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[TIRR] New Options Proposal and Correspondence [1974-1977] [2]
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[TIRR] New Options Proposal and Correspondence [1974-1977] [2]
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Records Relating to Disability Rights Organizations
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Originally Processed With FOIA(s):
FOIA Number:
S
S
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the George Bush Presidential
Library Staff.
Record Group/Collection: Donated Historical Materials
Collection/Office of Origin:
Frieden, Lex, Collection
Series:
Disability Rights Organizations
Subseries:
OA/ID Number:
52064
Folder ID Number:
52064-009
Folder Title:
[TIRR] New Options Proposal and Correspondence [1974-1977] [2]
Stack:
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Position:
TIRR TRANSITIONAL PROJECT
The TIRR transitional project will provide training in social adaptive skills
for persons with severe physical disabilities. The live-in program is designed
to last approximately nine weeks for each participant. Some persons may need
less training and leave the program after a shorter period of residence. Others
may profit from additional special services such as drivers' training, a formal
vocational evaluation, or time in a practice living situation which may require
more time.
During an individual's first week in the project, he or she will be introduced
to the various program activities and to the project techniques of self-assess-
ment and goal-setting. The participant will develop an individualized program
plan with project staff members which will be formulated in a contract specify-
ing what is expected of each party. Each participant will be assigned a buddy
at the beginning of his or her stay. The buddy relationship will serve as a
focus for work on social interaction and interpersonal relations throughout a
person's stay in the project.
The program will be organized so that all subject areas are covered in an eight-
week period. Some on-going activities will be scheduled on a weekly basis. Other
program areas will be developed as short-term training modules which are sche-
duled in an eight-week sequence. The various program elements are described
below.
social skills group
3 hours per week
Two sessions of 1 1/2 hours each will be conducted per week by a social worker,
to deal with social relationships inside and outside the project, family
relationships, feelings about self and the future, and other areas as
appropriate.
weekly seminar on educational and vocational opportunities
4
hours
per
week
Seminar will be conducted by a vocational counselor to include group dis-
cussions and numerous field trips to colleges, vocational training programs,
and employment locations; active handicapped persons in the community will
be involved as resource persons.
weekly seminar on living arrangements
4 hours per week
Seminar will be conducted by core project staff to include group discussions
and numerous field trips to nursing homes, residential projects, a college
dormitory, and individual living arrangements; active handicapped persons in
the community will be involved as resource persons.
2
weekly buddy counseling
1 hour per week
Individual and joint-counseling by project social worker will focus on
buddy relationship as a means of developing an understanding of other
persons and skill in interpersonal interaction.
weekly consultations with RN, PT, OT
1 1/2 hours per week
These professional staff members will be available one morning a week to
serve as consultants to project participants in assessing their needs and
devising programs to meet these needs; to include long-term planning as
well as dealing with immediate problems.
weekly mobility assessment group
1 1/2 hours per week
A weekly meeting will be conducted by core staff members to examine mobility
problems encountered by participants on various field trips and to consider
ways of dealing with these problems.
weekly sex and coffee group
1 1/2 hours per week
A weekly group will be conducted by the project social worker to examine
attitudes and feelings about sexuality, role expectations, and dating.
weekly evaluation and assessment session
3 hours per week
One morning per week, participants will take part in an evaluation session-
to be supervised by core project staff. These sessions will fill two pur-
poses. One is to measure the individual's status in various program areas
as an aid to self-assessment. This information will be used by the partici-
pant in formulating plans for the coming week. The second purpose is to
provide information to the staff about the effectiveness of various program
elements.
weekly group on problem-solving
1 hours per week
This group will meet :in the afternoon following a morning assessment session
to assist persons in considering needs, specifying goals, and formulating
plans formulating plans for the coming week. Long-range planning will also
be emphasized.
weekly group for significant others
1 1/2 hours per week
A group will be" conducted one evening per week as needed for family members,
spouses, close friends, or counselors of project participants. The group
will consider the transitional experience of the project participant, examine
the SO's feelings about these changes, and help the SO in being a supportive
influence after the participant has left the transitional project.
3
field trips
Field trips into the community will be included in many program activities
(visits to vocational training sites and residential projects, for example).
