מאמר זה נועד לתאר תהליך מחקר שהתבצע בגישת 'מחקר פעולה משתף' ולדווח על ממצאיו. בחלקו הראשון של המאמר, יתוארו העקרונות המרכזיים של אותה גישה בהתייחסות לאנשיםעם מוגבלות. כמו כן, יתואר התהליך של בניית קבוצת המחקר במחקר ספציפי זה. חלקו השני של המאמר יציג את המחקר אשר נערך ואת ממצאיו. (מתוך המאמר).

מחקר זה ביקש לבדוק את תפיסת הזקנה בקרב אנשים עם לקויות למידה מורכבות, בהשוואה לאנשים ללא לקויות למידה בגילאי טרום זקנה. אף שלא נמצאו הבדלים מובהקים בין אנשים עם לקויות למידה מורכבות לאלו ללא לקויות למידה מורכבות בציון הכולל של תפיסת הזקנה, מלמדים ממצאי המחקר על כך שאנשים עם לקויות למידה מורכבות בגיל טרום הזקנה תופסים את אתגרי הזקנה כשונים באופיים ומהותם, בהשוואה לאלה ללא לקויות למידה מורכבות. (מתוך המאמר)

This study examined disclosure strategies in cystic fibrosis (CF) and their psychosocial implications for adults. Disclosure styles were examined based on Corrigan and Lundin's (2001) model. In-depth qualitative interviews were conducted with 42 individuals diagnosed with CF from two CF clinics in Israel. Disclosure of CF is complex and involves multiple strategies. Two main themes regarding disclosure presented here are: (a) disclosure styles and their psychosocial implications, and (b) perceptions of the differences between previous and current disclosure styles. Of disclosure styles suggested by Corrigan and Lundin (2001), most participants were found to resort to secrecy, selective disclosure, and indiscriminate disclosure and very few resorted to avoidance or broadcasting. Disclosure was also dynamic, and individuals changed their disclosure styles during various stages of life and situations, in consideration of its benefits and costs. Decisions regarding whether and to what extent to disclose the illness were based on two processes: weighing the benefits and costs of disclosure and owning the decision to disclose. Professionals should partner with the patients to understand patients’ disclosure decisions and support them. Formal and informal support may assist individuals in making these decisions, helping them become aware of benefits and costs.

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.

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.

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.

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.

Introduction: Studies regarding the use of support services for persons with a dual diagnosis of intellectual disability and psychopathology are scarce; even fewer have focused on children and young adults. The aim of the present study, conducted in Israel, was to compare the use of support services and their perceived effectiveness by families of children and young adults with intellectual disability (ID) and with dual diagnosis. Methods: Data were collected from 195 family (parental) caregivers of individuals with ID or dual diagnosis, aged 10–30. Using a structured questionnaire, family caregivers reported on the use of support services and on their perceived effectiveness. Results: Findings showed that in addition to the obvious mental health services, caregivers of individuals with ID and dual diagnosis report using a range of services and resources. Caregivers of persons diagnosed only with ID perceived some of the mental health services as being more effective than did caregivers of individuals with dual diagnosis. Conclusion: We advocate for enhanced training for professionals working with individuals with dual diagnosis within all services. Furthermore, parents need to be supported in their search for services for their child and in dealing with complex situations. In addition, more research is needed to identify why individuals with dual diagnosis may not benefit from current mental health services and, in line with this, develop more effective services. Finally, we advocate for the establishment of a one-stop shop that can provide for the comprehensive needs of these individuals within one center.

Background: The relationship between ethnicity, service use and perceptions of service effectiveness is inconclusive. This study examined differences in service use and perceptions of service effectiveness between Israeli Jewish (Jewish) and Israeli Arab (Arab) parental caregivers of individuals with intellectual disabilities and dual diagnosis of psychopathology. Methods: Parental caregivers (n = 186) of individuals with intellectual disabilities or dual diagnosis, aged 10 to 30 years, completed a self-report questionnaire. Results: Arab parental caregivers perceived health services to be more accessible than did Jewish caregivers, but there was no difference between the two groups in the use of the services. Overall, greater enabling factors and accessibility were associated with higher use of education and social services. No differences were found between the groups in their perceptions of service effectiveness. Conclusion: Arab family caregivers use education and social services less than do their Jewish peers, possibly because they have fewer enabling resources. The finding that both groups reported similar use of health services may be explained by a shared perception that informal help may not be suitable for dealing with situations of psychopathology. The similar perceptions of service effectiveness may be explained by extensive services available in Israel, to the satisfaction of both groups, or by the fact that participants perceived these services as their only alternative, and therefore fear losing them.

