Narratives of Leisure: recreating the self

Utilising insights from narrative theory this paper explores the role of narrative in the everyday leisure experiences of people with a mild intellectual disability. Drawing on our experiences with an Australian leisure service Live it UP! we develop the connection between leisure and storytelling in order to open up an innovative approach to working with individuals. The stories of people's capabilities that we draw on run counter to a dominant cultural story of lack associated with disability. Through a post-structuralist analysis we argue that narratives of leisure are a powerful social medium with the potential to produce change in an individual's life and immediate social relationships. Such an understanding is crucial for the development of alternative leisure support services which identify the person's needs, challenging the social positioning of people with an intellectual disability.     

The Role of Formal Education in the Rehabilitation of Persons with Chronic Schizophrenia

Rehabilitation services seek to address the various needs of persons with chronic schizophrenia but little attention has been paid to their participation in formal education. This study surveyed the educational needs of this population. It was hypothesised that these needs are often unmet and that their expression is influenced by an individual's history, expectations and knowledge in relation to education. A questionnaire was administered to 60 subjects in the context of a structured interview. Of the total sample, 26 individuals expressed an interest in further education but only two were currently participating in educational courses. Twelve individuals had recently enquired about further education. Analyses of the data revealed that expressed interest in education was significantly associated with an individual's background and age and with how they construed the associated benefits and difficulties. The implications of the findings for rehabilitation services are discussed.     

Spinal Cord Injury

ABSTRACT

This article provides an overview of spinal cord injury (SCI) that is useful and informative for social workers and other health care professionals who work with this population. Social workers new to the specialty of spinal cord injury must expand their knowledge base of this chronic injury. Social workers contribute to the rehabilitation process through assessment, education, and discharge planning. This article also may be used to inform persons with spinal cord injury and their families and to encourage them to engage in dialogue about SCI in the earliest stages of treatment and rehabilitation.     

The experience of quality of life among older people

Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.     

Childhood and adolescent violent victimization and the risk of young adult intimate partner violence victimization

Using a nationally representative sample of participants, this study investigates childhood victimization in the home and adolescent violent victimization in the community on the risk of being a victim of intimate partner violence (IPV), general violence, or both during early adulthood. The study findings indicate being left home alone and being physically abused during childhood, and adolescent violent victimization in the community had strong independent effects on an individual's likelihood of becoming a victim of IPV, general violence, or both in early adulthood. The study findings suggest a consistent pattern of victimization across the life course, and intervention programs need to be developed that address the specific needs of children and adolescents at high risk for home and community violent victimization.     

Youth aging out of residential care in Israel: Readiness for independent living and need for help

Youth leaving state care are a vulnerable group. It is important to examine their status and needs before they leave care, so that policies and practices are designed to address their needs. The aim of this study is to assess readiness for independent living of youth on the verge of leaving residential care in Israel, and to identify the life domains in which they need further help. Further, the study examines personal and interpersonal resources that may predict levels of readiness and needs before leaving care.     

Men, sport, and spinal cord injury: an analysis of metaphors and narrative types

This article draws upon life history data from a small group of men who have experienced spinal cord injury (SCI) through playing the sport of rugby union football and now define themselves as disabled. The salient and most common metaphors used by the men in telling their stories post SCI, and the manner in which this is shaped by three narrative types, is focused upon in detail. The implications of this dynamic process for their identity reconstruction as disabled men are considered.     

To die in treatment: An opportunity for growth,consolidation and healing

This paper addresses death's place in human development and specific psychotherapeutic treatment, using a case illustration with a dying individual. Based on an ongoing diagnostic assessment and utilizing the principles of ego psychology and object relations along with thanatology and crisis models, formulations of essential treatment parameters emerged. The premises are that psychological growth and change can continue up through this final stage of life, and that a dying person is still an individual with needs similar to, but not identical with, those who go on living. Within this context, realistic and relevant interventions evolved to maximize this individual's capacity psychologically and physiologically to survive longer. As patient passed on to death, he was more intact, less alienated, and psychically and physically more comfortable. This has implications for victims of AIDS along with those who fall under The hammer of fate to catastrophic illnesses long known to humankind.This article is submitted in partial fulfillment of the requirements for certification in The Post Masters Program in Advanced Clinical Social Work at Hunter College (1987). The author expresses appreciation to Laura Melano Flanagan for her contributions to this paper.     

