| Abstract [eng] |
Introduction Social relevance. According to data from the World Health Organization1, there are currently more than one billion people with disabilities in the world (15 percent of the world’s population). According to the Department for the Affairs of Disabled2, the number of people with disabilities in Lithuania reaches (234 179) of the total population of the country. It is the largest group of social exclusion, representing 34.3 percent of all people receiving social services in Lithuania. There are more than 244 institutions providing social services in the country3, where the social workers provide services to 17 734 people with disabilities. People with disabilities are often unable to fully participate in social and economic activities due to public attitudes towards them, therefore, the number of people with disabilities and people receiving social services in the mentioned institutions tends to increase, while the need for high-quality and partnership-based social services is constantly growing (Lofquist, 1989). Disability shall be understood as a social problem rather than a personal one as disability depends less on personal health problems and more on how the environment accepts and integrates the person. The above-mentioned recommendations of the World Health Organization encourage moving away from still prevalent medical-clinical model of disability and move towards community-based model of the development of integration, which aims to involve people with disabilities in, the assistance processes. Scientific relevance. The United Nations Convention on the Rights of Persons with Disabilities (2008) promotes, protects and ensures the full and equal enjoyment of all human rights and fundamental freedoms by all people with disabilities based on the principle of effective participation and integration in society. Therefore, the social participation of people with disabilities and their participation in processes of social services become particularly relevant. Ruškus (2002) analysed the psychosocial portrait of people with disabilities and recognised the issues related to the coordination of paradigms regarding the education and social integration of people with disabilities in the aspect of social participation. According to the author, involvement of a person with disability in society is possible only with an active interaction between the society and the person with disability. As stated by Ruškus and Mažeikis (2007), the protective approach towards disability depreciates the skills of disabled people and emphasizes their weaknesses and disorders. The authors suggested viewing the participation of people with disabilities as an opportunity for changes, active participation, new practical experience, experimentation, allowing a person to search and share resources, which provide the potential development of involvement in society. Gerulaitis (2007) analysed the peculiarities of social participation of parents who are raising a child with disability and determined that the parents are fully involved in the process of child’s education, when the interests and needs of all participants are combined, a common goal, responsibilities and resources are established, new activities are initiated and implemented by joint decision making. Ruškus, Mažeikienė, Naujanienė, Motiečienė and Dvarionas (2014) who analysed the empowering model of social services in the context of social welfare policy, determined that the recipients and providers of social services are critical of the current status of social services as the current service system does not legally provide any flexibility and the clients may only choose services that are planned in advance. Šatkauskienė (2016) examined the importance of the development of cooperation system in the process of social work intervention and determined that the involvement of the client in the assistance process is important during the whole period of social work intervention. Raipa and Petukienė (2009) emphasized the importance of ensuring the quality and efficiency of services in the general service development process. The researchers emphasised the fact that the services which require the most involvement from the client are the ones designed to change the condition or behaviour of a person. While analysing the relationship between the clients and organization in the context of involvement, Damkuvienė, Petukienė, Valuckienė, Tijūnaitienė, Balčiūnas, Bersėnaitė (2014) determined that the involvement of the client depends on the type of service and perceived benefits of participation for the client himself/herself. As stated by Beneševičiūtė (2014), social involvement of people with disabilities in the activities of non-governmental organizations depends on the social participation of an open community and a person with disability. After reviewing the works of researchers it can be stated that most of them examine the importance of the participation of a person with disability in the process of social service provision. The empowerment-oriented social participation of people with disabilities was analysed more by foreign researchers, they have been analysing this approach and applying it in a social work practice for a longer period of time than we do. The idea of social involvement of people with disabilities was presented by Ebersold (2004) in order to minimise the problems of social participation and create more possibilities for a more active involvement in society, develop potential opportunities for problem solving. Ebersold and Detraux, (2006) examine the process of social participation of people with disabilities, which distinguishes person’s empowerment and involvement in society, develops a new approach towards people with disabilities - a person is seen as a personality capable to participate fully in society. According