Disability Issues for Social Workers and Human Services Professionals in the Twenty-First Century

Jean A Pardeck, John W Murphy

• Publisher: Routledge
• Year: 2012
• ISBN:
  9781136431999
• Edition: 1
• Topic: Médecine
• Subtopic: Théorie, pratique et référence de la médecine

Examine issues of vital importance to you and your disabled clients—today and in the years to come! This groundbreaking text provides you with up-to-date, authoritative information that will prove to be of critical importance for disability professionals in the coming years. It will leave you better informed about aspects of disability that have not been well covered in the literature—issues surrounding spirituality, civil rights, and the "medical model vs. social (or minority) model" (of viewing disability) controversy. You'll examine the impact of the Americans with Disabilities Act in the wake of the Supreme Court's narrowing of the Act's powers and explore newly developed theories designed to more accurately define the true meaning of disability. Disability Issues for Social Workers and Human Services Professionals in the Twenty-First Century explores:

• the current—and potential—roles of spirituality and religion in the rehabilitation process
  
• the use of medication in treating disability—with a study focusing on children in foster care whose emotional/behavioral disabilities are medically (rather than psychologically) treated
  
• Attention-Deficit/Hyperactivity Disorder (ADHD) in college students—how it impacts them as a disability requiring academic accommodations
  
• disability as an aspect of cultural diversity—with suggested methods for educating the non-disabled about people with disabilities
  
• limitations on the civil rights of those with disabilities—and what can be done to eliminate those limitations
  
• computer technologies designed to aid people with disabilities—with an examination of a health promotion Web site for children with disabilities and their families
  
• disability and the managed mental health system—with an examination of the differences in service utilization and satisfaction in rural and urban areas
  
• how disability can be viewed as a social construct, rather than something that is inherent to the disabled person

Keeping current with new developments is imperative for social workers and other professionals whose work affects people with disabilities. Disability Issues for Social Workers and Human Services Professionals in the Twenty-First Century provides the information you need to stay on the cutting edge of progress in this rapidly evolving field.

SECTION I

DISABILITY PRACTICE IN THE TWENTY-FIRST CENTURY

The Use of Religion and Spiritual Strategies in Rehabilitation

Debra J. Morrison-Orton

SUMMARY. Recently the helping professions have reopened the debate about utilizing religion or spirituality in both education and practice. In this study, in-depth interviews were completed to identify what, if any, strategies rehabilitation professionals had utilized in practice. Four major themes evolved from participants: (1) denial of having used strategies; (2) use of the concepts for their own benefit; (3) use of the concepts for client benefit; and (4) the use of multiple religious or spiritual strategies. Implications for professional and continuing education are addressed. Lastly, suggestions for future research are highlighted. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website: <http://www.HaworthPress.com> © 2005 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Use of spirituality and religion, rehabilitation, social work, health, disabilities, training, education

INTRODUCTION

While the process of rehabilitation is broad and varies by setting and discipline, Byrd (1999) made the point that rehabilitation should consider the whole person. He noted that professionals utilize the bio-psycho-social model in assessing and treating clients, but he argued that it is critical to incorporate the spiritual and religious elements of an individual’s life into the helping process. Although there is a call to include spirituality and or religion into the helping professions there are no clear guidelines about what spiritual (or religion) means or what one does to “concern one’s self directly with … spirit” (Byrd, 1999). Nor does Byrd identify what he meant by “reliance upon their spiritual resources” in the practice setting. An earlier study (Morrison-Orton, in press) strove to define the concepts of spirituality and religion as conceived by rehabilitation professionals. The remaining issue is once a particular understanding is developed, how do rehabilitation workers apply or mobilize spiritual or religious concepts in a rehabilitation practice?

Literature Review

Of all the human dimensions, spirituality has enjoyed only limited sporadic episodes of study. Scientists, it seems, prefer to leave most of the research to clergy, clerics, and mystics (Barbour, 1997). The issues surrounding the application of spiritual and religious concepts to daily living and dying have had a long history in the United States. The role these concepts have had on public life began in early and had many of its roots following the same trajectory as those seen in the fallout from the English Elizabethan Poor Laws (1601). These laws often reinforced dominant social values that were institutionalized via the volunteer work of church or religious communities and organizations. While some of these social values (Holland, 1989; Reid & Popple, 1992) included teaching ‘right’ moral behaviors others pertained to alms or charity (Lindberg, 1993; Van Wormer, 1997), compassion (Olasky, 1992), and caring (Brabeck, 1989; Dunajski, 1994). Society tried to figure out what to do with individuals who did not fit the norm of mainstream society physically, emotionally, socially, religiously, sexually, or racially (Axinn & Levin, 1997; Wuthnow & Hodgkinson, 1990). It became apparent those who could not be woven smoothly into the dominant social fabric would not disappear but had to be dealt with or provided for or protected (Skopal, 1995; Trattner, 1994). The call to consider the incorporation of spiritual or religious concepts into the rehabilitation practice has grown louder. Today, President George W. Bush has called on faith-based organizations to take over and or enhance social services more recently supported by the government.

