Social Work Practice Across Disability

Juliet Rothman

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781138037182
• eBook ISBN: 9781351712156
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This book will help prepare the reader to work across disabilities by providing knowledge and training grounded within the ecological framework in four principal areas. The four principal areas reader will be trained in are: the societal environment and disability; disability and the individual experience; essential skills for social work micro, mezzo, and macro practice with people with disabilities; and the resource and support network for persons with disabilities. The book is organized around four units, each of which addresses one of the areas noted. It is not the purpose of this book to enable the reader to gain expertise in any one disabling condition or impairment. Rather, the goal is to provide a broad base of knowledge and skills, which will enable the reader to work effectively across a variety of disabling conditions. Special educators, social workers,parents

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PART I

THE SOCIETAL FRAMEWORK

In Part I, we will be focusing on understanding disability through the societal framework. We know that the relationship between individuals and the society in which they live is complex and multifaceted. Societies influence the way in which individuals perceive themselves, their worldview, their values and goals, their expectations of themselves and others, social and group affiliations, and almost every other aspect of life. Individuals influence society as well, for society is an aggregate of individuals. Individuals create, sustain, and shape society, and society is thought to be the expression of the group values, ideals, aspirations, and worldview of its members.

In an ideal world, the “fit” between individuals and society is perfect, and each is a reflection of the other. In the real world, diverse and complex societal values, beliefs, goals, expectations, customs, and aspirations rarely, if ever, completely “match” those of individual members. For all of us, there are always certain areas where our interests and those of society are not the same. The person-in-environment framework that social workers use to describe and understand people considers this reciprocal relationship and attempts to optimize the “fit” between each member of society and the society as a whole.

In general, “society” tends to best represent those people who are members of the dominant and powerful groups within it. Conversely, it least represents those whose voices are rarely heard and still more rarely accepted. Members of groups that are subordinate and undervalued, oppressed, and without power in our society tend to have difficulties with the “fit” between themselves as individuals and as a group and the wider society in which they live.

For centuries, people with disabilities have been unseen members of our society. Their voices were rarely heard and, hidden in attics and basements, sequestered in large impersonal institutions, deprived of opportunities to participate meaningfully in society, people with disabilities were viewed sometimes with fear, at other times with pity or disdain. Only beginning in the twentieth century, through the Disability Rights movement and the legislation it has produced, have the voices of people with disabilities been heard. And what they are saying asks each of us to think about our conceptions and definitions of disability, and the role society plays in both creating potential difficulties for people with disabilities and in resolving them.

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Disability and society have a long mutual history: there were people with disabilities before there were any written records. Archeological exploration has unearthed skeletons and other evidence of people with disabilities, and it is thought that disability was not uncommon in prehistoric times.

Because of the complexity of the interaction between society and a person with a disability, some of the chapter divisions used here will seem quite arbitrary. They have been created to provide a structure and a continuity for readers, and to enable each chapter to build upon the one that precedes it. Chapter 1 will assist us in exploring some of the theoretical frameworks that, from antiquity to this new millennium, have informed the way in which people think about disability. Because we live in a Western society, much of the theoretical concepts that affect the way in which we think about disability are drawn from a European–American perspective. This does not mean that, in other societies and in other times, other views might not have prevailed, but only that in this time and in this society, the views included here appear to have had the strongest influence. The organization of the chapter provides some chronological order: many of the theoretical constructs followed one upon another, although none have disappeared, and each still influences the way in which our society thinks about disability.

Chapter 2 focuses on the history of disability in the United States, and provides a grounding upon which the material presented in Chapter 3, which explores the Disability Rights movement, and Chapter 4, which addresses legislation and the Americans with Disabilities Act (ADA), can be superimposed.

Chapter 5 provides information on current disability demographics: numbers of people with disabilities, their employment, income, race, gender, age, and other parameters, drawn from the U.S. Census and from other studies of disability in the United States. It will be clear from the studies included here that the Census Bureau tends to study disability in terms of functional impairments—that is, the ability to perform the activities of daily living and the instrumental activities of daily living, rather than by the medical categories that, as we shall see later, are often used to determine eligibility for programs.

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1

THEORETICAL FRAMEWORKS

What creates disabling conditions in people? How can responsibilities for people with disabling conditions be met? Who should be meeting them? To answer these and other foundational questions about disability, it is important to understand the theoretical concepts we use for thinking about disability. Disability models, or constructs, can assist us by providing a framework, a possible cause-and-effect perspective, and possible parameters for responsibility. In this chapter, we will explore the principal models for thinking about disability that have been used in Western civilization.

Disability models can be divided into two broad categories: individual and societal. The individual models have traditionally conceptualized disability as a problem of the person who is disabled, and have as their underlying assumption that people with disabilities have something wrong with them individually, something that has been caused by forces outside of society. Therefore, causation, blame, and responsibility rest exclusively with the individual. Most of the older models for thinking about disability use this individual context for discussion. Individual models have provided a framework for thought throughout most of recorded history. In today’s world, in spite of newer models that provide alternative ways of thinking, both people who are disabled and people who are not disabled often use the individual models to think about problems, causes, and responsibilities. Whenever someone says, “What did I do to deserve this?” or “Why did this have to happen to me?” he or she is using an individual model to frame the thought process.

