Disability facilitators' views of their work with children/youth with disability in South Africa

Children and youth including those with impaired body function or structure, in under resourced areas, can be disadvantaged in terms of education and health care, and can experience social hardship. Within South Africa, personal, health and education support to individual children and their families in under-resourced areas is provided by care workers from the National Association of Child Care Workers. This organisation also provides training and support to their care workers to take on the role of Disability Facilitator, to extend their services to children with impaired body function or structure. This study established the views of Disability Facilitators about their work. Fourteen participants (aged 25–54 years) were individually interviewed at their own worksite. Two themes were identified from the data - Empowerment and Burden of responsibility.The theme of ‘Empowerment’ encapsulated how participants viewed disability more widely than as it relates to impaired body function and structure. Disability Facilitators empowered children and their families in a holistic way, and advocated within their community to address negative perceptions about disability. They supported the wellbeing and participation of children with disability within their local communities, and perceived their work as motivating and worthwhile. However, the second theme ‘Burden of responsibility’ encapsulated the challenges in feeling solely responsible for disability support in their community and in providing care and support for children living in dysfunctional families. They recommended all care workers receive training about disability issues to reduce the burden of responsibility on themselves. This study has demonstrated the worth of Disability Facilitators to address the challenges inherent in disabling environments. This approach to service provision offers useful insights that could be adapted into other countries and contexts.     

Racial and Ethnic Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender-Nonconforming People

Members of the transgender/gender-nonconforming (GNC) community experience higher rates of discrimination based on their gender compared to their cisgender counterparts. Similarly, people of color experience higher rates of discrimination than White people. This study examines the difference in experiences of discrimination among transgender/GNC individuals in accessing social services providers by race/ethnicity (White and people of color). The data collected in a national cross-sectional survey (N = 6,451) and analyzed via chi-square test of independence and binary logistic regression demonstrate the disproportionate prevalence of discrimination based on race/ethnicity within the transgender/GNC population when accessing social services such as drug treatment centers, mental health clinics, domestic violence shelters, and rape crisis centers. Social workers are the most common provider of social services to the community, and have an ethical commitment to provision of services without discrimination. High rates of discrimination in accessing social services among transgender/GNC people, with even higher rates of discrimination for transgender/GNC people of color, highlight the need for improvement in social work education and practice.     

Why Extended Time on Newstart is Unsuitable for Aboriginal and Torres Strait Islander Australians Living with a Disability

ABSTRACT

Many Australians living with a disability find themselves recipients of Newstart Allowance when applying for the Disability Support Pension (DSP). Newstart Allowance is designed as a short-term payment for people looking for work, with a lower fortnightly payment and limited medical and transport subsidies compared to the DSP. This paper describes the financial challenges of living with a disability while on Newstart Allowance. With a focus on the experiences of Aboriginal and Torres Strait Islander (Indigenous) Australians from two regional towns, qualitative semistructured interviews and focus groups documented experiences of 39 community members and 21 medical and nonmedical service providers supporting clients living with a disability on Newstart Allowance. Four themes were identified: (i) living with severe financial hardship, (ii) challenges complying with the DSP application, (iii) being financially penalised for not complying with Newstart Allowance conditions, and (iv) supporting community members to manage severe financial stress. Although people living with a disability on Newstart were experiencing severe hardship and poverty, there was limited participation of Centrelink-employed social workers within their described experiences with Centrelink. We argue that social workers can work to humanise human service settings and potentially help to mitigate these financial challenges.

IMPLICATIONS

• Indigenous Australians living with a disability experience severe disadvantage and poverty while living on Newstart Allowance.

• Social workers must be easily accessible at Centrelink customer service centres and to Newstart Allowance recipients to help coordinate service engagement.

• Newstart Allowance should be increased to ensure recipients can respond to cost of living pressures.

     

The challenges of a hidden disability: Social work practice in the field of traumatic brain injury

Abstract

Traumatic brain injury (TBI) has become an important area for social work practice. Children and adults sustaining TBI often undergo hospitalisation, rehabilitation and face the prospect of lifelong cognitive and psychosocial impairments. Families are profoundly affected by the consequences of the injury. TBI is a ‘hidden disability’ because there are typically no physical markers indicating a person has brain damage. This paper aims to provide some guidelines for social work practice in the area, in particular, outlining options for social work interventions at individual, family, community, service system and policy levels. Social workers need to acquire specialised knowledge about brain injury, reformulate traditional models of grief counselling to address the adjustment challenges and utilise community education and service innovation to address the social stigma and reduced level of community participation associated with brain damage. Finally, social workers aim to nurture a sense of hope in the face of the tragedy.     

