The factors that affect professionals' social workers' identification and reporting intentions in cases of violence perpetrated against persons with disabilities

The research examined factors predicting the intention of social workers, who are engaged in treating persons with disabilities, to identify violence committed against persons with disabilities and report it to the relevant authorities. This examination renders the research unique and novel.

As opposed to other victims of violence who are not disabled, such as women and children, persons with physical, sensory, cognitive and mental disabilities are at high risk of experiencing different kinds of exploitation and violence at the hand of family members, acquaintances and strangers.  According to the professional literature, the estimated magnitude of violence against persons with disabilities is four to ten times higher than against individuals who are not disabled. Furthermore, fewer perpetrators of violence against persons with disabilities are prosecuted compared to perpetrators of crimes committed against non-disabled people (Shachar, 2004; Bryen, 2002; Bryen, Carey & Frantz, 2003 in Fitzsimons, 2009).

Despite the prevalence of the phenomenon, and notwithstanding the variance in the scope of identification between persons with different types of disabilities, the number of victims who are identified and reported, both in Israel and abroad, is very low (Marom & Uziel, 2001; Verdugo & Bermejo, 1997; Mansell & Sobsey, 2001).

Unlike family violence (against children, women and the elderly), violence against persons with disabilities has received marginal public, academic and therapeutic attention (Sebald, 2008; Calderbank, 2000; Gafni, 2002; Marom & Uziel, 2001).  Most research studies pertaining to persons with disabilities were conducted in the 1990s and the early part of the current millennium, and nearly all dealt with children rather than adults (Argaman, 2003; Arazi, 2003, Shachar, 2004; Sobsey, Randall & Parrila, 1997; Verdugo & Bermejo, 1995).  Furthermore, the majority of the studies examined the rates of violence against persons with disabilities compared to comparable groups without disabilities (Fitzsimons, Hagemeister & Braun, 2011).  No research studies were conducted that attempted to investigate the factors and causes underlying the abuse and how professionals deal with the problem (Gafni, 2002).  The latter can be attributed, among other things, to methodological and applied difficulties associated with gathering data about violence against persons with disabilities such as: an absence of uniform definitions regarding the phenomenon of violence, a shortage of accessible research tools for collecting data from and about the population in question, and a lack of professional personnel who have therapeutic expertise in this field (Gafni, 2002; Sebald, 2008; Russell, 2006; Rose, 2003). The research studies that were conducted found a disparity between the incidence of abuse against persons with disabilities and the actual identification and reporting of the cases.  The studies also suggest that many professionals typically do not identify victims of violence, or do not report them to the authorities even when they are identified (Vilner, 2006; Fitzsimons, Hagemeister & Braun, 2011; Goebbels, Nicholson, Walsh & Vries, 2008).

The research model is based on the Theory of Planned Behavior formulated by Ajzen & Madden (1986).  According to this theory, human behavior is guided by three considerations: attitudes and beliefs (related to the attributes of the case), subjective norms (organizational contexts), and perceived behavioral control (the decision-maker's traits). Based on this theory, the research examined the factors characterizing the decision-maker (the professional), the organizational context, and the attributes of the case which are related to professionals' intentions to identify and report violence against persons with disabilities. The identification intention refers to a professional's intention to identify suspected abuse of a disabled person.  The reporting intention refers to a professional's intention, after identifying the suspected abuse or after suspected abuse of a disabled person has been brought to his attention, to report it as mandated by law to the authorities.

 

A number of questions formed the foundation of the research:

1. Do differences exist between the barriers and factors associated with the identification intention and those which are associated with the reporting intention?

2. Does a correlation exist between a social worker's personal and professional traits and his identification and reporting intentions?

3. Does a correlation exist between identification and reporting intentions and the three considerations that guide human behavior according to the Theory of Planned Behavior: attitudes and beliefs (related to the attributes of the case), subjective norms (the organizational context), and perceived behavioral control (the decision-maker's traits)?

4. Are variables of the type of abuse (physical, emotional or neglect) and the type of disability (physical, intellectual or mental) also related to the social workers' identification and reporting intentions?

The following ten hypotheses were tested in this research:

1. The worker's personal and professional traits will predict the considerations that guide his behavior when it comes to identifying and reporting persons with   disabilities who are victims of violence.