In addition, other trips to shopping areas, recreational activities, etc.
will be regularly scheduled with participants to be involved in trip plan-
ning. After each trip, participants will complete a form concerning their
social interaction on the trip and a form on mobility problems they en-
countered. These experiences will later be discussed in group sessions.
short-term training modules, cycle I
41/2 hours per week
Short-term training programs in self-care and medical needs (two weeks),
functional skills (three weeks), and homemaking skills (three weeks) will
be conducted by an RN, PT, and OT respectively. These modules will meet
three mornings a week (1 12 hours per session) for the designated number of
weeks. They will be scheduled one at a time in an eight-week. cycle.
short-term training modules, cycle II
41/2 hours per week
Short-term training modules will be conducted by core project staff with
substantial involvement of active handicapped persons in the community.
Subject areas will include attendant management (two weeks), financial
management (two weeks), mobility and transportation (two weeks), consumer
affairs (one week), and leisure activities (one week). Groups will meet
three afternoons a week (1 hours per session) for designated number of
weeks. Modules will be scheduled one at a time in an eight-week cycle.
These activities will be combined in a weekly schedule as indicated below. The
scheduling will be varied às the project progresses to test the effectiveness of
alternative arrangements.
TENTATIVE WEEKLY SCHEDULE / TIRR TRANSITIONAL PROJECT
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
WEEKENDS
module I
buddy coun-
module I
module I
evaluation
field trips
seling
& self-
MORNING
consultations
social skills
field trips
staff meeting
assess-
ment
group
buddy coun-
consultations
seling
buddy coun-
seminar on
mobility
seminar on
problem-
field trips
seling
vocational-
assess-
living
solving
AFTERNOON
sex and coffee
educational
ment
arrangements
group
group
opportuni-
social skills
module II
module II
ties
group
module II
SO group
field trips
field trips
EVENING
cantrol Treaty D
direct ofs. seg.
11-12 hrs wak
Erhs. form ofs say.
3-4 hrs. work
for (Enter)
rams
(10 mg)
= Ohi talling indiv.
200 hrs including
interview May wb. ,
145,000
100 hr. interesting
zoo
700 Too his enduring
145/1400
220
9663 madewrole
you 1975
Houston Ayes
77042
assessment
100
Do
100
(no Othing)
hr, evel ating
system rend
40 hr. cottony data
direct ofs . 12
S
246
960 less
An analysis and description of the program as a whole will be made from an
anthropological perspective. The main objective of this portion of the study
is to document the planning of the transitional program and to trace its
evolution over time as new participant populations are included, staffing
arrangements change, and as the program content is refined. Fairweather's
study of the evoluation of a community=based program for ex-mental patients is
perhaps the best prototype of the type of study that is planned (1969). During
the course of the project Fairweather continuously
documented
the expected outcomes of various planning decisions. He then used on-going
experience in the project to test the accuracy of these predictions.
Two major types of data will be used in this portion of the study. The first
is factual information about how time is spent in the project. This information
will be provided by the system measures discussed above, by staff diaries to
be completed daily by professional staff members in a simple standardized
minutes
recording format, and by minutes of meetings with staff members and with outside
agencies to be mainbanded by the project director. The second type of data
includes perceptions and assessments made by various staff members about the
program. An evluation form will be completed monthly by staff members. It will
be based on the Community-Oriented Program Evaluation Scale (COPES) developed by
Roos et al in their study of psychiatric treatment settings (1974). The evaluation
form will focus on individual assessments of the various program elements, on
relationships among staff and among participants, on interaction between parti-
cipnats and the active handicapped community resource persons, on managerial
and decision making processes, on the social atmosphere, and on areas that are
seen as problems by the staff members. In addition to these types of data, the
project director will continuausly record observations in the form of anthro-
pological field notes. These observations will be focused on areas such as
staff relationships and on roles within the project. They will include
explicit statements of expectations expressed by staff members in various
planning meetings.
lex
MOITATIJIS
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to invite whomever
also scott Bigham
be thought would
be interested
Jean
960 leh. ffs
210 shows
mailing
300 interview
20 anylan 320h
200 not.
or
640 9
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it's
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multi method measures
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X102 103 simple tax ass. w module
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560
inventory
- behavior (undtensive)
archives
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books dants
money April
counters
observations sociogram
function vilists
interview
system mg design
monitor, organize file
transformation
evaluation
feedback
[unintended offects/good free
unknown treatments efficts
request more
Enstant and comp
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daily interviews
typtanic collection
Direct observation
diaries
Control Group
?
expensive
involves design of was
collection of deta
evide
feedback
11/2 hr. of direct off requires
11-12 hr. work
1/2 hr. of form obs requires
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3 Primary cologocias of
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lex-
This is the stuff from
esrael Gordiamond that
Baubara wanted to look
at iii formulating a
proposed resident-kept
record. & thought you
might want a copy
too
Jean
The University of Chicago
Taber 2 but widle
Rev. Mar. 74
Department of Psychiatry
Or. Feb. 70
I. CONSTRUCTIONAL QUESTIONNAIRE
(The purpose of these questions is to obtain information, hence their
wording is to be tailored to the occasion.)
