Academic journal article The Journal of Rehabilitation

Gang Affiliation and Disability: An Initial Investigation into Rehabilitation Counseling Implications

Academic journal article The Journal of Rehabilitation

Gang Affiliation and Disability: An Initial Investigation into Rehabilitation Counseling Implications

Article excerpt

Historically, throughout the 1980's and 1990's, nonfatal interpersonal violence accounted for a large percentage of spinal cord injuries in the United States (Ostrander, 2008; Nussabaum, 2004). Since 1990, violence has accounted for 24% of all new spinal cord injuries (National Spinal Cord Injury Statistical Center, 2003). This led to the development of a new disability category referred to as violently-acquired spinal cord injuries (VASCI) (Dijkers, 1999, Annest et al., 1995, Nussbaum 2004; Ostrander, 2008). Many of those who sustain VASCI are from Hispanic, African American, or other minority backgrounds; lower socioeconomic strata; and have a history of previous gang-involvement (Ostrander, 2008).

According to Ursano et al. (2004), populations exposed to continued amounts of gang violence may acquire acute stress disorder (ASD). In the last 20 years, this disorder has arisen rapidly in literature concerning posttraumatic stress disorder. Hamrin (1998) was one of the first to characterize persons experiencing this disorder as having episodic disassociation, flashback anxiety, reoccurring symptoms, sadness, and arousal. Flashback anxiety, as well as, sadness were among the most frequently described (Hamrin, 1998). More recently, Hamrin (2004) reported that subjects who are hospitalized for injuries acquired from gunshots were more likely to show symptoms of ASD than those who are hospitalized for medical reasons. Furthermore, the study reported that 40% of those who acquired injuries from gunshots were involved in gang activity (Hamrin, 2004). Ostrander (2008) points out that individuals who acquire an injury or disabling condition often tend to struggle with how their new condition will ultimately affect view of self in the aftermath of injury. Hence, there is no reason to think that persons involved in gang activity who sustain a gang related injury would be immune to effects of changing views of self after injury. The unplanned disruption threatens their established identity (Ostrander, 2008). As a result of a fragmented self-identity, Gill (1997) argued that individuals are susceptible to a host of mental illnesses, including depression and anxiety.

From previous literature, we have learned that populations involved in gang activity are typically associated with delinquency, violence, drug dependence, conduct disorder, legal problems, and victimization (Bryant & Harvey, 2000; Hamrin, 2004; Flamrin, 1998). However, much less research has been devoted to individuals living in neighborhoods with high rates of gang involvement who were not killed, but instead shot, stabbed, assaulted, impaired, and seriously disabled as a result of violence (Cook & Ludwig, 2000). These co-occurring issues coupled with the effects of ASD or VASCI may leave many gang involved populations vulnerable and in need of rehabilitation counseling services. Other than the previously mentioned disability categories in which gang involved populations may be found, there is limited knowledge about the state of those who acquire a disability after having participated in gang activity. As with other diverse populations that are regularly researched (e.g., LGBTQI, African Americans, Hispanics, Native Americans), rehabilitation counselors should be aware and have an understanding of gang culture and the worldviews of this population. However, literature has showcased to a large degree the disparities that exist in rehabilitation service delivery to the gang culture population.

Underutilization of Rehabilitation Services Access to Services

In general, the literature that is available regarding service underutilization points to the client as a cause. For example, clients may have help-seeking behaviors that are overly dependent (Chia & Kee, 2013; Gignac, Cott, & Badley, 2000); mistrust of other cultures (Burris, 2012; Lukyanova, Balcazar, Oberoi, & Suarez-Balcazar, 2014; Smart & Smart, 1992), and may rely heavily upon informal support networks (Harris, Renko, & Caldwell, 2013; Young, et al. …

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