1. A worker's personal and professional traits will predict his general attitudes towards violence and towards victims who are disabled.
2. A worker's personal and professional traits will predict his subjective norms regarding organizational commitment and the allocation of organizational resources.
3. A worker's personal and professional traits will predict his perceived behavioral control.

1. A correlation will be found between the social workers' professional traits – e.g.             position, seniority, frequency of contact with persons with disabilities – and the        intention to identify persons with disabilities who are victims of violence and the      intention to report the harm done to them.
2. The type of organization the social workers are employed in will predict their intention to identify persons with disabilities who are victims of violence and   their intention to report it.
3. A positive correlation will be found between the social workers' attitudes towards violence and towards victims who are disabled and their identification and reporting  intentions (more favorable attitudes towards persons with disabilities will be correlated to the worker's increased identification and reporting intentions).
4. A positive correlation will be found between the workers' subjective norms         (organizational context) and their identification and reporting intentions       (subjective       norms perceived as being more favorable towards persons with disabilities will be      correlated to the workers' increased identification and reporting intentions).
5. A positive correlation will be found between the social workers' perceived behavioral     control as regards violence towards persons with disabilities and their identification and reporting intentions (more favorable perceived behavioral control by a worker     of  his knowledge and ability to make the right decisions will be correlated to increased identification and reporting intentions).
6.  A positive correlation will be found between the social workers' identification    intentions and their reporting intentions.
7. Variance will be found in the rate and type of reporting relative to the type of     disability the victim has, regardless of the type of abuse he was subjected to, and       variance will be found in the rate and type of reporting relative to the type of abuse.
8. The rate of identifying physical abuse with a great degree of certainty will be higher       than the rate of       identifying neglect or emotional abuse with a great degree of certainty, regardless of the type of disability the victim has.
9. The type of abuse and type of disability will explain the intention to identify and            report cases involving persons with disabilities who are victims of violence.

 

The Methodology

To answer the research questions and test the hypotheses, a special tool comprised of the following questionnaires was designed:

1. A demographics questionnaire including the respondents' personal traits (gender,           country of birth, seniority, education) as well as professional traits (position in the    organization, the target population, contact with persons with disabilities, and the   frequency of that contact).
2. A questionnaire dealing with identification and reporting barriers/catalysts, designed in accordance with the Theory of Planned Behavior (Ajzen, 1991; Ajzen, 2002). The questionnaire relied on an analysis of information gathered from two focus groups of professionals conducted in the course of exploratory research, in addition to a           preliminary questionnaire (pre-test) that was distributed to and completed by 60       professionals. The design and formulation of the questionnaire were carried out as a preliminary stage of the proposed research (Morali Sagiv, 2007). The questionnaire includes the following components: [1] Knowledge – consisting of two subcomponents - (a) the receipt of training regarding family violence and training related to abuse against persons with disabilities; (b) experience in identifying, reporting and treating violence against persons with disabilities (the number of experiences the respondent had; [2] Attitudes – a questionnaire that examined attitudes towards victims  who are disabled and general attitudes pertaining to violence; [3] Organizational support - a questionnaire that examined how workers perceive their organization's support and its attitudes towards the treatment of violence and the resources allocated to it; [4] Perceived behavioral       control - a  questionnaire that examined the social workers' self-efficacy and their perceived control when it comes to identifying and reporting victims of violence.
3. Case descriptions – nine case descriptions were designed to test the research       hypotheses, which examined whether a correlation exists between the type of abuse and type of disability and identification and reporting intentions. The case  descriptions referred to three types of abuse (physical, emotional and neglect) and to three types of disabilities (physical, mental and intellectual).

 

278 social workers, who are employed in the public sector (social services departments and the National Insurance Institute), in various private sector services and in the nonprofit sector throughout Israel, and who are in regular contact with persons with disabilities, took part in the research. The research sample was taken from the list of social workers who are registered in the "Homesh" Association (the Rehabilitation Division of the Social Workers Union) and from the list of rehabilitation workers employed in social services departments through the Ministry of Social Affairs and Social Services.  The sample was designed on a quota basis, and 50% of it was comprised of workers employed by the government in social services departments and the National Insurance Institute, whereas the other 50% was comprised of workers employed in organizations and services run by the nonprofit sector and private sector (e.g. leisure, employment, and housing-related frameworks) nationwide.