Social work in mental health services: A survey of the field

Abstract

A survey of social workers employed in mental health services was conducted in Victoria in mid-1997. Approximately 300 social workers were identified as working in the sector. About half were employed in adult clinical services, 23% in psychiatric disability services, 12.4% in Child and Adolescent Mental Health Services, and the rest in a range of other services. More than 90% worked in a community based service or team. The number of entry-level (SW I) positions in clinical services was found to have declined over the last ten years from 61 to 14, resulting in a lack of opportunities for social workers to gain experience in base grade positions, and difficulty in recruiting to SW II positions. Major issues of concern reported by social workers included: the lack of accommodation and other community resources for consumers; diminished opportunities for professional development, supervision, and discipline-specific training; lack of professional recognition; increasing workloads; and organisational emphasis on throughput rather than quality.     

The Attitudes of Social Work Students and Practicing Psychiatric Social Workers Toward the Inclusion in the Community of People with Mental Illness

Abstract

This study measured and compared the attitudes of social work students and practicing psychiatric social workers to the inclusion in the community of people with mental illness. The Community Living Attitude Scale Mental Illness (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 68 Israeli BA social work students (first year: n = 35; third year: n = 33) and 28 practicing psychiatric social workers. Overall, the participants endorsed Empowerment and perceived the Similarity of persons with mental illness to themselves more than they agreed with the Exclusion attitude of segregating those persons from community life. First-year students rated Empowerment and Similarity significantly lower than did the third-year students and rated Sheltering significantly higher than did psychiatric social workers. Psychiatric social workers did not differ from third-year students and did not have stronger attitudinal commitment to the inclusion paradigm. They differed from first-year students only in the sheltering attitude; they showed lower support for sheltering people with mental illness.     

Consumer-operated self-help services

To create a mental health system focused on recovery, consumer-operated services, for which an evidence base is emerging, should be promoted. Consumer-operated services have become a viable, cost-effective model designed to provide social support and recovery opportunities for people diagnosed with a psychiatric disability who are living in the community. This article describes the consumer-operated services model and uses a self-help center as an example. The core components of consumer-operated self-help centers are outlined. Qualitative data gathered through a larger study of self-help centers is presented. The article highlights the benefits of and areas for improving this innovative resource, which offers many advantages and opportunities for people living with a psychiatric disability in the community.     

Social professionals' perceptions of activating citizenship

This article reports on qualitative research among 48 social professionals, managers and policymakers and their perceptions of activating citizenship, social work roles and responsibilities, carried out in Utrecht and Tartu. Professionals from both countries agreed to the idea of activating citizenship but stressing the perspective of personalised or lived citizenship, each person to his own capacities and embedded in the personal context. Nearly all respondents were critical about the recognition of social workers as a full profession, about the new management way of steering social work and about cooperation between different groups of professionals and services. Although both countries have quite different historical and cultural backgrounds, the authors found many similarities among social workers regarding their ideas on support, participation and commitment to the people they work for and work with. International research projects contribute to a more strongly recognised social work theory and social work practice by getting a better understanding, in particular of the way social work adapts to different contexts but from a highly recognisable international discourse within social work.     

The morphogenesis of disability policies and the personalisation of social services. A case study from Italy.

Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services came from different actors and perspectives: user-led organizations, intellectuals, policy makers, social workers, advocacy organizations, which call for a new way of programming, realizing and evaluating social policies. Personalization became a relevant part of the so called ‘welfare innovation narrative’, which concerns – to name but a few – English personalization agenda, Scottish self-directed support, Finnish education system, Norwegian cash-for-care policies. Even the European Commission is addressing new social services, reshaped through users’ capabilities. The aim of this paper is to critically explain, through a case study focused on the Sardinian disability policy, how social policy's morphogenetic cycles influence the governance of personalized disability plans and, consequently, the possibility of their implementation.     