to Sadan (2004), the idea of the empowerment of people with disabilities seeks to pave the way based on opportunities rather than difficulties, when a social worker believes in the individual’s ability to change and the benefits of his/her participation in decision-making. Lord (1991) models the possibilities of satisfying the needs of people with disabilities in the context of social services and acknowledges that the empowerment is a lifelong process, involving positive changes of a person with disability. Based on the theory of empowerment, Douglas and Zimmerman (1995) emphasize the competence and strengths of a person with disability, which allows creating an equal partnership between the worker and the client seeking for individual changes in life. Horkheimer (1995) stated that, by involving themselves in the processes of social services, people with disabilities seek for the control of their lives by changing the relationship of dominant power. Rodie and Kleine (2000) determined that the participation of the client is a deliberate and purposeful construct of behaviour, seeking for the involvement of the recipient in the service process by sharing tangible and intangible resources. The model of Lofquist (1989) describes the interaction between the specialist and the client as a partnership where the power of decision making is equal. The analysis of scientific sources allows making an assumption that the involvement of people with disabilities in the aspect of social work is not widely applied in Lithuania in comparison with Northern Europe and other countries. There is still a lack of researches which could subjectively reveal the possibilities of involvement of people with disabilities in the process of social service provision. There is also a lack of analysis regarding the importance of involvement of people with disabilities in the process of social service provision, its impact on social institutions an how the activities of social workers should be carried out by developing the empowerment of people with disabilities. In order to validate the problem of the research the following relevant questions were raised: how do people with disabilities become involved in the planning and provision of social services? What is the good practice of social work in the context of client involvement in Lithuania and Ukraine? What are the missed opportunities of the involvement of people with disabilities in the process of social service provision? Subject of the research. The involvement of people with disabilities in the process of social service provision. Aim of the research. To provide a model for the involvement of people with disabilities in the process of social service provision based on the theoretical and empirical analysis. Objectives: 1. To present theoretical-hypothetical model for the involvement in the process of social service provision based on the theoretical analysis. 2. After the qualitative research (an interview and a semi-structured survey in writing), to reveal the attributes of the involvement of people with disabilities in the process of social service in Lithuania and Ukraine. 3. To present the structure of the involvement in the process of social service provision based on the theoretical analysis. 4. Following the theoretical analysis and data of empirical research, to present the model for the involvement of clients (people with disabilities) in the process of social service provision. 5. To represent the possibilities and recommendations for the development of the involvement of people with disabilities in the social service provision based on data of the research. Participants of the research. 21 social workers, who work with adults with disabilities, participated in the research. In Lithuania. The research was carried out in Lithuanian social service institutions in the period October through December 2017. 8 social workers, who work with adults with physical, mental, psychological, sensory, complex disabilities, participated in the research. In Ukraine. The research was carried out in Kyiv on 18-22 September 2017. 13 informants, who work with adults and the elderly with physical, mental or psychological disabilities, participated in the research. The scope of the research was chosen while applying the convenient, non-probability selection method in the relevant context, i.e. only those social workers, who work with disabled people, participated in the research. Methodology and methods. The research of the Master’s Thesis is based on the theories of constructivism and empowerment. The theory of constructivism emphasizes the social aspect of disability and the possibility for a person with disability to fully participate in society. In the event of equal interaction between the participants and participation in the activities of an institution, a person with disability is seen as a person capable of coping with difficulties related to disability and revealing his/her potential. The main idea of the empowerment paradigm represents the identification of the person’s strengths and competence rather than his/her weaknesses. The empowerment-oriented social work practice gives a possibility for every person with disability to control his/her life while emphasising the fact that the empowerment is an attempt to unify the roles and powers of the participants by participating in and developing the processes of involvement together. In order to present the model for the involvement of people with disabilities in the process of social service provision, the following research methods were used: 1. Analysis of scientific literature. 2. Semi-structured written and oral survey. 