Sheltered employment and the second generation workshop.

Historical Overview

Sheltered workshops for persons with disabilities have a long history in the United States. Tracing the first workshops back to the Perkins Institution for the Blind in 1840 and the Pennsylvania Home for Working Men (Philadelphia) in 1874, Wallin (1967) outlined the objectives of workshops to include the development of vocational competence; training for competitive employment; providing academic remediation; treating personality maladjustments; and providing appropriate job placement and follow-up.

The critical component of workshops is related to the meaning attached to "sheltered." The original concept promoted a protected environment where the person with disabilities could experience the stimulation and learning required for work without the competitive factor adding to the psychological trauma already experienced in normal settings. Thus, the sheltered workshop was an effort to allow the individual the opportunity to work without having to risk competition and failure experiences which, it was assumed, would occur in normal work environments. Rather than provide normalization, it was intended to shelter the individual from normal frustrations, problems, and risks while allowing him to experience an attenuated form of normal task requirements on the job (e.g., paychecks, time clocks, work hours, supervision, production schedules). The sheltering imposed many constraints and limitations but these were judged as beneficial or even necessary to protect self-esteem. In many instances it was assumed that the workshop represented the limit of the potential for the individual client so that constraints imposed by the program itself were not assumed to be detrimental.

Doll (1967) emphasized that the sheltered workshop is a means rather than an end, and should be used to effect productive and competitive employment. He focused on the "work" rather than the "shop" that is designed to promote self-adequacy rather than provide bench-work. Doll argued for more effective evaluation procedures to distinguish between socially adequate mentally retarded, capable of self-direction, and those requiring a substantial degree of guardianship. This distinction would allow the setting of realistic aspirations for clients whom he judged capable of improvement. Doll was concerned that sheltered workshops not be limited to providing "baby-sitting" to those "mentally deficient" who cannot learn. Dubrow (1967), on the other hand, argued for the abandonment of traditional methods of classification of mentally retarded persons in favor of classification consistent with dimensions of employment and work adjustment.

Progress in serving people with mental disability in sheltered workshops by the 1970s is most apparent in the work of those using behavior analysis techniques to teach persons with severe retardation to handle relatively complex workshop tasks (Bellamy et al., 1970; Gold, 1973, 1975). Whereas Doll cautioned against trying to improve the capacity of the severely retarded individual, Gold cautioned against closing our minds to what any client might produce under appropriate conditions of training.

Criticisms of Workshops

In recent years, workshops have encountered a considerable degree of criticism, both in terms of their operations and philosophy. Surprisingly, such criticism has been generated internally from the rehabilitation field itself, rather than from external community or business sources.

Mallas (1976), reviewing workshop practices, observed that the image of the workshop, both from within and without, was negative, "a place where society relegates its unwanted cast-off goods and people..." Mallas attributed this image to the workshops themselves, whose Boards of Directors, staff, and clients were confused about the differentiation between rehabilitation and productivity roles. Boards were reluctant to apply sound business procedures to workshops and many workshop directors and managers were poorly trained to do so.

Mallas argued for a changing attitude toward workshops as a valued and appropriate employment resource rather than merely as a last resort for placement.

Beginning in the early 1970s, numerous reviews have documented ineffective or inefficient practices in workshops and have called for changes. Conte (1982) included such issues as: the limited effectiveness of workshops in achieving rehabilitation or employment outcomes; their exclusive or primary use for severely or chronically disabled populations; and their potential for exploitation of workers who are handicapped.

Studies conducted by Greenleigh Associates (1975) indicated that workshops are seriously limited by: (a) the absence of adequate varieties and quantities of work; (b) the predominance of low-challenge assembly work; (c) the absence of modern tools and machines upon which to train workers; (d) a limited number of skilled and competent staff; (e) funding mechanisms which encourage continued service to clients but not outside employment.

A more recent criticism of sheltered workshops has been leveled by Schuster (1990). In addition to the lack of placement in meaningful or competitive employment (Rusch, Chadsey-Rusch, & Lagomorcino, 1987; Bellamy et al., 1986), Schuster expressed concern about the decline of mass production industries and blue collar jobs nationally, so that increasingly workshops will be unable to provide necessary work. Another issue is the low client wage structure of workshops and federal disincentives to earning higher wages by the reduction of federal benefits. Subsequently, workshops place an economical burden upon society since taxes paid by clients are minimal. Schuster argued that workshops fail to provide "normalized" real work, wages and least restrictive environments, thereby perpetuating society's devaluation of persons with handicaps.

Supported Employment

An alternative to workshops is the concept of supported employment which requires a labor-intensive approach such as the use of job coaches in competitive employment settings. In this approach, training and employment occur in integrated work settings in proximity to nonhandicapped workers (Rehabilitation Act Amendments, 1986; Rogan & Murphy, 1991; Whitehead, 1986; Will, 1987).

Supported work incorporates several underlying principles including integrated work settings, paid employment, on-going support, priority of service provisions to people with more severe disabilities and unconditional inclusion of clients.

