Inside Rehabilitation Counseling
A Conversation with Sarah Price Hancock, MS, CRC
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)
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)
Hello and welcome to Inside Rehabilitation Counseling, presented by the Commission on Rehabilitation Counselor Certification. I'm Taylor Bauer with CRCC, and we're so glad to have you here for another conversation on the art and science of rehabilitation counseling. There are many certified rehabilitation counselors who first encounter the field as a client. The perspective of having a disability can offer profound insights and considerations into providing services for people with disabilities. Sarah Price Hancock is a CRC and advocate for electroconvulsive therapy recipients, having received 116 bilateral ECT treatments herself, Sarah became a CRC after receiving services and learning about the role of a rehabilitation counselor. You may have read Sarah's op-Ed in the San Diego Union Tribune last fall about how employers can ensure that people with disabilities are set up for success in the workplace. In our conversation, Sarah dives into this topic further and also shares her work on ECT assessments, the importance of emotional self-reliance for people with disabilities, and a candid look at her transformative journey as a certified rehabilitation counselor. Sarah , thank you so much for making time , uh, to be on inside rehabilitation counseling with us today. We like to start all of these conversations kind of in the same place, you know, your beginning with , um, your time in the profession. So when did you first learn about , uh, certified Rehabilitation Counselors? And if you're comfortable, can you explain a bit of the story behind your disability and the journey that led you to the career that you have today?
Speaker 2:Oh , certainly <laugh> . Thank you so much for this opportunity. Well, I remember learning about certified Rehabilitation counselors in 2009 from a community college disability services counselor. She was helping me get academic accommodations after I'd finished , uh, electroconvulsive Therapy, which is also known as ECT. Um, and , um, the colloquial name, I guess people call it Shock Treatment. I went to her because the ECT had erased all of my memory of my prior work experience and my educational experience. And I knew that in order to become a candidate for a competitive job, I'd need to go back and get completely retrained. So I went to the local Community College's Disability Office because I knew that it was a diagnosed illness that had caused the referral for the shock treatment. And in the appointment, the Disability Support Services counselor asked me, if you could do anything in the world, what would you want to do? And I told her that I wanted to help people like me get back on their feet after electroconvulsive therapy, just like she was helping me. And she smiled and she said, well, in that case, you need to become a certified rehabilitation counselor. <laugh>. Basically in the summer of 2009, my life was in chaos. Um, I just escaped an abusive mental health residential facility, which had been facilitating my receiving the electroconvulsive therapy. Unlike , like I mentioned before , um, after my treatment, I had no job, but I wanted to return to work. But the problem was I had no memory of anything required to do what I'd done in my previous career . Before treatment, I'd been an editor of faculty papers for the humanities department as a student at Brigham Young University. And I'd also been an a SL , uh, interpreter in college and university settings for several years. But I had no memory of my training and no memory of my work experience. I only knew that I had the experience, actually because I'd read about it in my own journals. And also because of what my family and friends had told me. Uh , I was determined to get a job. I was determined to pay rent. I was determined to live independently. I was determined to start my life over , um, rise from the ashes, if you will . Um , it was difficult because I'd suffered dense and pervasive amnesia from the shock treatments. But in my desire to become a protective member of society as soon as possible, I had a lot of deaf friends who were helping me to relearn my American sign language. And at one point, my high school, a SL teacher who was deaf, invited me to just take his a SL four class. He said that I needed more practice and that I would be the only student that actually understood what he was saying in the class. 'cause I'd known him at that point, I'd known him for more than a decade. And he was concerned that the students who had taken the earlier classes from other teachers didn't have the skills to understand the deaf person who spoke strictly in American Sign Language. So he actually invited me so that I could kind of be a liaison between the students when they didn't understand. I could help them recognize what he was saying so that he could better teach them how to speak incorrect American sign language, not like pigged in sign language. When I went back to class, we had reading assignments and I realized, you know, I really, I could hardly read. And so he suggested that I needed some academic accommodations. And so I hit over to the Campus Disability Services and Support Office. I walked into her office wearing my dark sunglasses, <laugh> , and she asked me why I was wearing sunglasses in her office. And I explained that the light just hurt too much. And she asked if I was having a migraine, but I didn't really know what that meant. I mean, I'd grown so used to the perpetual headache from the shock treatments that she asked me when I started having problems with light. And I told her it started during ECT and she said she thought I had a brain injury. Well, I laughed because I had no history of car accident. I had no history of like a fall or like hitting my head. I had no history of like being in sports or getting knocked out. And so I just kind of laughed at that. And she listened and she politely nodded. And I, I just told her I knew I didn't have a brain injury, but she asked if I was sensitive to noise. And I was like , uh, yeah. And then she asked, well, I told her that not only was I sensitive to noise, it was stressful to try and process sound. And that a hearing test right after my ECT showed that I had perfect hearing, but that I had delayed understanding of what I was hearing. So I'd actually started using closed captioning during the shock treatments because I couldn't follow what was happening on TV shows. I couldn't follow what was happening in conversations. And it was really, it was a delayed understanding, delayed processing problem. And so first she asked if I had any other problems, and I explained to her that I kept running into walls, particularly like when I say walls, like door jams, I'd go, like, I thought I was going through a door jam and I'd always slam my shoulder into the door jamb . It was like I hadn't oriented myself in the middle of the doorway to walk through, so I was always slamming myself into the walls. It was just really weird. And I told her also that , um, I'd have a lot of problems, like with the coordination for walking, which was kind of weird. I'd like, especially when I'd get tired, I'd step off a curb and land on my ankle instead of landing on my foot. And I did that all the time. So much so that my doctor had prescribed those orthotic boots for , uh, like if you'd broken your ankle, he'd prescribed them for both of my legs, expecting me to use