SOCW 6051 Week 9 Discussion 1 and 2

THEORETICAL APPROACHES TO DISABILITY CONTENT IN SOCIAL WORK EDUCATION

Stepiien French Giison University of Maine

Eiizabeth DePoy University of iVIaine

This article presents an analysis of disability theory and content in the social work curriculum and advances a theoretically expansive approach to disability that is consistent with social work's commitment to diversity and the elimination of oppression. A careful examination of relevant social work literature reveals that disability is generally discussed and treated from a diagnostic perspective. We suggest shifting the approach to disability content in social work curricula from one that emphasizes individual deficiency to one that addresses disability as the interaction of a medical condition or diverse conditions with disabling environments.

OVER THE PAST SEVERAL DECADES, theoretical

perspectives on disability have undergone a major paradigm shift. Traditionally viewed as a deficit, disability is now more commonly understood as an element of human diversity. Concurrently, on university campuses, defini- tions of disability have been revised to locate disability within the discourses of multicultur- aUsm and diversity. However, despite the foun- dational focus on diversity and social justice in the social work curriculum, discussion and analysis of disability in social work courses typically occur through a deficit-treatment lens. In this article disability is defined as the inter- play of diverse human conditions with envi- ronmental barriers to full community inclusion. This contemporary view of disability, although consistent with the mission and values of so- cial work, receives limited attention in social work curricula (DePoy & Miller, 1996; Liese,

Clevenger, & Hanley, 1999). Beginning with a review of the literature on disability and the positioning of disability theory within aca- demic discourse, this article goes on to exam- ine disability content in social work curricula and literature. Finally, a framework is pre- sented to guide social work educators in ad- dressing disability as an element of human diversity.

Literature Review

Disabiiity Perspectives

Historically, disability has been explained and understood from a variety of perspectives. These views of disability span a continuum from a diagnostic-medical perspective to a com- plex, interactive person-in-environment per- spective (Stiker, 1999). Simply put, the diagnostic-medical explanation of disability places the locus of disability internally, within

Journal of Social Work Education Vol. 38, No. 1 (Winter 2002). © Copyright 2002 Council on Sociai Work Education, inc. Aii rigiits reserved. 1 5 3

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an individual who has experienced illness, insult, or anomaly. This internal focus results in an interpretation of the disabled individual as defective with reference to normative physi- cal, behavioral, psychological, cognitive, or sensory being. The interactive, person-in-en- vironment lens, on the other hand, looks at the interaction of internal and external factors in an individual's life that creates a disabling condition. Between these two views, numer- ous other explanations and understandings of disability exist, including spiritual demonization or glorification of individuals with disabilities (Gilson & DePoy, 2000b). Con- temporary theorists, influenced by pluralism, a perspective which posits the phenomenon of multiple realities (DePoy & Gitlin, 1998), view disability within the complex and diverse uni- verse of human experience, and from this per- spective understand disability as a multilevel social justice concern embedded within par- ticular cultural, sociopolitical, economic, and relational environments (Gilson & DePoy, 2000b; Linton, 1998; Oliver, 1996; Scotch, 1984). Contemporary legislation and protection pro- hibiting segregation and externally imposed control over the lives of people with disabili- ties have emerged from this perspective (Ameri- cans with Disabilities Act of 1990, 1990; Rehabilitation Act of 1973, 1978). But even these laws advance diverse definitions of dis- ability. For example. Social Security defines disability as the inability to engage in remu- nerative employment as a result of a disabling condition (Kieman & Stark, 1986), whereas the Americans with Disabilities Act (ADA) de- fines disability more broadly as limitation in life activities due to impairment.

The literature reveals the complexity and conceptual confusion regarding definitions and

understandings of disability. However, two broad definitions of disability predominate: one locating disability as internal to individu- als, and one identifying disabling factors in environments external to individuals. There- fore, we propose that social work students be introduced to these two distinct ways of con- ceptualizing disability.

The Diagnostic Approach to Disability

The diagnostic approach to disability is based on medical explanations of individual human conditions. In this perspective disabil- ity is defined as a long-term to permanent physical, behavioral, psychological, cognitive, or sensory impediment that renders individu- als less able than those who are free of such impediments, or those with impediments from which they can recover (Mackelprang & Salsgiver, 1997). This perspective both essen- tializes disability and locates it within the indi- vidual (Shakespeare, 1996). Interventions provided by disability services are designed to be curative. That is to say, services are aimed at remediating the disability (Mackelprang & Salsgiver, 1997).