Parent, Hill and Wehman (1989) outlined the key aspects of facility conversion from sheltered workshop operations to supported employment services. They addressed the organizational change process, obstacles encountered and resources which can be used to assist in the conversion process. Benefits to participants were outlined, including consumers, family members, facilities, agencies, employers, rehabilitation or mental retardation agency and society in general.

Meaningful comparisons of the relative effectiveness of sheltered and supported employment are difficult to design and few studies are available. Rapp (1975) found that work station placements effected more significant rehabilitative gains than workshop placements. Lam (1986, 1987) provided such data comparing outcomes of the two models in terms of wages, hours worked, job satisfaction, and program costs. He concluded that the sheltered workshop model was more effective in providing more work hours at lower cost than supported work. Wehman et al. (1987) were critical of this study, pointing out the existence of several supported work models that are not equivalent. They further emphasized the need for comprehensive indices of the effectiveness of supported work programs including non-monetary outcomes such as self-esteem, social and community adjustment and indirect effects on family members. Goldberg et al. (1990) compared the outcomes of vocational placement after either extended sheltered employment or supported work. Both groups were being trained for competitive employment. Workers were randomly assigned to one of the two groups which were equated along age, primary disability, attendance, productivity and motivational variables. Clients were successfully placed into competitive jobs more often after supportive work than sheltered employment. Nesbet and Vincent (1986) reported that inappropriate behaviors occurred less often in non-sheltered than in sheltered work environments. Inge et al. (1988) examined several quality of life measures in 20 persons working in competitive jobs and in a matched group in sheltered employment. There was significantly more improvement in the competitively employed groups in several areas of adaptive behavior, community participation, social and vocational skills, fiscal responsibility and weekly income.

Rogan and Murphy (1991) have argued that, despite the intent of federal initiatives to provide real work with supports in integrated settings, supported employment in practice has been modified to be compatible with traditional vocational rehabilitation model. Specifically, a "readiness oriented" approach is applied, with the most severely disabled persons denied supported employment and relegated to workshops or activity programs. Furthermore, even those persons selected may not attain full status as employees and may still be placed in physically and socially segregated work settings. Rogan and Murphy recommended a "total inclusion" policy with restrictions on the number of persons with disabilities in any one work area.

Production Vs. Training

One area of confusion concerns the complex relationships between productivity, training, and employment. The potential for real employment implies a high level of productivity comparable to that of a non-disabled worker. Any other arrangement by definition implies sheltering. This creates a paradox of workshop management. If the shop is oriented primarily toward productivity, the shop may actually impede employability of clients. If normal workers are employed, critical production is assigned to that non-handicapped individual, particularly if it involves highly technical work. The person with disability working in the shop may be relegated to the same menial tasks that have been criticized in traditional workshops. The ideal situation would combine a focus on productivity necessary to workshop viability (and also to ensure employability) plus a focus upon training to bring a worker to a more productive level. This combination of elements is rare, indeed.

Neither the traditional sheltered workshop nor the supported employment setting is, per se, a training opportunity. Supported employment in a community setting may be just as sheltering as a workshop if: (1) the situation does not provide opportunities for socialization with persons who are not disabled; (2) the individual is not being trained to reach higher levels of productivity. The critical elements are the social opportunities and training program provided. Neither segregation nor training are necessarily or exclusively associated with workshops or work stations in the community.

This paper suggests that sheltered workshops can be altered to become more normalizing than the typical workshop of the 60s and 70s, yet still provide the structure and support required by the individual with disability. Seen in this light, the workshop is not an all-or-none entity but a dimension of more or less normalizing experiences, more or less sheltering environments. Shelter exists in the form of structure, training, job modifications, counseling, and staff support required to maximize performance of the client. Normalization is the degree to which this structure can be applied without jeopardizing the qualities of the workshop that render it a real work environment. This concept is illustrated by a case study of the workshops at Elwyn, Inc., Elwyn, Pennsylvania. Two phases of development are described.

The Elwyn Workshop, Phase I 1961 - 1989

The first Elwyn workshop was inaugurated in 1962 on the grounds of the institution. It provided work experience for approximately 30 moderately and severely retarded adults, many of whom previously had no involvement in day programming. The workshop represented one step in a continuum of programs of increasing complexity. A newly referred client underwent a several week vocational evaluation and then was placed at a specific rang of the vocational ladder with the opportunity to progress higher based upon performance. On-going evaluation and selection were a part of the process with training as a prerequisite for placement. Program evaluation and follow-up services were also part of the program. The Elwyn workshop was fairly traditional by today's standards. It relied on contract work with local industry rather than upon prime manufacturing.

By the mid-1980s, Elwyn gained approval as a National Industry for the Severely Handicapped (NISH) workshop facility under the Javits-Wagner-O'Day Act (1971) to begin working on government contracts on a national level. Long standing work orders such as packaging plastic knives, forks, and spoons -- workshop staples since its inception--gave way to the assembly of U.S. military medals and decorations, and the production of sterile gauze bandages for the U.S. Department of Defense.