them. So I was walking around rather than having like a , like an ankle foot orthotic. They didn't prescribe me that. They prescribed me two boots, like as if I'd just had foot surgery or something. So I was walking around looking like Frankenstein. It was just terrible. But that's what happens. Anyway , so I told her that the reason I was really there was because I had lost my ability to read. I was really struggling to read. I could read a line, but then I couldn't recognize which line. I'd just read to know which line to read next, which makes reading very difficult. And my eyes would jump all over the page. And I had really difficult time with headaches. The more I read then the stronger the headache would get, it would just, it was just exhausting. And I'd started reading when I was three. I was reading chapter books at the time, I was in kindergarten. So this was a huge change from my previous ability. She is like, I hate to tell you this, but those were all symptoms of traumatic brain injury. Sarah , your shock treatment hurt you. And I told her that my doctor told me if my parents, that it was safe and that the only real problem was memory. And they'd never mentioned any of these other things as part of the consequence of the treatment. And then she's like, well, then why are you going to community college if you already have a bachelor's degree? And I said , well, I wanna work, but I can't remember all of the rules to edit, so I can't be an editor again. And I told her that I'd been an a SL interpreter. And the reason I was on campus was , 'cause again, my deaf friend had invited me to come into his fourth year a SL class, kind of like as a teacher's assistant. And he invited me to just enroll. That way I could like have ASL four on my transcript , um, because I'd become an interpreter at the university level in the early nineties. So at that time, they hadn't required, they'd only required like proficiency testing , not like a formal transcript. Well, anyway, so my friend had , all of my deaf friends had told me, if you wanna get a job fast, you just need to relearn and repolish your interpreting skills, and then you'll be able to get right back into work. And, you know, that was like the fastest route to earn gainful employment. But she said I needed to address my brain injury first. And again, I laughed and she listed everything back to me that I just said and explained again that they were all symptoms of brain injury. And she said, I know you feel interpreting is your fastest option to get a competitive job, but what do you really want to do? And I explained that I really wanted to do what she was doing and help people with disabilities achieve their fullest potential. I wanted to help people like me get back on our feet after we've been sidelined by an acquired disability. And her eyes just lit up <laugh> . And she told me that she knew what I needed to do. She said that I needed to get my master's in rehabilitation counseling and that locally here at San Diego State University right here in town, we had one of the top programs in the nation. And she gave me all the information about the California Department of Rehabilitation explaining that they had funding to help qualified candidates get into graduate school, or, I mean, not get in, but you know, basically funding to pay, help pay for the tuition and the books and whatnot. 'cause I didn't have any, any money at all. And she's like, then you'd be able to graduate and then you'd be able to give back to society by working in the field. And I was like, that's exactly what I want to do. And so she explained that because I already had a , a great, great transcript, good grades , uh, from BYU . Um, and I already had my bachelor's degree. Basically the only other prerequisite would be taking the GRE. And so she told me who to contact at San Diego State, and she really sent me on my path path and all the way home on the bus. Like I processed that conversation. It took me even longer to process her suspicions about my plausible brain injury. But within months, I was accepted to San Diego State Rehabilitation Counseling program, and I was absolutely floor that I was accepted because I, even though I had been editor on faculty papers, I had lost most of my vocabulary. And just to give you a perspective, I scored in the bottom third percentile for , uh, on the GRE and vocabulary, which means 97% of the people that took it scored better than I did, even though I had been faculty and editor of faculty papers . And my, the dear woman that interviewed me, Karen Sachs, she looked through all of my transcripts. We had a good conversation about my interests, my abilities, and the diagnoses that I've been labeled with and whatnot. And she is like, well, Sarah , given your your lived experience and your personal resilience and determination, I really feel like our program would be a good fit for you. And I was like, well, what about my GRE score? And she is like, well, the good news is you have a great grasp of vocabulary, so we're just going to ignore that score because you have all of the requirements. You've met all of the requirements necessary to be a good rehabilitation counselor. Sorry. She changed my life by , invited me into the rehab counseling program. And , um, while I was there, I was basically set up for success because the faculty at San Diego State University understood how to work with students who have disabilities, and they understood how to see people as individuals with unique strengths and unique capacities. And so I had spent 12 years in a mental health system that had always looked at me from a deficit-based model. And suddenly I was surrounded by people who were looking at me through a strength-based model. And all of the students in my cohort are part of the reason that I was able to graduate. And that is because every time they had any class projects that involved assessments and using the results of assessments to identify accommodations, every single class for assessment and , uh, assistive technology, there was typically at least one group that asked if they can use me as their person. And so gradually, each of those people in that cohort, many of them helped me identify my strengths, and they helped me identify appropriate accommodations. And then I was able to take their documentations in their term papers, justifying the appropriate accommodations back to the Department of Rehabilitation, which had never, before, previously funded 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 and track and use , uh, use the alternative communic or alternative , uh, text, you know, access to access textbooks and whatnot. They'd, at that time, they'd never before funded an iPad for that. But because the students in my cohort had worked so hard to do comprehensive assessments and they could justify each of the accommodations that we were requesting, the Department of Rehabilitation agreed. And suddenly I had, I had ergonomic chairs, I had, and I've had to help with the scheduling and coordination of my schedule and reading my materials. I had all kinds of things that I previously had no access to, didn't even know I could ask for. And I think that is the case for many people with acquired disabilities because we grow up without an IEP , uh, we don't know that there are even systems in place to help us learn about what we can use to circumvent the problems that are causing barriers in our life, whether it's in our activities 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 help other people with disabilities.