精神残疾群体的社会保障需求与供给:现状、问题与发展建议

精神残疾人多生活困难,构成社会最为弱势的群体。本文采用实地研究与文献研究的方法,对精神残疾人的社会保障需求与供给进行专门考察。研究发现,精神残疾群体的主要需求包括治疗、基本生活支持、康复、长期照护与监管以及社会参与。对此,我国政府已通过多项社会保障制度安排予以回应,基本满足了精神残疾人的基本生活与治疗需求,但还存在社区康复服务匮乏、替代性照护服务供给不足、就学、就业难等问题。基于以上发现,本文认为精神残疾人的基本生存权虽得到较好保障,但是对其发展权和参与权依然关注不足。原因在于当前精神残疾人社会保障存在三个不平衡:经济保障与服务保障发展的不平衡,医疗服务与社会服务发展的不平衡,以及卫健、民政、残联不同部门能力与投入的不平衡。针对这些问题,笔者对未来政策的完善提出了参考建议。     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Working with young people from refugee backgrounds in Australia

Social workers who are new to working with young people who are refugees may feel overwhelmed, out of their depth and inclined to defer to powerful psychiatric discourse. Arguing a role for social work engagement with young people as they face the personal, social, communal, cultural, political and economic challenges of settlement, this paper proposes a reflexive, deconstructive and dialogical approach within a broadly ecological model. All settlement tasks require mediation through the powerful discourse (language, values, constructs, social practices) of both the young person's own community and those of the new context. Creating spaces where young people can identify and negotiate the forces vying to shape them underpins and complements the urgent task of combating ethnocentricity in Australian institutions.     

Globalising accessibility: drawing on the experiences of developed countries to enable the participation of disabled people in Zambia

This paper explores the accessibility situation in a developing country such as Zambia. The global view of accessibility for disabled people is provided to examine the accessibility situation in developed and developing countries, highlighting the role of the environment in achieving rights for disabled people. Recognition of disability rights relating to accessible built environments is a necessary element to ensure their participation. Limited disability research, lack of disability policies and systems, evaluation of disability rights and support from developed countries have been cited as contributing to the non-recognition of disability rights and low participation by disabled people in Africa. An international perspective of disability, accessibility and participation and the experiences of developed countries are examined and their potential for advancing accessible built environments for participation in developing countries considered. However, accessibility concepts, having been developed in western countries, are presented with caution acknowledging the geographical, social–cultural and economic differences that exist.     

Individualization and Prevention

SUMMARY

In 1905, Massachusetts General Hospital initiated the first medical social work program in the United States. Based on the writings of its leaders, this paper presents the early history of medical social work in the United States. Inspired by developments in European health care that emphasized the community context of disease, medical social work pioneers saw a need to individualize the patient while also promoting public health measures in the community, improving the patient's environment to eliminate the causes of disease. In addition, since they served patients because of their diseases rather than their poverty, medical social workers were among the first to provide social work services to the non-poor. In spite of their emphasis on environmental change, many of early medical social work leaders had an anti-institutional bias; they were suspicious of large-scale solutions for what they saw as fundamentally individual problems. Consequently, methods for promoting individual adaptation developed more rapidly than methods for promoting environmental change. Ironically, the medicalization of social problems in contemporary times has resulted in a focus on individual pathology rather than social and lifestyle causation in health, even as the rising cost and complexity of the system challenges health care consumers in the United States. Reaffirming the environmental emphasis of medical social work pioneers provides a way for today's health care social workers to incorporate environmental modification into their practice and promote the health of all citizens.     

Involving People with Disabilities in Volunteer Roles

Abstract

According to the 2002 National Health Interview Survey, 33.7 million non-institutionalized Americans have limitations in usual activities. A recent poll on community participation found that, overall, people with disabilities have lower rates of community participation compared to those without disabilities. An analysis of that same poll concluded that people with disabilities continue to be treated as second class citizens by being excluded from the mainstream of everyday life. Social role valorization theory proposes creating and supporting socially valued roles for people who are kept at a social distance. It is through these valued social roles that they gain equal access to other opportunities that society has to offer. One such socially valued role is that of a community volunteer. Volunteer activities can foster a social environment where people with disabilities are seen as credible coping individuals. This paper reports the results of a survey of twenty-six community agencies which regularly use volunteers. The purpose of the survey was to identify barriers to volunteer opportunities for people with disabilities and to explore openness to methods to remove the barriers through community collaborations.     

