Israeli Social Workers' Recommendations on Guardianship and Supported Decision-Making: Examination of Client and Social Worker Factors

We examined social workers' recommendations regarding the possible appointment of a guardian, a supported decision maker (SDM), or neither for persons with disabilities. Social workers (N = 328) were presented with four vignettes that contained factors potentially relevant to guardianship and SDM judgments. They expressed higher support of SDM and maintaining the status quo (without a guardian or SDM) and lower support for guardianship. Social workers were more likely to recommend guardianship when the person depicted in the vignette was labeled as having an intellectual disability, needed support in decision-making, lacked familial support, and agreed to guardianship. They were more inclined to support the status quo for individuals with mental illness, when there was little need for decision-making support, when the family was supportive, and when the individual refused guardianship. Social workers who had not heard of the SDM reform, and those with positive attitudes toward guardianship, supported guardianship. Findings are discussed in light of the status and functional approaches to guardianship and the relational notion of autonomy. As part of the SDM reform, decision-making capacity should not be assessed based on diagnosis or on independent decision-making, but rather on the ability to make decisions when receiving appropriate support. Public Policy Relevance Statement Supported decision-making aims to enable persons with disabilities to make choices with support from others. Social workers, who have an integral role in judgments regarding supported decision-making, should be provided with training in relational autonomy and guidelines on how to make such decisions.