Speaker 1:Thank you so much for sharing that. It's always encouraging and empowering to hear those stories because I , I , I've spoken to other folks who, you know, haven't acquired disability, where just having someone like as you mentioned, come from a , a strength-based perspective of what's the path forward is such an empowering experience and , and hearing you share that , um, is so moving and, and , um, motivational, and I'm sure a lot of people who have entered the field the way that you have, you know, from the point of a , a client first, you know, seeking services for a disability and then becoming a , a certified rehabilitation counselor yourself. That perspective and that journey, we, we know CRCs are already motivated, passionate people, but , um, to go from client to counselor, that, that brings a whole nother perspective to the table that really drives, as you said, a lot of meaning professionally and personally.
Speaker 2:Can I just share one additional experience with that? Yeah. So I just, just to make example of one of the students that helped me , um, and how that help went on to basically form my career. So when I very first entered the rehabilitation and counseling program, I met a third year student and we were talking and I told her, you know, about my problems reading. And I told her about my, my difficulties organizing my thoughts. And she's like, well, you know, you just recently finished your e ct, so let's just assume you do have a brain injury, and as you continue working on things, it will become easier for you. And I was like, okay. And she said, I said, well, do you have any hints for someone like me? And oh, dear Lisa <laugh> , she said that , uh, because it took me so long to read, she suggested that if I chose one topic to pursue for the entire three years of the program , not only would I save time because I'd gradually approve like a familiarity with what I'd read, and gradually with the repetitive reading of it, I'd be able to remember what I'd read. She also said that I would have read articles on that topic that I would use for like research papers in different classes. And so she smiled and she said, I've got a few articles you could use just like 12 or 15 articles that she had used in her papers. And so I got to work reading those and that she gave me a really good head start . And now 15 years later, my library has more than 500 books, journal articles, court transcripts, user device manuals. It's so much for , so like her advice was the best ever. It really set me on a successful path to help people with a history of electroconvulsive therapy. I think it really speaks to her understanding of my passion. You know, as an individual we so strive to help recognize an individual's strengths, but we also have to recognize their passions. And when we can tap into someone's passion, then their efforts become synergistic. When they're using their strengths to help fuel their passion, then that that effort becomes synergistic.
Speaker 1:Yeah. And you know, that really speaks to the, the difference of working with the CRC, right? That expertise of disability coupled with the counseling skills, makes it so you're not just looking to work with an individual with a disability and say, let's find you any job, right ? Something nearby, something you can get as fast as possible. And then we send you on your way, A CR C's going to approach that and say, what's going to fulfill you? Um, what's, what's going to put you in a place where you look back however long a month, a year, you know, years down the road and say, I did all of these things to make this dream. I have come through. And the CRC is there to put you on that path. And it sounds like from the story you just shared, you know, you start with , uh, a handful of journal articles and , um, that's a library that , uh, dwarfs mine , uh, for sure <laugh> of , of all those , uh, things you just listed. Um, so yeah, it's, it's always great to hear , um, that extra emphasis and knowledge that CRCs bring to that experience , um, manifest itself in such an impactful, you know, outcome.
Speaker 2:You know, I think you're right. I think one of the unique capacities that CRCs have in terms of not only, you know, the , like we discussed strength-based model and the counseling skills. I mean, when you can take an individual and identify their strengths, identify appropriate accommodations to circumvent what could plausibly be a weaknesses or deficit, and then help them , uh, focus on their passion, then you've basically empowered an indi an individual to , uh, prevent burnout in their career. So longevity is there . They're not going to just be going into a job that they don't really have an interest in or aren't passionate about. And I , it's so easy to get burnt out when you are not passionate about your job or when you're passionate about your job, but you don't have the counseling skills and wellness tools in order to sustain that passion. That's a , that's a recipe for burnout. And I think all of us , uh, could probably benefit from speaking with a rehabilitation counselor specifically for that reason, because good rehabilitation counselors understand , understand the tools and wellness tools necessary to prevent burnout or to work through burnout, to work around burnout, and to find joy in the journey again.