The societal models view disability in the context of the surrounding milieu, which is composed of many different kinds of things, including the natural environment, the built environment, societal values, societal institutions, and people, social groups, public images, as well as the disability culture. Rather than viewing disability as a problem of the individual, societal models view people with disabilities as a group who are treated differently in terms of their value and the considerations given to them as individuals. Societal models of disability are primarily twentieth-century phenomena, and are grounded in the concept that it is not the individual who is disabled; rather, it is the society itself that “creates” the disability. Variations among people occur naturally with our humanity, social models say, but they become a problem, a “disability,” because of the way society has structured itself.

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The shift from individual to societal models is reflected in recent laws and policies, such as the Americans with Disabilities Act and the Individuals with Disabilities Education Act. However, the impact of the individual models, so long dominant, persist within both ourselves and the social milieu. Many of us, whether we consider ourselves “disabled” or not, have been exposed to the individual model in both public and private settings. We may have created an uneasy alliance of individual and societal models within ourselves. Because the societal models are more acceptable in today’s world, we often speak in terms of these constructs. But we often think in terms of the individual models. As social workers, it is especially important for us to be aware of this potential duality within ourselves.

Contained within these two broad categories—the individual and the societal—are the complex and entangled strands of two others: the religious/spiritual and the scientific. As we explore the frameworks, we may be able to see the way in which these ideas of causation and responsibility, value, and purpose form a part of each model. In addition, two new and evolving models have broadened choices further, and given us additional frameworks to consider. Although one model is “individual” and the other “social,” they differ from preceding theories extensively, and do not seem to fit comfortably under the traditional groupings. They are presented together as “21st Century Disability Models.”

Individual Models

Locating the problems of disability within the individual implies the existence of an inherent fault or responsibility somewhere in the person. In early times, in Western civilizations, it was thought that sin caused God’s displeasure, and punishment came in the form of a disability. Later, a more secular view regarded people with disabilities as flawed and in need of repair. They were imperfect in some way, and, for the general societal good, should be changed; if change was not possible, isolation, denial of civil rights, and ultimately extermination were considered as alternatives. It was felt that the presence of disability prevented the perfectability of the human race, a perfectability that was inherent in humanness. For, after all, wasn’t God perfect, and wasn’t man made in God’s image?

Separation of Physical and Mental: The Earliest Models

Early Neolithic tribes considered persons with disabilities to be shamans. Evidence of osteoarthritis, and tubercular spine and dental malformations have been found in mummies, giving proof of deformities and disabilities in early societies (Albrecht, 1992, p.37). During the Classical period, the idea of disability as something evil, or inferior, provided a grounding for a range of behaviors. Perhaps the most severe of these was that practiced in the ancient Greek city-state of Sparta. With its strong cultural emphasis on the body, strength, and physical fitness, Spartans commonly left helpless people with disabilities, often newborns, the very young, and the very old, to die alone of exposure and hunger. Athenians, too, abandoned or isolated people with disabilities, viewing them as inferior members of society, not entitled to the privilege of citizenship, nor to the society of others (Albrecht, 1992, p.37). It is interesting to note that this treatment was aimed primarily at people with physical disabilities. Because Greek religious beliefs especially valued seers and prophets as people who were possessed of spirits and given special powers, people with mental disabilities were sometimes considered sacred, and used for interpreting signs, foretelling events, and reading omens.

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Classical Rome was not as absolute in its abandonment of people with disabilities, but expected that those who required assistance be complacent and accepting of the needs and desires of those who provided it as a form of thanks. Reciprocity demanded that something had to be given by both parties in exchange: care for money, care for acquiescence, care for complacency. The Romans also viewed disability and chronic illness as something in need of treatment, and both exercise and hydrotherapy were used for healing (Albrecht, 1992, p.37). The famous baths, such as those of Caracalla in Rome, and of Bath in England, were not for cleanliness alone: the hot baths relieved conditions from arthritis to nerves, and the massages that often accompanied them soothed and relaxed body and mind. This seems to support a more scientific understanding of illness and disability in Roman society.

The Moral Model

Within the context of Western civilization, the moral model is generally drawn from the religions that have influenced Western moral thought through the ages. Two dominant strands, existing side by side and simultaneously, have influenced much of our thinking today: disability as a punishment for wrongdoing or sin, and disability as creating an obligation in others to provide care, support, and assistance.

Disability as Punishment for Sin or Wrongdoing

In the Judeo-Christian tradition, ancient Judaism recognized in God the source of health, but also of all illnesses, including disabilities. Because illness and disability came from God as Creator, they could be viewed only in terms of a punishment for sins (Castiglioni, 1941, p.65). Diseases of all kinds came from God as a punishment, but also as a way of educating the people about the powers of the Almighty, who was able to cause diseases and also to cure them, such as leprosy (Exodus 4:6) and Job’s malignant ulcers (Job 2:7) (Castiglioni, 1941, p.66). The biblical texts do not discuss the importance of physicians or healers; rather, they support the idea that all disease and disability is caused by God and can be cured only by God (Castiglioni, 1941, p.78). This belief was carried over into Christianity and gave rise to the belief in faith as the ultimate healer and savior of both mind and body (Castiglioni, 1941, p.79).

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During the Middle Ages, the birth of a child who was abnormal was viewed as the result of evil and sin on the part of the parents. Similarly, people with mental ...

Table of contents

• Cover Page
• Social Work Practice Across Disability
• Title Page
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgments
• Introduction
• Part I The Societal Framework
• Part II The Individual Framework
• Part III Skills for Social Work Practice
• Part IV The Disability Resource and Support Network
• References
• Index