In large part, the diagnostic approach is based on the historic notion of illness advanced by Parsons in the early 1950s. According to Parsons (1964), illness releases the sick person from compliance with socially enforced be- havioral norms. In exchange for release from behavioral obligations, the individual who is ill is expected to be compliant with, and appre- ciative of, medical intervention designed to cure. Not unexpectedly, the diagnostic ap- proach to disability does not bode well for those with conditions that cannot be cured, modified, or changed by professional inter- vention (Quinn, 1998, p. xix). In this view, the

DISABILITY CONTENT IN SOCIAL WORK EDUCATION 155

individual who cannot be "fixed" remains de- ficient in the sense that the person appears to function in ways outside of socially acceptable norms (Longmore, 1997; Mackelprang & Salsgiver, 1997). The diagnostic approach to understanding disability, then, classifies an individual as a deviant or as noncompliant with conventional behaviors.

The concept of rehabilitation underlying a wide variety of interventions is firmly situated within the diagnostic approach, in that most interventions are aimed at improving the func- tion and well-being of individuals with medi- cal diagnoses (Granger & Fiedler, 1997). While fields such as occupational therapy and voca- tional rehabilitation are concerned with the elimination or alteration of environmental bar- riers that impede individual function, these fields are still based on the diagnostic approach to disability. This orientation is apparent in these fields' concern with addressing diagnos- tic-functional abnormality (developmental dis- ability, psychosis, and so forth), regardless of the locus of the interventions. An individual is referred to rehabilitation because of what is perceived to be a medical condition that limits function, and this view of disability frames the work of the rehabilitation professional, even if modification of the individual's environment is the intervention. Within this perspective, rehabilitation practice can range from adapt- ing an environment to fit individual limita- tions to working with individuals to adapt to an environment and exhibit more normative function (Johnston, Steinman,&Velozo, 1997).

Disability as a Construct

From a constructionist approach, disabil- ity is viewed as a phenomenon constructed by factors and forces in the external environment

rather than as a physical, behavioral, psycho- logical, cognitive, or sensory inadequacy (Shakespeare & Watson, 1997). For many people with disabilities, while physical, behavioral, psychological, cognitive, or sensory anomalies are acknowledged, they are not necessarily seen as undesirable, in need of remediation (Quinn, 1988), or even relevant to understand- ing the circumstance and experiences of dis- abled people. Central to this approach is the notion of human diversity. A fundamental question raised by constructionist approaches to disability is why a condition such as impair- ment of an individual's ability to walk, which requires the use of adaptive equipment, is perceived as a disability, and a condition such as mild nearsightedness, which also requires the use of adaptive equipment, is not. In con- structionist approaches to disability, language or the terms that one calls oneself are deter- mined by the disabled person reflecting that individual's interpretation of his or her con- nection to the social, political, economic, physi- cal, cognitive, and sensory environment. Because disability is seen as a social "construc- tion" rather than a condition which is located "with" an individual, the admonitions by pro- fessionals, and even scholarly writing venues, for those not using person-first language are not appropriate. The individual is "disabled" by a socially created set of circumstances and has the right to declare or define himself or herself as "disabled" by an environment rather than living with a disability (DePoy & Gilson, 2001).

Unlike the rehabilitation approach, which can also address the environment as the needed locus of change, constructionist approaches to disability attribute an individual's incapacity to function to a disabling environment in which

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barriers are socially erecfed arid mainfained (Halm, 1993). Negafive affifudes, limited or nonexisferif physical and communicafion ac- cess, and fhe denial of rights and privileges are examples of just some of the barriers that inter- fere with a disabled individual's potential to actualize desired social roles such as student, partner, parent, etc. (Barnes, Mercer, & Shakes- peare, 1999). Thus, disability is seen as ineq- uity in how an environment responds to and interprets human diversity, rather than as a deficit to be cured, remediated, or fixed (Barnes et al., 1999). It is not surprising that individuals with disabilities have advanced this notion of disability in direct response to models that devalue them (Oliver, 1996).

Within constructionist conceptualizations of disability, there are many different empha- ses, each of which has been posited as a model of disability in and of itself. For example, in the view of those who see disability as a political construction, the barrier creating the disabling condition is disempowerment caused by un- equal earning opportunities for individuals with conditions that are socially constructed as disabilities. Discrimination and exclusion from the workplace limit the disabled individual's capacity to exchange earned resources for privi- leges, goods, and services. For disabled people political life is an economic life wherein the discrimination, exclusion, and disenf ranchise- ment are experienced as an increased probabil- ity of substandard wages and poverty. According to Oliver (1996), the political under- standing of disability, and we would suggest an economic understanding of disability, while not equivalent to policy, legislation, or social change, does provide direction for future po- litical action.

