healthsystem that had always looked
at me from a deficit-basedmodel. And suddenly I was
surrounded by people who werelooking at me through a
(15:44):
strength-based model. And allof the students in my cohort
are part of the reason that Iwas able to graduate. And that
is because every time they hadany class projects that
involved assessments and usingthe results of assessments to
(16:06):
identify accommodations, everysingle class for assessment and
, uh, assistive technology,there was typically at least
one group that asked if theycan use me as their person. And
so gradually, each of thosepeople in that cohort, many of
(16:26):
them helped me identify mystrengths, and they helped me
identify appropriateaccommodations. And then I was
able to take theirdocumentations in their term
papers, justifying theappropriate accommodations back
to the Department ofRehabilitation, which had
(16:47):
never, before, previouslyfunded many of the things that
these students had identified,like, for example, an iPad to
help schedule, you know, help a, a student under , uh, keep
their schedule in place andtrack and use , uh, use the
alternative communic oralternative , uh, text, you
(17:11):
know, access to accesstextbooks and whatnot. They'd,
at that time, they'd neverbefore funded an iPad for that.
But because the students in mycohort had worked so hard to do
comprehensive assessments andthey could justify each of the
accommodations that we wererequesting, the Department of
(17:32):
Rehabilitation agreed. Andsuddenly I had, I had ergonomic
chairs, I had, and I've had tohelp with the scheduling and
coordination of my schedule andreading my materials. I had all
kinds of things that Ipreviously had no access to,
(17:55):
didn't even know I could askfor. And I think that is the
case for many people withacquired disabilities because
we grow up without an IEP , uh,we don't know that there are
even systems in place to helpus learn about what we can use
to circumvent the problems thatare causing barriers in our
(18:20):
life, whether it's in ouractivities of daily living or
in our employment settings.
That program changed my life,not only my life as a
individual with a disability,but also my life as an
individual striving to helpother people with disabilities.
Speaker 1 (18:38):
Thank you so much for sharing that. It's always
encouraging and empowering tohear those stories because I ,
I , I've spoken to other folkswho, you know, haven't acquired
disability, where just havingsomeone like as you mentioned,
come from a , a strength-basedperspective of what's the path
forward is such an empoweringexperience and , and hearing
(19:00):
you share that , um, is somoving and, and , um,
motivational, and I'm sure alot of people who have entered
the field the way that youhave, you know, from the point
of a , a client first, youknow, seeking services for a
disability and then becoming a, a certified rehabilitation
counselor yourself. Thatperspective and that journey,
we, we know CRCs are alreadymotivated, passionate people,
(19:23):
but , um, to go from client tocounselor, that, that brings a
whole nother perspective to thetable that really drives, as
you said, a lot of meaningprofessionally and personally.
Speaker 2 (19:32):
Can I just share one additional experience with
that? Yeah. So I just, just tomake example of one of the
students that helped me , um,and how that help went on to
basically form my career. Sowhen I very first entered the
rehabilitation and counselingprogram, I met a third year
(19:52):
student and we were talking andI told her, you know, about my
problems reading. And I toldher about my, my difficulties
organizing my thoughts. Andshe's like, well, you know, you
just recently finished your ect, so let's just assume you do
have a brain injury, and as youcontinue working on things, it
(20:13):
will become easier for you. AndI was like, okay. And she said,
I said, well, do you have anyhints for someone like me? And
oh, dear Lisa
me so long to read, shesuggested that if I chose one
topic to pursue for the entirethree years of the program ,
(20:37):
not only would I save timebecause I'd gradually approve
like a familiarity with whatI'd read, and gradually with
the repetitive reading of it,I'd be able to remember what
I'd read. She also said that Iwould have read articles on
that topic that I would use forlike research papers in
(20:57):
different classes. And so shesmiled and she said, I've got a
few articles you could use justlike 12 or 15 articles that she
had used in her papers. And soI got to work reading those and
that she gave me a really goodhead start . And now 15 years
(21:19):
later, my library has more than500 books, journal articles,
court transcripts, user devicemanuals. It's so much for , so
like her advice was the bestever. It really set me on a
successful path to help peoplewith a history of
electroconvulsive therapy. Ithink it really speaks to her
(21:43):
understanding of my passion.
You know, as an individual weso strive to help recognize an
individual's strengths, but wealso have to recognize their
passions. And when we can tapinto someone's passion, then
their efforts becomesynergistic. When they're using
(22:05):
their strengths to help fueltheir passion, then that that
effort becomes synergistic.