In between formal and informal: Staff and youth relationships in care and after leaving care

This paper deals with the contact and relationship youth have with staff while in care and after emancipation and examines the young adults' needs in contacting staff after leaving care. The study was conducted through 60 interviews with young adults ages 21–26 who emancipated from residential settings in Israel. Results showed that most youth report having had a meaningful staff member in care and that 62% were in contact with staff after their transition to independent living for both emotional and practical needs that could not always be answered by staff. One of the study's conclusions is that despite their departure staff's relationship with these young adults continues informally years after. However, without formal recognition of the place staff have in the lives of aged-out youth, no resources are invested in training them to properly meet the young adults' needs. The discussion highlights the need for an integrative approach that sees residential settings and staff as a meaningful part in the continuity from care to independent living by supporting aged-out youth's gradual transition to adult life.     

Brief admission program. An alliance of inpatient care and outpatient case management

1. Brief planned and crisis admissions to an inpatient psychiatric unit are presented as a component supportive of outpatient care and case management for chronically mentally ill patients. 2. Typical patients admitted to this inpatient short-term program are those experiencing a life stress or temporary crisis; chronically mentally ill patients who cycle and experience exacerbations of their illness; and those who need to make the transition from an acute inpatient unit to community living. 3. The Brief Admission Program treats the individual's response to and the consequences of a lifelong illness and enables the patient to return to his previous level of functioning and continue necessary outpatient treatment.     

Services to Families with Dependent Elders

This article analyzes the role of states in providing service and financial incentives for family caregivers to impaired older people. Results from a recent Massachusetts study of family relations of the elderly are reported, focusing on the role of relatives in providing care. Next, critlcal needs of family caregivers are discussed, and major service initiatives to respond to these needs are reviewed. The Massachusetts home care system is used as an example of how services that support family care can be delivered in a comprehensive fashion. Two financial incentive programs (tax incentives and direct payment of caregivers) are then presented. The article concludes with a call for experimental demonstration projects to expand knowledge in this area.     

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。     

Child Care and Child Births: The Role of Grandparents in the Netherlands

This study explored the involvement of grandparents in the care for young children and its effect on subsequent child births in dual‐earner families, using data on 898 Dutch men and women aged 18–49 from the Netherlands' Kinship Panel Study. Three theoretical perspectives were used to develop hypotheses: (a) needs and opportunities, (b) normative preferences, and (c) gendered involvement of grandparents. The findings showed that needs and opportunities informed involvement of grandparents but that the availability of formal child care did not predict grandparents' involvement. Maternal grandparents were more likely to provide child care than paternal grandparents, and grandmothers were more likely to do so than grandfathers. Involvement of both maternal and paternal grandparents in turn increased the likelihood of additional child births. The authors conclude that grandparental child care may be part of an emerging reproductive strategy. Implications of these findings for the theoretical approaches used are discussed.     

The social care needs of unaccompanied minors: the Irish experience

This article examines forms of care which can be used by social workers to best respond to unaccompanied minors (UAMs) given their complex needs and particular vulnerability combined with their agency and resilience. The vulnerabilities and agency/resilience of UAMs are examined in the context of multiple borders (cultural, political and physical) being negotiated by these young people. While it focuses on Ireland as an example of a country where care provision for UAMs has improved considerably in recent years, it draws on both the Irish and international literatures. This article critically analyses the shift from hostel to foster care provision for UAMs in Ireland and explores benefits and difficulties associated with using foster care, while also discussing the use of alternative forms of care, such as residential care. We argue that social workers must always give consideration to a range of care options, to the needs of the individual child and to both their vulnerability and their resilience/agency. This is especially true given the diversity within the population of UAMs. Given the increasing numbers of refugees entering Europe and the mix of provision for UAMs across the continent, the Irish situation may represent a useful site for examination of their care.     