Another important focus within construc- tionist approaches to disability is the view of

disability as culture. This focus suggests that all individuals who define themselves as dis- abled belong to a unique group, which shares circumstances, experiences, tacit rules, lan- guage, and discourse. In this view, the notion of disability is one of group belongingness and distinction from other groups who do not share the disability identity (Mackelprang & Salsgiver, 1997). That is to say, anyone who identifies as disabled is disabled. Who belongs and does nof belong to the culture is therefore not based on diagnosable condition, since di- agnosis is irrelevant in this approach to deter- mining who is disabled and who is not. Those individuals who perceive themselves to be unfairly treated and perceived as undesirable by dominant social institutions are therefore members of the culture of disability in that they share disadvantage and curtailment of civil rights (Linton, 1998). Within this frame- work, issues involving race, class, gender, sexual orientation, and disability identifica- tion are important determinants of the shared experiences that bind people together in single, identifiable communities of concern (Charlton, 1998). Linton (1998) notes,

we [disabled people] are bound together, not by . . . [a] list of our collective symp- toms but by the social and political cir- cumstances that have forged us as a group. We have found one another and found a voice to express not despair at our fate but outrage at our social posi- tioning, (p. 4)

This outrage is tied not only to the political position of disabled people, but from a materi- alist analysis, which identifies the "economic restrictions imposed on the individual that disable him or her" (Rioux, 1994, p. 5).

DISABILITY CONTENT IN SOCIAL WORK EDUCATION 157

Disability Content in Sociai Worit Curricuia

For the most part, the academy has taken the diagnostic approach to disability, viewing disability as a medical phenomenon to be un- derstood by professionals and treated through the provision of services and supports that counterbalance personal deficits. Thus the pri- mary study of disability has been limited to such academic disciplines as education, health, and human services. And, according to Linton (1998), the current division of disability into specialized applied fields in higher education (e.g., rehabilitation, special education, health, and so forth) perpetuates the view of disability as pathology.

One way to assess disability content in social work education is to look at the Council on Social Work Education's 1992 Curriculum Polio/ Statement (CPS) and the 1994 Handbook of

Accreditation Standards and Procedures. Both re-

veal an ambiguous approach to disability defi- nition and content requirements. Prior to the most recent CPS, social work programs were guided to organize their curricula arovmd ei- ther populations or problem areas. In this tax- onomy, disability was included under problem areas, while other vulnerable groups were in- cluded in populations. Thus disability was seen as an individual deficit rather than as a group characteristic.

The 1992 CPS reflected some attempt to more thoughtfully or progressively address the issue of disability. However, in addition to the term "disability," the use of phrases such as "populations at risk" (B6.6), which deny posi- tive experiences of disability and position it within a medical and pathological perspective continued to be used without further position- ing disability in the category of diverse popu- lations along with other devalued "at risk

groups." Placing disability solely within the category of at risk groups leads one to ques- tion, "at risk for what?" The implicit answer is that the condition of disability places one "at risk" for failure in one or more essential life functions as a result of an intrinsic pathological condition. Thus, services and protection from professionals are asserted as necessary by the categorical placement of disabled people in anticipated jeopardy even when no such con- dition should be ascribed.

It is of great concern that disability in social work curricula is primarily presented and examined through a diagnostic lens, not only because of the current academic trends towards pluralism, but also because of the fundamental commitment of social work to eradicating oppression, promoting equal op- portunity, and advancing self-determination. While we do not suggest that the diagnostic approach to disability be entirely eliminated from social work education, we offer an educa- tional model below that critically examines each perspective of disability and applies it thoughtfully to the curriculum areas of human behavior in the social environment, practice, research, and policy.

Modei Disabiiity Curricuia

As presented in Table 1, the two views of disability correspond to different theoretical, methodological, and action approaches in the primary social work curriculum areas. The social work curricular content areas on which we focus are human behavior and the social environment (HBSE), social work practice, so- cial welfare policy and services, and research. We have not included a section on the field practicum, due in part to the great number of practicum settings in which students are placed, and because this educational component tends

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to have an experiential rather than didactic focus. Our discussion considers baccalaureate and foundation-year master's content.

The Diagnostic Approach to Disabiiity and Sociai Worit Curricuia

Human Behavior and the Social Environment.