Speaker 1 (22:14):
Yeah. And you know, that really speaks to the, the
difference of working with theCRC, right? That expertise of
disability coupled with thecounseling skills, makes it so
you're not just looking to workwith an individual with a
disability and say, let's findyou any job, right ? Something
nearby, something you can getas fast as possible. And then
we send you on your way, A CRC's going to approach that and
(22:36):
say, what's going to fulfillyou? Um, what's, what's going
to put you in a place where youlook back however long a month,
a year, you know, years downthe road and say, I did all of
these things to make thisdream. I have come through. And
the CRC is there to put you onthat path. And it sounds like
from the story you just shared,you know, you start with , uh,
(22:57):
a handful of journal articlesand , um, that's a library that
, uh, dwarfs mine , uh, forsure
, uh, things you just listed.
Um, so yeah, it's, it's alwaysgreat to hear , um, that extra
emphasis and knowledge thatCRCs bring to that experience ,
um, manifest itself in such animpactful, you know, outcome.
Speaker 2 (23:19):
You know, I think you're right. I think one of
the unique capacities that CRCshave in terms of not only, you
know, the , like we discussedstrength-based model and the
counseling skills. I mean, whenyou can take an individual and
identify their strengths,identify appropriate
(23:39):
accommodations to circumventwhat could plausibly be a
weaknesses or deficit, and thenhelp them , uh, focus on their
passion, then you've basicallyempowered an indi an individual
to , uh, prevent burnout intheir career. So longevity is
(24:01):
there . They're not going tojust be going into a job that
they don't really have aninterest in or aren't
passionate about. And I , it'sso easy to get burnt out when
you are not passionate aboutyour job or when you're
passionate about your job, butyou don't have the counseling
skills and wellness tools inorder to sustain that passion.
(24:22):
That's a , that's a recipe forburnout. And I think all of us
, uh, could probably benefitfrom speaking with a
rehabilitation counselorspecifically for that reason,
because good rehabilitationcounselors understand ,
understand the tools andwellness tools necessary to
(24:44):
prevent burnout or to workthrough burnout, to work around
burnout, and to find joy in thejourney again.
Speaker 1 (24:52):
So after obviously becoming a CRC yourself , um,
you mentioned that , um, a lotof your work in research has
been related to ECT. And , um,if people aren't aware of your
work , um, you have someincredible stuff on your
website that people can , uh,check out. We'll have it in the
notes for the podcast episode,so they can check that out.
But, you know, a lot of yourresearch that I was going
(25:12):
through discusses communicationdisorders that come from ECT
for , for other CRCs who, whomight be working with a client
who has experienced , um, ECT.
What are the unique needs orconsiderations that you've
identified as being, you know ,um, considerations that CRC
should take with these sorts ofclients?
Speaker 2 (25:32):
I think to best understand how ECT impacts an
individual, you have to look atit from the perspective of a
neuropathologist whounderstands brain injury. And
so , um, I would just referthem to , uh, Dr. Bennett Amala
(25:53):
, who during the Department ofRehabilitation in Californians
during their traumatic braininjury advisory board meeting,
he was explaining that peoplewho have a history of
electroconvulsive therapy,while their MRI standard MRI
(26:13):
might not show anything wrongwith their brain. It is a
functional injury akin to arepetitive traumatic brain
injury because it's not justone ECT treatment, the
individual receives, it'smultiple, it's an entire series
or multiple series oftreatments. And so he
(26:35):
recommended that we view ECTrecipients through two lenses,
both the lens of a repetitivetraumatic brain injury and the
lens of repetitive electricaltrauma. Keeping that in mind,
it's important that werecognize the long-term
consequences of, of repetitivetraumatic brain injury. And we
(27:00):
recognize the long-termconsequences of a repeated
electrical trauma or even asingle electrical trauma. And
so in terms of communication,assessing your client for, for
problems, so you'd want to askthem like, why , person asked
me, do you have any problemswith bounds? Do you have any
(27:20):
problems with lightsensitivity? Do you have any
problems with motion ? When youbegin getting tired , does your
voice begin to slur? Did yourspeech begin to slur? Do you
have difficulty finding yourwords? Um, do you have
difficulty organizing yourthoughts? Do you have
(27:42):
difficulty planning andcarrying out tasks and then
contingent on that person'sanswers, you know, they could
even go into further. Do youhave difficulty with
coordination? You know, can youstill type at the level you
used to be able to type? Canyou still read and enjoy
(28:05):
reading the level that youpreviously did? Those kinds of
things are very basic skillsthat many individuals have
never been assessed for . Andso routing that person for a
