Tim Stainton

Empowerment and the architecture of rights based social policy

This article considers what the notions of empowerment, rights and citizenship imply in the way of structures and policies. It argues that a coherent model is emerging with recognizable elements. The article begins with a brief discussion of some background and theoretical questions. It then examines four elements: support for people to articulate their claims; support for people to identify, obtain and manage supports necessary to actualize their claims; providing control over resources; and governance. Examples will be drawn primarily from the UK and British Columbia, Canada to illustrate the elements. The article then looks at some of the issues related to successful implementation of a rights or empowerment based model of policy and structures for supporting people labelled as having a learning disability.

Ageing Adults with Intellectual Disabilities: Self-advocates' and Family Members' Perspectives about the Future

Abstract Although the numbers of ageing adults with intellectual disabilities are increasing, current systems are ill-prepared to meet the unique needs of this population and research is needed to direct policies and practices aimed at supporting ageing adults with intellectual disabilities. This article presents the qualitative findings of research conducted in British Columbia (BC), Canada, which explored the future perspectives of 11 ageing adults with intellectual disabilities and 11 family members. Future concerns of the adults with intellectual disabilities included concerns for their ageing parents, for their future living arrangements, and about loneliness. Family members concerns centred on ensuring the future security of their loved one with an intellectual disability, addressing legal issues and financial security, and promoting future choice and self-determination. The results point to the importance of early and intentional planning that supports and balances the needs and desires of both ageing adults with intellectual disabilities and family members.

1'Social Work and Disability: An Uneasy Relationship', , 63:1, 1 - 3

People with disabilities remain one of the most marginalised groups in society with poverty, exclusion, and constant struggle to be seen as equal, valued citizens often characterising their lives. The involvement of social work with people with a disability goes back virtually to the beginnings of the profession. Even further back, disability has featured in social policy for as long as anything recognisable as such has existed. The early Greek city states had disability-related pensions for those returning from the many wars of the period, early poor laws included provision for the ‘‘infirm’’, and provision for the licensing of ‘‘beggars’’ with a range of impairments. Late medieval alms houses were often home to ‘‘idiots and cripples’’ and, in more modern times, institutional provisions -whether prison, workhouse, or asylum-served as the default welfare system for many people with disabilities. As the above suggests, the relationship between people with disabilities and social work and policy has not always been a positive one: a mix of charity at best and incarceration at worst, a trend that has continued to some degree into the present day. Social work itself shows the same gamut of response. As Bigby and Atkinson (2010) show in their contribution to this issue, many social workers were a valued and integral part of the early British system of support for people with intellectual disabilities and their families. At the same time, their work was initiated under the eugenics inspired Mental Deficiency Act (1913), which led to widespread incarceration of people with intellectual disabilities. In more recent times, it is easy to understand that people with disabilities and their families have a mix of reactions to social work. These can range from valued supporter, ally, and advocate to paternalistic interventionist, assumed expert, and gate-keeper to flawed service systems. Since the 1970s, people with disabilities have been increasingly demanding their rights as full and equal citizens. Current trends in establishing recognition in law to secure their rights, notably the UN Convention on the Rights of Persons with Disabilities, and demands for control over how, when, and by whom they are supported, reflect this new paradigm. The calls for increased recognition of decision-making capacity and personalisation of supports through measures such as supported decision making, individualised funding, and person-centered planning have significant impact on both policy and practice to which social work must respond. In the United States, this latter set of trends has become known as ‘‘self-determination’’. For social work, these demands for social justice and self-determination align directly with core social work values and suggest that ethical practice should place social workers squarely in line with the disability movement in their struggle for meaningful equality. However, the challenges of responding to this paradigm are complex, requiring not only changes in practice and policy, but also in new models of understanding, collaboration, and research. It also comes at a time when, as Bigby and Atkinson

Reason, Grace and Charity: Augustine and the Impact of Church Doctrine on the Construction of Intellectual Disability.

This paper examines how early church doctrine influenced the construction of and response to intellectual disability. Though the main focus of the paper is on intellectual disability, much of the discussion is more broadly relevant to other types of impairments and human differences. The vehicle for this examination is the work of the key figure in the development and codification of church doctrine, Augustine, Bishop of Hippo (354–430 CE). The paper concludes that while church doctrine mitigated the stark association of reason and human value found in classical Greek thought, it did not engender an attitude of equality in this world. The ideas of grace and the ‘divine plan’, while opening up a limited space for acceptance and broad equality in the eyes of God, also reinforced and legitimated an inferior position in this world, leaving those considered to have an intellectual disability on the margins of social life and subject to a charity ultimately undertaken for the salvation of the giver, rather than for the welfare of the recipient. Subsidiary themes related to the construction of intellectual disability, such as ‘object lessons to the wise’ or as ‘monsters’, use as sources of amusement, innocence and their association with children and the charity ethic, are also examined.