As mentioned above, the diagnostic approach to disability defines disability as a long-term or permanent, physical, behavioral, psychologi- cal, cognitive, or sensory impediment to be treated by working with individual recovery or adaptation, or both (Longmore, 1997; Mackelprang & Salsgiver, 1997; Shakespeare & Watson, 1997). Given this definition, disabil- ity can be examined in the HBSE curriculum area through developmental, psychodynamic, biological, behavioral, and psychopathologi- cal theories. That is to say, these theories pro-

vide the "normal backdrop" from which dis- ability can be distinguished. By "normal back- drop," the authors are referring to the set of norms that provide the boundaries for what is considered to be typical as well as acceptable. Anything existing outside of those boundaries is therefore deviant. Medical model theories that are studied within the HBSE curriculum provide a foundation for assessing functional adequacy and providing intervention for indi- vidual improvement. This foundation provides a framework for viewing individuals in direct practice, policy practice, and research practice.

The theoretical frameworks studied in HBSE courses posit normative behaviors that differentiate age-related phases from one an- other. Those who do not fit within the riorms are labeled on a continuum from eccentric or odd to deviant or dysfunctional. These theo-

TABLE 1 . Diagnostic and Constructionist Approaches to Disabiiity Content across Four Major Curricuium Areas

HBSE

Diagnostic Developmental

Psychodynamic

Psychopathology

Behavioral

Biological

Constructionist Systems

Sociohistorical / economic context

Social construction

Humanistic

Multiculturalism

Practice Policy

Clinical intervention Rational models

Case management

Problem Solving Rational and nonrational models

Community/group organization

Psychoeducational

Legislative intervention

Direct action (e.g. lobbying, civil disobedience)

Research

Clinical, outcomes oriented

Integrated

Critical theory approach

Participatory

Ethnography

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ries serve to identify those who are in need of professional guidance at the clinical or institu- tional levels and provide a set of normative outcomes to which an individual should be professionally directed.

Social Work Practice. Guided by the diag-

nostic approach, direct practice education would center on teaching clinical strategies to "normalize" or "fix" disabled individuals to the degree possible. These strategies may be collaboratively developed with clients, but also may be determined as best practice by the social worker, professional team, or both.

To illustrate we focus on a typical sequence of hospital-based practice, followed by reha- bilitation settings, and specialized clinical com- munity outpatient service experienced by a young adult who has sustained a closed head trauma. This vignette or illustration reflects a composite characterization of individuals with brain trauma with whom one of the authors worked. The hospital social worker is involved primarily as educator to the family, and sec- ondarily to the individual, and as discharge planner. Within a diagnostic model, social work practice would focus on the individual's ad- justment to the illness experience and the family's adjustment to the change in the status, role, and functioning of the individual. If the social worker is practicing from a family strengths perspective (Freedman & Boyer, 2000), it is likely that the family would be perceived in the role of caregiver and, by ex- tension, as a part of the treatment team (par- ticularly in the presence of severe disability). Social work direct practice tasks might typi- cally involve assisting the individual and fam- ily with the acquisition of equipment, social service supports, educational interventions, and linkages to specialized clinical community outpatient services and support groups. Reha-

bilitation would focus on teaching compensa- tory skills to the individual with the head injury, modifying the environment to accom- modate the individual's condition, and, to the extent possible, restoring normative roles. Additional practice modalities guided by the diagnostic-based model include community case management and case coordination (Gilson, 1998; Gilson & Casebolt, 1997; Net- ting, Kettner, & McMurtry, 1998).

Social Welfare Policy and Services. In the

social welfare policy sequence, rational mod- els of policy, practice policy, or policy imple- mentation analysis and development are often taught. Rational models of policy develop- ment, implementation, and analysis tend to approximate both linear-based reasoning and an ideologically conservative framework of thought. While this characterization may not always be an absolute, these models tend to share more commonalities with traditional medical models of analysis and determination than a nonrational model (Jansson, 1994; Net- ting et al., 1998). These models of policy and administrative management analysis, devel- opment, and implementation are grounded on assumptions that: (a) the individuals exchange productivity for privilege and (b) individual self-interest is a given. Because of this exchange, the social worker would advance policy to promote maximum function for disabled indi- viduals but would also maintain clinical con- tact as a mechanism to supervise the continuation of valued productive function on the part of the disabled individual. Within disability practice, the social worker would therefore advance policies through an approach to agency management that promotes the maxi- mum ftmctioning of a disabled individual for the least social/economic cost, while maintaining clinical models of professional intervention.