Speaker 1:So after obviously becoming a CRC yourself , um, you mentioned that , um, a lot of your work in research has been related to ECT. And , um, if people aren't aware of your work , um, you have some incredible 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 your research that I was going through discusses communication disorders that come from ECT for , for other CRCs who, who might be working with a client who has experienced , um, ECT. What are the unique needs or considerations that you've identified as being, you know , um, considerations that CRC should take with these sorts of clients?
Speaker 2:I think to best understand how ECT impacts an individual, you have to look at it from the perspective of a neuropathologist who understands brain injury. And so , um, I would just refer them to , uh, Dr. Bennett Amala , who during the Department of Rehabilitation in Californians during their traumatic brain injury advisory board meeting, he was explaining that people who have a history of electroconvulsive therapy, while their MRI standard MRI might not show anything wrong with their brain. It is a functional injury akin to a repetitive traumatic brain injury because it's not just one ECT treatment, the individual receives, it's multiple, it's an entire series or multiple series of treatments. And so he recommended that we view ECT recipients through two lenses, both the lens of a repetitive traumatic brain injury and the lens of repetitive electrical trauma. Keeping that in mind, it's important that we recognize the long-term consequences of, of repetitive traumatic brain injury. And we recognize the long-term consequences of a repeated electrical trauma or even a single electrical trauma. And so in terms of communication, assessing your client for, for problems, so you'd want to ask them like, why , person asked me, do you have any problems with bounds? Do you have any problems with light sensitivity? Do you have any problems with motion ? When you begin getting tired , does your voice begin to slur? Did your speech begin to slur? Do you have difficulty finding your words? Um, do you have difficulty organizing your thoughts? Do you have difficulty planning and carrying out tasks and then contingent on that person's answers, you know, they could even go into further. Do you have difficulty with coordination? You know, can you still type at the level you used to be able to type? Can you still read and enjoy reading the level that you previously did? Those kinds of things are very basic skills that many individuals have never been assessed for . And so routing that person for a comprehensive speech assessment for a comprehensive occupational therapy assessment, looking at a hand eye coordination, looking at motor coordination, because one of the, one of the recognized problems , uh, identified in the manufacturer's user manual for , uh, electroconvulsive therapy is, well , brain injury is one of the official serious adverse events, but also general motor dysfunction is another , uh, recognized , uh, problem. So I would specifically refer them if it were me with a new ECT recipient, I would refer them to ACE pH therapist for assessment to evaluate for cognitive communication disorder. I would also refer them for a visual assessment with a neuro optometric rehabilitation , uh, provider through the Nora network. Um, because the neuro optometric rehabilitation providers are optometrists who are trained in brain injury or developmental visual problems, who can see whether or not the person's eyes are aligning correctly. If your eyes cannot align correctly, which is most common consequence of ease of brain injury, then you are going to fatigue faster. Because as you read, as you look at life, your eyes are struggling to maintain their alignment, I guess is what you'd say. Um, and so that is gonna be tiring. And so you want to set your client up for success. And a comprehensive, a assessment will be able to break down barriers to accessing not only the vocational rehabilitation necessary, but the physical rehabilitation necessary after, after an injury of this nature. And so it wasn't until like I went through my entire program with alternative text and people taking notes for me. And I mean, I had a lot of, I had extra time on tests 'cause I qualified for all of that, but they never , uh, recognized that, gee, you know, vision rehabilitation could really improve your quality of life and vision. Rehabilitation has improved my memory. Vision rehabilitation has improved my ability to create sequence. And , uh, so vision rehabilitation is probably something that not many rehabilitation counselors had considered because we typically think in terms of speech, occupational therapy, physical therapy, and mental health therapy. Um, and neuropsych testing does not go into like vision , uh, and visual processing. But you'd want visual processing assessment. And also, I also , uh, benefited from getting an auditory processing, you know , like a central auditory processing assessment because then they were able to recognize, oh, okay, she can, like I scored off the charts in one-on-one conversation. My hearing, I got 99% of my hearing. But when they started putting all the other people noise in my head and I had to focus on the one voice, my comprehension dropped to profoundly disabled. It was like the 23rd percent being able to understand the world around 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 you can use an a SL interpreter 'cause you understand a SL you know, those kinds of things because you need those kinds of things to work and survive in an employment environment. So yes, the central auditory testing and the basically the neuro optometric rehabilitation provider, that's a basically a central visual processing assessment. And so that's wonderful. Thank you so much. If I could see me again as an individual back in 2009, this is what you need. One last thing. Mm-Hmm. <affirmative> you've mentioned , um, you know, what do we know? What, what would you do? Well, it's wonderful that you can ask me that, but not everyone has much of an understanding of what has happened to people with electroconvulsive therapy. And to that end, I'm actually working on a project with a colleague of mine and several other ECT recipients and psychologists. We currently have a survey that is open right now, and the survey is open for any ECT recipient and their family member or close friends who understand how ECT impacted them. And it's basically functioning as a needs assessment. And that survey will likely be open through the end of August, maybe September. But we're basically doing a needs assessment so that we can better understand what individuals with history of ECT need in order to move on through life after ECT. So I can give you that information. If you could share in your show notes, that would be fabulous. 