3. Content analysis. RESEARCH ANALYSIS OF INVOLVEMENT OF PEOPLE WITH DISABILITIES IN PROCESSES OF SOCIAL SERVICES Theoretical concept of methodology. The prevailing form of social work practice in the contemporary society is helpful to a person while providing social services (Žalimienė, 2003) aiming the growth and satisfaction of a person. The permanent interaction between the social worker and the client allows the social worker to see the client as an equal participant of the process who gains certain strengths which help him/her to overcome difficulties and take responsibility for their lives. Such interaction in social work is based on the idea of constructivism, which emphasizes the social aspect of disability and the possibility for a person with disability to fully participate in society. The theory of constructivism is a form of the approach towards a person, which examines the formation of knowledge of the participants creating social relations through the continuous experimentation in discovering the mistakes of your own and other people (Berger, Luckmann, 1999). Constructivism-based practice focuses on relevant concerns: the need to empower the clients, the right of the clients to make independent decisions, the aim to create conditions for maintaining dignity and respect of all groups (Turner, 2011). The paradigm of constructivism during the formation of knowledge recognizes the close interaction between the participants and equal participation in the activities of service development, when a person with disability is seen as a person capable of coping with difficulties related to disability and constructing the perception of the real world based on his/her experience (Delanty, 1997). The social work in the framework of the theory of constructivism starts with the perception of the reality of the recipient of the service while interacting with others, when each person understands the social reality in a different way in relation to his/her experience (Berger, Luckmann, 1999). In the perspective of constructivism, the process of social assistance is understood as activities where people create interpretations of their experience and new situations while working together with others (Payne, 2005). According to Adams, Dominelli, Payne (2009), the constructive social work practice must empower the clients as the limitation of possibilities does not comply with the priority objective - to achieve the positive change in people’s lives. The theoretical modelling of the involvement of people with disabilities in the process of service provision and the theoretical-hypothetical model of the involvement of people with disabilities in the context of social services are based on the theory of constructivism, which treats the social worker as an advisor, while people with disabilities construct the perception of the real world themselves based on his/her experience. The operationalization (determining the empirical indicators reflecting the subject of the research) and research instrument were designed based on the indications of the theory of constructivism. The interpretation of data obtained from the research was carried out based on the main ideas of constructivism. The social workers often work with clients who are oppressed by the society, do not trust themselves when they are in a difficult life situation, but in any case seek to control their daily lives and participate in a community (Sadan, 2004). When the social workers try to help the clients discover their competence and strengths rather than their weaknesses, they participate in the empowerment process for the transition of a person from passive to active state (Zimmerman, 1995). The theorist Payne (2005) states that in accordance with the theory of empowerment the social work focuses on the participation of the recipient of services in the processes of developing services, provides an opportunity to control your life by emphasizing the client’s independent decision-making and belief in the possibility to function effectively. The empowerment of a person begins when there occurs an opportunity in a person’s life to independently establish his/her own needs and goals, take responsibility for your own actions, change your environment to a more acceptable and right one (Turner, 2011). The empowerment is understood as an individual and continuous process of personal development, during which the strengthening of self-assessment is emphasized, social skills and resources necessary for social participation are acquired, powers and abilities, with the help of which a person seeks for individual changes, are distributed (Ruškus, Mažeikis, 2007). The concept of empowerment when the client participates in the processes of service provision, emphasizes the equal partnership between the social worker and a person with disability, whose main goal is social participation (Douglas and Zimmerman, 1995). Adams (2008) understands the empowerment as a creative use of personal resources which help to reveal one's potential, achieve personal goals and be able to independently control the social life. Lord (quote Gerulaitis, 2007) described four stages of empowerment: 1) understanding, awareness (new information is provided to the clients, the social worker, while acting as a mediator, tries to provide new conditions for a person with disability); 2) communication and learning (a person who understands his needs starts seeking for social relationships with other people and in this way develops and learns new skills); 3) mobilization and action (after the above mentioned stages a person with disability is ready to act, engage himself/herself in meaningful activities, while the participation in service processes causes joy, strengthens the self-esteem and encourages him to be active); 4) contribution to joint activities (during the empowerment the client integrates new resources, newly acquired skills and knowledge). The social worker can help to go through all these stages by taking the role of a mediator or partner, when he participates in the