(INTRODUCTION)
I am going to ask some questions to help us both understand what it is
that we should work toward.
The questions have three purposes:
First, we'll need information to help acquaint us with you.
Second, from the questions people ask, you can learn things about them,
so this should help you learn about our approach.
Third, to see how we're progressing, we need records, and befores and
afters. This is a kind of before on how you see things now, and what aims
you want now, SO please speak up.
(QUESTION 1: OUTCOMES)
I am going to ask you a group of questions about our goals. You are
here because you want certain changes to occur, or want something else.
(a. Presented outcome) The first of these is: Assuming we were
successful, what would the outcome be for you?
(b. Observable outcome) Now, this may sound silly, but suppose one of
these flying saucers is for real. It lands and 2,000 little Martians pour
out. One of them is assigned to observe you -- your name was chosen by their
computer on some random basis. He lands some time after L-Day -- Liberation
Day from your problems -- and follows you around invisibly. He records his
observations and these are put on IBM (Interplanetary Business of Mars) cards.
Their computer will decide on the basis of the sample of 2,000 Earthlings
they have, what their disposition toward Earth should be. What does he
observe?
(b. Alternate or added form: What would others observe when the
successful outcome was obtained?)
(c. Present state) How does this differ from the present state of
affairs?
(d. Example) Can you give nie an example?
(QUESTION 2: AREAS CHANGED, UNCHANGED)
The next group concerns things in your life which are going well, and
things which are not.
(a. Areas unchanged) What's going well for you now, and what areas
of your life would not be affected by our program?
(b. By-products) What areas other than those we'd directly work on
would change?
(QUESTION 3: CHANGE HISTORY)
This next series concerns your efforts to change things.
(a. Present attempt) Why start now? How come?
(b. First attempt) When did it first occur to you to try to change?
What was going on? What did you do? How did it come out?
(c. Intervening attempts) What did you do then? What was going on?
How did it come out? (Series continues until present).
(QUESTION 4: ASSETS)
The next series is concerned with the strengths and skills you have
that we can build on. No one starts out from scratch.
(a. Related skills) What skills or strengths do you have which are
related to what you'd like to program?
(b. Other skills) What others do you have?
(c. Stimulus control) Are there conditions when the present problem
is not a problem?
(d. Relevant problem-solving repertoire) In the past, what related
problems did you tackle successfully? What related programs did you succeed
in? How?
(e. Other problems solved) What other problems did you tackle
successfully? How?
(f. Past control) Did you once have mastery of the present problem
area? If so, when, and under what circumstances? Any idea of how?
(QUESTION 5: CONSEQUENCES)
I am going to ask some questions about effects produced, and effects
you'd like to produce.
(a. Symptom reinforcer: positive) You've heard of the proverb,
"It is an ill-wind that blows no good.' With regard to some advantages
that might have "blown your way," has your problem ever produced any special
advantages or considerations for you? (Examples: in school, job, at home)
please give specific examples.
(b. Symptom reinforcer: negative) As a result of your problem, have
you been excused for things -- or from things -- that you might not be
otherwise?
(c. Symptom cost) How is your present problem a drag, or how does it
jeopardize you? (Note: Omit if answered in 3a. Why start now?)
(d. Possible current reinforcers) What do you really like to do,
or would like to do? Is there anything that really sends you?
(e. High probability behaviors) What do you find yourself doing
instead? (or getting instead?)
(f. Social reinforcers) Who else is interested in the changes you're
after?
(g. Past social reinforcers) What people have been helpful in the
past? How did they go about it? How did you obtain this from them?
(QUESTION 6: COMPLETION)
Is there anything we left out or didn't get enough about? Was
there something we overlooked - - or made too much of? Are there any
impressions you'd like to correct?
