Recovery Lessons Learned from Individuals with Psychiatric Disabilities

ABSTRACT

Over a long career in the public mental health system, the author has seen the progress in the service delivery that has given consumers more independence and ownership of their recovery. Until another breakthrough in brain science improves the outlook for prevention and treatment of brain disorders, the push to improve expectations with supports to manage their recovery needs to continue. The author describes Harbor City Services, Inc, a market-based social enterprise that creates jobs offering security against losing a job because of reappearing symptoms, including some jobs with the potential for growth beyond entry level. The growth of this business over 25 years shows the highs and lows of moving from public funding and charity to a self-supporting business. The author encourages the use of business strategies to improve the vocational opportunities that help sustain recovery and offers tips on employment and business.     

Successful Vocational Rehabilitation for Individuals with Significant Mental Disabilities

ABSTRACT

Individuals with significant mental disabilities (SMD) frequently have scattered work histories (Finch, 1997; Tan, 1996). Often the SMD consumer is unable to find competitive employment or, if a job is secured, termination repeatedly ensues because of impaired interpersonal skills, faulty behaviors such as the inability to interact with coworkers, inadequate follow-through such as not reporting to work, and poor hygiene (Tan, 1996). The services provided to SMD consumers in this study were designed to address a cadre of support needs that would foster job retention and increase the number of successful employment closures. This cross-sectional exploratory study sampled 211 SMD consumers who received vocational rehabilitation support services through a vocational rehabilitation center in Columbus, Ohio. The SMD consumers sampled experienced both successful and unsuccessful employment closures.     

Correlates of Voting Participation of People with Intellectual and Developmental Disabilities

ABSTRACT

People with intellectual and developmental disabilities (IDD) vote less frequently than nondisabled people and people with other disabilities. This study explores what factors facilitate and hinder people with IDD’s voting participation. To do so, 1,341 people with IDD were surveyed using the Personal Outcome Measures®. Binary logistic regressions revealed significant relationships between voting participation, and support needs, residence types, guardianship statuses, and organizational supports. Along with the right supports, attention to barriers that might exist can ensure people with IDD are able to make use of their civil rights and participate in this crucial form of civic engagement.     

Spiritual Transformations in Clinical Relationships Between Social Workers and Individuals Living with Disabilities

Abstract

Some individuals living with disabilities have expressed a need to have spirituality recognized within clinical relationships. Social workers and other professionals have not responded to this need and therefore, there is a growing difference between what individuals with disabilities need and what clinicians, including social workers, are providing. Jean Vanier is a Canadian who has spiritual wisdom gained from over 40 years of living with people who have disabilities. Applying insights from both Vanier and transformational learning theory, this paper demonstrates that Vanier's approach is an important resource as social workers integrate spirituality into the clinical relationship with disabled individuals.     

Welfare Reform and Its Impact on the Employment Prospects of Individuals with Psychiatric Disabilities

ABSTRACT

Welfare policy in Australia has undergone a marked shift in direction since the election of the Liberal Coalition (Conservative) Government in 1996. This paper examines welfare policy and, in particular, the disability support pension, in the light of the vocational needs of those with psychiatric disabilities who seek to gain employment. Empirical data is presented concerning a case study of 65 clients participating in a vocational program. These participants had all been diagnosed with psychiatric disabilities, and were assisted to obtain open employment. The paper demonstrates that welfare policy, in conjunction with the recently privatized employment services network, not only fails to address the barriers faced by individuals with psychiatric disabilities, but undermines their efforts to gain employment and recover from the illness.     

How Rehabilitation Professionals Define the Concepts of Spirituality and Religion When Working with Individuals with Disabilities

ABSTRACT

Recently, some helping professionals have called for the inclusion of spirituality and religion in practice. This has created an important debate. As a result, it has become apparent that individual educators and practitioners are unclear about what is meant by these concepts as they relate to practice. This study utilized in-depth interviews to understand the essential meanings that fifteen rehabilitation professionals assigned to the concepts of spirituality and religion in their practices with individuals with disabilities. Two essential themes developed for spirituality, and three developed for religion. Implications for the future use of these concepts in practice are discussed.     

A Qualitative Study of the Perceptions of Individuals with Disabilities Concerning Health and Rehabilitation Professionals

This paper examined the perceptions of persons with disabilities concerning their interaction with health and rehabilitation professionals. Data were collected and analysed with grounded theory methods, and resulted in a typology and a thematic analysis that found that: (a) most persons who perceived themselves to be disadvantaged by social oppression or stigma were also dissatisfied with health and rehabilitation professionals; and (b) those persons who de-emphasised the impact of disability either reported satisfaction with health and rehabilitation professionals or perceived their own efforts as being the primary factor in their ability to live with disability. The perceptions of respondents were, in most instances, mediated by dominant gender stereotypes.     

