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Background: Psychiatrists are responsible for providing proper care for people with intellectual disability who have psychiatric disorders. This study examined psychiatrists' perceptions of their own training, knowledge and therapeutic skills, as well as their attitudes towards this population. Methods: Questionnaires were distributed to 679 psychiatrists working within the public sector in Israel. Results: Completed questionnaires were returned from 256 psychiatrists (38% response rate). Most (90%) participants reported having had limited training in the diagnosis and treatment of people with intellectual disabilities, while between 34% and 72% reported having inadequate knowledge in specific areas. Conclusion: The findings of limited training and self-perceived inadequate knowledge are at least partially explained by the service model, wherein people with intellectual disabilities are cared for by general mental health services. The identified inadequacies could be overcome through the implementation of a model in which specially trained psychiatrists are deployed within generic services. (Contains 3 tables.)

Throughout the years, disabled people, especially those with intellectual and mental disabilities, have frequently been appointed authorised guardians. Having been criticised for restricting individual freedom and autonomy and in line with the 2006 UN Convention on the Rights of Persons with Disabilities, a 2016 reform in Israel's Legal Capacity and Guardianship Law called for restricting the use of guardianship and preferring less restrictive alternatives, specifically supported decision making (SDM). The success of this reform rests largely on social workers. This study examined the meanings social worker attach to guardianship and SDM. In-depth semi-structured interviews were conducted with twenty-seven Israeli social workers. The findings showed that whilst they acknowledged the shortcomings of guardianship, they nevertheless perceived it to be vital. They provided three justifications for this view: guardianship as a safeguarding practice, guardianship as promoting individual well-being and guardianship in the service of third parties. These findings are discussed in terms of their meaning for guardianship as a risk-aversive practice designed to promote service users' well-being and quality of life and in terms of the role played by third parties in bringing SDM into force. Recommended steps for moving the current reform in guardianship from paper to practice are highlighted. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background Stigma may negatively impact individuals with intellectual disabilities (ID). However, most studies in the field have been based on the use of direct measurement methods for assessing stigma. This study examined public stigma towards individuals with ID within a representative sample of the Israeli public by comparing direct versus indirect questioning. Methods Vignette methodology was utilised with two questionnaire versions. In the direct questionnaire ( n = 306), the participants were asked how they would think, feel and behave if a man with ID asked them a question in a public place. In the indirect questionnaire ( n = 301), the participants were asked to report how a hypothetical 'other man' would think, feel and behave in the same situation. Results Higher levels of stigma were reported among participants that answered the indirect questionnaire version. Furthermore, among those participants that answered the indirect questionnaire version, subjective knowledge of ID was a less important correlate of stigma than for those participants that answered the direct questionnaire. Conclusion Several explanations are suggested for the finding that indirect questioning elicits more negative stigmatic attitudes. Among others, indirect questioning may be a more appropriate methodology for eliciting immediate beliefs. Furthermore, the results call for implementing a comprehensive, multi-level programme to change stigma. [ABSTRACT FROM AUTHOR]

Background Studies have shown that beyond public and self stigma, stigma can also impact family members. Only scant research has examined the internalised aspects of stigma, known as affiliate stigma, among family caregivers of individuals with disabilities. This study examined affiliate stigma among family caregivers of individuals with developmental disabilities via a comparison between caregivers of individuals with intellectual disabilities ( ID), autism spectrum disorders ( ASD) and physical disabilities ( PD) in Israel. Methods Family caregivers ( n = 171) of individuals with developmental disabilities, mainly ID (22.4%), ASD (32.9%) and PD (27.1%), completed a self-report structured questionnaire including the Affiliate Stigma Scale and background variables. Results Results supported a one-factor structure for the Affiliate Stigma Scale. Overall, affiliate stigma was relatively low in this sample, but was found to be higher among caregivers of individuals with ASD when compared with caregivers of individuals with ID or PD. Conclusion Findings from this study point to the importance of supporting caregivers of individuals with ASD to decrease their feelings of stigma. It is also important to further develop scales measuring affiliate stigma in order to capture the multi-dimensional nature of the concept. [ABSTRACT FROM AUTHOR]

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., (© 2023 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

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., (© 2022 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)

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., (© 2022 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

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.

The study examined the effect of an educational intervention on the willingness of Israeli social work students to work with older adults, comparing them to students of nursing, speech therapy, and physiotherapy. A sample of 187 first-year students were divided into two groups: a research group (n=83) exposed to an educational intervention on ageing, and a control group (n=104) that received no intervention of any kind. Following the intervention, ageism among social work students in the research group decreased and positive behavior toward older adults increased. No significant differences were found among students of the health professions following the intervention. In addition, ageism mediated between knowledge of ageing and willingness to work with older adults.Furthermore, the higher the students assessed the contribution of the intervention, the lower their level of ageism, the more positive their behavior toward older adults, and the more willing they were to consider a career in geriatrics. The results suggest that introducing into the curriculum a variety of learning methods aimed at increasing knowledge of ageing and familiarity with the world of older adults is likely to encourage more students of social work and other therapeutic professions to work with the older population.