'cause we've really, we really, this is a gap in our understanding in general in helping people who have severe mental illness, many e ct, many ec , many CRCs don't even know that if they have someone who has a history of a mental health diagnosis, we really, and even these days, we need to look also at people who have a history of autism or who who are autistic , um, people who , uh, have any kind of developmental disability. We need to begin asking on our intake forms if they have a history of electroconvulsive therapy. Because a lot of times we won't understand why the individual isn't thriving in the situation that we've put them in or in their, in their plan, in their treatment plan. And it's because we haven't completely understood , uh, some of the problems that they are dealing with. And I , so for that reason, I would encourage everyone to include, do you have a history of electroconvulsive therapy on your intake form? Because you'll be surprised at how many people will be able to check. Yes. One of the things about brain injury is that the symptoms of brain injury will wax and wane depending on the individual's level of cognitive fatigue and the individual's level of , um, sensory overload. And so, for example, we purposefully scheduled this appointment in the morning because in the morning I have speech that people can understand, but I really only have functional speech because I am advanced in my delayed electrical injury. I really only have functional speech about two to four hours a day. And so I actually use a speech device to communicate , um, as my speech becomes so slurred that people cannot understand what I say. That was not a problem when I very first began this journey. And it will likely crop up at different periods of time for individuals with a history of ECT simply because of the nature of delayed electrical injury that typically develops between six months to more than a decade after ECT or after electrical injury. In general, it's referred to as delayed electrical injury. Right? Now, I don't need an alternative communication device to speak with you, but I do have one prescribed, and it was prescribed because as I get tired, I lose my speech. And when I am surrounded by sensory input, I cannot coordinate the muscles required to speak with in a way that people can understand me. And so I do use a speech generating device. So I just wanted to put that out there because if anyone wanted to look at me, they might look at me today in this interview and say, well , she could talk . But we need to understand that disabilities, a lot of people that live with disabilities, their symptoms wax and wane . And so we need to ask people, you know, not treat people as like their symptoms are static. They'll never get better, they'll never get worse. A lot of individuals, depending on the disability, will have an ebb and flow of their capacity, another ebb and flow of their ability. And so keeping that in mind when you do your assessments for individuals with a history of brain injury , especially keeping in mind the , how the environment impacts the person. For example, one of the things that we discovered with my personal injuries , that because the electrodes are placed on the trigeminal nerve, the trigeminal nerve goes right into the brainstem, and that goes right into all of the other parental nerves. It goes all the way down your spine. And so all of my ability to process sensory input with my eyes and with my ears, and with my touch, that has been compromised with my motor output because that nerve, the trigeminal nerve, does both sensory input and motor output. And so , um, that's critical to understand because when they referred me for central auditory processing assessment, and they discovered that I could not understand the world around me when I was flooded with too much auditory stimulation, they actually prescribed basically their musician's earplugs. They filter out 25 decibels of sensory input so that I can focus on just the person sitting in front of me and it will get rid of all of the external, you know, the typing or the other people con , um, conversations in the phone or in the , in the work environment. And so being able to be aware of how sensory input, input impacts not only stress levels, but ability to process the world around you would be really critical for , uh, someone doing an assessment for an individual who had a history of electroconvulsive therapy or any brain injury.
Speaker 1:And I think, you know, it's really telling, like you mentioned, scheduling this call earlier in the day , um, as opposed to maybe the afternoon or something like that was a, a type of, you know, a , a accommodation to, to scheduling this that like an employer, if they have somebody who maybe throughout the afternoon starts to lose speech function, maybe schedule meetings with them in the morning or, you know, it , it's those little, those, those tweaks to what is considered maybe like the norm with a business that can be so transformative for an individual with a disability. And those accommodations a lot of times are just rescheduling the way that the day's gonna flow, you know, and we always hear from CRCs that a lot of accommodations don't even cost a business anything. It's just allowing a little bit of flexibility to the way that the day usually plays out for everyone to be able to function at their, you know, their, their maximum potential. And I think that was a great example that you pointed out.