comprehensive speech assessmentfor a comprehensive
occupational therapyassessment, looking at a hand
(28:27):
eye coordination, looking atmotor coordination, because one
of the, one of the recognizedproblems , uh, identified in
the manufacturer's user manualfor , uh, electroconvulsive
therapy is, well , brain injuryis one of the official serious
(28:48):
adverse events, but alsogeneral motor dysfunction is
another , uh, recognized , uh,problem. So I would
specifically refer them if itwere me with a new ECT
recipient, I would refer themto ACE pH therapist for
(29:12):
assessment to evaluate forcognitive communication
disorder. I would also referthem for a visual assessment
with a neuro optometricrehabilitation , uh, provider
through the Nora network. Um,because the neuro optometric
(29:35):
rehabilitation providers areoptometrists who are trained in
brain injury or developmentalvisual problems, who can see
whether or not the person'seyes are aligning correctly. If
your eyes cannot aligncorrectly, which is most common
consequence of ease of braininjury, then you are going to
(29:56):
fatigue faster. Because as youread, as you look at life, your
eyes are struggling to maintaintheir alignment, I guess is
what you'd say. Um, and so thatis gonna be tiring. And so you
want to set your client up forsuccess. And a comprehensive, a
assessment will be able tobreak down barriers to
(30:18):
accessing not only thevocational rehabilitation
necessary, but the physicalrehabilitation necessary after,
after an injury of this nature.
And so it wasn't until like Iwent through my entire program
with alternative text andpeople taking notes for me. And
(30:39):
I mean, I had a lot of, I hadextra time on tests 'cause I
qualified for all of that, butthey never , uh, recognized
that, gee, you know, visionrehabilitation could really
improve your quality of lifeand vision. Rehabilitation has
improved my memory. Visionrehabilitation has improved my
(31:02):
ability to create sequence. And, uh, so vision rehabilitation
is probably something that notmany rehabilitation counselors
had considered because wetypically think in terms of
speech, occupational therapy,physical therapy, and mental
health therapy. Um, andneuropsych testing does not go
(31:26):
into like vision , uh, andvisual processing. But you'd
want visual processingassessment. And also, I also ,
uh, benefited from getting anauditory processing, you know ,
like a central auditoryprocessing assessment because
then they were able torecognize, oh, okay, she can,
(31:48):
like I scored off the charts inone-on-one conversation. My
hearing, I got 99% of myhearing. But when they started
putting all the other peoplenoise in my head and I had to
focus on the one voice, mycomprehension dropped to
profoundly disabled. It waslike the 23rd percent being
(32:10):
able to understand the worldaround me in a conversation ,
uh, or in a room, you know ,like in a meeting. And so they
were recommending things like,you need, you know, real time
captioning you need, and youcan use an a SL interpreter
'cause you understand a SL youknow, those kinds of things
because you need those kinds ofthings to work and survive in
(32:35):
an employment environment. Soyes, the central auditory
testing and the basically theneuro optometric rehabilitation
provider, that's a basically acentral visual processing
assessment. And so that'swonderful. Thank you so much.
If I could see me again as anindividual back in 2009, this
(32:55):
is what you need. One lastthing. Mm-Hmm.
you've mentioned , um, youknow, what do we know? What,
what would you do? Well, it'swonderful that you can ask me
that, but not everyone has muchof an understanding of what has
happened to people withelectroconvulsive therapy. And
to that end, I'm actuallyworking on a project with a
(33:16):
colleague of mine and severalother ECT recipients and
psychologists. We currentlyhave a survey that is open
right now, and the survey isopen for any ECT recipient and
their family member or closefriends who understand how ECT
impacted them. And it'sbasically functioning as a
(33:38):
needs assessment. And thatsurvey will likely be open
through the end of August,maybe September. But we're
basically doing a needsassessment so that we can
better understand whatindividuals with history of ECT
need in order to move onthrough life after ECT. So I
can give you that information.
(33:59):
If you could share in your shownotes, that would be fabulous.
'cause we've really, we really,this is a gap in our
understanding in general inhelping people who have severe
mental illness, many e ct, manyec , many CRCs don't even know
that if they have someone whohas a history of a mental
health diagnosis, we really,and even these days, we need to
(34:23):
look also at people who have ahistory of autism or who who
are autistic , um, people who ,uh, have any kind of
developmental disability. Weneed to begin asking on our
intake forms if they have ahistory of electroconvulsive
therapy. Because a lot of timeswe won't understand why the
(34:45):
individual isn't thriving inthe situation that we've put
them in or in their, in theirplan, in their treatment plan.