Ageing Siblings: Supporting New Care Partnerships

Through the lens of a case study of a sibling caring for an unmarried sister affected by dementia, the article explores a phenomenon of growing social importance, late life care for those ageing without a spouse, partner or adult children. The purpose of the article is to describe the experience of sibling care partnering, to highlight the needs of sibling care partnerships and discuss how the support group model can address some of the challenges faced by this population. This article addresses the caregiving sibling's experience of participating in a support group of adult children caregivers of parents with Alzheimer's. Ultimately, the article argues for the development of services geared specifically for older adult siblings caring for each other for the first time in later life.     

Men,spinal cord injury,memories and the narrative performance of pain

This article draws upon data generated from life history interviews with a small group of men who had experienced spinal cord injury (SCI) through playing sport and defined themselves as disabled. By focusing on the initial acute phase of rehabilitation following SCI their autobiographical memories of pain are explored in relation to the narratives constructed by the participants some years after the event had taken place. Attention is given to the themes of unspeakable pain, naming pain, welcomed pain, hidden pain and locked in pain. The analysis highlights the contextual nature of this phenomenon and the narrative resources that are drawn upon by individuals to give meaning to pain over time.     

The moderating effect between strengths and placement on children's needs in out-of-home care: A follow-up study

The negative impact of childhood maltreatment, which can often extend well into adulthood, consistently appears to be ameliorated if victimized children possess several resiliencies or strengths. However, little is known about how vulnerable children's outcomes are affected by different levels of strengths across different out-of-home placement settings. Hence, this study examined the association of two factors — children's strengths and placement type, with outcomes at two time-points during out-of-home care. The Child and Adolescent Needs and Strengths (CANS) tool was used to assess the outcomes of 285 children placed in residential homes or foster care in Singapore. Multiple regressions were conducted on CANS domain scores to evaluate whether level of baseline strengths and placement type predicted outcomes at two time-points after controlling for race, prior placements, age, gender, interpersonal trauma, and baseline needs scores. Results indicate that relative to residential care, foster care children are reported to be younger, with lower baseline needs, more prior placements, fewer baseline strengths and suffered fewer types of interpersonal trauma. After controlling for covariates, higher baseline strengths significantly predicted lower baseline needs of children across 3 of 4 CANS domains, regardless of placement settings. However, at reassessment 1 year later, there were significant interactions between strengths and placement type, whereby baseline strengths significantly predicted lower life functioning needs only in foster care. To conclude, in both residential and foster care, the protective effects of high strengths against child maltreatment were similarly apparent at baseline, despite clear differences in children's profiles across placement types. Over time, these initial benefits appeared to persist somewhat for children in foster care but seemed to diminish in more restrictive, residential settings and this warrants further investigation on children with more similar profiles. Nonetheless, it is clear that the continual development of children's strengths should be prioritized in case planning.     

Leaving the Parental Home: Chinese Culture in an Urban Context

Leaving the parental home is increasingly treated as an essential stepping‐stone toward adulthood in the modern world. The authors argue that this is a cultural process regulated by social norms and institutional settings that vary from place to place. Hong Kong provides an excellent scenario in which Chinese traditions coexist with rapid economic development. Rather than looking at leaving the parental home as a developmental process, Chinese tradition tends to link it with filial obligations and gender status. On the basis of life history data collected in Hong Kong, the authors establish that leaving home has neither gained substantial popularity nor become a unique life stage among Chinese; it continues to be closely associated with the marriage transition and practical considerations such as housing, childcare needs, and the availability of elderly care.