stages of empowerment, but the results of these stages belong to the progress of the processes of growth and development of a person with disability. THE MODEL FOR THE INVOLVEMENT OF CLIENTS IN THE PROCESS OF SERVICE PROVISION After the analysis of scientific literature, the theoretical-hypothetical model for the involvement in the process of social service provision was presented (see Fig. 6, p. 39). This model defines the components of involvement and the quality criteria for social services. Parts of the mentioned model provide the system of social services, which seeks to pave the way based on opportunities rather than obstacles (Sadan, 2004). What is more, not all provided services require active participation and involvement of the client. It is important only in relation to those services where the primary service result takes place, i.e. changes in status or behaviour of the recipient of the service. Thus, the involvement of people with disabilities is necessary in order to ensure the quality of such services (Raipa and Petukienė, 2009). In accordance with the analysis of scientific literature and results obtained during the research, the model for the involvement of the client in the process of service provision was developed. The model consists of theoretical, research and new indicators. After the analysis of data obtained during the research, the final model for the involvement in the process of service provision was developed. Blue theoretical indicators were not disclosed and identified by the informants as the components used during the process of social service provision and as the principles of service provision. Therefore, it can be concluded that people with disabilities are not always able to change their own and other people’s perception of heir competence and abilities while participating in the processes of social service provision. Not all people with disabilities are aware of their responsibilities and functions, rights and duties. Although all participants of the research acknowledge that people with disabilities are involved in the process of social service provision by being able to control it, make decisions independently and choose the services they want, but the research failed to find out whether all of this leads to the continuous growth of the clients and changes which encourage the identity formation. The research results showed that a negative social attitude towards disability still prevails in both countries. Unfortunately, such attitude does not contribute to the empowerment of a person and does not help to reveal his/her strengths, thus an open community is still something to strive for. During the content analysis the red research indicators were disclosed as the components of involvement existing in the institutions providing social services and the quality criteria for social services. They were also listed in the theoretical-hypothetical model for the involvement. Therefore, the satisfaction and activeness of the client, the power to choose and control the service process, independent decision making, self-confidence, sense of recognition, satisfaction of needs, equal interaction between the worker and the client as well as exchange of resources are the components of involvement which encourage people with disabilities to become involved in the process of social services. The following quality criteria for services: rights, partnership, participation, focus towards the person and results, complexity and continuous improvement of services, were revealed during the research by the specialist providing social services, thus it can be assumed that the quality of provided services is ensured at the workplaces of the participants of the research and in this way the conditions for the involvement of the client are created. In accordance with data obtained during the research, the new component of involvement was created - the development of relationships between the clients, which motivates the clients to be an active recipient of services and become involved in the processes of service provision as during these processes people with disabilities communicate, make new friends, share their feelings and experiences. After the summary of research results it can be concluded that the Lithuanian and Ukrainian social workers, who work with disabled adults, see them as partners, when the relations between the workers and the clients are based on the partnership principle. This means that people with disabilities are involved in the process of social service provision, during which the activities of an institution are carried out together with the clients who can make decisions independently, choose and control the service process. The partnerships are based on the benefit of mutual involvement, when the recipient of services becomes an active member of society and is able (depending on his/her abilities) to be responsible for his/her own life, while the institution providing services seeks to achieve the highest possible quality of service. Parts of this involvement model are inseparable from one another as ensuring the quality of provided services leads to successful involvement of a person and availability of its components. The model for the involvement of clients in the process of service provision can be applied not only at the institutions providing social services which work with people at risk, but also at other organizations who seek to develop services which meet the needs of clients. Conclusions 4. After the theoretical analysis of the involvement of people with disabilities in the processes of social service provision, the theoretical-hypothetical model for the involvement of people with disabilities was presented in the context of social services. The model is based on the paradigms of constructivism and empowerment. The model consists of the components