Mental health clinicians do not consistently use evidence-based assessment (EBA), a critical component of accurate case conceptualization and treatment planning. The present study used the Unified Theory of Behavior to examine determinants of intentions to use EBA in clinical practice among a sample of Masters' level social work trainees (N = 241). Social norms had the largest effect on intentions to use EBA. Injunctive norms in reference to respected colleagues accounted for the most variance in EBA intentions. Findings differed for respondents over 29 years of age vs. younger respondents. Implications for implementation strategies and further research are discussed.
Neurodiversity advocates apply the same kind of critiques to psychiatric conditions such as autism that disability theory has long applied to somatic conditions. Yet these critiques have received little attention from philosophy of psychiatry. Although the arguments of neurodiversity advocates often are undeveloped, they raise critical issues about psychiatric diagnosis and classification. This chapter uses Jerome Wakefield’s “harmful dysfunction analysis” of the concept of mental disorder to reconstruct and evaluate neurodiversity arguments that autism is a normal variation, not a mental disorder. We argue that because of the heterogeneity of “autism,” these arguments are more plausible for some subgroups than others. We find support for a moderate neurodiversity position that objects to psychiatric overreach without denying the reality of some forms of autistic disorder.
The history of intellectual and developmental disabilities (IDD) in the United States is, in many ways, a triumphant story reflecting an increasingly progressive attitude acknowledging the equality of all persons. The law now recognizes people with IDD as citizens, possessing an equal right to education, health care, and employment-each of which represents milestone victories. However, this progression was not a linear development but rather a product of periods of growth and decline, backsliding, and hard-won battles across political, cultural, and legal domains. This article explores the vacillating historical trajectory for people with IDD in the United States from the colonial period to the present. Particular attention is paid to the conceptual understanding of disability itself across time periods as that which informs particular developments in treatment, law, and social status. The capabilities approach, as outlined by Martha Nussbaum, is then brought to bear as a heuristic framework, consonant with current developments in disability studies, and which may guide future social and legislative action.
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