(QUESTION 7: TURNABOUT)
Turnabout is fair play. We have asked you a lot of questions. Are
there any questions you'd like to ask of us? Any comments? Kicks? Any-
thing you'd like to know about our goals, or approach?
The University of Chicago
Analysis of Behavior
Constructional Development Program
Department of Psychiatry
PROGRAM CONTRACT ONE: ASSESSMENT
PART ONE: Purpose
Two program contracts will be signed. The purpose of this statement is
to explain the first one.
The first program contract deals with the arrangements necessary for us
to find out how we can best help you attain your goals.
We obtain this information in two ways. One way is the initial inter-
view we have been engaged in. The other has yet to be done. It concerns
the way things are going now outside the office. This information can only
be obtained from direct observation, either by us, or by you. For this
purpose records are required.
Professionals collect data in addition to histories and purposes for
coming. For example, the physician collects "resting" measures or basal
measures. These records include temperature, pulse rate, blood pressure,
basal metabolism, X-ray, as well as other tests. If you want to learn
something, the educator may require aptitude and achievement scores. The
architect may want to know your living requirements.
Very often, the physician does not initiate his treatment immediately.
Nor does the educator immediately plunge you into the course. They wait
to see what the data will tell them. The physician may also want data on
your situation outside the office before treatment starts. The educator
may want to see how you do in temporary classes before assigning you to
your regular class. The architect may want to visit you in your present
home.
In our program, we require at least two weeks, or two assessment
sessions before we start the program. These are called baselines. Some-
times, it may take longer, but we hope to start as soon as possible.
After we are satisfied that we know enough to make our assessment and
plans, we shall supply you with our analysis and recommendations. Please
note the following: these will be recommendations which we shall offer for
your approval. If you have other opinions, you can then say SO. Whatever
comes out will be by mutual agreement. Otherwise, there is no point in
either of us agreeing to go ahead: We may, however, agree to continue to
explore further possibilities, if this is mutually agreeable. Or either
or both of us may decide to go no further.
Whenever we have obtained mutual agreement regarding the outcomes,
programs, and requirements, we shall present a second program contract.
If for some reason we decide that continuation will not help you or us,
we shall terminate.
We need your consent to get the information necessary for assessment.
This first program contract is for this assessment period.
The University of Chicago
Analysis of Behavior
Department of Psychiatry
Constructional Development Program
PROGRAM CONTRACT ONE: ASSESSMENT - DIAGNOSIS
PART TWO: General Arrangements
IN ORDER FOR US TO ASSESS
PROGRAM OUTCOMES, PROGRAM PROCEDURES
AND PROGRAM REQUIREMENTS,
A. On your part you agree that
B. On our part we agree that
with regard to
with regard to
1. APPOINTMENTS,
You will attend sessions set up.
We shall keep appointments
If you find it impossible to
set up. If we can not meet
attend, please notify us on a
them, we shall try to in-
business day not less than
form you at least three
24 hours. in advance. Time and
days in advance, barring
place are in Part Three,
emergencies.
specific arrangements.
2. RECORDS,
You will try to keep the records
We shall explain the purpose
we assign as well as you can,
of the records, the entries,
and will bring them to sessions.
and analyze and provide feed-
Types of baseline records are in
back on how well you are
Part Three.
keeping them.
3. OTHER ASSIGNMENTS,
You will try to fulfill various
We shall similarly explain
other specified assignments, as
purpose of assignments and
made.
provide feedback on your
performance.
4. OTHER CONSULTATIONS,
You will, if requested, consult
We shall explain the
with other professionals or
rationale involved, and
concerned parties. Nature of
where necessary, make or
consultation is indicated in
suggest arrangements.
Part Three.
5. OTHER RECORDS,
You consent, if requested, to
We shall similarly explain
authorize examination of other
the rationale involved.
records, to be indicated in
Part Three.
The University of Chicago
Analysis of Behavior
Department of Psychiatry
Constructional Development Program
6. RESEARCH, TRAINING, AND CONFIDENTIALITY,
(Data from your records can by
We shall preserve the confi-
useful for consultation with
dentiality of your records
other staff members, training
and take every precaution
of staff, and research pub-
to insure that any data dis-
lications which help other
seminated are not identified
professionals and thereby
with you, in accord with
other clients. ) You consent
prevailing practice with
to the use of such data for
medical and psychiatric
these purposes, with re-
records and research. Any
strictions noted in Part
other type of dissemination
Three.
is specified in Part Three.