Speaker 2:Well, to your point, I think Covid has taught us the value of remote working. And you know , for me, as someone with a brain injury who lives with a form of mild neuro disorder, my body shuts down as it becomes fatigued. But when I rest, I take a nap, all of a sudden my speech will come back, my ability to communicate, my ability to work will return , my ability to function will return. And so when you have flexible scheduling in an employment setting, having the opportunity to log out, take a nap, and then log back in to continue, you know, getting your, your hours in, you'll be a much more productive person. I'm a much more productive person when I'm well rested . And especially with my, my own neural disorder, people can understand me better when I speak clearly, and I can only speak clearly what I'm very well listed . So just, I think that was actually one of the good things that came out of Covid was that now employers recognize that employees can still be productive when they are at home in quiet , secluded environments. They can still meet , uh, employment expectations in terms of, of making, you know, achieving their job responsibilities. And they know that now from a personal perspective, because they 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 be if they're stuck at home. And now we know that you can even be productive at two in the morning because you, you know, your sleep got schedule messed up, but guess what? You can still respond to emails or you do, you know, job responsibilities at, at, at times that would not typically be between the typical nine to five. And I think that was very valuable experience. Probably the one valuable thing that came out of the covid shutdown was opening employers eyes to the possibilities of what can be done from home, what can be done in quiet work environments, how productive people can be at their own schedule.
Speaker 1:Thank you for adding that, and we will absolutely , uh, link that survey into the show notes. There was another interview you did where you mentioned 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 client beyond just being able for that individual to say, I now have a job. Can you, can you talk a little bit about your view of employment as a way for people with disabilities to feel , um, active and integrated into society and their community? Well,
Speaker 2:Employment in a job or career you love is empowering. And until people feel empowered, they do not recognize that they are agents of change. Many people who live with a variety of disabilities acquired or developmental congenital disabilities we're often surrounded by people who have looked at us through a deficit based model for so long that they routinely tell us, I know, they told me what I can't do, what I can't do, what I shouldn't try, what I can't even try. I mean, little by little, our circle of influence feels smaller and smaller and smaller and little by little, especially people like me who are diagnosed with what they said was treatment resisted mental illness, we begin to develop learned helplessness because it didn't matter how, how compliant I was with my medical treatment, I was not getting better. In fact, I was getting worse. And so , um, people who live with these experiences so many times, because we've been told what we can't do so much, we gradually learn not to try. And so in terms of looking at employment as a treatment plan, especially, I mean, even pre pre-employment as a treatment plan, right? Basically my doctors told me that I was treatment resistant. And after 12 years of faithful treatment compliance without improvement, I believed them. And essentially I turned my power over to my doctors and my counselors who were telling me and my family that I cannot do what I cannot do or what I shouldn't even try to do because it might make me worse. But finally I realized if my doctors couldn't make me better, I had two choices. I could either just give up and die or I could make myself better. And so I began learning from people diagnosed with severe mental illness, what their strategies were. For example, I enrolled in a class developed by Mary Ellen Copeland, who lives with bipolar disorder diagnosis. That class is a wellness recovery action plan class. And in that class I learned how, you know, to develop a wellness toolbox, which is basically all of the strategies and skills that I would need to use in my daily life. And the more tools I had in that wellness toolbox, the more capable I became. And when I wasn't having success in managing my illness, you know, I would <laugh> I went , I was like, I'm determined to go back to work. I went back to work. This is actually even before I went to the community college, I'd actually gone back to work. And I was like, the only thing I know how to do for sure , for sure is answer a phone answer . And so I applied for a job as a receptionist, and I did so well. And my interactions with people at the regional manager actually recognized my skills within three weeks, and she hired me to be her adva administrative assistant. So here I was in my physical health, my mental health, running up against wall after wall after wall. And yet at work, because I had personality on the phone that sounded, well, clearly I didn't have this voice, but even if I had this voice, I'm a very good per people person. And I was able to communicate with , with people in such a way that I was getting padded on the back all the time for what I was capable of doing. And that is why employment as a treatment plan, if you want to help someone feel empowered, help them find a job they can really do, and their environment will become empowering and be by feeling empowered, they will be more likely to try and explore new things to stretch their capacity.
Speaker 1:Yeah, rehabilitation counseling has such a deep history , um, over a century now. It has existed and , um, has, has deep ties obviously to the vocational aspect of, of that disability counseling experience. And, you know, we know that the knowledge of a , of a certified rehabilitation counselor can be utilized in , uh, several different practice settings and fields. We keep seeing CRCs , um, join organizations or, or, or , uh, service providers and industries that we don't see a lot of CRCs. And then suddenly a couple years later, there's more of them. And it's kind of like a good, good news that spreads, right? Like if you hire one CRC, you see their , uh, impact and the potential they have to, to aid your organization and then you want more of 'em, which is what we love to see here at CR ccc . Yeah . You know, based on, you know, your experience as a CRC, where would you like to see certified rehabilitation counselors working or making an impact , uh, given their unique expertise and disability?