The Relationship of Adaptive and Maladaptive Behaviour to Social Outcomes for Individuals with Developmental Disabilities

The purpose of this study is to examine social outcomes including social interaction opportunities and self-expression, and how they relate to other quality of life indicators. These indicators include the overall assessment of adaptive skills, and the frequency and severity of challenging behaviour. The social interaction opportunities measured in this research include family contact, hours of habilitation, community outings, hours of employment and hours of education. Self-expression refers to the extent to which the individuals assessed indicated liking and choosing what they do in their everyday lives. The data utilised in this study were obtained from personal interviews from 3781 individuals with developmental disabilities and their caregivers. Interviewers received extensive training prior to conducting the assessments. The results indicate that people with higher adaptive ability had more contact with their families, received fewer hours of habilitation, were reported to participate in community outings more frequently, worked more hours and spent fewer hours in education. These significant correlations, however, were of marginal strength. Overall, the frequency and severity of challenging behaviour were not associated with the social interaction opportunities assessed in this study.     

Development of Parenting Skills in Individuals with an Intellectual Impairment: an epigenetic explanation

Current changes in legislation in the United States support the rights of individuals with an intellectual impairment to marry and have children. Current societal views, however, are heavily influenced by our history of viewing these individuals as inadequate parents. This historical view is based upon the assumption that those with intellectual impairments are genetically inferior. Changing views of development, however, suggest that the issue of how individuals with intellectual impairments develop is somewhat more complex. The epigenetic model is one that proposes that development is the result of the complex transaction between the individual and the environment. This paper applies this model to persons with an intellectual impairment to better understand the parenting skills they display. It is argued that by intervening and changing developmental pathways, the development of parenting skills of those with intellectual impairments can be facilitated.     

Effective Responses to Offenders with Intellectual Disabilities: Generalist and Specialist Services Working Together

Abstract

Despite policies of deinstitutionalisation, many people with intellectual disabilities in developed western countries continue to live in mainstream institutional settings, such as correctional facilities, rather than in the community with support from disability services. This paper reports on the life stories of 10 people with intellectual disabilities, who had been imprisoned in adult correctional facilities in Queensland. The pathways taken by these 10 people into and out of prison are marked by significant abuse, neglect, and poverty. Significant disparity and disconnection is also displayed between the policies and service approaches, particularly between the disability, mental health, and correctional systems in Queensland. Based on these findings, a framework for practice, which spans both generic and specialist services, is suggested.     

Ageing Adults with Intellectual Disabilities: Self-advocates' and Family Members' Perspectives about the Future

Abstract

Although the numbers of ageing adults with intellectual disabilities are increasing, current systems are ill-prepared to meet the unique needs of this population and research is needed to direct policies and practices aimed at supporting ageing adults with intellectual disabilities. This article presents the qualitative findings of research conducted in British Columbia (BC), Canada, which explored the future perspectives of 11 ageing adults with intellectual disabilities and 11 family members. Future concerns of the adults with intellectual disabilities included concerns for their ageing parents, for their future living arrangements, and about loneliness. Family members concerns centred on ensuring the future security of their loved one with an intellectual disability, addressing legal issues and financial security, and promoting future choice and self-determination. The results point to the importance of early and intentional planning that supports and balances the needs and desires of both ageing adults with intellectual disabilities and family members.     

High School Students' Contact with and Attitudes towards Persons with Intellectual and Developmental Disabilities in Kuwait

Abstract

This study aims to investigate demographic variables, contact-related correlates, and attitudes towards persons with Intellectual and Developmental Disabilities (IDD) among Kuwaiti high school students (N = 700). The study focuses on variables that few studies have investigated and attempts to raise awareness among social workers to advocate for the inclusion of people with IDD and reform social policy that would improve the inclusion in society. The adapted Mental Retardation Attitude Inventory—Revised (MRAI-R) was used. A set of demographic variables and known predictors of attitudes to people with IDD were tested in multivariate analyses. Except for age, differences in global attitudes were found to be a function of gender, knowing persons with IDD, intimacy, frequency of contact, intensity of contact, and knowledge of IDD. Higher levels of Contact-Intensity and higher age were associated with more positive attitudes on the Integration–Segregation, Social Distance, Private Rights, and Subtle Derogatory Beliefs subscales. These findings support the development of legislation aimed at promoting successful inclusion that contributes to positive attitudes of students towards a person with IDD.     

Individuals with Disabilities and Professional Education Programmes: an analysis of legislation, court rulings and policy

Despite the protection provided by Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act, there remain barriers to inclusion of people with disabilities in institutions of higher education and in particular in professional programmes. Focusing on the case, Ohio Civil Rights Commission v. Case Western Reserve University (1996), this paper presents legal actions that are helping to clarify the policies protecting people with disabilities from exclusion from institutions of higher education. In particular, the paper focuses on a legal decision from the Ohio Supreme court affirming the right of Case Western Reserve's Medical School to reject a blind woman for admission to the medical school. By analysing this case using a policy analysis framework, the paper discusses the present impact and concerns for the future of these pieces of federal legislation on people with disabilities related to inclusion in institutions of higher education.     

