Israeli social workers' recommendations on residential settings for individuals with intellectual disabilities.

BACKGROUND: People with intellectual disabilities have the right to live in the community. As social workers have an important role in decisions regarding residential settings, this study examined their recommendations regarding residential living arrangements of individuals with intellectual disabilities. METHOD: Using a factorial survey approach 174 social workers were presented with true-to-life vignettes and asked to provide their recommendations regarding housing in community apartments, hostels (large group homes) and meonot (large institutions). RESULTS: Higher likelihood of recommending housing in a community apartment was associated with mild intellectual disability, lack of daily support needs, no sexual abuse history, and stated preference for a community apartment. Social workers' experience in working in a specific residential setting was associated with recommending it. CONCLUSIONS: Ongoing training on rights-based ethics and the importance of community inclusion should be provided to social workers. Further, community alternatives should be made available to all individuals with disabilities.

Perspectives of adolescents with disabilities and their parents regarding autonomous decision-making and self-determination.

BACKGROUND: Parents' promotion of autonomous decision-making (PADM) is essential for adolescents with disabilities and constitutes the basis for maturation of self-determination (SD). SD develops based on adolescents' capacities and the opportunities offered to them at home and at school, to make personal decisions regarding their life. AIM: Examine the associations between the PADM and SD of adolescents with disabilities from their own perspective and that of their parents. METHOD: Sixty-nine adolescents with disabilities and one of their parents completed a self-report questionnaire including PADM and SD scales. OUTCOMES: The findings showed associations between parents' and adolescents' reports of PADM, and opportunities for SD at home. PADM was associated with capacities for SD among adolescents. Gender differences were also apparent, with both adolescent girls and their parents reporting higher ratings of SD than adolescent boys. CONCLUSIONS: Parents who promote autonomous decision-making among their adolescent children with disabilities start a virtuous circle by offering greater opportunities for SD within the home. In turn, these adolescents rate their SD as higher, and communicate this perspective to their parents. Consequently, their parents offer them more opportunities for autonomous decision-making at home, thus enhancing their SD.

Israeli soldiers' intentions and actions toward seeking mental health help: Barriers and facilitators.

BACKGROUND: While military settings may increase psychological distress, soldiers frequently avoid seeking professional help. This study aimed to examine barriers and facilitators associated with intentions to seek help and actually seeking help from a mental health officer (MHO) and how these differ among soldiers who had sought help in the past and those who had not. METHOD: This cross-sectional study included 263 combat and noncombat soldiers. The Health Belief Model and the Help-Seeking Model were the theoretical framework used to map the potential variables associated with soldiers' decision to seek help. RESULTS: Stigma and administrative barriers were found to be significant barriers to both the intention to seek help and actually consulting an MHO. These findings were more definitive among combat soldiers. The belief in the effectiveness of mental health treatment was positively associated with the intention to seek help. Positive associations were found between well-being, perceived seriousness of one's condition, and belief in the effectiveness of mental health care and intention to seek MHO help. Distress and self-concealment were positively associated with actual consultation with an MHO. Public stigma about seeking help was associated with both the intention to seek mental health assistance and actually consulting an MHO. CONCLUSION: Military commanders should make an effort to make soldiers feel safe to seek mental health assistance by creating a supportive organizational atmosphere to reduce the stigma associated with mental health care.

Burden and Growth during COVID-19: Comparing Parents of Children with and without Disabilities.

The COVID-19 pandemic and the measures taken to contain it have had a disproportionate impact on families with young children, especially with disabilities. This study examined factors associated with burden and growth among parents of young children in Israel, while comparing parents of children with and without disabilities. We hypothesized that the association between family functioning, informal social support, and perceived adequacy of educational services and burden and growth would be moderated by disabilities. An online questionnaire was completed by 675 parents of young children, 95 of them with disability. The moderating effect of disability on burden and growth was examined using PROCESS. Compared to parents of children without disabilities, greater burden was found among parents of children with disabilities, but levels of growth were similar. External support was lacking for both parent groups. Educational services were perceived as severely inadequate. Lower perceived adequate educational services were associated with greater burden. On the other hand, higher levels of family functioning (i.e., family cohesion and adaptability) and greater adequacy of educational services were associated with growth. The results show that while burden was greater for parents of children with disabilities, growth during the COVID-19 period was possible for parents of both groups. The findings also pointed to the importance of the family system for sustaining the wellbeing of its members in lockdown situations. Put together, the findings highlight the importance of planning for such national and global emergencies.

