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Making Life Work

Making Life Work: Freedom and Disability in a Community Group Home

JACK LEVINSON
Copyright Date: 2010
Edition: NED - New edition
Pages: 312
https://www.jstor.org/stable/10.5749/j.cttts7kf
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  • Book Info
    Making Life Work
    Book Description:

    A clear-eyed ethnography of a New York City group home, Making Life Work shows how the group home needs the knowledgeable and voluntary participation of residents and counselors alike. Jack Levinson reveals that rather than being seen as the antithesis of freedom, the group home must be understood as representing the fundamental dilemmas between authority and the individual in contemporary liberal societies.

    eISBN: 978-0-8166-7339-1
    Subjects: Sociology

Table of Contents

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  1. Front Matter
    (pp. i-viii)
  2. Table of Contents
    (pp. ix-x)
  3. PREFACE The Self-Organized Life
    (pp. xi-xx)
  4. ACKNOWLEDGMENTS
    (pp. xxi-xxii)
  5. INTRODUCTION Welcome to Driggs House
    (pp. 1-16)

    Driggs House is a large apartment in a modest building on a quiet side street near a busy commercial area in one of New York City’s outer boroughs. Driggs House has fifteen residents and is categorized as a community residence (CR), which specifies the number of residents, staffing patterns, staff-resident ratios, and on-site services (14 N.Y.C.R.R. § 686.3).¹ For the most part, CR residents are able to come and go without supervision, and there are fewer program requirements for a CR than for the kind of group home just prior to it on the continuum of services, an intermediate-care facility...

  6. I. LOCATING THE PROBLEM

    • 1 INTELLECTUAL DISABILITY: A Brief History
      (pp. 19-36)

      After the Second World War, institutionalization was, in effect, the professional consensus about how to deal with people diagnosed with intellectual and other developmental disabilities (such as cerebral palsy). Physicians explained to parents that “nothing could be done” for their disabled children but provide custodial care, which was too great a burden at home and held potentially serious consequences for normal siblings. In many institutions, visits were limited or prohibited for a period following admission so as not to exacerbate the difficulties of adjustment for both patients and families.

      Within this context, some parent groups focused on creating a larger...

    • 2 GOVERNING DISABILITY IN THE COMMUNITY
      (pp. 37-56)

      On moral grounds there was no debate—especially after Willowbrook—that abuse and coercion were integral to institutions for people with intellectual disability. As a legal matter, too, there was little argument that the rights of inmates were being violated in the most fundamental and egregious ways. This emerging consensus accounts for the readiness of New York and some other states to sign consent decrees. Apart from the honorable goals they laid out, such decrees avoided costly legal proceedings the states would have had to mount on indefensible positions. But the transformed climate of opinion is one thing. It is...

    • 3 THE WORK OF EVERYDAY LIFE
      (pp. 57-66)

      The claim that residents are governed is plausible prima facie, given the mission of Driggs House and the indirect character of its authority. This study of everyday life there shows that the dilemmas of freedom are ongoing practical dilemmas that organize the social order of the group home. More than that, because of the common assumption, no doubt held by some readers, that a diagnosis of intellectual disability is equivalent to social incompetence, a description of how residents govern themselves will demonstrate that they actually do. The insights of ethnomethodology are particularly suitable to this task. It is a naturalistic...

  7. II. HOW THE GROUP HOME WORKS

    • 4 ALL IN A DAY’S WORK
      (pp. 69-92)

      On weekdays, I tried to arrive at Driggs House around noon, to take advantage of the relative quiet before the evening shift, when the house was full. Most of the residents were not at home during the day, because residents of community-based facilities in New York State must be provided services (or be employed) outside their group homes for at least five hours per day during the week. This requirement is meant to prevent group homes from turning into institutions, if only on a smaller scale. Along with residential facilities, day treatment programs and sheltered workshops since the late 1970s...