Maternal Self-Efficacy of Mothers of Children with Intellectual Developmental Disabilities,Down Syndrome,and Autism in Kuwait

This study aims to identify the perception of maternal self-efficacy among 95 Kuwaiti mothers of children with Developmental Disabilities (DD) to determine the differences in perception of maternal self-efficacy variables among the mothers based on demographic variables: Child’s age, Gender, Type of disability, Leisure time, and Mother’s age. A survey was conducted using Kandari’s (2005, Unpublished doctoral dissertation, Simmons College, Boston) Arabic version of the Caregiving Self-Efficacy Scale. The mothers were selected from different special education settings in Kuwait. They had 33 children with Intellectual Developmental Disabilities (IDD), 41 with Down Syndrome, and 21 with autistic disorder. The children included both males and females, and ranged between the ages of 6 and 15. The findings showed that (1) mothers of children with DD did not differ in their beliefs about aspects of maternal self-efficacy according to the Child’s age, Child’s gender, and the Mother’s age; (2) mothers of children with IDD, when compared to other mothers, had negative beliefs of all aspects of maternal self-efficacy; (3) mothers of children who did not attend a respite facility for an afternoon had negative beliefs of all aspects of maternal selfefficacy except for the child’s behavioral management; and (4) all mothers’ groups had negative beliefs about their ability to control their child’s behavior and their own emotions. Implications are discussed to provide services for mothers to help them develop their adaptive skills and meet their children’s needs, as well as their own.     

Examining Outpatient Health Care Utilization Among Adults with Severe or Profound Intellectual Disabilities Living in an Urban Setting

Abstract

The present study examined the health status and outpatient health care utilization among 52 adults with severe or profound intellectual disabilities (IDs) living with their families or in group homes in New York City. Bivariate and regression analyses among demographic variables, medical conditions, health care utilization, and type of living situation were conducted. Findings indicate that demographic factors andhealth statuses were similar regardless of living situation, except for ageand the presence of Down Syndrome, that is, younger people and people with Down Syndrome were more likely to live with family than in group homes. The results indicated that regardless of where they lived, individuals had high rates (70%) of overweight/obesity. The mean number of internal medicine, specialty medicine, nursing, and total clinic visits were significantly higher for those living in group homes compared to those living with their families. The findings and their implications are discussed with respect to social work policy and practice.     

Parental Caregivers' Desires for Lifetime Assistance Planning for Future Supports for Their Children with Intellectual and Developmental Disabilities

Future life planning is a growing concern among families with children with disabilities. This article presents a needs assessment evaluating feasibility of a new model for future life planning for family caregivers, Lifetime Assistance, which will provide ongoing planning and monitoring for individuals with intellectual and developmental disabilities. Using surveys informed by a series of focus groups, data were gathered from older and younger parents in one midwestern state regarding the potential program. Study results indicate that respondents did not feel the current system of support was adequate for planning for their child's future, nor sufficient for monitoring the quality of life for their children in the future. Although almost all families had identified a person to support their family members when they were no longer able to do so, parental caregivers overwhelmingly identified the need for the Lifetime Assistance program and many were willing to pay for this service themselves.     

From Refrigerator Mothers to Warrior‐Heroes: The Cultural Identity Transformation of Mothers Raising Children with Intellectual Disabilities

This article examines public performances of mothering children with intellectual disabilities through thematic discourse analysis of thirty‐three published memoirs. These data reveal presentations of self that, once consumed and interpreted by public interaction, emerge collectively as a “warrior‐hero” identity, a reformulated archetype in the social construction of a good mother. This archetype places a cultural expectation on mothers to do battle to attain resources and possible cures for their children, ultimately shifting the historical burden on mothers from causing the intellectual disabilities of their children to curing them. The article concludes with a discussion of how this hyperfocus on expert parenting has the potential to leave mothers of children with intellectual disabilities strained and subject to the pitfalls of systems of inequality.     

Rewards of Fostering Children with Disabilities

Poverty and hunger are increasingly significant issues facing the United States. An additional trend, the consolidation in food retail, also contributes to food insecurity. This qualitative study of rural food insecure households investigates how assistance services and retail consolidation affect hunger for households in a changing rural environment. The data shows disparities exist in the amount of food assistance available based on household levels of social integration and social capital, leaving less connected residents experiencing hunger.     

Adoption of Children with Developmental Disabilities

Abstract

THE MORALITY OF ADOPTION: SOCIAL-PSYCHOLOGICAL, THEOLOGICAL, AND LEGAL PERSPECTIVES, edited by Timothy P. Jackson. (c)2005 Wm. B. Eerdmans Publishing Co. Reviewed by Steve Krausz Vicki Krausz.

CHILDREN AND YOUTH IN ADOPTION, ORPHANAGES, AND FOSTER CARE: A HISTORICAL HANDBOOK AND GUIDE, edited by Lori Askeland. Westport, CT: Greenwood Press, 2006. Reviewed by Ellen Herman.