Rede De Reabilitação Lucy Montoro, Sao Paulo

This post describes a comprehensive rehabilitation center in Sao Paulo for individuals with physical and intellectual disabilities over the age of 14. The Rede De Reabilitação Lucy Montoro, or Rehab Network of Lucy Montoro was originally created by private donations. The center itself occupies an enormous centrally-located building which used to be part of a train station. The building was donated for the rehabilitation center and the center now receives philanthropic and government funding.

Exterior of the Rede De Reabilitação Lucy Montoro

Exterior of the Rede De Reabilitação Lucy Montoro

The Center has gone through some changes in the past few years. It used to have no strict rules for entrance or exit, and provided day workshops for people with disabilities. It was described by Dr. Gabriela Stump (Psy.D.), who previously worked at the Rehab Center, as a place where people with disabilities came and stayed because it was convenient. Individuals may have attended day programs here for 10-14 years. Dr. Stump has tried to put in place a process with entrance and exit procedures, with workshops that are differentiated for various levels of functioning, and with individualized goals for participants. Now, the Center serves individuals a few hours a day, two days a week. This means that there are different groups in the mornings and afternoons, and individuals may come on different days. Dr. Stump aims to have a functional network of providers that will also serve the individuals with disabilities who attend the Center. Now, individuals may stay for approximately 2 years and are re-evaluated every 3 months to see if they are meeting their goals. Overall, the Center serves about 600 individuals a day.

Outdoor snack area at the Rehabilitation Center on the old train platform. The train car now serves as a rehabilitation room.

Outdoor snack area at the Rehabilitation Center on the old train platform. The train car now serves as a rehabilitation room.

What do you think of the change in service procedures at the Center? Why do you think the Center wanted to systematize services in this way? What may be some of the benefits and consequences of the changes?

9 thoughts on “Rede De Reabilitação Lucy Montoro, Sao Paulo

  1. The change in the cervices of the center seems to make sense to me. It appears to be a natural progression of events the center became more widely visited and systematized. The center probably wanted to add more order to its work in order to increase productivity. Having a place for people with different development to just hang out is nice, but providing them a structure which they can use to grow is much more beneficial to the community and the individual. Some benefits would be marking progression and (hopefully) improvements of participants. Some consequences would have been a general resistance to change, and perhaps losing some participants who just needed a place to exist peaceably, or to find support in an unstructured atmosphere. What kind of services do participants engage in at the center?

  2. I agree with the statement listed above. The change in service procedure was a good change for the program because it incentivized learning and created a system to track the changes within and between individuals as a result of receiving services. In addition to this, categorizing individuals based on their ability and establishing learning goals provides an incremental, methodological way to ensuring that participants in the program are benefiting from services. Some disadvantages to the new changes could be that it limits the number of days that individuals can attend to only two days. I believe that it would be ideal if individuals were able to come to the center as many times as they wanted. Especially if they wanted to improve on a particular skill.

  3. First, I think it’s very promising that the Rehab center was first created by private donors but now receives both philanthropic and government funding. This shows that the government is paying more attention to the needs of those with disabilities, which is necessary if their needs are actually going to be adequately addressed and met. I think the biggest benefit of the change is that the services are now more individualized, and a person’s specific needs can be met in the various workshops they offer. But you also said that now people can stay for approximately two years and are re-evaluated every three months to see if they are meeting their goals. So does this mean it’s a two-year limit? Is there any way for them to stay longer? And what if they aren’t meeting their goals? What would the center do then?

    I agree that participants should be able to attend the center more than two days a week, and if in fact there is a two-year limit, I think this limit should be taken away as well. I do also understand that this was done because it allows them to service more people, which is obviously important, but it does seem unfortunate to limit people to how many days a week they can attend the center.

    I am sure money and resources are an issue (even though it is now government funded), but I think it would be ideal if they expanded or opened up another center that remains a place to simply hang out, as I think having this environment is important for these individuals with disabilities. It’s a place where they can be surrounded by people who share their situation and understand what they are going through.

    Lastly, to expand on the questions of what kind of services they provide, do these services include support groups for these individuals?

  4. I, too, agree with the two former comments. I think that the changes were made for the better, both because they add structure that promotes a spirit of progress both in the staff and in the clients, and also because it seems as though it might help the center access a greater number of individuals with disabilities. That being said, I am curious whether or not the two day per week visit limitation placed on the clients is the best policy. What do the clients do on the other days of the week? Is the center partnered with other services that might be able to serve individuals who are really focused on improving and progress during the days that these individuals cannot come into the center?

  5. While having a place for people to go is nice, I think that the change in the structure of the center benefits, overall, the people that the center serves because structure and planning for specific individuals to take certain workshops that will benefit their specific needs, as we have learned in class, that we all have individual differences, will impact the individuals in a more beneficial way. Personally, I know it is nice to have a goal to work towards, and having a goal may motivate both staff members and people who use the services. I think that the center probably changed their policy about how long the patients could use the center for in order to create a sense of urgency to be able to reintegrate the individuals into mainstream society so that they can function and thrive. I’m concerned with where the individuals who use the centers go on the other days that they are not in the center, and I am also wondering- if the center completely free for these individuals? Is there a fee? How does this impact what demographic uses the center?

    • I agree with what everyone has been saying. I think that the changes made to the center were mostly positive. It’s great that it is now more individually structured. I am most excited that because they are checking in every few months to see if people are meeting their goals, hopefully this means that if these people are not, the staff will change their approach for this person.

      As for the discussion about the limit of 2 days I am not sure what I think. It does seem a bit unfair that they used to be able to spend as much time there as they wanted and now they cannot. On the other hand, the center can serve so many people which is a really great and important thing. Also, the limit of 2 days may be okay if the staff help their clients find something meaningful to do with the rest of their days.

  6. I agree with what everyone has been saying. I think that the changes made to the center were mostly positive. It’s great that it is now more individually structured. I am most excited that because they are checking in every few months to see if people are meeting their goals, hopefully this means that if these people are not, the staff will change their approach for this person.

    As for the discussion about the limit of 2 days I am not sure what I think. It does seem a bit unfair that they used to be able to spend as much time there as they wanted and now they cannot. On the other hand, the center can serve so many people which is a really great and important thing. Also, the limit of 2 days may be okay if the staff help their clients find something meaningful to do with the rest of their days.

  7. I agree with Sami’s comment that more structure would increase productivity. Structure provides direction for both the individuals providing and the individuals receiving services so that there are clearer standards and goals. Less, but more focused time is more beneficial than more unfocused time. By limiting the time that each individual receives services, the center can work with a greater number of individuals in more depth. Also because each person receives such individualized services, they can be given suggestions on how to integrate into the community or practice their skills on their days without session, as Rachel mentioned above. This allows for the center to provide support in multiple contexts. I think that, overall, moving towards a more structured format is a great step for the center and I’d be curious to see the progress.

  8. I agree with Liz P. because though I think that these changes are beneficial in that they are assuring that participants are getting more individualized attention and that their progress is being tracked, I worry about the community that may have been lost. It is important that people with disabilities are able to support each other, give advice to each other and have somewhere to interact. The limit on number of visits per week as well as the more structured programs has taken that away. I agree that it would be ideal if another center could be opened for community purposes.
    The changes, however, do provide amazing support and hopefully will ensure improvement and learning within each individual. With the new structure, more people will be able to be helped and in ways more appropriate to them.

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