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On an agency level, macro practice may take the form of working to extend individual and family services for a specific individual, family, or a subset of individuals with disabili- ties, such as Individuals diagnosed with devel- opmental or mental disabilities or individuals with multiple sclerosis.

For the micro-focused social worker, policy concerns are commonly limited to a program and agency base of practice. Practice policy guided by the diagnostic approach takes the form of advocating for goods and services for the immediate need(s) of individuals and fami- lies. Examples of this approach include work- ing with third-party payers to purchase a wheelchair, medications, secure educational or vocational evaluation and services, or modify the home environment to improve function.

Research. In the diagnostic approach, re- search methods that examine disability from a researcher-driven perspective are emphasized in the research sequence. In particular, clinical outcome research relying on predetermined, standardized testing is indicated. Social work students are taught strategies such as single case study designs, experimental, quasi-ex- perimental, and nonexperimental approaches to examining client and family outcome (Yegidis, Weinbach, & Morrison-Rodriguez, 1999). Research methods to maintain account- ability and measure the outcomes of interven- tions are emphasized, along with cost-benefit investigation strategies.

The Constructionist Model ef Disability and Sociai Worit Curricuia

Human Behavior and the Social Environment.

As discussed above, in the constructionist model, while an individual's anomalous physi- cal, behavioral, psychological, cognitive, or

sensory conditions may be acknowledged, they are not necessarily perceived as undesirable, in need of remediation (Quirm, 1988; Shakes- peare & Watson, 1997), or even relevant to disability. Rather, individuals are perceived to be disabled by marginalization, oppression, and hostile environments—those characterized for example by a lack of ramps, limited atten- tion to alternative formats for printed material, and a severe shortage of sign language inter- preters, as well as any number of forms of social, political, and economic devaluation.

Taught from the constructionist view of disability, the HBSE curriculum would be in- formed by several perspectives. A broad sys- tems perspective extending beyond individuals and their families to their interactions with multiple sociocultural systems would be most useful in examining disability as a construct. These interactions with sociocultural systems would be examined to discover the extent to which they are disabling to particular groups and individuals. Targets of change would be the negative attitudes, discrimination, oppres- sion, limitations in civil rights, devaluation, and limited access to resources, privilege, and community life experienced by individuals and groups stigmatized on the basis of anoma- lous physical, behavioral, psychological, cog- nitive, or sensory conditions. Several theories would serve as lenses through which to exam- ine disability and the marginal social/cultural positioning assigned to individuals and sub- groups whose physical, behavioral, psycho- logical, cognitive, or sensory conditions are perceived as "disabilities." These would in- clude social learning theory, social construc- tion, pluralistic perspectives, and multiculturalism. A specific focus on social, economic, political, cultural, and environmen-

DISABILITY CONTENT IN SOCIAL WORK EDUCATION 1 6 1

tal barriers that prevent individuals from full community participation might be a point from which to define and examine disability (Hutchison, 1999). Further examination of dis- ability as minority culture would not only include analysis of members of disabled groups as marginalized, but also would include look- ing at disability, race, gender, and class as interactive factors that serve as barriers to civil rights and social justice. In such an examination disability would be located within the larger discussion of domination and op- pression experienced by marginalized cul- tural groups.

An example of how social work practice might unfold if approached from a construc- tionist view of disability can be seen by recon- sidering the individual who has been hospitalized after sustaining a closed head in- jury. A social worker practicing from this per- spective would use medical information to understand the conditions of head injury. With that knowledge, attitudes towards individuals with head injuries, their recovery environ- ments, and their social limitations would be examined through the lenses of systems theory (Chetkow-Yanoov, 1992), social learning theory (Gambrill, 1997), and postmodern construc- tionist and deconstructionist theories (Pease, 1999). These views would inform a broad un- derstanding and analysis of the social position- ing, advantage, and disadvantage likely to be experienced by the disabled individual.

Social Work Practice. Practicing from a con- structionist perspective a social worker might engage in advocacy, assurance of civil rights, and elimination of oppression. Whether in a central or peripheral role, the social worker's practice model would be based on theory in which disability is seen as a social construction

within oppressive systems (Chetkow-Yanoov, 1997). Practice education would therefore in- clude problem solving, emancipatory ap- proaches (Gambrill, 1997) in which multiple systems would be challenged, and culturally competent methods to eliminate barriers to community inclusion and social justice for dis- abled individuals (Longres, 1995). Moreover, practice would be client/consumer driven or directed, with the social worker acting coUaboratively as facilitator and liaison to elimi- nate barriers, advance opportunity and choice for individuals, families, and groups of dis- abled individuals, and link disabled people together in arenas which promote the healthy celebration of disability identity and the ad- vancement of self-determination (Gilson & DePoy, 2000a).