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.

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.

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., (© 2018 John Wiley & Sons Ltd.)

ABSTRACTWe examined ageist beliefs, attitudes, and knowledge towards sexuality in later life among 148 nursing students and 137 social work students in their first year of studies. The students completed the Fraboni Scale of Ageism, the Attitudes and Knowledge towards Older Adults' Sexuality Scale, and questionnaires regarding contact with older adults, prior sexual education, and socio-demographics. The results indicated that nursing students have more conservative attitudes towards older adults' sexuality. Ageist beliefs correlated positively with more conservative attitudes towards older adults' sexuality. These conservative attitudes 'were negatively correlated with knowledge about sexuality in later life. Older students have more knowledge about sexuality in later life and more permissive attitudes towards older adults' sexuality. Religious students have less knowledge, and more conservative attitudes, towards older adults' sexuality. Previous sexual education was not associated with the students' attitudes and knowledge towards older adults' sexuality. Implications for designing continuing education programs are discussed.

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., (© 2018 John Wiley & Sons Ltd.)

Studies in the area of intellectual disability (ID) stigma are few and atheoretical. This study examined the adequacy of the conceptual framework of stigma from the mental illness field regarding ID. Telephone interviews were conducted with a nationally representative sample of 304 adults in Israel. Participants were read a vignette describing a man with ID and answered items related to cognitive, emotional, and behavioral reactions. Behavioral dimensions included: Withdrawal, Social distance, and Helping behaviors. The stigma process leading to Withdrawal was drawn through Negative affect, whereas the process to Social distance was drawn through Calm affect. One unique aspect of the stigma process in ID is the importance of Calm affect, which helped reduce Social distance.

Stigma may have detrimental effects on the rights of individuals with disabilities. This study examined the association between stigma and the perception of rights of people with intellectual disabilities and people with physical disabilities. Telephone interviews using vignette methodology were conducted with a nationally representative sample of 605 adults. Items included stereotypes, prejudice, behavioral reactions and the perception of rights of these individuals. More negative stereotypes, greater social distance and greater withdrawal behaviors were found toward people with intellectual disabilities as compared to people with physical disabilities. Lower support of rights was found toward people with intellectual disabilities as compared to people with physical disabilities. Lower degree of acceptance and higher perception of dangerousness were associated with greater social distance, which was related to lower perception of rights. Programs should aim at decreasing social distance to improve support to exercise rights, especially among people with intellectual disabilities., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: The Convention on the Rights of Persons with Disabilities enshrines the right of people with intellectual disability to optimal mental health services. However, the literature suggests that psychiatrists' ability to meet such a standard is questionable. Psychiatrists' self-assessment regarding their training, knowledge and skills in working with this population was examined, as well as the availability of continuous education resources., Methods: A questionnaire was completed by 256 psychiatrists working within the public sector in Israel., Results: Training in the field was very low; average level of self-perceived knowledge and skills was found to be slightly below the midpoint of the scale, while actual knowledge, as assessed through a case vignette, was found to be low for all psychiatrists, in particular for general psychiatrists., Discussion: Results point to an urgent need to increase the level of knowledge and skills of psychiatrists and improve the level of services offered to people with intellectual disabilities and mental health problems. Various options for achieving this are presented.

Needs of individuals with serious mental illness (SMI) must be understood in order to promote recovery. This study examined the needs of 206 individuals with SMI and compared their perceptions with those of their professional caregivers. Needs were reported in the areas of accommodations, psychotic symptoms, daytime activity, intimate relationships, and psychological distress. Caregivers reported more met needs, while individuals themselves reported more unmet needs. Results suggest that in order to promote recovery, services for persons with SMI should be developed in accordance with patients' most prominent needs, specifically in the social and personal areas of intimate and sexual relationships.

Providing holistic care to individuals with the dual diagnosis (DD) of intellectual disability and mental illness is a challenging task that requires the work of various health care specialists. The aim of the current study was to examine the intentions of students from various fields to work with individuals with DD. A questionnaire was completed by 512 social work, occupational therapy, speech and language therapy, special education, and nursing students in Israel to measure students' attitudes toward working with individuals with DD, as well as their perceptions of subjective norms, controllability, and self-efficacy. Structural equation modeling showed that the students' intentions to work with individuals with DD were predicted by their attitudes and perceptions of subjective norms. Controllability was found to negatively affect their behavioral intentions. Furthermore, social work and nursing students were found to have the lowest behavioral intentions. Given the lack of education in the field of DD and the prevailing stigmatic attitudes toward this population, university programs should focus on increasing knowledge, promoting positive contact, and reducing the fear attached to working with people with DD.