And it's because we haven'tcompletely understood , uh,
some of the problems that theyare dealing with. And I , so
for that reason, I wouldencourage everyone to include,
do you have a history ofelectroconvulsive therapy on
(35:07):
your intake form? Becauseyou'll be surprised at how many
people will be able to check.
Yes. One of the things aboutbrain injury is that the
symptoms of brain injury willwax and wane depending on the
individual's level of cognitivefatigue and the individual's
(35:31):
level of , um, sensoryoverload. And so, for example,
we purposefully scheduled thisappointment in the morning
because in the morning I havespeech that people can
understand, but I really onlyhave functional speech because
(35:53):
I am advanced in my delayedelectrical injury. I really
only have functional speechabout two to four hours a day.
And so I actually use a speechdevice to communicate , um, as
my speech becomes so slurredthat people cannot understand
(36:15):
what I say. That was not aproblem when I very first began
this journey. And it willlikely crop up at different
periods of time for individualswith a history of ECT simply
because of the nature ofdelayed electrical injury that
(36:36):
typically develops between sixmonths to more than a decade
after ECT or after electricalinjury. In general, it's
referred to as delayedelectrical injury. Right? Now,
I don't need an alternativecommunication device to speak
with you, but I do have oneprescribed, and it was
(36:59):
prescribed because as I gettired, I lose my speech. And
when I am surrounded by sensoryinput, I cannot coordinate the
muscles required to speak within a way that people can
understand me. And so I do usea speech generating device. So
(37:19):
I just wanted to put that outthere because if anyone wanted
to look at me, they might lookat me today in this interview
and say, well , she could talk. But we need to understand
that disabilities, a lot ofpeople that live with
disabilities, their symptomswax and wane . And so we need
(37:40):
to ask people, you know, nottreat people as like their
symptoms are static. They'llnever get better, they'll never
get worse. A lot ofindividuals, depending on the
disability, will have an ebband flow of their capacity,
another ebb and flow of theirability. And so keeping that in
mind when you do yourassessments for individuals
(38:03):
with a history of brain injury, especially keeping in mind
the , how the environmentimpacts the person. For
example, one of the things thatwe discovered with my personal
injuries , that because theelectrodes are placed on the
trigeminal nerve, thetrigeminal nerve goes right
(38:26):
into the brainstem, and thatgoes right into all of the
other parental nerves. It goesall the way down your spine.
And so all of my ability toprocess sensory input with my
eyes and with my ears, and withmy touch, that has been
compromised with my motoroutput because that nerve, the
(38:48):
trigeminal nerve, does bothsensory input and motor output.
And so , um, that's critical tounderstand because when they
referred me for centralauditory processing assessment,
and they discovered that Icould not understand the world
around me when I was floodedwith too much auditory
(39:11):
stimulation, they actuallyprescribed basically their
musician's earplugs. Theyfilter out 25 decibels of
sensory input so that I canfocus on just the person
sitting in front of me and itwill get rid of all of the
(39:32):
external, you know, the typingor the other people con , um,
conversations in the phone orin the , in the work
environment. And so being ableto be aware of how sensory
input, input impacts not onlystress levels, but ability to
process the world around youwould be really critical for ,
(39:53):
uh, someone doing an assessmentfor an individual who had a
history of electroconvulsivetherapy or any brain injury.
Speaker 1 (39:59):
And I think, you know, it's really telling, like
you mentioned, scheduling thiscall earlier in the day , um,
as opposed to maybe theafternoon or something like
that was a, a type of, youknow, a , a accommodation to,
to scheduling this that like anemployer, if they have somebody
who maybe throughout theafternoon starts to lose speech
function, maybe schedulemeetings with them in the
(40:21):
morning or, you know, it , it'sthose little, those, those
tweaks to what is consideredmaybe like the norm with a
business that can be sotransformative for an
individual with a disability.
And those accommodations a lotof times are just rescheduling
the way that the day's gonnaflow, you know, and we always
hear from CRCs that a lot ofaccommodations don't even cost
(40:41):
a business anything. It's justallowing a little bit of
flexibility to the way that theday usually plays out for
everyone to be able to functionat their, you know, their,
their maximum potential. And Ithink that was a great example
that you pointed out.