Systems change and political action would be important elements of practice within the constructionist framework of disability. Inter- vention would be carried out through team- work with other professionals, politicians, family, and community members who are in- volved in the life of the disabled individual. Intervention techniques might involve advo- cacy, psychoeducational groups, sharing of information with client systems, policy change, and collaborative political action.

Social Welfare Policy and Services. Policy

and services work framed within a construc- tionist model of disability would focus on a continuum ranging from rational to nonra- tional approaches, and would be carried out at multiple system levels (Stone, 1997). Work might begin at the local agency level and progress to the larger community, state, and federal systems levels. As described above, the rational model of policy analysis suggests a plarmed and linear approach to the develop-

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ment of policy. In contrast, in the nonrational perspective policy creation is viewed as a se- ries of complex and nonlinear events and phe- nomena. Multiple and often competing value-based interests are viewed as important influences on the creation and revision of policy. Stone's (1997) model is based on the assump- tion that policy development, modification, and overturn occur within a paradoxical po- litical environment in which personal values and stake-holding supercede evidence-based, reasoned policy change. The nonrational model focuses on social values, political decision making, community interests, and the polis.

A more conservative rational approach within the constructionist framework would involve social workers assuring that disabled individuals could be included within existing services and supports of a particular client system. A social worker's analysis or interpre- tation of intervention and change strategies would combine a rational model (e.g., Jansson, 1994; Netting et al., 1998) and a nonrational model (e.g.. Stone, 1997). While the rational approach would explain the reasoned, evi- dence-based foundation for policy, the intro- duction of a nonrational perspective would provide the social worker with an expanded view of social, civil, economic, and legal expe- riences of disabled people and communities of disabled people. Consistent with Schneider and Netting's (1999) call for social workers to "embrace ambiguity and to connect the often- invisible struggles of individuals with the more public actions of decision makers in powerful positions" (p. 349), this viewpoint would help the worker begin to appreciate the multiple and competing meanings of social welfare policy and services as they affect individuals and communities.

Considering disability as culture. Netting and colleagues (1998) suggest that policy work involves (a) identification of target population, (b) determining community characteristics, (c) recognition of differences, and (d) identifying structure. Further, the authors of this article believe that the addition and synthesis of Figueira-McDonough's approach (1993) pro- vides a complementary policy analysis and practice perspective guiding the social worker to promote the acknowledgment of disability as a marginalized culture in need of protective efforts such as the ADA.

Research. For students to be able to exam- ine disability from pluralistic and multilevel viewpoints, both experimental and interpre- tive research methods (DePoy & Gitlin, 1998) would be taught. Experimental-type models of research yielding quantitative findings might be most useful in concert with interpretive approaches. Using mixed methods would al- low for the measurement of service needs and outcomes to be synthesized with a qualitative understanding of the attitudinal social context in which these needs and outcomes occur. These two important areas of knowledge would inform and advance social change in multiple social, political, and economic arenas. Research from a critical theory perspective—which is conducted for the purpose of political change— would guide inquiry towards the production of knowledge for social, political, and eco- nomic change (DePoy & Gitlin, 1998). Studies undertaken from this epistemological perspec- tive would enhance understanding of power relationships and action strategies designed to provoke change. Traditional methods of eth- nography (see Babbie, 2001) hold the members of a culture as experts in their own lives and experiences and, thus, the investigator would

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look to cultural members to answer questions about language, rules, traditions, rituals, etc. that would inform social work knowledge and practice in disability. Along with ethnographic approaches, participatory action research would be useful in identifying areas and meth- ods for cultural and social change.

Conclusion

Disability content in social work educa- tion is taught largely from a diagnostic per- spective. However, this approach is seriously outdated and does not encourage social work- ers to engage in practice, thought, inquiry, and policy change aimed at the eradication of so- cial injustice resulting from discrimination to- wards disabled individuals. As indicated in the literature, disability coexists with poverty, limitations in civil rights, prejudice, and de- valuation. In concert with social work's mis- sion to advance social justice and eliminate oppression are conceptualizations of disability which fall broadly within the constructionist approach. It is critical that these conceptualiza- tions of disability be included in social work curricula so that students can develop an in- formed, contemporary understanding of dis- advantage resulting from disabling environmental factors.