7. REGULAR AND SPECIAL FEES,
You consent to payment of fees
We shall provide the con-
described in Part Three, both
ditions and personnel
for regular sessions and for
necessary for assessment,
special purposes described.
and shall explain the
special fees involved.
8. STAFFING,
You will work with whatever
We shall try to adhere to
staff are agreed upon.
staffing arrangements made.
9. DISPOSITION,
You understand that upon
We shall report to you the
evaluation, we can consider
results of our assessment
the outcomes to be attained,
and the disposition we
the program procedures and
recommend.
requirements necessary, to
be of such a nature as to
make it unprofitable for
you or for us to continue.
THE University 01 Citicago
Analysis of Behavior
Department of Psychiatry
Constructional Development Program
PROGRAM CONTRACT ONE: ASSESSMENT - DIAGNOSIS
PART THREE: Specific Arrangements
1. Appointments:
2. Baseline records:
Time:
Place:
3. Other assignments:
4. Initial consultation required:
5. Other records required:
6. Research and training needs:
Dissemination consented to for each:
a. Tapes of sessions
Video:
Audio:
b. Other tapes:
C. Baseline records:
:
i
:
d. Other assignments:
e. Other records:
f. Programmer notes:
Write ups:
g. Special agreements:
I
Audience 1. GD General Dissemination
5. TR Trainees
Key
2. GS General Sessions
6. CS Clinic staff
3. SS Scientific Journals,
7. PG Program staff
Sessions
only
4. HS Hospital staff
8. CC Case con-
sultants
The University of Chicago
Analysis of Behavior
Department of Psychiatry
Constructional Development Program
7. Fees
Amount:
Per:
Payable to:
When
Other:
Regular
Special
8. Staffing agreed upon:
Baseline:
Thereafter:
9. Consent does not imply continuation beyond assessment, or before, if 'terms unmet,
or for other reasons.
I agree to the foregoing:
I agree to the foregoing:
Client(s)
Programmer (s)
Monitor(s)
Date:
Date:
The University of Chicago
Rev. Mar. 74
Department of Psychiatry
II. CASE PRESENTATION GUIDE
A. Introduction
1. Identifying information.
Brief description of patient and a few qualifying statements
which are relevant to what follows.
2. Background for the program.
Use A3 as the resolution toward which this presentation is
directed. Weave in various items from questionnaire and
other sources to present a coherent picture of a person
functioning highly competently, given his circumstances and
implicit or explicit goals, and personal and social history.
Infer how symptom may have been shaped and its functional
history.
3. Symptom as costly operant.
Infer how, as a result of A2, the patterns shaped and reinforced
up to now are now too costly or otherwise jeopardizing the
patient. Infer what reinforcers are presently maintaining
patterns, sources, and type of jeopardy and its source. This
should be brief and simply stated as the logical outgrowth
from A2, which presented in somewhat more detail what led up
to this.
B. Tentative program directions.
1. Outcomes which seem reasonable as targets
2. Evidence for each of these
a. Relation to reinforcers maintaining symptom
b. Likelihood of producing additional reinforcers.
C. Feasibility of substitution for jeopardizing symptom
d. Relation to present repertoires
i. Personal
ii. Environmental and available.
3. Feasibility (cost, resources)
C. Current relevant repertoires
1. General, for program-recording requirements:
a. Analytical, types of relations explained
b. Recording repertoires
2. For each of targets recommended:
a, Previous programs
b. Current relevant repertoires: assay of current resources
C. Social repertoires
d. Environmental assets
e. Maintaining and available consequences; accessibility.
Symptom as reinforcement indicator.
D.
Change procedures: programing guides
1. For program-recording and analysis of each target
a. Analytic procedures to be used (texts, manual, , discussions)
b. Records to be kept; graphs.
2. For target areas
a. Programs and repertoires in past to be transfered or modeled.
How?
b. Shaping, modeling, or transfer procedures for changing present
repertoires
C. Getting and shaping program cooperation from others; reinforcing
such cooperation
d. Ways current environmental resources might be used. Facilities.
Possible social models
e. Social and other possible support. Analysis of symptom as
successful operant.
E.
Maintenance guides
1. Through program
a. Records, graphs, other assignments
b. Other possibilities
C. Reliability checks
d. Extraneous consequences
2. Thereafter
F.
Specific programs
1. Available specific programs
2. Staffing
3. Other suggestions