Addressing our own ableism and fear when it comes to sex and the people with disabilities we work with

disability poses no limits to sex
(For screenreaders: Black sign that says “disability poses no limits to sex” in colorful letters)

By Maria Scippa, MSW Candidate

Salem State University

As part of my coursework for my social work degree, I was asked to read some first person narratives from people with disabilities regarding sexuality. For example, I read an article entitled “Dating in a wheelchair: Your problem, not mine” as well as “Dating in a wheelchair and representation: Interview with Lolo,” among others.

I was moved by these readings. I am also appreciative for the insights and raw honesty of the people who shared their experiences. It is sad that our society has operated from both the medical and moral models of disability, and as such has fallen victim to assumptions about people with disabilities and their experience with sex, love and intimacy. Even though this is not a topic I have given much thought to before, I am afraid that I, too, may have been very ill-informed regarding the experiences of people with disabilities before engaging with these readings.

The theme that I found throughout these readings was that there are two different sets of challenges that people with disabilities may face when it comes to dating and intimate relationships. First, one set of challenges involves the specifics of people’s disabilities, and finding creative ways to overcome them within a relationship. Second, the other challenges appear to be centered around societal views that create barriers to people with disabilities even forming intimate relationships. These barriers can manifest in different ways, whether that be as a result of a lack of respect for self-determination within a residential setting or assumptions on the part of a potential partner when they find out the person they are talking to has a disability, perhaps ending the relationship before it starts. The latter set of challenges are that which social workers should be paying attention to addressing in our work. The more we educate ourselves and others about the presence of ableism, and work to shift the perception of people with disabilities as not interested in or capable of physical intimacy, the first type of challenge become quite manageable.

A common thread through all of this seems to be fear. In his article on the dignity of risk concept, Craig Parson states, “one of the biggest barriers is fear: fear of the unknown; fear of legal ramifications and fear of failure” (Parson, 2008, p. 28). We see this barrier manifest itself within individuals, institutions and the larger society.  Unfortunately, this may be the driving force behind laws, regulations, policies and policy implementation that end up creating damage to people. When operating from a place of fear, social workers may deny people opportunities to fail and try something all should have access to. Perhaps social workers neglect to honor people’s rights in the hopes of avoiding a negative situation. This approach can prove to be ineffective in so many ways. In this regard, Ann Thomas has a powerful message in sharing her own story, “but all it takes to remove that fear is self awareness and a conversation with the person who is different” (Thomas, 2015, p. 1). Although this statement sounds so simple, there is so much truth to it. If social workers were to take on this attitude of curiosity and openness, some of these barriers could start to fall away for the people with disabilities that we work with.

Parsons, C. (2008). The dignity of risk: Challenges in moving on. Australian Nursing Journal15(9), 28.

Thomas, A. (2015). Dating in a wheelchair: Your problem, not mine. The New York Times. Retrieved from http://nytlive.nytimes.com/womenintheworld/2015/04/08/dating-in-a-wheelchair-your-problem-not-mine/ (Links to an external site.)

Maria Scippa is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. She holds a Bachelors in Social Work from Salem State University. She hopes to continue her career in social work, working with children and families. Ms. Scippa chose to study social work practice with people with disabilities because this knowledge will help her in providing well informed, competent services to families that have a person with a disability. Ms. Scippa can be reached at mscippa@salemstate.edu.

 

 

Balancing the medical and social models of disability in an education setting

Graduate social work students working with Dr. Elspeth Slayter at Salem State University were asked to reflect on the ways in which they approach their work with clients with disabilities. Specifically, they were asked to reflect on what aspects of their practice were “under” the medical model of disability and which were “under” the social model of disability. Students were first introduced to the medical model of disability, in which the person’s impairment was the focus. Then, students were introduced to the social model of disability, in which society is seen as the disabling factor as opposed to the part of the person with the impairment. In order to begin to re-visualize what social work practice with a client with a disability would look like, students were asked to answer the following question:

“How can social workers approach the needs of people with disabilities without perpetuating the negative impacts associated with the medical model of disability? Provide a case example and then describe how you could/do/would engage in medical model-informed practice and social model-informed practice with that client.”