In this article we have examined multiple explanations for disability and have illustrated how the social work curriculum can be revised to integrate a diagnostic approach into the broad perspective of disability as constructed by social, cultural, political, and economic fac- tors. The knowledge, theory, and skills that would emerge from this complex, multifaceted, and contemporary treatment of disability would reflect social work's professional commitment to social justice and locate discussions of disabihty

within the larger discourse on diversity. We do not deny that content on various

physical, behavioral, psychological, cognitive, or sensory conditions is necessary to an under- standing of disability. However, we assert that decreasing the emphasis on the diagnostic ap- proach to disability and increasing the empha- sis on constructionist approaches are essential if social work is to actualize its mission and values. Moreover, adopting an approach to studying disability that is similar to the ap- proach that has been taken by other vulnerable groups is an important step in advancing civil rights for those who currently belong to this group and those who do not. Dissimilar to other groups such as women and ethnic mi- norities, the boundaries of the disability com- munity are permeable. Anyone can become a member at any time, whether through injury or illness. Integrating disability into the dia- logue on diversity and oppression therefore has a wide application for those who are cur- rently disabled as well as for those who are not.

References

Americans with Disabilities Act of 1990, Pub. L.

No. 101-336,104 Stat. 327 (1990).

Babbie, E. (2001). The practice of social research

(9th. ed.). Belmont, CA: Wadsworth.

Barnes, C , Mercer, T., & Shakespeare, T. (1999).

Exploring disability: A sociological introduc-

tion. Cambridge: Polity Press.

Charlton, J. I. (1998). Nothing about us without us:

Disability oppression and empowerment. Ber-

keley: University of California Press.

Chetkow-Yanoov, B. (1992). Social work practice:

A systems approach. Binghamton, NY:

Haworth.

Council on Social Work Education. (1992). Cur-

riculum policy statement for baccalaureate and

1 6 4 JOURNAL OF SOCIAL WORK EDUCATION

master's degree programs in social work educa-

tion. Alexandria, VA: Author.

Council on Social Work Education. (1994). Hand-

book of accreditation standards and procedures

(4th ed.). Alexandria, VA: Author.

DePoy, E., & Gilson, S. F. (2001, July). Sticks,

stones and language. Paper presented at the

Society for Disability Studies Annual Meet-

ing, Winnipeg, Manitoba, Canada.

DePoy, E., & Gitlin, L. (1998). Introduction to

research: Understanding and applying mul-

tiple strategies (2nd ed.). Chicago: Mosby

Yearbook.

DePoy, E., & Miller, M. (1996). Preparation of

social workers for serving individuals with

developmental disabilities: A brief report.

Mental Retardation, 34(1), 54-57.

Figueira-McDonough, J. (1993). Policy practice:

The neglected side of social work interven-

tion. Social Work, 38,179-188.

Freedman, R. I., & Boyer, N. C. (2000). The power

to choose: Supports for families caring for

individuals with developmental disabilities.

Health and Social Work, 25(1), 59-68.

Gambrill, E. D. (1997). Social work practice: A

critical thinker's guide. New York: Oxford

University Press.

Gilson, S. F. (1998). Case management and sup-

ported employment: A good fit. Journal of

Case Management, 7(1), 10-17.

Gilson, S. F., & Casebolt, G. M. (1997). Personal

assistance services and case management.

Journal of Case Management, 6(1), 13-17.

Gilson, S. F., & DePoy, E. (2000a, February).

Disability as culture: Four didactic curriculum

areas. Paper presented at the Council on

Social Work Education Annual Program

Meeting, New York, NY.

Gilson, S. F., & DePoy, E. (2000b). Multicultural-

ism and disability: A critical perspective.

Disability and Society, 15(2), 207-218.

Granger, C. V., & Fiedler, R. C. (1997). The mea-

surement of disability. In M. J. Fuhrer (Ed.),

Assessing medical rehabilitation practices: The

promise of outcomes research (pp. 103-126).

Baltimore: Paul H. Brookes.

Hahn, H. (1993). The politics of physical differ-

ences: Disability and discrimination. In M.

Nagler (Ed.), Perspectives on disability (2nd

ed., pp. 37-42). Palo Alto, CA: Health Mar-

kets Research.

Hutchison, E. D. (1999). Dimensions of human

behavior: Person and environment. Thousand

Oaks, CA: Pine Forge.

Jansson, B. S. (1994). Social policy: From theory to

policy practice (2nd ed.). Belmont, CA:

Wadsworth.