of involvement (partnership, satisfaction, resources, confidence, identity formation, open community, satisfaction of needs, social participation, decision making, continuous growth and changes, change of the perception of your own competence and skills, power to choose and control, sense of recognition, responsibilities and functions, rights and duties) and quality criteria for social services (leadership, personnel, rights, ethics, partnership, participation, focus towards the person, complexity, focus towards the results, continuous improvement. Parts of the theoretical-hypothetical model for the involvement are inseparable from one another as ensuring the quality of provided services leads to successful involvement of a person and availability of its components. The effective application of the model can only be possible if the individuals participating in the processes of service provision are not seen as objects for which the services are predefined, but as equal partners who are involved in the decision making, can choose and control as well as develop services meeting their needs together with the service provider. 5. After the qualitative research, the peculiarities of the involvement of people with disabilities in the process of social service provision were determined. The research results showed that people with disabilities become involved in the process of social service provision in Lithuania and Ukraine by being able to choose the type of daily activity that they want to do, having an opportunity to contribute to the continuous improvement of social services, being able to make decisions independently, participate in the development of and individual plan of social services together with the specialist and in this way have an opportunity to choose and control the service process. During the involvement in the processes of social service provision all participants are seen as capable of contributing to the achievement of the common goal, i.e. to share resources. In this way a partnership between a specialist and a client is developed. 6. While applying the method of analysing the content of data obtained during the research, the structure of the involvement of people with disabilities in the process of social service provision was revealed. The great importance in the process of social service provision is given to the social services mainly focusing on the provision of socio-cultural services and informing the clients as people with disabilities need complex social assistance and a wide range of services, which would allow the clients to shift from passive to active recipients of services. The opportunity to become involved in the desired activities becomes a significant factor in seeking social participation of people with disabilities, thus the participants of the research distinguished various types of activities, trips and events where the clients participate. The recipients of services have the possibility to choose what kind of activity they want to do, that is why the services provided in an institution are oriented towards the person and his/her involvement in the processes of social service provision. The main benefits of the involvement experienced by people with disabilities are related to the growth of self-confidence, power to choose and control the service process, increasing the power of independence and decision-making. The satisfaction of clients’ needs and self-realization are the main factors encouraging the involvement in the process of social service provision. People with disabilities have an opportunity to contribute to the continuous improvement of social services by giving their own ideas and complaints, while an institution, which empowers the client to become involved in the processes of self-assessment, in this way focuses on the results. The social workers see themselves as partners, when the power of decision making is understood as an equal right and the client can make decisions independently. The individual plan of social services is developed together with all the participants of the involvement process. 4. In accordance with the peculiarities and theoretical concepts of the involvement of people with disabilities in the process of social service provision, which were identified during the theoretical analysis and the qualitative research, the model for the involvement of people with disabilities in the process of social service provision was developed. The mentioned mode includes: • Components of involvement: change in the perception of your own competence and abilities, equal interaction between the worker and the client (partnership), satisfaction; responsibilities and functions, rights and duties; the power to choose and control the service process; the satisfaction of needs; the need for self-realization; activeness of the client; independent decision making; self-confidence; identity formation; continuous growth and changes; open community; sense of recognition; resources; development of relationships between the clients. • Quality criteria for social services: leadership, personnel, rights, ethics, equal interaction between the worker and the client (partnership); participation; focus towards the person; complexity; focus towards the results; continuous improvement. The social workers, who work with disabled adults, see them as partners, when the relations between the workers and the clients are based on the partnership principle. Parts of this model for the involvement are inseparable from one another as ensuring the quality of provided services leads to successful involvement of a person and availability of its components. The model can be applied not only at the institutions providing social services which work with people at risk, but also at other organizations who seek to develop services which meet the needs of clients. |