The focus of this research centers on the concepts of religion and spirituality as rehabilitation professionals apply these concepts when intervening with persons experiencing physical, cognitive and or mental health disabilities, or their loved ones and or caregivers. The way any person believes, the manner in which a person’s culture ascribes meaning to behaviors, language, and rituals will all impact an individual’s values and worldview. Clients and rehabilitation professionals will share in this co-created reality. This reality will, in turn, affect mental and physical health of clients (Pellebon & Anderson, 1999) and impact the way professionals interact with clients.

Spirituality and Religion: Their Relationship to Health, Disability and Adjustment

Serving individuals with disabilities presents many opportunities for rehabilitation professionals to come face to face with spiritual and religious issues. Many professionals have spoken directly to the issues (Havranek, 1999; Canda, 1995). McCarthy (1995b) postulated that while the general population has the commonality of religiosity

there is likely to be an increase, within the rehabilitation target population, in spiritual interests or needs associated with the fact that many clients seek or are referred to counseling because they are confronting personal crises. Such situations tend to stimulate contemplation of life’s meaning or to test their faith. (p. 189)

Hunt (1996) stated that in working with individuals infected with HIV, rehabilitation professionals should not “shy away from discussing … issues related to religion and spirituality …” (p. 71). Keith Byrd (1999) suggested, “the greatest potential for healing from a spiritual frame of reference can be found in a relationship between the person with a disability or chronic illness and God” (p. 12). Carolyn Vash (1981) contrasted the experience of having a disability in a spiritual sense and a technological sense. She called for the integration of the concept of transcendence into a stage model for integrating a disability into one’s life. Conrad (1989) also believed spirituality was a potentially positive and helpful tool in the taming of the harsh and often seemingly inhumane application of biomedical ethics faced in the bureaucratic organization. O’Hanlon’s (1999) suggestion to use the arts to connect to self and others also may be one step in humanizing impersonal or sterile bureaucratic health and justice systems caring for people.

Modern psychoneuroimmunologists believe the spiritual dimension of an individual has its organic and physical correlates in the essential organization of genetics (Jerotic, 1997; Trieschmann, 1995). Introducing the spiritual principle into the treatment of mentally ill patients can help restore the physical-mental-spiritual balance of the individual. Jerotic (1998) called for the introduction of the spiritual principle within group therapy with its main purpose being to strengthen Victor Frankl’s concept of the “will to” or for meaning (1969, 1986). This according to Jerotic helps to strengthen an individual’s psychoneuroimmunological organization.

The medical model assumes that good physical health produces happiness and well-being and the focus of rehabilitation efforts is the happiness of the individual with a disability (Trieschmann, 1995). Trieschmann believes that rehabilitation has always emphasized the whole person, including the emotions of the individual and their environments. She encouraged rehabilitation professionals to consider psycho neuroimmunology as closer to the whole person model of intervention. Specifically she argued for an energy model, which integrates “the body, mind, emotions, and soul into a philosophy of health and wellness which returns humanity to a linkage with nature” (p. 222). She linked this model to the field of physics where energy cannot be destroyed but is interdependent and transformed. Using an oriental philosophy and strategies to create spiritual harmony and tranquility she identified a goal of addressing these spiritual issues as a way “to provide a methodology that allows us to live more comfortably with ‘what is’ … so we do not burn ourselves up with sustained emotional reactions …” (p. 226).

Multiple articles have appeared in the literature describing how individuals with disabilities or their caregivers have found spiritual or religious interventions important to the process of living with, adjusting to, or working with those with disabilities (Dunbar, Mueller, Medina, & Wolf, 1998; Kaplan, Marks, & Mertens, 1997; Lane, 1992, 1995; Rotteveel, 1999).

Sistler and Washington (1999) found that in a caregiver group that focused on the serenity prayer and participant spirituality, African American women perceived a greater sense of control, greater confidence in their ability to problem solve, and achieved a greater sense of happiness and well-being when caring for a parent with dementia. Caregivers of Alzheimer patients who regularly worshiped and reported that their spiritual needs were being met had greater well-being and decreased stress than those caregivers who reported that their spiritual needs are not being adequately addressed (Burgener, 1994). In elder patients living in nursing homes there was a reverse relationship between worship practices and functional and perceived disability (Idler & Kasal, 1997a, 1997b).