Between the convention and conventional practice: Israeli social workers' recommendations regarding the legal capacity of people with disabilities.

BACKGROUND: Following the convention on the rights of persons with disabilities (CRPD), various countries have recently amended their legal capacity laws with the aim of restricting the use of guardianship and increasing the use of other, less restrictive practices, mainly supported decision making. As social workers have a key role in carrying out these reforms, this study examines how Israeli social workers make legal capacity-related decisions. METHOD: Semi-structured interviews with 27 Israeli social workers. RESULTS: Thematic analysis identified three factors driving social workers' recommendations regarding guardianship and supported decision-making: the person's diagnosis and functioning level, and the presence of a supportive family. A fourth factor, the person's preferences, played a complex and more limited role. CONCLUSIONS: Many changes have yet to be made to fully apply the support paradigm in Israel, since social workers still tend to base their recommendations on factors not fully aligned with the CRPD.

"Together in a pressure cooker": Parenting children with disabilities during the COVID-19 lockdown.

BACKGROUND: COVID-19 has had a disproportionate and unprecedented impact on children with disabilities, their parents and families. This impact has been particularly evident during periods of lockdowns and severe restrictions. OBJECTIVE: This study employed the social model of disability to illuminate negative and positive experiences of Israeli parents of children with disabilities during the first COVID-19 lockdown, as well as the way social environments, particularly educational and welfare services, shape that experience. METHODS: The study draws upon thematic analysis of written responses of 80 Israeli parents to open-ended questions. RESULTS: Three main themes were found: (1) lack of responsiveness of both informal and formal supports to family needs, mainly in the educational and welfare systems; (2) juggling multiple roles and tasks along with the parents' routinely intensive caregiving role; and (3) the impact on the family's wellbeing and relationships. CONCLUSION: These results are discussed in light of the social model of disability, showing how social restrictions and barriers affect both negative and positive experiences of these families. Also discussed are practical implications for future crises.

Correction: Can self-efficacy mediate between knowledge of policy, school support and teacher attitudes towards inclusive education?

[This corrects the article DOI: 10.1371/journal.pone.0257657.].

Israeli social workers' recommendations on guardianship and supported decision-making: Examination of client and social worker factors.

We examined social workers' recommendations regarding the possible appointment of a guardian, a supported decision maker (SDM), or neither for persons with disabilities. Social workers (N = 328) were presented with four vignettes that contained factors potentially relevant to guardianship and SDM judgments. They expressed higher support of SDM and maintaining the status quo (without a guardian or SDM) and lower support for guardianship. Social workers were more likely to recommend guardianship when the person depicted in the vignette was labeled as having an intellectual disability, needed support in decision-making, lacked familial support, and agreed to guardianship. They were more inclined to support the status quo for individuals with mental illness, when there was little need for decision-making support, when the family was supportive, and when the individual refused guardianship. Social workers who had not heard of the SDM reform, and those with positive attitudes toward guardianship, supported guardianship. Findings are discussed in light of the status and functional approaches to guardianship and the relational notion of autonomy. As part of the SDM reform, decision-making capacity should not be assessed based on diagnosis or on independent decision-making, but rather on the ability to make decisions when receiving appropriate support. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Can self-efficacy mediate between knowledge of policy, school support and teacher attitudes towards inclusive education?