A range of professionals needs to work collaboratively in providing services for the growing numbers of people diagnosed with autism. Given the challenges of recruiting health professionals to work with people with disabilities in general, it is important to understand the factors that affect students' choices about working with people with autism, in particular. The aim of the present study was to assess attitudes of students in various health and social professions toward working with people with autism. An elicitation study based on the theory of planned behavior was conducted among 42 female students from the departments of social work, education, nursing, occupational therapy, and communication disorders/speech and language therapy. Working with people with autism was perceived as difficult, challenging, and frustrating, yet rewarding, important, and an opportunity to develop personally and professionally. Furthermore, the importance of awareness to stigmatic beliefs was raised. Familiarity, knowledge, and training were perceived as important. The results call for increasing university curriculum in the area of autism, increasing the contact of students with this population and focusing on training in interprofessional collaboration.

Objectives: In recent years advanced technologies, such as Global Positioning Systems (GPS), allow for tracking of human spatial activity and provide the ability to intervene to manage that activity. The purpose of this study is to examine the issue of who should decide about the use of electronic tracking using GPS for people with dementia., Methods: Based on quantitative data collected from 296 participants comprising cognitively intact elderly, family caregivers of people with dementia, social workers, other professionals, and social work students, study participants were asked to rate nine different potential decision-makers to make this decision., Results: The results show that figures inside the family, particularly the spouse or the most involved family caregiver, were perceived more important in the decision-making process than figures outside the family, whereas the person with dementia was ranked third in the order of the figures. Since the decision to use GPS for tracking raises the ethical dilemma of personal safety versus autonomy and privacy of people with dementia, the findings seem to indicate that the reluctance of professional caregivers to assist family caregivers to make this decision is experienced as frustrating., Conclusions: The findings imply that in order to reach a balance between the wishes and interests of both people with dementia and their family caregivers, there is a need for more active involvement of the professional caregivers to facilitate the family decision-making process.

Objective: Attachment theory was employed as the theoretical framework for the purpose of examining attitudes toward people with disabilities., Method: A total of 404 Jewish Israeli students without disabilities completed the Multidimensional Attitudes Scale Toward Persons With Disabilities (MAS) and the Experiences in Close Relationships Scale (ECR)., Results: Reading a scenario about an encounter with a person with a disability gave rise to more negative emotions than reading a similar scenario about an encounter with a person without a disability, regardless of participants' attachment orientations. However, attachment orientations moderated participants' positive cognitions and distancing behaviors., Conclusions: Findings suggest a dynamic process of self-regulation when reacting to a written scenario about people with disabilities. This process consists of an initial spontaneous negative emotional response accompanied by compensatory positive cognitions and behavioral tendencies.

in this study we examined the ethical aspects of the use of the Global Positioning Systems (GPS) to track people with dementia. The findings are based on qualitative data gathered from focus groups of family and professional caregivers. The most important theme was the need to balance patients' need for safety with the need to preserve their autonomy and privacy. The main potential benefit of the use of GPS was related to the peace of mind of the caregivers themselves. The findings also suggest that caregivers' views change according to the locus of responsibility of the caregivers for the safety of people with dementia. The caregivers give preference to patients' safety more than autonomy when they are responsible for the patients. When the patients are under the responsibility of other caregivers, they give preference to patients' autonomy more than their safety. Overall, the variety and the depth of the views of different stakeholders toward the use of electronic tracking for people with dementia presented in this article provide a meaningful contribution to the ethical debate on this topic.

Background: One of the more common behavioral manifestations of dementia-related disorders is severe problems with out-of-home mobility. Various efforts have been attempted to attain a better understanding of mobility behavior, but most studies are based on institutionalized patients and the assessment usually relies on reports of caregivers and institutional staff, using observational approaches, activity monitoring, or behavioral checklists. The current manuscript describes the research protocol of a project that measures mobility in Alzheimer's disease and related cognitive disorders in an innovative way, by taking advantage of advanced tracking technologies., Methods/design: Participants are 360 demented persons, mildly cognitively impaired persons, and unimpaired controls aged > or = 65 in Israel and Germany. Data regarding space-time activities will be collected via a GPS tracking kit for a period of 4 weeks in 3 waves (one year apart) with the same participants (using a repeated measures design). Participants will be interviewed by use of a battery of instruments prior to and following GPS data collection. Further, a family member will complete a questionnaire both before and after data tracking. Statistical analyses will strive to explain differences in mobility based on a wide range of socio-structural, clinical, affect-related and environmental variables. We will also assess the impact of the use of advanced tracking technology on the quality of life of dementia patients and care givers, as well as its potential as a diagnostic tool. Systematic assessment of ethical issues involved in the use of tracking technology will be an integral component of the project., Discussion: This project will be able to make a substantial contribution to basic as well as applied and clinical aspects in the area of mobility and cognitive impairment research. The innovative technologies applied in this study will allow for assessing a range of dimensions of out-of-home mobility, and provide better quality data.