Anderson, Anderson, and Felsenthal (1993) surveyed individuals released from a rehabilitation hospital and discovered that 45% did not believe enough attention was given to their spiritual needs while hospitalized. Among cancer patients being treated in a hospice setting, stronger religious beliefs were associated with reduced anxiety (Kaczoroswki, 1989). Patients with chronic medical illnesses, such as cystic fibrosis (Stern et al., 1992), cancer (Smith, Stefanek, Joseph, & Verdieck, 1993), lung cancer (Ginsburg et al., 1995), diabetes (Landis, 1996) and chronic renal failure (O’Brien, 1982) frequently used religious and spiritual adjuncts to medical care and reported positive benefits from these practices. Yates et al. (1981) found cancer patients and their religious beliefs were associated with reduced levels of pain. Additionally, Comstock and Partridge (1972) found a relationship between regular (weekly) church attendance and significantly lower rates of coronary disease, emphysema, cirrhosis, and suicide. A study of heart transplant patients revealed that religious beliefs and practices at the time of the transplant predicted improved physical, functioning, adherence to medical regiments, higher self esteem, and diminished anxiety about health one year post surgery (Harris et al., 1995).

In serving clients who had severe mental illness Garske (1999) emphasized the importance of the relationship the client had with self and others in the form of social support and community to help maximize the potential of these individuals. It was argued that community and social support might come from involvement in faith communities (Peck, 1993; Sullivan, 1992). Other elements identified with religion and spirituality include Carl Rogers’ (1942) expectations for empathy, unconditional positive regard, and congruence; inclusion (Atkins, 1988; Sullivan, 1992); community (O’Hanlon, 1999; Peck, 1993); and relationship to self and others (Taylor & Wolfer, 1999). Several authors have called for the inclusion of spirituality in mental health service delivery to include putting the ‘soul’ back in psychotherapy (Becvar, 1997; Cornett, 1998; Goldberg, 1996; Haake, 1996; Pezzulo, 1997; Sheridan, 1995; Simons, 1992). Some mental health patients in one study identified sin as a reason for their mental illness (Sheehan & Kroll, 1990). In a cross-sectional survey with a case-control design for the study sub-sample, 720 patients were reinterviewed from a previously large-scale community study of psychiatric epidemiology. The authors of another study concluded patients with suicidal feelings are more likely to be female, to have been treated for other psychiatric symptoms (especially depression) and medical symptoms, to be socially isolated, to have fewer religious affiliations, less religious attendance and prayer, and have a greater frequency of stressful life events than patients who were not suicidal (Paykel, Myers, Lindenthal, & Tanner, 1974). Others have looked at spirituality in treating clients with depression (Cadwallander, 1991; Kaiser-Ryan, 1991), severe mental illness (Sullivan, 1992), including schizophrenia (Walsh, 1995), and multiple personality disorder (Iorfido, 1996). Data gathered from 131 community-dwelling chronically ill elderly revealed significant findings of a correlation between mental health, coping with pain of chronic illness and “closeness to God” (Burke, 1999).

Substance abuse rehabilitation has a long history of using spirituality in the healing process of traditional self-help groups (Gregoire, 1995; Krill, 1990b; Morell, 1996). These programs build in components of what has been described as spirituality. The components include respect for self and others, dignity for all, compassion, belief in a higher power, forgiveness, and service to others. AA forbids endorsement of any religious or political organization, including religious organizations. The traditional philosophy and governing rules of AA makes an important distinction between spirituality and religion stating that there is no requirement to believe in a particular God, but rather a higher power of the individual’s choice. Data suggests that persons in recovery who embrace a higher power often undergo life-altering transformations (Green, Fullilove, & Fullilove, 1998), which can contribute to long-term abstinence and recovery. There are studies linking religious affiliation that seem to have a moderating effect on an individual’s behavior of alcohol and drugs use (Burkett, 1977; Dudley, Mutch, & Cruise, 1987). Miller (1998) believed that religious involvement and spiritual re-engagement during recovery was correlated with recovery and abstinence.

Other rehabilitation workers who have acquired disabilities themselves have written about the importance of spirituality in their healing. One example is the story of Megel Elie (1995), a graduate of Tulane Medical School. Shortly after graduation at age 27, Elie had a sickle cell attack that left her in a coma for 41 days. When she regained consciousness she expected to get up and walk. However, her ability to do anything for herself was gone. After many losing struggles to return to her premorbid state she came to realize that God had always been the one who had given h...

Table of contents

• Cover Page
• Half Title page
• series page
• Title Page
• Copyright Page
• Contents
• In Memoriam
• About The Editors
• List of Contributors
• Preface
• Introduction
• Disability Practice in the Twenty-First Century
• The Use of Religion and Spiritual Strategies in Rehabilitation
• Medication of Children and Youth in Foster Care
• Attention-Deficit/Hyperactivity Disorder in Community College Students A Seldom Considered Factor in Academic Success
• Using Children's Books as an Approach to Enhancing Our Understanding of Disability
• Disability Policy and Programs in the Twenty-First Century
• Reaching Out Evaluation of a Health Promotion Website for Children with Disabilities and Their Families
• Rural and Urban Differences Among Mental Health Consumers in One Midwestern State Implications for Policy, Practice, and Research
• An Analysis of the Americans With Disabilities Act (ADA) in the Twenty-First Century
• Disability Theory in the Twenty-First Century
• Social Norms and Their Implications for Disability
• Conclusion
• Index