BACKGROUND: While research has focused on understanding teachers' attitudes towards the inclusion of children with special educational needs into general education classrooms, there are lacunae that have yet to be addressed. This study examined the association between perceived self-efficacy and attitudes towards inclusion among elementary school teachers. The study also examined the role of teachers' self-efficacy as a mediating variable between knowledge of inclusion policy, perception of school support and teachers' attitudes towards inclusion. METHODS: Teachers (N = 352) working in general or special education schools completed questionnaires assessing attitudes towards inclusion, sense of self-efficacy, knowledge of current policy, and perception of support for inclusive practices. RESULTS: Higher perceived knowledge of inclusion policy and higher perceived school support of inclusion were both related to higher self-efficacy regarding inclusion, which, in turn, was related to more positive attitudes about inclusion. CONCLUSION: Our results suggest that point to being knowledgeable regarding local and national policy is important in order to increase feelings of self-efficacy regarding the implementation of effective educational practice. To enhance inclusion, local and national policy must be clearly communicated to teachers. Furthermore, leadership and a supportive school environment are conducive to successful inclusive education.

Activism, Growth, and Empowerment of Israeli Parents of Children With Disabilities.

Traditionally, studies on parenting children with disabilities have focused mostly on experiences of stress. More recently, studies have turned to examining parental coping from the perspective of strength, focusing on the ability to achieve growth and empowerment. Most studies, however, have not examined parental activism as a coping mechanism. Based on the Double ABCX Model of Family Adjustment and Adaptation, this study, conducted in Israel, assessed the adequacy of a theoretical model linking stress, coping, activism, growth, and empowerment of parents of children with disabilities. Activist and nonactivist parents (N = 123) completed a structured questionnaire that included measures of stress, coping, empowerment, and growth. Stress was negatively associated with empowerment and growth, whereas problem-focused coping and parental activism were positively associated with empowerment and growth. Activism was found to mediate the relationships between stress and growth and empowerment, with lower levels of stress being related to higher levels of activism, which was in turn correlated to higher levels of empowerment and growth. Parental activism, consisting of deconstructing problems faced by the family and demanding change in social discourse with a view toward inclusion, choice, rights, and equality, is a useful mechanism for parents in alleviating levels of stress and enhancing sense of empowerment and growth.

Tradicionalmente, los estudios sobre la crianza de los niños con discapacidades se han centrado principalmente en las experiencias de estrés. Pero recientemente, los estudios se han volcado a analizar el afrontamiento de los padres desde la perspectiva de la fortaleza, centrándose en la capacidad de crecer y empoderarse. Sin embargo, la mayoría de los estudios no han analizado el activismo parental como mecanismo de afrontamiento. Este estudio, realizado en Israel y basado en el modelo Doble ABCX de Adaptación Familiar, evaluó la adecuación de un modelo teórico que conecta el estrés, el afrontamiento, el activismo, el crecimiento y el empoderamiento de los padres de niños con discapacidades. Un grupo de padres activistas y no activistas (N = 123) contestaron un cuestionario estructurado que incluyó medidas de estrés, afrontamiento, empoderamiento y crecimiento. El estrés estuvo asociado negativamente con el empoderamiento y el crecimiento, mientras que el afrontamiento centrado en los problemas y el activismo parental estuvieron asociados positivamente con el empoderamiento y el crecimiento. Se descubrió que el activismo medió las relaciones entre el estrés, el crecimiento y el empoderamiento. Los niveles más bajos de estrés estuvieron relacionados con niveles más altos de activismo, el cual, a su vez, estuvo correlacionado con niveles más altos de empoderamiento y crecimiento. El activismo parental, que consiste en deconstruir los problemas que enfrenta la familia y exigir un cambio en el discurso social en beneficio de la inclusión, la elección, los derechos y la igualdad, es un mecanismo útil para los padres a la hora de aliviar los niveles de estrés y mejorar el sentido de empoderamiento y crecimiento.

Cooperation or Tension? Dyadic Coping in Cystic Fibrosis.

