An ecological approach to facilitate successful employment outcomes among people with multiple chemical sensitivity

Many adults with multiple chemical sensitivity (MCS) must prematurely exit the workforce because of the severity of their MCS symptoms, the resulting disability stigma, and their unmet needs for on-the-job accommodations. To help individuals with MCS continue working or re-enter employment, rehabilitation professionals must understand the barriers resulting in unemployment and implement interventions to reduce or remove those barriers. In this article, the Ecological Model of Career Development is presented as a scheme for identifying barriers and implementing rehabilitation interventions to improve the employment outcomes among people with MCS.     

Theorizing accommodation in supportive home care for older people

This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work – ethnographic studies of home care practice undertaken in Canada and Iceland – and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way.     

Evaluation of selected ergonomic assessment tools for use in providing job accommodation for people with inflammatory arthritis

Inflammatory arthritis (IA) is a leading cause of work disability, especially for those with jobs involving repetitive, hand-intensive or manual work. Ergonomic interventions may mediate against job loss. Our objective was to identify desirable features of an ergonomic tool for use in providing job accommodation for people with IA, and to evaluate a selection of ergonomic and rehabilitation tools against these features. Eight desirable features were compared across 16 assessment tools. None of the tools met all the pre-determined features. Ergonomic assessment tools should incorporate objective assessment of risk factors together with subjective perceptions of symptom aggravation, and identify risk factors that may not currently be causing problems, but may increase risk of aggravation or injury in the future. To accommodate the needs of people with IA, the tool should allow for evaluation of risks and generation of solutions without a worksite visit in situations where the client does not want to disclose their illness. Finally, an assessment tool needs to be applicable to a wide range of worksites, easy to use, valid, and reliable. Against these criteria, it appears that there is a lack of appropriate ergonomic assessment tools for use in people with IA.     

The accommodation and support needs of people with a mental illness: A process and framework for action

Abstract

This paper reports the results of a consumer-focused assessment of the accommodation and support needs of people with a mental illness living in a regional city. The study utilises a 'pathway to stability' approach to assess the phase-contingent accommodation and support needs of mental health consumers through interviews and focus groups with consumers, carers and service providers. The study identifies five broad phases of the life course impacted by mental illness—beginnings, long-term needs become clearer, instability as needs evolve, finding stability and ongoing. Five key issues—information, self-competence, comorbidity, coordination and flexibility were expanded upon in focus groups. Principles for planning future service delivery are identified. The implications of the findings and research methodology for social work practice and research are discussed.     

Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three-hundred eighty-one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health-related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients lives.     

Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three‐hundred eighty‐one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health‐related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients' lives.     

Work status, benefits, and financial resources among people with HIV/AIDS

With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in their health, making many of their ongoing employment and career goals more realistic. However, people with HIV/AIDS continue to have major concerns regarding the impact of working on their benefits and entitlements, including apprehensions about potential economic hardships related to loss of financial supports and health insurance coverage. This article focuses on factors related to employment status, sources of health benefits, and entitlements among people with HIV/AIDS. In addition, results of the study demonstrate differences in employment status, benefit types, and the amount of financial support individuals receive based on gender.     

Asking for trouble with pure accommodation: Paracrises as rhetorical situations

Through the application of rhetorical analysis, this essay examines three cases that exemplify a specific type of paracrisis - faux pas - with the purpose of entertaining consideration of paracrisis as a rhetorical situation. This analysis explicitly concerns the rise of an “expectation gap” that leads to a paracrisis of an organization’s own doing. Using three cases as illustrations, this paper looks at how an organization alters one rhetorical situation through a choice of rhetorical strategies, ranging from pure advocacy to pure accommodation, only to generate a new rhetorical situation that requires a reconsideration of Burke’s scene-purpose pentadic ratio to inform conflict positioning.     

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be particularly hard for people living with multiple disadvantage, such as disabled people from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participatory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these methods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented.     