Independence pays: a cost and resource analysis of direct payments in two local authorities

Although there is an increasing amount of literature on direct payments (DP), to date there have been few studies which have examined in any detail the costs and resources associated with them. This paper presents findings from a two year study conducted in two Welsh local authorities that jointly fund an Independent Living Support (ILS) scheme. The main study was not designed to provide definitive cost comparisons with conventional services, however, cost and resource implications of DP were considered and an analysis to determine comparative costs between DP and traditional services was undertaken. The study notes the difficulty in identifying the true cost of DP and reasonable comparators with traditional services. A set of four case studies are presented comparing actual costs of DP and in‐house and independent sector services in the two local authorities studied. The comparison of costs and resources, which did not include significant costs for traditional local authority services but included the cost of the DP support scheme, found that DP was cheaper than traditional in‐house service provision and relatively cost neutral when compared with independent sector provision. User satisfaction, however, was significantly greater with DP than traditional service delivery methods. The paper also examines factors which can potentially influence the cost of DP. The study suggests that DP represent a substantial improvement over traditional arrangements from a cost–benefit perspective. There is strong evidence to suggest that greater ‘opportunity cost’ savings can be anticipated when DP schemes become more fully integrated into policy, practice and procedures.

Comparison of community residential supports on measures of information & planning; access to & delivery of supports; choice & control; community connections; satisfaction; and, overall perception of outcomes

BACKGROUND This paper reports on some of the findings of a large-scale survey (n = 852) of family members and support staff of adults with intellectual disabilities receiving community living services in British Columbia, Canada, concentrating on comparison of outcomes across four types of community residential settings: group homes, family model homes, independent home or apartment, and family home. METHOD Comparisons were conducted on six domains: information and planning; access to and delivery of supports; choice and control; community connections; satisfaction; and, overall perception of outcomes. Where applicable, further multivariate analyses were undertaken to determine the effect of the degree of help required by the residents and the respondent type. RESULTS Findings indicate that on all measures other than choice and control, group homes and family model homes showed better outcomes than either independent settings or family homes. CONCLUSION The findings may indicate that the move to more independent living settings is not being accompanied by appropriate supports.

Supported decision-making in Canada: principles, policy, and practice

This article considers the experience of supported decision-making in Canada and the lessons for the implementation and practice of supported decision-making that can be drawn from the Canadian experience to date. Supported decision-making has a long history in Canada with both legal and practice initiatives dating back to the 1970s. In Canada, most social policy and legislation related to decision-making, legal capacity, and support falls within provincial jurisdiction, so much of this article deals with provincial rather than national developments with a particular focus on British Columbia, which has the most developed system of supported decision-making.

Rights and Rhetoric of Practice: Contradictions for Practitioners

This chapter highlights contradictions in the rhetoric of community care policy, and is concerned that practitioners should understand their own limitations in relation to redressing the ambiguity of social constructions such as ‘choice’, ‘rights’ and consumer power, and its negative effect on service users.

Social Work Practice and Intellectual Disability: Working to Support Change

people with disabilities to create and find contexts for experiencing competence in their lives. It opens pathways to honour the experience of disability. It would be of value also to professionals who have a disability in its affirmation of the unique contribution they have to make to their workplaces. Shortcomings of the book reflect problems with the social model in general. Shakespeare critiques the social model of disability as simplistic, glossing real disadvantage and downplaying the role of impairment in the lives of disabled people (2006). Reducing the complex phenomenon of disability to social causes alone is to limit our understanding of the response required to alleviate the impact of impairment in the lives of people with disabilities. As a final comment there are sixteen contributors to the book but no biographical details about their background, why they were selected or contact details for them. In the interests of transparency and good scholarship this is a significant oversight on the part of the editors.

Idiocy: A Cultural History

design their own charter and set of principles for their advocacy work. This book also explores other key concepts such as confidentiality, duty of care and risk assessment. The book ends with a very helpful discussion on the questions to consider when deciding to become an advocate. Here some of the sensitive relationship and communication issues are explored and these are reinforced in the third and fourth books. One of the key features of the series is the way concepts and strategies are introduced and reinforced by using examples in different contexts and situations. These are reiterated and integrated across the four volumes. This approach and the clear and accessible format enable the reader to use the books as a ready reference guide and easily locate in each of the volumes the information they are seeking. The third book focuses on the central strategies of advocacy and provides some practical examples of how to speak up and be heard. It traverses the range of advocacy situations outlined in the previous book and provides detailed suggestions on how to address challenging situations where people’s needs are not being met. The ideas about communication strategies including listening and speaking up in formal situations such as meetings could be used in a range of situations and by those in other roles; for example social workers and support workers. As with the other books this one provides helpful guidelines and checklists to be used to plan advocacy strategies including how to facilitate meetings and form relationships with others in the setting that the advocacy work is taking place. The fourth book explores advocacy in action and brings together many of the ideas discussed in the previous three books. The case study used to begin the book raises many of the issues that advocates are likely to confront. The book then moves to a discussion on how to construct a plan to deal with such situations. Of much interest in this book is the section on how to deal with problems that may arise in the advocacy role; again very useful guidelines are provided for the reader to reflect on and discuss with others. Also of interest is the section on advocacy and the law. These books will be of much value to those working in the advocacy field but also in other support roles. Their clarity and ‘‘no-nonsense’’ approach will appeal to many workers in the field who are looking for a way to convey complex issues in plain English. While many strategies and guidelines are presented as ‘‘tried and true’’ these are not designed to be a prescriptive formula for advocacy and the reader is strongly encouraged to develop their own approaches and guidelines for advocacy practice that match their own needs and contexts. The books can be used in training with groups but equally they can be used as a reference guide for individuals wanting to take their own learning journey and work through what advocacy means for them personally. I very much enjoyed reading these books. They make a very useful addition to one’s bookshelf and I encourage all those interested in advocacy and in learning how to be effective in support and advocacy roles to read these books.