Following a rise in the life expectancy of cystic fibrosis (CF) patients, many adults with CF form couple relationships. Yet, dyadic coping has not been previously examined in people with CF. This study examined how adults with CF and their partners cope as a couple with the illness, and what meanings each partner and the couple as a unit attribute to the experience. Seventeen adult CF patients and their partners participated in separate semi-structured in-depth interviews. Two main patterns of dyadic coping with CF were identified as follows: cooperation and tension. For couples in cooperation, the marital relationship served as a resource for adaptive coping. These couples were characterized by similarities in their perception of the place of CF in their lives and of their roles in the marital relationship. Couples in tension described the couple relationship as strained by difficulty of accepting the disease, proliferation of negative emotions, and a sense of burden and loneliness in the process of coping. Findings point to the importance of mutual empathy, clear and accepted division of roles between the partners, and open communication for facilitating coping as a couple.

Después de un aumento de la expectativa de vida de los pacientes con fibrosis quística, muchos adultos con fibrosis quística forman relaciones de pareja. Sin embargo, no se ha analizado previamente el afrontamiento diádico en personas con esta enfermedad. Este estudio analizó cómo los adultos con fibrosis quística y sus parejas afrontan como pareja la enfermedad, y qué significados cada integrante de la pareja y la pareja como unidad atribuyen a la experiencia. Diecisiete pacientes adultos con fibrosis quística y sus parejas participaron en entrevistas individuales, detalladas y semiestructuradas. Se identificaron dos patrones principales de afrontamiento diádico de la fibrosis quística: la cooperación y la tensión. En las parejas del patrón de cooperación, la relación conyugal sirvió como recurso para el afrontamiento adaptativo. Estas parejas se caracterizaron por similitudes en su percepción del lugar que ocupa la fibrosis quística en sus vidas y de sus roles en la relación conyugal. Las parejas del patrón de tensión describieron la relación de pareja como deteriorada por la dificultad de aceptar la enfermedad, la proliferación de emociones negativas y una sensación de carga y soledad en el proceso de afrontamiento. Los resultados señalan la importancia de la empatía mutua, una división clara y aceptada de los roles entre los integrantes de la pareja y una comunicación abierta para facilitar el afrontamiento como pareja.

Attitudes toward guardianship, social work goals, and perspectives of disability among social work students.

Purpose: Guardianship of people with disabilities has been under growing scrutiny, leading some welfare states to offer supported decision-making as a legal alternative. This study examined the attitudes of Israeli social work students toward guardianship and supported decision-making and the relationship between these attitudes and the perceived importance of social work goals, as mediated by perceptions of disability.Materials and methods: Participants were 414 undergraduate and graduate level social work students from Israel. Participants completed a structured questionnaire that measured: attitudes toward guardianship and supported decision-making, importance of social work goals, and perception of disability.Results: Although social work students tended to support limiting the scope of guardianship, they did not clearly oppose it. Individual model perspective of disability mediated the association between the social work goal of social control and attitudes toward guardianship. Social model perspective of disability mediated the association between the social work goal of social justice and attitudes toward guardianship.Conclusion: To reduce guardianship appointments, social work educators should educate students better regarding current supported decision-making trends, emphasize the importance of social justice goals, and discuss critically the necessity of social control. Further, educators need to embrace the social model of disability, in particular its view of autonomy and interdependence.Implications for rehabilitationThe UN Convention on the Rights of Persons with Disabilities has urged limiting guardianship practices, and developing instead less restrictive alternatives, especially supported decision making.In order to fully implement the Convention's vision, efforts must be placed in social work training programs on discussing the limitations of guardianship, the dilemmas it raises and the advantages of other less restrictive alternatives, including that of supported decision-making.Social work educators should also emphasize the importance of social justice goals and discuss critically the necessity of social control.Similar emphasis should be placed on exposing students to the social model of disability, including its view of autonomy and interdependence.

Help-Seeking by Parental Caregivers of Individuals with Intellectual Disabilities and Dual Diagnosis.

This study examined the roles of stigma and of enabling factors in help-seeking by parental caregivers of individuals with intellectual disabilities and dual diagnosis. Questionnaires were completed by 195 family caregivers. Lower family stigma was related to higher personal enabling factors (e.g. knowledge about services and previous experience in seeking help), which in turn was related to higher help-seeking behaviors. Higher professional enabling factors (e.g. attitude of the professional, services in the vicinity) were related to higher intentions to seek help, which were related to higher help-seeking behaviors. Professionals can help families achieve a greater sense of self-efficacy in their own help-seeking process by providing them with knowledge about services and facilitating a more positive experience in the process.