Speaker 2 (40:54):
Well, to your point, I think Covid has taught us the
value of remote working. Andyou know , for me, as someone
with a brain injury who liveswith a form of mild neuro
disorder, my body shuts down asit becomes fatigued. But when I
rest, I take a nap, all of asudden my speech will come
(41:16):
back, my ability tocommunicate, my ability to work
will return , my ability tofunction will return. And so
when you have flexiblescheduling in an employment
setting, having the opportunityto log out, take a nap, and
then log back in to continue,you know, getting your, your
(41:37):
hours in, you'll be a much moreproductive person. I'm a much
more productive person when I'mwell rested . And especially
with my, my own neuraldisorder, people can understand
me better when I speak clearly,and I can only speak clearly
what I'm very well listed . Sojust, I think that was actually
(41:59):
one of the good things thatcame out of Covid was that now
employers recognize thatemployees can still be
productive when they are athome in quiet , secluded
environments. They can stillmeet , uh, employment
expectations in terms of, ofmaking, you know, achieving
(42:20):
their job responsibilities. Andthey know that now from a
personal perspective, becausethey were the ones working from
home striving to be productive.
And I think before then,employers really had no concept
of how productive people can beif they're stuck at home. And
now we know that you can evenbe productive at two in the
(42:43):
morning because you, you know,your sleep got schedule messed
up, but guess what? You canstill respond to emails or you
do, you know, jobresponsibilities at, at, at
times that would not typicallybe between the typical nine to
five. And I think that was veryvaluable experience. Probably
the one valuable thing thatcame out of the covid shutdown
(43:05):
was opening employers eyes tothe possibilities of what can
be done from home, what can bedone in quiet work
environments, how productivepeople can be at their own
schedule.
Speaker 1 (43:19):
Thank you for adding that, and we will absolutely ,
uh, link that survey into theshow notes. There was another
interview you did where youmentioned the phrase employment
as a treatment plan. And we've,we've heard that from other
CRCs as well, that, you know,employment has a profound
impact on, on , on a clientbeyond just being able for that
individual to say, I now have ajob. Can you, can you talk a
(43:42):
little bit about your view ofemployment as a way for people
with disabilities to feel , um,active and integrated into
society and their community?
Well,
Speaker 2 (43:51):
Employment in a job or career you love is
empowering. And until peoplefeel empowered, they do not
recognize that they are agentsof change. Many people who live
with a variety of disabilitiesacquired or developmental
congenital disabilities we'reoften surrounded by people who
(44:13):
have looked at us through adeficit based model for so long
that they routinely tell us, Iknow, they told me what I can't
do, what I can't do, what Ishouldn't try, what I can't
even try. I mean, little bylittle, our circle of influence
(44:34):
feels smaller and smaller andsmaller and little by little,
especially people like me whoare diagnosed with what they
said was treatment resistedmental illness, we begin to
develop learned helplessnessbecause it didn't matter how,
how compliant I was with mymedical treatment, I was not
(44:56):
getting better. In fact, I wasgetting worse. And so , um,
people who live with theseexperiences so many times,
because we've been told what wecan't do so much, we gradually
learn not to try. And so interms of looking at employment
as a treatment plan,especially, I mean, even pre
(45:21):
pre-employment as a treatmentplan, right? Basically my
doctors told me that I wastreatment resistant. And after
12 years of faithful treatmentcompliance without improvement,
I believed them. Andessentially I turned my power
over to my doctors and mycounselors who were telling me
and my family that I cannot dowhat I cannot do or what I
(45:43):
shouldn't even try to dobecause it might make me worse.
But finally I realized if mydoctors couldn't make me
better, I had two choices. Icould either just give up and
die or I could make myselfbetter. And so I began learning
from people diagnosed withsevere mental illness, what
their strategies were. Forexample, I enrolled in a class
(46:07):
developed by Mary EllenCopeland, who lives with
bipolar disorder diagnosis.
That class is a wellnessrecovery action plan class. And
in that class I learned how,you know, to develop a wellness
toolbox, which is basically allof the strategies and skills
that I would need to use in mydaily life. And the more tools
(46:32):
I had in that wellness toolbox,the more capable I became. And
when I wasn't having success inmanaging my illness, you know,
I would
to work. I went back to work.
This is actually even before Iwent to the community college,
(46:53):
I'd actually gone back to work.
And I was like, the only thingI know how to do for sure , for
sure is answer a phone answer .
And so I applied for a job as areceptionist, and I did so
well. And my interactions withpeople at the regional manager
actually recognized my skillswithin three weeks, and she
(47:17):
hired me to be her advaadministrative assistant. So
here I was in my physicalhealth, my mental health,
running up against wall afterwall after wall. And yet at
work, because I had personalityon the phone that sounded,
well, clearly I didn't havethis voice, but even if I had
(47:41):
this voice, I'm a very good perpeople person. And I was able
to communicate with , withpeople in such a way that I was
getting padded on the back allthe time for what I was capable
of doing. And that is whyemployment as a treatment plan,
(48:04):
if you want to help someonefeel empowered, help them find
a job they can really do, andtheir environment will become
empowering and be by feelingempowered, they will be more
likely to try and explore newthings to stretch their
capacity.