By Colleen Dalton, MSW Candidate

Salem State University

My case example is that of a student with diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) and a psychiatric disability who attends the school where I am doing my internship, a Kindergarten through -8th grade inclusion school. This student’s treatment involved medical model-informed practice as he engaged in psychological testing, which compared his functioning to that of students with “normal” learning capacities. This student was placed on medication, either to attempt to “cure” him or get him to a place where he would behave “acceptably” in the school system (Mackelprang & Salsgiver, 2015, p. 105).

However, before this student’s educational plan was implemented along the lines of the medical model, there were a number of steps taken under a social model-informed practice approach.  For example, a functional behavior plan was created as was a behavior plan that was centered on his own interests as incentives. This student was also given the option of using a sensory tool during class time as well as scheduled movement breaks and cues to help with transitions.

I was lucky for the opportunity to work in a placement that devoted a great deal of time, effort, and funds towards trying to create the most inclusive setting possible. A large driving force for the school was the disproportionately high number of students with disabilities and socio-emotional troubles within the learning community. The school’s administrators recognized that the prevailing medical model played a major role in disempowering their students within the larger society.

As Mackelprang & Salsgiver (2015) discuss,  “the medical model’s emphasis on normality as defined by the dominant society results in enormous emotional, psychological, and social costs for people with disabilities” (Mackelprang & Salsgiver, 2015, p. 105). The school set out to normalize the use of sensory tools, movement breaks, and inclusive classrooms.  These actions were taken so that their students could graduate and head on to high school with the confidence and tools they needed to succeed. At the same time, the school also recognized that sometimes testing and medication were needed to keep students safe and promote the best educational opportunities for everyone in the classroom.

As Shakespeare (2006) points out, “the social model so strongly disowns individual and medical approaches that it risks implying that impairment is not a problem” (p. 217-218). Finding the balance between the social and medical models of practice can be tough but is definitely essential in terms of keeping people safe in my opinion.

Mackelprang, R. & Salsgiver, R. (1999). Disability: A diversity model approach in human service practice, 3rd edition. New York: Lyceum Books.

Shakespeare, T. (2013). The social model of disability. In Ed., Davis, L. (2013). The Disability Studies Reader, Fourth Edition. New York: Routledge.

Colleen Dalton
Colleen Dalton, MSW Candidate at Salem State University. (For screenreader: Young white woman with reddish-brown hair sitting at a table next to a window looking out onto the sea)


Colleen Dalton is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work.  She holds a B.A. in Human Services from the University of Massachusetts Boston. She hopes to work with children and families after graduation. Dalton can be reached at Colleen.Dalton001@gmail.com.

 

 

Weighing the pros & cons of the medical & social model of disability when working with people facing medical complexities

Graduate social work students working with Dr. Elspeth Slayter were asked to reflect on the ways in which they do their work with clients with disabilities. Specifically, they were asked to reflect on what aspects of their practice were “under” the medical model of disability and which were“under” the social model of disability. Students were first introduced to the medical model of disability, in which the person’s impairment was the focus of the model. Then, students were introduced to the social model of disability, in which society is seen as the disabling factor as opposed to the person with the impairment. In order to begin to re-visualize what social work practice with a client with a disability would look like, students were asked to answer the following question:

“How can social workers approach the needs of people with disabilities without perpetuating the negative impacts associated with the medical model of disability?  Provide a case example and then describe how you would engage in medical model-informed practice and social model-informed practice with that client.”

By Erica Sarro, MSW Candidate

Salem State University

“Sarah” was a five year old girl that was referred to my agency by the school system. Her treatment goals included providing resource allocation and engaging in parental education, as well as supporting Sarah with behavior management assistance. Sarah had a diagnosis of intellectual disability as well as a rare genetic condition, which required the assistance of a walker for mobility and a feeding tube.  Sarah was also non-verbal and required assistance with improving her receptive language capacity.