    • 5 ENDLESS, UNCERTAIN WORK
      (pp. 93-114)

      Driggs House is very much like the kind of workplace Michael Lipsky calls a “street-level bureaucracy.” Counselors face many of the dilemmas that characterize the public service work of “people processing” in a range of settings—welfare offices, public schools, free medical clinics, and police stations, to name a few—in which there is an inherent conflict between always-limited resources and potentially limitless work. The climate of regulation and accountability that dominates social services, both public and private, is also always at odds with an ideology of care. That is, bureaucratic rationalization and the prevailing emphasis on client autonomy and...

    • 6 THE CLINICAL PROBLEM OF EVERYDAY LIFE
      (pp. 115-142)

      Another way I approached work was in group home know-how, the practical, often tacit knowledge individuals have about their work that they develop in doing the work itself. Know-how is a kind of knowledge posed in contrast to what counselors learn in their formal training and have available in written materials such as procedure manuals and the goal and behavior plans of residents. Because the domain of clinical work extends to all of everyday life at Driggs House, any aspect of a resident’s conduct can at any time be defined and acted on by counselors as a problem. This ongoing...

  8. III. GROUP HOME TECHNOLOGIES

    • 7 EXPERTISE AND THE WORK OF STAFF MEETINGS
      (pp. 145-162)

      There was a weekly staff meeting at Driggs House every Thursday afternoon, from 2:00 to 5:00. Its length was one indication of the complexity of work coordination and, for both clinical and legal reasons, the value placed on efficient communication and consensus across shifts. Sonia and the main counselors—those who worked the weekday morning and evening shifts—were the regular attendees. The weekend counselors never attended, but the morning and evening counselors all worked one weekend shift, and it was part of their responsibility to convey information from the meeting to weekend staff, who were expected also to review...

    • 8 PAPER TECHNOLOGIES: Doing and Documenting
      (pp. 163-188)

      A substantial part of the work at Driggs House comprises the ongoing collection, assessment, and display of data about the work. The shelves in the staff office are lined with binders that document the lives of residents in multiple ways: daily, weekly, monthly, annually. These books, and the forms they contain, are more than just instrumental means of administrative and clinical operation; they are technologies that organize group home work, in its course, as a central aspect of that work. They involve many of the techniques for monitoring, assessment, and intervention that shape what counselors can see, know, and do...

    • 9 GOAL PLANS AND INDIVIDUAL CONDUCT
      (pp. 189-210)

      At Driggs House, “goal plans” are the technologies at the core of the group home’s individual work with residents. Lipsky (15) writes that in “people-processing,” work goals in the general sense have “an idealized dimension that make them difficult to achieve and confusing and complicated to approach.” Goal plans formalize what conduct can be seen and known, and how it should be acted on, as clinically warrantable conduct, by translating the “needs” of individual residents into practical matters of clinical work. In specified techniques of assessment and intervention, “preferences, capabilities and capacities” become “what residents are working on.” For this...

  9. IV. AT RISK

    • 10 WHAT EVERYBODY KNOWS ABOUT PAUL
      (pp. 213-242)

      Work at Driggs House is never done. It is endless because demand is endless, because human conduct is complex, unpredictable material, and because the goal of group home work is itself a process. One aspect of this endlessness is the nature of clinical work in the community: no longer contained within the unifying walls of the institutions, psychiatry and psychology had to adapt in order to function effectively outside the segregated settings that had been its province for so long. By the early 1970s, psy knowledge had already become integral to contemporary culture in many aspects of everyday life (Rose...

  10. CONCLUSION Making Life Work
    (pp. 243-250)

    The rhetoric of risk is terribly compelling in a setting organized to supervise individuals by cultivating their independence. One aspect of this in practice is working to reduce the problems residents are likely to cause themselves. It’s not difficult to see how they could be presumed to be always at risk, given that risk administration is a primary function of psychiatry and psychology in the community. Yet, beyond this complex topography, the problem of risk is central to everyday life everywhere. The ways residents govern themselves, however circumscribed by the group home’s organizational demands and documentary practices, illustrate the forms...

  11. NOTES
    (pp. 251-254)
  12. BIBLIOGRAPHY
    (pp. 255-270)
  13. INDEX
    (pp. 271-286)
  14. Back Matter
    (pp. 287-287)