Johnston, M. V., Steinman, M., & Velozo, C.

(1997). Outcomes research in medical reha-

bilitation: Foundations from the past and

directions for the future. In M. J. Fuhrer

(Ed.), Assessing medical rehabilitation prac-

tices: The promise of outcomes research (pp. 1-

42). Baltimore: Paul H. Brookes.

Kiernan, W. E., & Stark, J. A. (1986). Pathways to

employment for adults with developmental dis-

abilities. Baltimore, MD: Paul H. Brookes.

Liese, H., Clevenger, R., & Hanley, B. (1999).

Joining university-affiliated programs and

schools of social work: A collaborative

model for disabilities curriculum devel-

opment and training. Journal of Social Work

Education, 35, 63-69.

Linton, S. (1998). Claiming disability: Knowledge

and identity. New York: New York Univer-

sity Press.

Longmore, P. K. (1997). Conspicuous contribu-

tion and American cultural dilemmas: Tele-

thon rituals of cleansing and renewal. In D.

T. Mitchell c& S. L. Snyder (Eds.), The body

DISABILITY CONTENT IN SOCIAL WORK EDUCATION 165

and physical difference: Discourses of disability

(pp. 134-160). Ann Arbor: University of

Michigan Press.

Longres, J. F. (1995). Human behavior in the social

environment. Itasca, IL: F.E. Peacock.

Mackelprang, R. W., Sz Salsgiver, R. O. (1997).

Disability: A diversity model approach in hu-

man service practice. Pacific Grove, CA:

Brooks/Cole.

National Organization of Disability. (1994).

N.O.D./Harris survey of Americans with disabili-

ties. New York: Louis Harris and Associates.

Netting, F. E. (1992). Case management: Service

or symptom? Social Work, 37,160-164.

Netting, F. E., Kettner, P. M., & McMurtry, S. L.

(1998). Social work macro practice (2nd ed.).

New York: Longman.

N.O.D./Harris. (2000). The 2000 N.O.D./Harris

Survey of Americans with Disabilities: Survey

program on participation and attitudes [Online].

Available at http://www.nod.org.

Oliver, M. (1996). Defining impairment and dis-

ability: Issues at stake. In G. Barnes & G.

Mercer (Eds.), Exploring the divide: Illness

and disability (pp. 39-54). Leeds, UK: Dis-

ability Press.

Parsons. T. (1964). Social structure and personality.

Free Press.

Pease, B. (1999). Transforming social work practice:

Postmodern critical perspectives. New York:

Routledge.

Quinn, P. (1998). Understanding disability: A

lifespan approach. Thousand Oaks, CA: Sage.

Rehabilitation Act of 1973, Pub. Law No. 93-112,

87 Stat. 335 (1973) (codified as amended at

29 U.S.C. § 701, 797 [1978]).

Rioux, M. H. (1994). New research directions

and paradigms: Disability is not measles. In

M. H. Rioux, & M. Bach (Eds.), Disability is

not measles: New research paradigms in disabil-

ity (pp. 1-7). North York, Ontario, Canada:

Roeher Institute.

Scfineider, R. L., & Netting, F. E. (1999). Influenc-

ing social policy in time of devolution: Up-

holding social work's great tradition. Social

Work, 44, 349-357.

Scotch, R. K. (1984). From good will to civil rights:

Transforming federal disability policy. Phila-

delphiia: Temple University Press.

Shakespeare, T. (1996). Disability, identity and

difference. In G. Barnes & G. Mercer (Eds.),

Exploring the divide: Illness and disability

(pp. 94-113). Leeds, UK: Disability Press.

Shakespeare, T., & Watson, N. (1997). Defend-

ing the social model. Disability and Society,

12, 293-300.

Stiker, H. J. (1999). A history of disability. Ann

Arbor, MI: University of Michigan Press.

Stone, D. A. (1997). Policy paradox: The art of political

decision making. New York: W.W. Norton.

Yegidis, B. L., Weinbach, R. W., & Morrison-

Rodriguez, B. M. (1999). Research methods for

social workers. Boston: Allyn & Bacon.

Accepted: 1 0 / 0 1 .

Stephen French GMson is associate professor, School of Social Work, and Elizabeth DePoy is professor. School of Social Work, and coordinator of research and evaluation. Center for Community Inclusion, University of Maine.

Address correspondence to: Stephen French Gilson, University of Maine, 5770 Annex C, Orono, ME 04469; email: [email protected].