Building Cultural Competence for Work with Diverse Families

Abstract

This paper proposes a postmodern approach to social work practice that links the perspectives of cultural competence, diversity, social constructionism, and a generalist strengths-based orientation for work with families. The profession's early work with diverse families is put into the context of privilege and contrasted with more contemporary models built on affirmation of diversity and the strengths of families. The component theoretical perspectives are reviewed and followed by a flexible pedagogical model that includes four steps and representative teaching strategies for implementation.     

Practising for Social Work Practice: Integrating Knowledge and Skills for Social Work with Children and Families

The UK Government has categorically stated in its Knowledge and Skills Statement for Children and Family Social Work what social workers need to know and be able to do when responding to concerns about children. The Hope for Children and Families modular systemic interventions programme provides evidence informed responses for targeting harmful parenting and the associated impairment of children. The training resources, developed by Bentovim et al., apply the ‘common elements approach’ and are aimed at qualified practitioners. However, there also appears to be scope for their use in social work qualifying programmes. This paper will review the development of an undergraduate children and families module using the materials. It discusses how these resources were incorporated into a learning, teaching and assessment strategy which aims to develop and test the interpersonal components of knowledge and skills alongside technical/procedural knowledge. The outcomes indicate that these resources have contributed significantly in closing the gap between study and practice by providing an applied starting point from which learners can critically engage in the complexities of what they need to know and be able to do to be effective practitioners. Further use of these resources across programmes is recommended.     

Multiple chemical sensitivity and workplace discrimination: the national EEOC ADA research project

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experiences of Americans with multiple chemical sensitivity (MCS) in comparison to Americans in a general disability group with allergies, asthma, HIV, gastrointestinal impairment, cumulative trauma disorder and tuberculosis. Specifically, the researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom allegations were filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcomes or resolutions of these allegations. Findings indicate that persons with MCS were, on average, older than the comparison group and comparatively overrepresented by Caucasians and women. People with MCS were proportionally more likely than the comparison group to allege discrimination related to reasonable accommodations. People with MCS were proportionally more likely than the comparison group to file allegations against employers in the manufacturing and public administration industries, employers with 201-500 workers, and employers in the Western Census region. People with MCS were proportionally more likely than the comparison group to receive non-merit resolutions as a result of the EEOC's Americans with Disabilities Act Title I investigatory process. Implications for policy and advocacy are addressed.     

Work and Work Alternatives for Disabled Young People

This paper presents results from a population based action research study in East Devon of the needs of 383 young people aged 16-25 years with a whole range of impairments and disabilities, and 152 able-bodied controls. A comparison between these two groups is made of their current and past experiences of work and work alternatives. The aspirations and expectations of the disabled young people are also compared with those of their families and service providers, and the preferred occupations of the young people, with various profiles of disability, are explored. Although the analysis pinpoints groups of disabled young people with particularly high levels of employment handicap, there is, throughout the study group, a need for progress out of static or unstable occupational paths. The handicapping features of employment services that impede this progress are discussed together with an examination of society's response to high levels of unemployment among disabled people. The research findings, set within this context, provide a basis for action research now being undertaken in local communities within East Devon to improve employment opportunities.     

Social enterprises as enabling workplaces for people with psychiatric disabilities

In recent years, western governments influenced by neoliberalism have emphasized paid work as a key route to social inclusion and community participation for people with psychiatric disabilities. Although paid work can offer many rewards, access to mainstream employment for people with psychiatric disabilities is difficult as they continue to encounter discrimination and a lack of workplace accommodation. One response to these challenges has been the creation of social enterprises as ‘alternative spaces’ of employment for people with psychiatric disabilities. On the basis of interviews with key informants from 21 different social enterprises across Ontario, Canada, this paper critically analyzes the strategies used by organizations to create jobs that are both accommodating for people, but also conducive to the ongoing success of the business.