An exploratory analysis of community-based disability workers’ potential to alleviate poverty and promote social inclusion of people with disabilities in three Southern African countries

This article draws on accounts by community-based disability workers (CDWs) of their life and work experiences in resource-limited rural communities in Botswana, Malawi and South Africa. Using the World Health Organisation’s community-based rehabilitation (CBR) matrix and the United Nations’ Millennium Development Goals as analytic frameworks, the article explores CDWs’ potential to contribute to improving the lives and increasing the levels of social, economic and political inclusion of people with disabilities, their families and communities. The article argues that CDWs’ knowledge, experience and understanding of disability in resource-limited communities may constitute an important local resource for helping to address the inter-related effects of poverty and disability in developing countries.     

Social workers and intercultural mediators: challenges for collaboration and intercultural awareness

ABSTRACT

Social work in Europe is facing numerous challenges in terms of promoting the participation of migrants and their descendants in super-diverse societies. This study investigates collaboration between social workers and intercultural mediators based on international debate and fieldwork in Italy. Does social work require collaboration with other professions specialised in intercultural relations? What are the characteristics of intercultural professionals? What are the pros and cons of collaboration between social workers and intercultural mediators? This study shows that local social services need to work with intercultural mediators, allowing local social services to implement various strategies for tackling cultural and linguistic barriers with their clients and rely on professionals inside or outside their own. Furthermore, intercultural mediators tend to have weak and heterogeneous training backgrounds and working conditions. This article aims to contribute to the debate on the welfare reform process to support migrants and their descendants’ equal rights and participation in society, highlighting the need for collaboration between interculturally aware social workers and intercultural mediators to tackle institutional structural weaknesses in such professions as part of an organisational innovation process in social-welfare institutions.     

Introduction

Abstract

The author shares some practice experience and personal reflection on her introduction to working with people with disabilities. Recognizing that the construct of “disability” is in the eye of the beholder, she shares an outline for one approach to an introductory course in working with people with physical, cognitive and developmental, and psychiatric disabilities. Common themes in practice and service delivery are discussed, as well as the unique role social workers can play in interagency collaboration.     

‘If this wasn’t here I probably wouldn’t be’: disabled workers’ views of employment support

UK governments since 1997 have introduced significant changes to move disabled people off benefits and into employment. Commentators have criticised the adoption of the ‘medical model’ of disability implicit in many of these policies, with its focus on individual rather than institutional change. This paper reports empirical data about participants’ experiences of one national supported employment programme. Participants of WORKSTEP were overwhelmingly positive about their experiences both of work and the support to find work. The rare reports of negative experiences reflect the focus on intervening at the level of individual workers, rather than the workplace or organisation of work. Analysis of their views is valuable in the light of ongoing welfare reform as well as recessionary pressures on labour markets and employment services, which, in emphasising individual solutions to employment problems, may overlook the need for more broad-based, social interventions.     

Launching the workplace flexibility movement: work family research and a program of social change

The Alfred P. Sloan Foundation's Workplace, Work Force & Working Families program was established in 1994 and ended in 2011. Over the course of its 17-year lifespan, this program – through its vision, commitment and unique, pragmatic grant-making strategies – pioneered the interdisciplinary field of work–family research and spearheaded a national movement to create more flexible workplaces that effectively meet the needs of employees and employers. The program's first strategic phase supported high-quality, multidisciplinary research to examine what was happening within working families at all stages of their lives, both at home and at work. Results from these investigations highlighted the structural mismatch between the needs of this diverse workforce – comprised increasingly of working parents and older workers – and the demands of a rigidly structured workplace requiring full-time, full-year work, with little to no flexibility in how, when, or where work gets done. After a decade of scholarly research documenting that the challenges facing American families were not private, individual problems but public, societal concerns, the Sloan Foundation designed and launched in 2003 the National Workplace Flexibility Initiative. Its goals were twofold: to make workplace flexibility a compelling national issue and to establish it as a standard of the American workplace. As a result of the collective efforts of Sloan-supported organizations and people, the stage is now set for a social movement to realign the structure of the American workplace to the needs of the twenty-first century workforce. Lessons for subsequent research-driven social movements close the article.