Speaker 2:I would like to see CRCs in two places that I typically don't see them. I would like to see them in HR departments because one of the most important things an HR person in HR can do is to take the strengths and all of the training that an an employee has invested, an employer has invested in an individual and use them in , if they come back and they can no longer do X portion of their job description, the employer knows how much they've invested in that individual and that they still have these abilities. And being able, as an hr, you would be person, you'd be able to job carve , create job specifically for those job responsibilities for, you know, and pay for those specific job responsibilities. And without, you know, without the one thing or two things or five things that the person can no longer do, they still have this entire skillset . 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 for Boeing. Boeing actually employs CRCs. And because the Boeing has such a dynamic, you know, it's a ginormous corporation, right? And they invest in their employees years of training. And when an employee develops a disability for any reason, they work hard to tap into that employee's strengths and assign them to a different job within the community, within their, within their company. So , um, I think HR departments definitely could use , uh, CRCs, but I also think that we really need , uh, certified rehabilitation counselors in rehabilitation settings. I would love to see certified rehabilitation counselors in the clinic with the brain injury. Uh, people, you know, in these rehabilitation facilities, these long-term care facilities that are, you know, rehabilitation nursing facilities, like the transition between hospital discharge and back into the community, lots of people go to these rehabilitation facilities or they go to outpatient rehabilitation programs for speech, physical therapy, occupational therapy, et cetera. I mean, those therapists are designed like physical therapy, occupational therapy, speech therapy. They're designed to help them with activities of daily living. But until they have a concept of the job that the person's going to be going back into, you know, CRC has a unique perspective because they'll already understand the job responsibilities of that individual's job, whatever that job might be, and then know how to help them identify reasonable accommodations so that they, when they want to go back to work because they're finally physically capable of returning to work, then they'll be able to say, and, you know, to their HR department, these are the accommodations that will allow me to maintain my productivity, or these are the accommodations that are reasonable that would allow me to maintain not only my productivity, but my longevity so that you do not lose me as a skilled employee. So that's why I really think that rehabilitation settings in general would be extremely beneficial. I think that we should really, as a group advocate for Medicare reimbursement, because once certified rehabilitation counselors can be reimbursed through Medicare, it sets precedent. We can build in ways that will allow us to be able to get , get into these medical settings, and we will be able to augment the rehabilitation already ave available in rehabilitation settings because essentially we are helping people get back to work. So, I mean, not only are we going to be alleviating the tax burden on people, you know, taxpayers, you know, because we're gonna be able to keep people employed because we recognize their skills, we recognize their abilities, we recognize their capacities , we recognize the accommodations that need to be put into place so that they can continue in their preferred career as A-C-R-C-C, I think we should really work on helping get our CRCs into medical settings by advocating through Medicare for reimbursement. Because in the long run, I mean, they've talked about wanting to get people back to work, but there's really a disconnect between wanting people to work and getting them back to work. And the CRC is what's going to branch that if they want to get people off the disability and off of social security and they want to get them back to work, they need to facilitate that by not siloing certified rehabilitation counselors into just state rehabilitation, vocational rehabilitation departments or into , uh, university or, you know, community college settings. We need to have them in all settings so that we can actually facilitate the rehabilitation of individuals who can work and can get and maintain competitive employment.
Speaker 1:The rehabilitation settings in the HR settings are similar in that when I come across job listings , um, for a, a disability specialist or an accommodations coordinator, things like that, and I see that they're under requirements, they're not looking for a rehabilitation counselor or even better A CRC, they're looking for people, maybe like you said, traditional HR backgrounds , um, social work, other fields that are related, but that skillset of A CRC is gonna have the most impact. I always wanna message the hiring manager and be like, man, do I have a field of professionals for you? You know? Um, so hopefully we continue to see CRCs , uh, in those spaces more often.
Speaker 2:I think also in our push to help people get competitive integrative employment, I would like to see CRCs in schools, in school districts because, you know, we want to start young in these pre-employment trainings. And if we're actually going to help people find work after they leave schools, we need to have them already understanding the kind of , uh, employment accommodations that they need to request. We also need to help educate employers to understand, you know, if you can find a talented individual that might do things di differently, but who is a has superhero powers for their passion, you want to be able to work with their reasonable accommodations.
Speaker 1:Uh, if you're listening and you work in a school setting or a rehabilitation setting or, or in hr, and you , um, want to share with us at CRCC how you've broken into that field so we can help advocate for more folks , um, like yourself joining those fields, please reach out to us on our website or social media. Um, we've spoken to people who work in insurance or at companies like Amazon in the past and have had success helping them build, you know, advocacy resources to be able to try to get their , uh, hiring managers or, you know, district managers to hire more CRCs. So if that's, if that's you listening today , uh, we're happy to partner with you on that. You know, we're, we're so happy that you're on our podcast today, Sarah , but you have a podcast yourself called Emotional Self-Reliance. Um, and I, I really liked that term when I was researching a little bit about it , um, in , in preparation for speaking with you today. Um, can you tell us a little bit about emotional self-reliance as a wellness tool and how it's used in practice?
