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为智力和发育障碍者提供的创伤知情护理:从差异到有效行动的政策

Trauma-Informed Care for Individuals with Intellectual and Developmental Disabilities: From Disparity to Policies for Effective Action.

作者信息

Houck Elizabeth J, Dracobly Joseph D

机构信息

University of North Texas, 1155 Union Circle, Box 310919, Denton, TX 76201 USA.

出版信息

Perspect Behav Sci. 2022 Sep 28;46(1):67-87. doi: 10.1007/s40614-022-00359-6. eCollection 2023 Mar.

Abstract

People with intellectual disabilities (ID) are an often overlooked minority population. They experience significant health disparities and a high risk of exposure to traumatic events that can lead to stress-related disorders. Access to effective treatments for stress-related disorders is limited for people with ID due to a lack of appropriate assessments and common communication deficits. We discuss and analyze four factors that have led to these disparities: (1) historical segregation; (2) society's response to identification of trauma in vulnerable populations; (3) lack of accessible assessments and treatments for stress disorders in people with ID; and (4) communication deficits common in people with ID. Based on this analysis, we suggest behavior analysts advocate for policy development that would (1) increase acknowledgement of trauma in people with ID and mandate sharing of information about trauma across providers; (2) require observable and measurable goals be included in the assessment and treatment of trauma-related behavior change; and (3) increase funding for services and research in this area.

摘要

智力残疾者是一个常被忽视的少数群体。他们面临显著的健康差距,且遭受创伤性事件的风险很高,这些事件可能导致与压力相关的障碍。由于缺乏适当的评估和常见的沟通障碍,智力残疾者获得与压力相关障碍的有效治疗的机会有限。我们讨论并分析了导致这些差距的四个因素:(1)历史隔离;(2)社会对弱势群体创伤识别的反应;(3)智力残疾者缺乏可及的压力障碍评估和治疗;(4)智力残疾者中常见的沟通障碍。基于此分析,我们建议行为分析师倡导政策制定,这将(1)增加对智力残疾者创伤的认知,并要求各服务提供者之间共享有关创伤的信息;(2)要求在与创伤相关的行为改变评估和治疗中纳入可观察和可测量的目标;(3)增加该领域服务和研究的资金投入。

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本文引用的文献

1
Toward trauma-informed applications of behavior analysis.迈向行为分析的创伤知情应用。
J Appl Behav Anal. 2022 Feb;55(1):40-61. doi: 10.1002/jaba.881. Epub 2021 Sep 15.
10
Persons with disabilities as an unrecognized health disparity population.残疾人作为一个未被认识到的健康差异人群。
Am J Public Health. 2015 Apr;105 Suppl 2(Suppl 2):S198-206. doi: 10.2105/AJPH.2014.302182. Epub 2015 Feb 17.

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