Information and communication technologies: where are persons with intellectual disabilities?

Individuals with disabilities are entitled to equal access to information and communication technologies (ICT), including the Internet. The study to which this commentary refers has shown that over time (between 2003 and 2015), Internet access by persons with disabilities has increased, but a gap still exists between people with and without disabilities. One population that has been excluded from this study is that of individuals with intellectual disabilities. This is unfortunate because these individuals may face an even greater gap than others in access to the Internet. In this commentary we review the state of ICT use specifically by individuals with intellectual disabilities, and make a few recommendations for future ICT research and for reducing this gap.

On self-identity: the process of inclusion of individuals with intellectual disabilities in the military.

PURPOSE: Identity development among individuals with disabilities may depend on their being included in central institutions in society. The centrality of the military in Israeli society makes it a highly important setting for inclusion and identity development. We examined the self-identity of young adults with intellectual disabilities who serve in the "Equal in Uniform" project. MATERIAL AND METHODS: Forty-nine interviews were conducted with 31 individuals with intellectual disabilities. RESULTS: Findings showed that military service helped develop the identity of soldiers, which enhanced their self-efficacy. Participants described their participation in the military as an opportunity to take an active part in socially valued roles. CONCLUSIONS: Findings are discussed with reference to the effect of the project on the self-identity of individuals with intellectual disabilities. The meaning of successfully serving in socially valued roles for self-efficacy is discussed. Implications for rehabilitation Completing socially valued roles leads to greater self-efficacy, enhanced self-esteem and greater psychological well-being among individuals with intellectual disabilities. Inclusion of individuals with intellectual disabilities within a central community setting (specifically the military) allows them to deal with issues of identity development, as it does for other young people without intellectual disabilities. Receiving ongoing positive input from others for one's abilities and success is a conducive factor in positive identity formation.

"It opened up a whole new world for me": Experiences of military commanders in employing individuals with intellectual disabilities.

BACKGROUND: Research on supported employment for individuals with intellectual disabilities has focused mainly on its effect on employees. Scant research has assessed the influence on employers and on the work setting. This study focused on a unique program to foster the employment of individuals with intellectual disabilities in the Israeli military and examined the effect of the program on the employers (military commanders) and on the military units. METHOD: Semi-structured interviews were conducted with 28 military commanders. RESULTS: Four themes illustrate the influence of people with intellectual disabilities on the military units in which they work: (a) functioning of the military unit, (b) effect on other soldiers, (c) effect on commanders, and (d) effect on attitudes toward people with intellectual disabilities. CONCLUSIONS: Results suggest that employing soldiers with intellectual disabilities has beneficial effects on both commanders and the military units, although some negative attitudes remain and merit interventions.

Perceptions towards disability among social work students in Israel: Development and validation of a new scale.

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale-Perceptions Toward Disability Scale (PTDS)-to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = -.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy-to-administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people.

Social inclusion of individuals with intellectual disabilities in the military.

BACKGROUND: Despite policies advocating the social inclusion of persons with disabilities in all settings that are a part of everyday life within society, individuals with intellectual disabilities (ID) are usually excluded from service in the military. AIMS: This study examined the meaning of service in the military for individuals with ID from the perspective of various stakeholder groups. METHODS AND PROCEDURES: Semi-structured qualitative interviews were conducted with 31 individuals with ID, 36 relatives, and 28 commanders. The recent model for social inclusion developed by Simplican et al. (2015) served as the basis for analyses. OUTCOMES AND RESULTS: Findings suggest a successful social inclusion process for individuals with ID, which resulted in them feeling as an integral part and as contributing members of the military unit and of society at large. Social inclusion in the military was described with reference to two overlapping and interacting domains of interpersonal relationships and community participation. CONCLUSIONS AND IMPLICATIONS: The interaction between interpersonal relationships within the military and community participation has led to positive outcomes for soldiers with ID. Recommendations are provided for the continued inclusion of individuals with ID in the military and in other everyday settings.