Handbook on Quality of Life for Human Service Practitioners. Robert Schalock and Miguel Angel Verdugo Alonso. Washington, DC: American Association on Mental Retardation, 2002.
If you have any interest in the topic of quality of life (QOL) for individuals in human services, whether it be on an individual level, a programmatic assessment, research or measurement, or policy that reflects QOL for individuals with special circumstance, then Schalock and Alonso have done you a tremendous favor. They have amassed a huge review of the literature on QOL and thoughtfully categorized it into segments that will be helpful to both the seasoned researcher and program director, as well as to new students or professionals in the field.
The authors utilize an ecological analysis (micro-, meso-, and macro-systems reviews) of six areas of human service (Regular and Special Education, Physical Health, Mental and Behavioral Health, Mental Retardation and Intellectual Disability, Aging, and Families) integrating research, measurement, and application to each of those areas. The editors hope to “Provide the reader with a clear understanding of the concept of QOL . . . and. . . outline a model to guide . . . practitioners in QOL assessment, application and evaluation” (p. 1). They do.
As a guide to the book, Schalock and Alonso provide a heuristic model of QOL measurement, application, and evaluation, which helps to orient the readers to the information provided in the integration of research chapters on each of the six focus areas. In chapters 3 through 8, each of the focus areas is broken down into eight domains (Physical Well-Being, Emotional Well-Being, Interpersonal Relations, Social Inclusion, Personal Development, Material Well-Being, Self-Determination, and Rights), which are in turn divided into indicators. A table is constructed for each of the areas showing the research conducted in the eight domains that are also subdivided into the domain's indicators. These six focal areas are represented on 36 pages of charts clearly indicating where research has been conducted, in which domain, and for what indicators. The domains are arranged hierarchically for each area according to the relative volume of research conducted in that domain. In addition, those references are highlighted as conceptual or in plain font as applied research. It is a remarkable review of the literature, valuable in its own right, let alone the overlay of the authors' conceptual analysis of that literature. The literature is drawn from across the globe and is presented in 123 pages of references, both tied to these areas of interest as well as provided at the end of the book.
For those readers who may be particularly interested in measurement techniques currently used in QOL research for programmatic or evaluation purposes, the authors also offer charts that pinpoint the domain and techniques used in what I counted as 353 referenced studies, presented on 24 pages of charts and followed by 33 pages of references. The attempt is not to evaluate each of the methodologies, but to point the readers to their origin for further study and analysis. Schalock and Alonso go on to present five core principles of measurement that emphasize methodological pluralism, which they define as combining the use of personal appraisal, functional assessment, and social indicators. These principles take into account the social scientists' demand for scientific rigor as well as the self-advocates' demand for the individual or subjective appraisal of one's personal quality of life. There is room for both the participatory action research model along side the detached scientific assessment.
What helps to carry this book further is the authors' continued look at linking QOL research and measurement to an agenda for social change and public policy. As someone who has broad interest in the sociological study of disability and cross cultural perceptions of individuals who may be perceived as different, I was also pleased to see a strong recognition of the cross cultural components of their conceptual orientation. Schalock and Alonso's model allows for individual variations of perception and includes measurement and application of the ideas from many vantage points, while still demanding rigor and consistency in implementation.
If you have followed the QOL literature to any degree over the past decade or so, you will be familiar with and comfortable with much of the material. The Handbook, however, moves beyond the usual discussion of the conceptual and measurement issues and addresses many broader social concerns as well. Is QOL to be used mostly as a sensitizing social construct, or can it be used as a policy instrument to evaluate legislation? How do these ideas relate to the societal or global quest to enhance the lives of individuals with disabilities? References to such documents as the United Nations Standard Rules in the Equalization of Opportunities for Persons With Disabilities (United Nations, 1993) tie QOL studies into those concerns. The authors reflect upon these broader issues and challenge us, the readers, to do so as well. Undeveloped areas of research in educational settings and in the realm of rights for individuals with special circumstance is also pointed out and pondered.
For me, this Handbook represents a review of the state of the science and the state of the art on quality of life research. It is both remarkably comprehensive of the research that has been achieved and yet humbly deferential to the work that still needs to be done. Their reminder that the guiding conceptual principle of QOL “is composed of those same factors and relationships for people with special needs that are important to everyone” and their core application principle that the “QOL application should enhance a person's well-being” are key elements of their model that allows one to take their model beyond human services into a broader policy and ethical realm. In many ways the authors provide a meta-analysis of the thousands of articles offered in the literature on QOL. Their conceptual model drives their analysis and provides readers with an exceptional overview. My only qualm with the book resides with the use of the term handbook in the title. This is not a book where a program director would look to copy charts or to emulate a specific QOL assessment protocol; it is not a recipe book on how to do a QOL assessment. Rather, this book provides researchers or program practitioners with the resources to decide what kinds of things they should assess and where to look at other tools or instruments to do so.
This is a book well worth the investment. It will serve as both a practical guide and reference book for a long time to come.