Speaker 2:Well, in terms of wellness tools , uh, we've already talked about how there skills and strategies , um, that we use to improve our quality of life physically and emotionally. Um, but I believe that together our wellness tools create like an emotional self-reliance toolbox. And so basically the more wellness tools we gather, the more resilient we become as individuals, and we can depend on ourselves to work through our problems and not look outward for other people to solve our problems. So I think more of emotional self-reliance, more of, you know, as self-exploration to identify as many tools as possible to facilitate wellness. And so I kind of look at my emotional self-reliance, like as the , the label on my wellness toolbox. <laugh>.
Speaker 1:Yeah, I love that. Um, you wrote a book , uh, called Daring to Dream Essential Tools to find Employment , uh, which helps people find a job that, as we've talked about in this conversation, that they'll truly love. Right? Um, where, where do you think employers need to do the most catching up in regards to the way that they understand inclusive and accessible employment?
Speaker 2:Well, that book's actually a workbook. Um, and it really, it's really the pre-employment blueprint, I guess, for individuals. And I deci I designed it to facilitate my job club, and it was so successful that many people employ, many people enroll , they found jobs, and then the club spread by word of mouth. But once all of these people began developing their pre-employment skills, at times they were met by employers who couldn't see the bigger picture, which was, if you employ people with diverse life experiences, it's better for the bottom line. So people with living with disabilities, I mean, if you're an employer and you want to better understand inclusive and accessible employment, you really need to understand that individuals with disabilities, I'm just gonna say humans, humans need to be seen through a strength-based model. And when looking at individuals with disabilities, we are quite creative problem solvers. We might not do things the way other people can, but we figured out how to do them anyway. And often when everyone else told us what we couldn't do and that we'd never be able to do what we're presently doing. So overcoming that amount of opposition in our lives, it takes creativity, it takes determination, and it takes resilience. So inclusive and accessible employment means created an environment where an individual can use whatever appropriate combination necessary for them to get the job done. Um , many of us learn to streamline our daily tasks to conserve energy, and this helps us learn how to streamline other tasks, right? It's a transferable skill, so it helps us learn how to streamline other work tasks to become more efficient. And I mean, many of us, I'm just gonna say we're superheroes within our own skillsets that us it sounds really prideful. I'll just say I take pride in my humility, <laugh>,
Speaker 1:I think it's accurate,
Speaker 2:<laugh>, but I mean, all of us are superheroes in a certain aspect of our experience because we have unique experience that nobody else does. And so , um, we might, you know, I know I, I struggle with things that are outside of my skillset , but if mo , if more businesses could be trained in job carving, those member , again, and HR departments that have a certified rehabilitation counselor to help split up and divide job responsibilities and assign them to individuals with the skills to perform that task at or above expectations, I really believe employers and businesses will love what happens to their employee morale. And consequently there are productivity.
Speaker 1:I have one more question for you, which, if anyone listening today listens to the podcast regularly, this is a question we love to ask everybody who comes to speak with us, we often hear that CRCs say that this job, this profession, this, this field that they've pursued is, is a calling that they've answered. What brings you joy in the work that you do as a CRC? Hmm .
Speaker 2:Sorry, I'm gonna get emotional. Um, until I studied rehabilitation counseling, there is not a single other person in the research on electroconvulsive therapy that has addressed improving quality of life after ECT. And by my learning about appropriate comprehensive assessments and then sharing that indivi information with individuals who have a history of ECTI am for the first time, I am facilitating the breaking of barriers for accessing assessments even , uh, for people who previously had no access to assessments. And we know that once you have assessments, appropriate assessments, then the results can drive appropriate rehabilitation interventions. And it brings me such tremendous joy to hear from people and their families, or people who've had history of ECT tell me that my assessment recommendations helped them gain access to the rehabilitation necessary to improve their quality of life after ECT and to move beyond the tragic circumstances of their, their life had become after they'd been abandoned, after their injuries and hearing about their newly discovered interests and exploring employment in fields that they'd never previously considered hearing them say, I thought my life was over, but now I realize there's more to life after ECT, that that is what brings me joy. And yes, I do see it as a calling.
Speaker 1:The work that you're doing is , um, is profound and so impactful. Uh, I can't thank you enough and we can't thank you enough. Um, we really appreciate your time today , um, in speaking with us. We'll make 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, thank you so much , uh, for your time and insight today.
Speaker 2:Thank you so much. I I'm really grateful for the opportunity to do anything I can to support certified Rehabilitation counselors because they've radically improved my quality of life and I want to be able to help them help others. You so much.
Speaker 1:Thanks again to Sarah Price Hancock for that engaging conversation. You can find links to Sarah's work, her current research study for ECT patients and their families, and more resources in the show notes. If you have any takeaways or insights on topics covered in this episode, email us at contact us@crccertification.com. Be sure to subscribe to this show on Apple Podcasts, Spotify, or wherever you're listening to us today. You can find us on Facebook, Twitter, and LinkedIn at CRC Cert , and our website is crc certification.com. Until next time, I'm Taylor Bauer. Thank you for listening to Inside Rehabilitation Counseling.