 

Findings:

A number of factors correlated to the social workers' intentions to identify and report disabled victims of violence were found.  The three considerations guiding human behavior  that were incorporated in the research model – (a) general attitudes towards acts of identifying and reporting violence and attitudes towards disabled persons who are victims of violence, (b) subjective norms that include organizational commitment and support for identification and reporting as well as allocation of organizational resources, and (c) perceived behavioral control which includes the level of knowledge and training needed to address abuse against persons with disabilities and its characteristics, and the ability to make decisions regarding the treatment of violence victims who are disabled – were found to be correlated to identification and reporting intentions.

Attitudes towards the type of disability explained the correlations between the considerations guiding human behavior and the identification and reporting intentions, whereas attitudes pertaining to stereotypic perceptions of the type of disability, with an emphasis on mental disability, explained only the identification intention.  Subjective norms relating to the existing degree of personal and organizational commitment to treat people with a specific disability, explained the correlations to identification and reporting intentions, whereas subjective norms relating to work load and job descriptions explained just the reporting intention correlations.  Perceived behavioral control as regards the level of knowledge required to treat abuse against persons with different types of disabilities explained the correlations to the identification intentions, whereas perceived behavioral control relating to the complexity of the situation and the existence of ethical dilemmas explained the correlations to reporting intentions.

A correlation was also found between the type of disability the victim has and the type of abuse and the workers' identification and reporting intentions.  The highest identification intentions were found in the case intellectually challenged persons, average identification intentions were found in the case of physically disabled persons, and the lowest identification intentions were found in the case of mentally disabled persons.  Similar findings were obtained with regard to reporting intentions.  As for the type of abuse, the highest identification intentions were found in the case of physical abuse, followed by neglect, and the lowest identification intentions were found in the case of emotional abuse.  With regard to reporting intentions, the highest reporting intentions were found in the case of physical abuse and neglect, and the lowest reporting intentions were found in the case of emotional abuse.

Furthermore, it was found that, overall, reporting intentions were higher than identification intentions.

The social workers' personal and professional traits were not found to explain their identification and reporting intentions.

Additionally, the research findings suggest variance in the social workers' detection of the type of abuse.  The workers identified abuse of the neglect type with a high degree of certainty, but not physical abuse, especially among the intellectually challenged.  The professionals also found it difficult to make a distinct detection of emotional abuse and ascribed it to abuse of the neglect type.  Variance was also found in the rates of reporting different types of disabilities and abuse by social workers.  Reporting rates for all types of abuse, in general, and rates of mandated reporting, in particular, were the highest in those cases involving intellectually challenged victims. Reporting rates in cases not considered mandatory, or non-reporting rates in general, were the highest when victims with a mental disability were involved.

 

Research Limitations and Contribution

The research has a number of limitations related to the research model, the sample and the research tools, which stem from the fact that it is a groundbreaking, first of its kind study. Furthermore, due to the absence of existing research tools, a special tool was designed for the present research which relied on a preliminary qualitative study.

 

Alongside its limitations, the research contains a theoretical and applied contribution. In the theoretical sphere, the research has led to increased theoretical knowledge pertaining to violence against persons with disabilities. It has done so by examining, for the first time, behavioral intentions associated with abuse against disabled persons, while attempting to trace the relative contribution made by each factor to predicting behavioral intentions.  The research did not make due with a general investigation of persons with disabilities, but rather examined the problem, for the first time, in relation to three categories of disabilities (physical, mental and intellectual,) and three categories of abuse (physical, emotional and neglect).  The research has added knowledge that is likely to facilitate understanding of the barriers that hinder professionals from identifying and reporting different types of abuse against persons with disabilities, and offers recommendations for continued research in this area.  The research has also provided confirmation that the Theory of Planned Behavior can be used to explain identification and reporting intentions regarding persons with disabilities.  The research therefore adds to the developing body of knowledge concerning ways to deal with abuse against persons with disabilities, a subject which is still in its infancy.  In the applied sphere, the research findings can make a significant contribution to the following areas: planning and formulation of pertinent policies, design of programs and services for treating disabled victims of violence, provision of suitable training to workers, heightening public awareness of the issue, and encouraging the authorities to develop knowledge and new modes of intervention.