Although many nations advocate for the full inclusion of people with intellectual disabilities in all realms of life, these individuals are nevertheless still frequently excluded. One field of life that has rarely been considered central for inclusion of people with intellectual disabilities is military service. A unique programme was developed that provides an opportunity for people with intellectual disabilities to serve in the military in Israel. The centrality of the military within Israeli society, along with the aims and phases of the project are described, and brief evidence of the impact of the programme is provided.

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.

Some have argued that stigmatization of individuals with intellectual disabilities may be rooted in the terms used to describe the condition, others have maintained that stigma may be inherent in the condition itself, not in the label used. This study took advantage of a recent change in terminology introduced in Israel to examine differences in stigma attached to the term intellectual disability in comparison with the previous term, mental retardation. An online questionnaire, based on the Multidimensional Attitudes Scale (Findler, Vilchinsky, & Werner, 2007), was completed by 226 lay persons. Participants were presented with a questionnaire using either the term intellectual disability or mental retardation and asked to report on stereotypes, prejudice, and discrimination in response to a vignette. Moderate levels of stigma were found. An indirect effect was found between dangerousness and withdrawal behavior mediated by negative affect, and between low ability and withdrawal behavior mediated by negative affect. The term used was not found to be associated with stigma. It is possible that previous stigma attached to the term, mental retardation, was transferred to the new term, intellectual disability.

התוכנית שווים במדים נועדה לאפשר לאנשים עם מוגבלות שכלית להתגייס לשירות צבאי בצה"ל בדומה לכלל חיילי צה"ל. במאמר זה מוצג מחקר שבחן את תפיסותיהם של חיילים ללא מוגבלות שכלית בנוגע לשילובם בצה"ל של אנשים עם מוגבלות שכלית. במסגרת המחקר השווינו בין תפיסות חיילים המכירים חיילים עם מוגבלות שכלית לבין תפיסות חיילים שלא מכירים חיילים כאלה. במחקר השתתפו 239 חיילים ללא מוגבלות שכלית, 154 מתוכם הכירו חיילים מהתוכנית. המשתתפים השיבו על שאלון מובנה הבוחן תפיסות בדבר שילוב חיילים עם מוגבלות שכלית בצבא, ובו 19 שאלות סגורות ושתי שאלות פתוחות. תפיסות המשתתפים כלפי שילוב חיילים עם מוגבלות שכלית בצה"ל היו חיוביות ככלל, ויותר בקרב משתתפים שהכירו חיילים עם מוגבלות שכלית. אף שבתשובות לשאלות הפתוחות ביטאו חלק מהחיילים רגשות מעורבים כלפי השילוב, רבים יותר ראו את תרומתו לצבא ואת האפשרות שיגביר את ההנעה לשירות צבאי בקרב חיילים ללא מוגבלות. הם חשבו ששילוב זה תורם לפיתוח תפיסות חיוביות כלפי חיילים עם מוגבלות שכלית, מחזק את תחושת השוויון והשייכות של חיילים אלה, מפתח אצלם כישורים חברתיים ומיומנויות תעסוקה ומשפר את תחושת המסוגלות העצמית שלהם. הממצאים מצביעים על תרומת התוכנית ליצירת תפיסות חיוביות כלפי אנשים עם מוגבלות שכלית ולחיזוק האידיאולוגיה של שילוב חברתי ופסיכולוגי בצה"ל. מבחינה יישומית ממצאי המחקר מדגישים את החשיבות הטמונה בעידוד היכרות מתמשכת בין חיילים עם וללא מוגבלות שכלית. (מתוך המאמר)