Speaker 1 (48:25):
Yeah, rehabilitation counseling has such a deep
history , um, over a centurynow. It has existed and , um,
has, has deep ties obviously tothe vocational aspect of, of
that disability counselingexperience. And, you know, we
know that the knowledge of a ,of a certified rehabilitation
counselor can be utilized in ,uh, several different practice
(48:46):
settings and fields. We keepseeing CRCs , um, join
organizations or, or, or , uh,service providers and
industries that we don't see alot of CRCs. And then suddenly
a couple years later, there'smore of them. And it's kind of
like a good, good news thatspreads, right? Like if you
hire one CRC, you see their ,uh, impact and the potential
they have to, to aid yourorganization and then you want
(49:08):
more of 'em, which is what welove to see here at CR ccc .
Yeah . You know, based on, youknow, your experience as a CRC,
where would you like to seecertified rehabilitation
counselors working or making animpact , uh, given their unique
expertise and disability?
Speaker 2 (49:23):
I would like to see CRCs in two places that I
typically don't see them. Iwould like to see them in HR
departments because one of themost important things an HR
person in HR can do is to takethe strengths and all of the
(49:45):
training that an an employeehas invested, an employer has
invested in an individual anduse them in , if they come back
and they can no longer do Xportion of their job
description, the employer knowshow much they've invested in
that individual and that theystill have these abilities. And
(50:05):
being able, as an hr, you wouldbe person, you'd be able to job
carve , create job specificallyfor those job responsibilities
for, you know, and pay forthose specific job
responsibilities. And without,you know, without the one thing
or two things or five thingsthat the person can no longer
(50:27):
do, they still have this entireskillset . Um, and so I think,
I think a good example of that, uh, I mean in a major
corporation would be Boeing.
I've done a training forBoeing. Boeing actually employs
CRCs. And because the Boeinghas such a dynamic, you know,
it's a ginormous corporation,right? And they invest in their
(50:50):
employees years of training.
And when an employee develops adisability for any reason, they
work hard to tap into thatemployee's strengths and assign
them to a different job withinthe community, within their,
within their company. So , um,I think HR departments
(51:16):
definitely could use , uh,CRCs, but I also think that we
really need , uh, certifiedrehabilitation counselors in
rehabilitation settings. Iwould love to see certified
rehabilitation counselors inthe clinic with the brain
(51:36):
injury. Uh, people, you know,in these rehabilitation
facilities, these long-termcare facilities that are, you
know, rehabilitation nursingfacilities, like the transition
between hospital discharge andback into the community, lots
of people go to theserehabilitation facilities or
they go to outpatientrehabilitation programs for
(51:56):
speech, physical therapy,occupational therapy, et
cetera. I mean, thosetherapists are designed like
physical therapy, occupationaltherapy, speech therapy.
They're designed to help themwith activities of daily
living. But until they have aconcept of the job that the
(52:17):
person's going to be going backinto, you know, CRC has a
unique perspective becausethey'll already understand the
job responsibilities of thatindividual's job, whatever that
job might be, and then know howto help them identify
reasonable accommodations sothat they, when they want to go
back to work because they'refinally physically capable of
(52:40):
returning to work, then they'llbe able to say, and, you know,
to their HR department, theseare the accommodations that
will allow me to maintain myproductivity, or these are the
accommodations that arereasonable that would allow me
to maintain not only myproductivity, but my longevity
so that you do not lose me as askilled employee. So that's why
(53:03):
I really think thatrehabilitation settings in
general would be extremelybeneficial. I think that we
should really, as a groupadvocate for Medicare
reimbursement, because oncecertified rehabilitation
counselors can be reimbursedthrough Medicare, it sets
(53:25):
precedent. We can build in waysthat will allow us to be able
to get , get into these medicalsettings, and we will be able
to augment the rehabilitationalready ave available in
rehabilitation settings becauseessentially we are helping
people get back to work. So, Imean, not only are we going to
(53:47):
be alleviating the tax burdenon people, you know, taxpayers,
you know, because we're gonnabe able to keep people employed
because we recognize theirskills, we recognize their
abilities, we recognize theircapacities , we recognize the
accommodations that need to beput into place so that they can
continue in their preferredcareer as A-C-R-C-C, I think we
(54:11):
should really work on helpingget our CRCs into medical
settings by advocating throughMedicare for reimbursement.