The Elwyn Workshop, Phase II 1989 - Present

The Bandage Factory was established in 1989 with $6.8 million Department of Defense contracts to manufacture first aid wound dressings and compresses. The factory provides services to persons with severe to mild mental retardation, and to individuals diagnosed with emotional problems. IQs range from the 30s to 70. The average age of clients is approximately 40. The largest proportion of clients has a primary diagnosis of mental retardation. Several have secondary diagnoses of emotional disturbance, visual impairment, hearing impairment or brain damage. Non-disabled workers are drawn from an under-employed, lower socio-economic status and senior citizen population. The factory has attempted to integrate employees while still maintaining its licensing as a workshop. The ratio of workers with disabilities to those without is approximately 75:25. Increasing the percentage of non-disabled workers would be in violation of the regulations of governing agencies.

Productivity is maintained at a high level by means of a large number of workers, close supervision and highly technical equipment. Currently, 404 workers who are disabled are manning the production lines. During the recent Persian Gulf crisis, total employment (disabled and non-disabled) increased to 625 workers (509 disabled and 116 non-disabled). The second shift was added to keep up with the increased production damands and resulted in a 33% increase in production. The average daily production is 17,500 units. Monthly production is approximately 350,000 units. Yearly production is approximately 4.2 to 5 million bandages. Gross revenues for the year ending June 30, 1991 are projected at $7-$7.5 million.

Raw materials in bulk arrive at the factory's warehouse where they are cut, slit, pleated, sewn together, compressed by hydraulic presses, paper-wrapped, bagged and packaged according to precise government standards. In-box sterilization is accomplished off-site. Each production step is closely monitored for fabrication, assembly, and labeling. Start-up costs included approximately one million dollars for equipment and $400,000 for materials.

The factory currently employs 26 full time staff, 1 part time consultant, 3 full time case managers and 1 fiscal manager. The supervisor to client ratio is 1:15. Piece rate plus incentive is the basis of reimbursement to client production workers. Non-disabled workers are paid on the same piece rate as persons with disability.

Although production is a prime goal, training and rehabilitation are also a part of the program. Over 20% of the workers with disability have increased in skill level. At the start of the program in June 1989, the average productivity rate for workers with disability was 12% of that of a worker without disability and the average hourly wage was 60 cents. As of April 1991, the productivity rate for workers with disability increased to 42%. During the same period, their average hourly wage increased to $1.57. Many workers are now earning $4.25 per hour. Despite pressures for production during the war, several clients graduated to community-based competitive employment.

Summary and Conclusion

Sheltered workshops have been an important component of comprehensive programming for persons with disability for at least 100 years. Thousands of persons have received training and employment at such settings. With the advent of demands for normalization workshops have come under closer scrutiny and criticism. They have been characterized as segregated facilities where persons with disability are "dumped" as a last ditch effort, not only inconsistent with, but also detrimental to rehabilitation goals. Workshops have been viewed as inadequate substitutes for alternative work training and employment options such as supported work.

Supported employment implies that persons with disability are employed in competitive work settings regardless of the degree of supervision, support, instruction and monitoring required. Indeed, the promise of such options provided by supported work, work enclaves within industry, and job coaches has proven effective and offers new hope. Yet such options do not work equally well for everyone; nor are they generally available. Sheltered workshops can continue to offer opportunities for large numbers of people with disabilities, provided they are able to accommodate to concepts of realistic training and integration. Workshops need to be objectively evaluated using comprehensive criteria such as those suggested by Wehman et al. (1987). If they are discarded as viable options, this should be done only on the basis of objective evidence not prejudice or philosophical preference.

Workshops undoubtedly must make changes required to meet the challenges of their most severe critics. The Elwyn Bandage Factory demonstrates that, with the support of government and private industry, a second generation workshop can continue to provide needed rehabilitation and employment for the more severely mentally handicapped individual.

Workshops can be integrated with non-handicapped workers. They can become "high tech" settings, providing useful products and services without sacrificing rehabilitation goals to demands for productivity. They can be located wherever there is a labor supply and ready access to markets. This location may be within an institution or in the community.

Criticism within a field is healthy if it produces change. Yet change need not be limited to black or white outcomes. The provision of services to people with disability has never been without challenge or controversy. No program or approach has provided all the solutions to all the people involved. Nor is there any approach that is truly innovative in the sense that it has never been tried before. Hopefully, the era of polemics has passed and the 90s will allow us to examine less emotionally where we have been and where we are going. We need to be secure enough to retain whatever was effective in previous years, salvaging what is still workable and modifying what remains. Workshops need not be apologetic of their past so long as they are flexible enough to alter their future.

Authors' Note

This article was prepared during the Desert Storm hostilities in the summer of 1991. Contracts for bandages with the Department of Defense terminate in January 1993 and have not been renewed. The workshop referred to as the Bandage Factory in this paper continues to function but is no longer producing bandages. The principles elaborated in this paper are still applicable to the new program. Production involves technical equipment, staff are skilled, and non-disabled workers are integrated into the work force. The authors remain committed to the continued value of sheltered employment. The opinions expressed in this paper are soley those of the authors.

Marvin Rosen, Ph.D., Elwyn, Inc., 111 Elwyn Road, Elwyn, PA 19063.

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