Background: It has been argued that interpersonal contact is the best intervention for reducing negative attitudes and discrimination toward individuals with intellectual disabilities (ID). In Israel, the Equal in Uniform project makes it possible for individuals with ID to serve alongside soldiers without ID in ordinary military units in the Israeli Defense Forces. The project provided the opportunity to examine the effect of contact on the attitudes of soldiers without ID. Methods: Data analyses are based on data collected from 220 soldiers without ID via a self-administered questionnaire based on the Multidimensional Attitudes Scale. Of these, 138 were in contact with soldiers with ID as part of the project. Results: A mediation model showed that the impact of contact with a soldier with ID on withdrawal behaviour was mediated by cognitive attributions and negative affect. Contact was directly associated with prosocial behaviour. Discussion: Results support the importance of contact between soldiers with and without ID to bring about improved attitudes toward the former.

Purpose: Recent research has promoted the use of supported decision making, in contrast to historical methods of substitute decision making when working with people with intellectual disabilities. In Israel, people with disabilities are protected by the Legal Capacity and Guardianship Law of 1962, which was amended in 2016. The purpose of this paper is to consider how these recent changes are perceived by the professionals in Israel. Design/methodology/approach: Professionals with experience in policy making, law, social work and with direct experience working with people with intellectual disabilities (ID) were interviewed using semi-structured interviews and one focus group. Interviews were recorded and subsequently coded and analysed qualitatively. Findings: Two major themes were identified. These were: the law and its phrasing, and changing culture. Findings highlight the process of change within guardianship law and practice and the challenges in implementation encountered so far and anticipated in the future. Originality/value: Guardianship laws are changing in many states and the challenges to implementation of supported decision-making in these countries have been echoed in this study. Functional models to allow implementation of supported decision-making have not yet been strongly evidenced. It is hoped that this research may provide a springboard for further study into legal capacity and guardianship issues in Israel and elsewhere.

Objective Examine physicians’ implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors. Methods Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID. Results Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect. Conclusion Greater familiarity may enhance care for these patients. Practice implications Increase exposure to patients with ID within training.

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.

Background: The present study aimed to explore the applicability of the attribution model to social workers' attributions towards clients with dual diagnosis of intellectual disability and psychiatric illness. Specifically, the study examined the relations between social workers' attribution of responsibility, causality, stereotypes of dangerousness, their emotional reactions and behavioural reactions towards clients with dual diagnosis. Method: Social workers (N = 279) completed questionnaires measuring attributions of responsibility, causation and dangerousness, and reported on their emotional and behavioural reactions to clients diagnosed with DD. Results: Most social workers reported high levels of helping behaviours. The strongest predictor of discriminatory behaviours was the stereotype of dangerousness. Social workers who reported feeling less anger and more pity towards clients with DD tended to report higher levels of helping behaviour. But contrary to attribution theory, fear and anger did not predict discriminatory behaviours. Conclusion: The results are discussed in relation to the core values of social work and to professional identity.

Introduction: People with disabilities often identify professionals’ stigmatic views as significant barriers to accessing mainstream services. This study aimed to examine differences in stigmatic attitudes held by social workers toward individuals with intellectual disabilities (ID), mental illness (MI), or dual diagnosis (DD) of ID and MI. Methods: One hundred and fifty-eight social workers responded to three versions of a structured questionnaire. Participants were provided, in random order, with vignettes describing an individual with ID, MI, and DD, after which they completed the Attribution Questionnaire. Results: Results revealed a significant effect of disability type, so that individuals with MI were perceived to be more responsible for their condition than were individuals with ID or DD. Individuals with MI and DD were perceived as more dangerous than those with ID, and social workers endorsed more coercive and segregating behaviors toward individuals with MI and DD than toward those with ID. No differences were found in helping and avoidant behaviors in relation to disability type, and correlations between stigma constructs were found across all three disabilities. Conclusions: Findings are discussed in light of social workers’ obligation to assist individuals to realize their rights to full social and civil inclusion. Given these obligations, they are expected to set aside their personal views and provide help to all their clients regardless of their diagnosis.