Because in the long run, Imean, they've talked about
wanting to get people back towork, but there's really a
disconnect between wantingpeople to work and getting them
(54:33):
back to work. And the CRC iswhat's going to branch that if
they want to get people off thedisability and off of social
security and they want to getthem back to work, they need to
facilitate that by not siloingcertified rehabilitation
counselors into just staterehabilitation, vocational
(54:55):
rehabilitation departments orinto , uh, university or, you
know, community collegesettings. We need to have them
in all settings so that we canactually facilitate the
rehabilitation of individualswho can work and can get and
(55:15):
maintain competitiveemployment.
Speaker 1 (55:18):
The rehabilitation settings in the HR settings are
similar in that when I comeacross job listings , um, for
a, a disability specialist oran accommodations coordinator,
things like that, and I seethat they're under
requirements, they're notlooking for a rehabilitation
counselor or even better A CRC,they're looking for people,
maybe like you said,traditional HR backgrounds ,
(55:40):
um, social work, other fieldsthat are related, but that
skillset of A CRC is gonna havethe most impact. I always wanna
message the hiring manager andbe like, man, do I have a field
of professionals for you? Youknow? Um, so hopefully we
continue to see CRCs , uh, inthose spaces more often.
Speaker 2 (55:58):
I think also in our push to help people get
competitive integrativeemployment, I would like to see
CRCs in schools, in schooldistricts because, you know, we
want to start young in thesepre-employment trainings. And
if we're actually going to helppeople find work after they
(56:19):
leave schools, we need to havethem already understanding the
kind of , uh, employmentaccommodations that they need
to request. We also need tohelp educate employers to
understand, you know, if youcan find a talented individual
that might do things didifferently, but who is a has
(56:42):
superhero powers for theirpassion, you want to be able to
work with their reasonableaccommodations.
Speaker 1 (56:50):
Uh, if you're listening and you work in a
school setting or arehabilitation setting or, or
in hr, and you , um, want toshare with us at CRCC how
you've broken into that fieldso we can help advocate for
more folks , um, like yourselfjoining those fields, please
reach out to us on our websiteor social media. Um, we've
spoken to people who work ininsurance or at companies like
(57:11):
Amazon in the past and have hadsuccess helping them build, you
know, advocacy resources to beable to try to get their , uh,
hiring managers or, you know,district managers to hire more
CRCs. So if that's, if that'syou listening today , uh, we're
happy to partner with you onthat. You know, we're, we're so
happy that you're on ourpodcast today, Sarah , but you
have a podcast yourself calledEmotional Self-Reliance. Um,
(57:32):
and I, I really liked that termwhen I was researching a little
bit about it , um, in , inpreparation for speaking with
you today. Um, can you tell usa little bit about emotional
self-reliance as a wellnesstool and how it's used in
practice?
Speaker 2 (57:45):
Well, in terms of wellness tools , uh, we've
already talked about how thereskills and strategies , um,
that we use to improve ourquality of life physically and
emotionally. Um, but I believethat together our wellness
tools create like an emotionalself-reliance toolbox. And so
basically the more wellnesstools we gather, the more
(58:08):
resilient we become asindividuals, and we can depend
on ourselves to work throughour problems and not look
outward for other people tosolve our problems. So I think
more of emotionalself-reliance, more of, you
know, as self-exploration toidentify as many tools as
(58:30):
possible to facilitatewellness. And so I kind of look
at my emotional self-reliance,like as the , the label on my
wellness toolbox.
Speaker 1 (58:44):
Yeah, I love that.
Um, you wrote a book , uh,called Daring to Dream
Essential Tools to findEmployment , uh, which helps
people find a job that, aswe've talked about in this
conversation, that they'lltruly love. Right? Um, where,
where do you think employersneed to do the most catching up
in regards to the way that theyunderstand inclusive and
(59:05):
accessible employment?
