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

Abstract

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, decisionmaking 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. Public Policy Relevance StatementSupported decision-making aims to enable persons with disabilities to make choices with support from others. Social workers, who have an integral role in judgments regarding supported decision-making, should be provided with training in relational autonomy and guidelines on how to make such decisions.

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

“…The study described in this paper is part of a larger mixed-methods research project examining social workers' perceptions and practices regarding guardianship and SDM. In a factorial survey study included in this project (Werner & Holler, 2021), we found four client-level characteristics to be influential in the social workers' recommendation process: diagnosis, level of decision-making support needed, availability of family support, and client preference.…”

“…The study described in this paper is part of a larger mixed‐methods research project examining social workers' perceptions and practices regarding guardianship and SDM. In a factorial survey study included in this project (Werner & Holler, 2021 ), we found four client‐level characteristics to be influential in the social workers' recommendation process: diagnosis, level of decision‐making support needed, availability of family support, and client preference. Social workers were more likely to recommend guardianship when the client was diagnosed with intellectual as opposed to mental disability, needed high support in decision making, lacked family support, and agreed to guardianship.…”

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

“…Experienced social workers usually express more positive attitudes towards individuals with disabilities (Araten‐Bergman & Werner, 2017). Furthermore, knowledge has been found to be negatively associated with restrictive recommendations such as guardianship (Werner & Holler, 2022). Thus, we assume that greater knowledge and experience are associated with recommendations of less restrictive housing alternatives.…”

“…Relatedly, studies have shown that people with intellectual disabilities having greater need for support are more likely to live in institutional settings and less likely to be offered community‐based alternatives (Bigby, 2012; Esteban et al, 2021; Wright et al, 2015). Professionals, including social workers, also tend to support restrictive interventions, such as guardianship, for people perceived as having higher support needs (Werner & Holler, 2022); referring to their duty to protect these clients against risk, abuse and neglect. As such risk‐aversive justifications are also central when professionals support institutional placement (Holler & Werner, 2022), social workers may tend to support more restrictive residential settings for people with higher support needs.…”

“…We examine social workers' years of professional experience and specifically in the disability field, experience working with individuals with disabilities, and knowledge and experience in residential services. Previous studies have shown that professional knowledge is of utmost importance in social workers' judgements (Petros & Solomon, 2019; Werner & Holler, 2022). Experienced social workers usually express more positive attitudes towards individuals with disabilities (Araten‐Bergman & Werner, 2017).…”