The combined contribution of individual and community interventions in in explaining psychological resilience of disabled socially active participants

The first objective of the current study was to examine the differences in psychological resilience of disabled participants from two groups. One group was consisted of participants that took part in an intervention combining an individual and community interventions (hereinafter: The Combined Intervention), and the other was consisted of participants that took part only in a community intervention (hereinafter: The Community Intervention).

Other objective of the study was to examine the relationships between the participants' assessment of the effectiveness of the interventions in which they took part, and their psychological resilience. The depended variables that were examined were the psychological resilience: the sense of well-being, the psychological empowerment, the political empowerment and the sense of community coherence. In addition, we examined variables that characterize each of the interventions and their effectiveness, and used them as the independent variables. To assess the effectiveness of the individual intervention, we examined the variables: the participants’ assessment of the quality of the therapeutic alliance; and the participants’ assessment of the success of the individual intervention. To assess the effectiveness of the community intervention, we examined the variables: the degree of participation in the community project; the degree of the participant's sense of belonging to the community; and the assessment of the success of the community intervention.

The rationale underlying the current study was derived from the policy of the Ministry of Labor and Social Affairs in Israel and various theoretical models in social work, that aim to the integration of the individual and the community interventions. However, there seem to be only few programs implementing the integration between the two interventions, and fewer studies have examined it. Therefore, the current study was set out to examine the contribution of a professional intervention that integrated an individual intervention and a community intervention to explaining the diversity in the psychological resilience among disabled socially active participants. Accordingly, the study hypothesis predicted that the participants who took part in the combined intervention would show higher psychological resilience than those who took part only in the community intervention. Additionally, the hypotheses were that relationships would be found between the participants' assessment of the effectiveness of the interventions in which they took part, and their psychological resilience. Furthermore, we examined the contribution of the personal and the environmental resources (financial resources, health resources and social support resources) to explaining the diversity in the psychological resilience among the study participants.

The sample of the study was consisted of 72 socially active participants in Accessible Community Project and other community projects in various cities in the center of Israel. 37 participants took part in the combined intervention and 35 participants took part only in the community intervention. The sample was consisted of men and women with various disabilities (physical, sensory, cognitive and emotional), aged 30 and above, and was sampled based on a convenience sampling, snowball method and sample lid (focusing on population that took part in the combined intervention). The research data were collected using structured, closed questionnaires.

The findings revealed a complex picture. Between the two groups there were no significant differences found in the psychological resilience measures: the political empowerment and the sense of community coherence. However, differences were found between the two groups in the sense of well-being and the psychological empowerment. But those differences were contrary to our hypothesis, and the sense of well-being and the psychological empowerment among the participants who took part in the combined intervention were lower compared to these variables among the participants who took part only in the community intervention.

In addition, the hypotheses addressing the relationships between the psychological resilience and the participants' assessment of the effectiveness of the interventions (individual and community), were not fully confirmed. Hence, among the study participants, no relationships were found between their assessment of the quality of the therapeutic alliance with their therapist, as well as their assessment of the success of the individual intervention, and their psychological resilience. Additionally, no relationships were found between the participants’ degree of participation in the community project and their sense of well-being, psychological empowerment and political empowerment. Furthermore, no relationships were found between the degree of the participant’s sense of belonging to the community and his or her psychological and political empowerment, as well as between the participants’ assessment of the success of the community intervention and his or her sense of well-being and political empowerment.

However, significant relationships were found between the degree of the participation in the community project and the sense of community coherence; the degree of the participant's sense of belonging to the community and his or her sense of well-being and sense of community coherence; and the participant’s assessment of the success of the community intervention and his or her psychological empowerment and sense of community coherence.

Notwithstanding, strong relationships were found among the study participants between the personal resources and the psychological resilience. Hence, relationships were found between friends' support (within the social support resource) and the sense of well-being, the psychological empowerment, the political empowerment and the sense of community coherence, and between the economic resource and the health resource and the psychological empowerment.

When compared with other studies, the findings moreover indicated that people with disabilities displayed different patterns in seeking out of professional individual intervention compared to the general population. Hence, the findings indicated that the study participants that appealed to an individual intervention were young people, that received a low social support (from their friends and from their family), or young people whose health resource was poor and the support they received from their friends was low, but the support they received from their family was high.

The findings of the study were unexpected, and had been likely affected by various factors, some of which are listed in the limitations. It is possible that some of the findings were representative of the unique nature of the population - people with disabilities and others were related to the interventions, the combined intervention and the community intervention, and their implementation. Based on the findings, the main conclusion is that the combined intervention, as it was implemented in the current study, did not contribute to explaining the diversity in psychological resilience within the study sample. Furthermore, rethinking should be done regarding the methods of the intervention that are offered to people with disabilities, and following studies should reexamine the issues that were examined in the current study.

Another limitation of the current study could relate to the fact that apart from the type of the intervention, the two groups differed from each other in other characteristics that might have influenced the findings. In the future, that issue should be reexamined by a more complex research system, which would monitor and account for aforementioned differences.

The importance of the current study is in its potential contribution to an improvement of the various interventions that are offered to disabled people, by redirecting those interventions to the real needs of disabled people and thus achieving their goals. Therefore, it is recommended to invest in social networks and employment guidance, which may lead to improvement of the economic resource, as it was found that those resources were significant to explaining the diversity in the psychological resilience among the study participants. In addition, the contribution of the study is in its findings that showed relationships between the variable the sense of community coherence, and some of the variables that were examined, as well as in the establishment of its validity and reliability and of the questionnaire that was developed for its measurement.

Eventually, the importance of the study is in the identification of patterns of seeking out of support and professional individual intervention among people with disabilities. Understanding and identifying the nature of those patterns, might be crucial for accommodating the services that are provided to people with disabilities and their needs (Gross, Baum and Oved-Or, 2009). Moreover, identification of those patterns might allow us to identify the factors that inhibit or prevent the use of those services by disabled people, and deal with them (Yeatts, Crew & Folts 1992).