Speaker 2 (59:07):
Well, that book's actually a workbook. Um, and it
really, it's really thepre-employment blueprint, I
guess, for individuals. And Ideci I designed it to
facilitate my job club, and itwas so successful that many
people employ, many peopleenroll , they found jobs, and
then the club spread by word ofmouth. But once all of these
(59:27):
people began developing theirpre-employment skills, at times
they were met by employers whocouldn't see the bigger
picture, which was, if youemploy people with diverse life
experiences, it's better forthe bottom line. So people with
living with disabilities, Imean, if you're an employer and
(59:48):
you want to better understandinclusive and accessible
employment, you really need tounderstand that individuals
with disabilities, I'm justgonna say humans, humans need
to be seen through astrength-based model. And when
looking at individuals withdisabilities, we are quite
(01:00:11):
creative problem solvers. Wemight not do things the way
other people can, but wefigured out how to do them
anyway. And often when everyoneelse told us what we couldn't
do and that we'd never be ableto do what we're presently
doing. So overcoming thatamount of opposition in our
lives, it takes creativity, ittakes determination, and it
(01:00:33):
takes resilience. So inclusiveand accessible employment means
created an environment where anindividual can use whatever
appropriate combinationnecessary for them to get the
job done. Um , many of us learnto streamline our daily tasks
to conserve energy, and thishelps us learn how to
(01:00:55):
streamline other tasks, right?
It's a transferable skill, soit helps us learn how to
streamline other work tasks tobecome more efficient. And I
mean, many of us, I'm justgonna say we're superheroes
within our own skillsets thatus it sounds really prideful.
I'll just say I take pride inmy humility,
Speaker 1 (01:01:17):
I think it's accurate,
Speaker 2 (01:01:18):
certain aspect of ourexperience because we have
unique experience that nobodyelse does. And so , um, we
might, you know, I know I, Istruggle with things that are
outside of my skillset , but ifmo , if more businesses could
(01:01:41):
be trained in job carving,those member , again, and HR
departments that have acertified rehabilitation
counselor to help split up anddivide job responsibilities and
assign them to individuals withthe skills to perform that task
at or above expectations, Ireally believe employers and
(01:02:02):
businesses will love whathappens to their employee
morale. And consequently thereare productivity.
Speaker 1 (01:02:11):
I have one more question for you, which, if
anyone listening today listensto the podcast regularly, this
is a question we love to askeverybody who comes to speak
with us, we often hear thatCRCs say that this job, this
profession, this, this fieldthat they've pursued is, is a
calling that they've answered.
What brings you joy in the workthat you do as a CRC? Hmm .
Speaker 2 (01:02:33):
Sorry, I'm gonna get emotional. Um, until I studied
rehabilitation counseling,there is not a single other
person in the research onelectroconvulsive therapy that
has addressed improving qualityof life after ECT. And by my
(01:03:01):
learning about appropriatecomprehensive assessments and
then sharing that indiviinformation with individuals
who have a history of ECTI amfor the first time, I am
facilitating the breaking ofbarriers for accessing
(01:03:21):
assessments even , uh, forpeople who previously had no
access to assessments. And weknow that once you have
assessments, appropriateassessments, then the results
can drive appropriaterehabilitation interventions.
And it brings me suchtremendous joy to hear from
(01:03:48):
people and their families, orpeople who've had history of
ECT tell me that my assessmentrecommendations helped them
gain access to therehabilitation necessary to
improve their quality of lifeafter ECT and to move beyond
(01:04:08):
the tragic circumstances oftheir, their life had become
after they'd been abandoned,after their injuries and
hearing about their newlydiscovered interests and
exploring employment in fieldsthat they'd never previously
considered hearing them say, Ithought my life was over, but
(01:04:29):
now I realize there's more tolife after ECT, that that is
what brings me joy. And yes, Ido see it as a calling.
Speaker 1 (01:04:40):
The work that you're doing is , um, is profound and
so impactful. Uh, I can't thankyou enough and we can't thank
you enough. Um, we reallyappreciate your time today ,
um, in speaking with us. We'llmake sure , um, as we've
mentioned throughout the show,that , uh, there'll be some
links in the show notes , um,so you can follow along with
Sarah's work. And , uh, thankyou so much , uh, for your time
and insight today.
Speaker 2 (01:05:01):
Thank you so much. I I'm really grateful for the
opportunity to do anything Ican to support certified
Rehabilitation counselorsbecause they've radically
improved my quality of life andI want to be able to help them
help others. You so much.
Speaker 1 (01:05:25):
Thanks again to Sarah Price Hancock for that
engaging conversation. You canfind links to Sarah's work, her
current research study for ECTpatients and their families,
and more resources in the shownotes. If you have any
takeaways or insights on topicscovered in this episode, email
us at contactus@crccertification.com. Be
(01:05:46):
sure to subscribe to this showon Apple Podcasts, Spotify, or
wherever you're listening to ustoday. You can find us on
Facebook, Twitter, and LinkedInat CRC Cert , and our website
is crc certification.com. Untilnext time, I'm Taylor Bauer.
Thank you for listening toInside Rehabilitation
Counseling.
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