If I took a medical model approach to this case, which is defined as; “the belief that with the correct intervention all human abnormalities could be corrected,” I would focus on encouraging medical interventions (Mackelprang & Salsgiver, 2015; p 103). This would include helping Sarah and her family connect with surgeons and genetic doctors, who might be searching for a cure for her condition.  Additionally, I would also have worked with the occupational and physical therapists in both community and school settings, with the goal of helping Sarah to walk like a “normal person”, instead of needing a walker or other device.

While practicing under the social model, I would focus on helping the family and school make the environment a more welcoming and accessible place. For example, I would encourage both the school and the family not to focus on interventions with the goal of curing Sarah’s disabilities.  Instead, I would educate the family on the rights of a student with disabilities, coordinate with the school to ensure that the correct services were in place so that the medical needs did not overshadow or define Sarah’s school experience.  I believe that even though Sarah’s medical issues, (such as the feeding tube) do need to be addressed, that Sarah is more than her impairments and that the school and family should accommodate her needs in order for her to feel successful and equal.

The social model of disability is important when viewing Sarah’s’ ability to interact with her environment.  With respect to the social model, Shakespeare states that “the problems disabled people face are the result of social oppression and exclusion, not their individual deficits.  This places the moral responsibility on society to remove the burdens which have been imposed and enable disabled people to participate. (Mackelprang & Salsgiver, 2015).  As a social work provider, it is my ethical responsibility to advocate for social justice for people with disabilities, including Sarah.  Especially important for Sarah’s well-being would be making her home a clutter-free environment, so that she could access all of the rooms in her home.  With respect to her school environment, ensuring that Sarah’s classes were accessible and just as equal in opportunities as all classrooms should be.

I would argue, however, that the social model approach is not the perfect model nor is the medical model.  As a social worker, I would realize that the social model is not realistic for all aspects of Sarah’s life.  Sarah is going to struggle with frustration, and making her life barrier free is not going to be possible all the time.  Sarah’s family has to balance her medical and physical needs along with her emotional and communication needs equally.  Some medical intervention is needed and any improvement with eating or walking should be celebrated along with her ability to access her environment and society in the least restrictive way possible.  Being knowledgeable in both models will not only enhance the quality of integrative care for people with disabilities, but also the assurance of continued cultural competency in the social work profession.

Mackelprang, R. & Salsgiver, R.  (2015). Disability: A diversity model approach in human service practice, 3rd edition.  New York: Lyceum Books.

Shakespeare, T. (2013). The social model of disability. In Ed., Davis, L. (2013). The Disability Studies Reader, Fourth Edition. New York: Routledge.

Erica Sarro
Erica Sarro, MSW Candidate at Salem State University (Note for Screenreaders: Photo depicts a young white woman with dark hair, sitting in a car)

Erica Sarro is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. She holds a B.A. in Social Work from Salem State University. She hopes to continue her career in policy related macro social work. Mrs. Sarro chose to study social work practice with people with disabilities in order to become a better advocate for equal rights for people with disabilities. Mrs. Sarro can be reached at e_sarro@salemstate.edu.

Why social workers should learn about disability culture

By Sage Lucas, MSW Candidate

Salem State University

Understanding disability culture is one of the most important things you can do as a social worker. Judith Heumann, noted disability civil rights advocate, talks about the importance of accessibility in everyday life, as well as people’s attitudes towards the disability culture and community. You can see these comments on this YouTube video. Ms. Heumann goes over the fact that one of the most limiting parts of improving disability culture is working on what other non-disabled people think (Heumann, 2012).

I think that Ms. Heumann’s comments ring true for working in the social work profession as well. I say this because when one has a certain view about a group of people or a program, it can determine whether one has an overall positive or negative view of a person with a disability. Also, our own views can help skew other people’s views as well, so we should be aware of this.

Another reason why it is so important to have an understanding of disability culture as a social work practitioner is so that we may advocate for and with our clients who are persons with disabilities. According to Duprè (2012), “disability activists and theorists have also deconstructed the way that disabled people have been depicted in history, literature, art and in the entertainment industry. In doing so they not only bring existing normative sub-texts to light but write alternative perspectives which incorporate the lived experiences of disabled people as active agents in culture, rather than passive and dependent receivers of cultural messages and meanings (Duprè, 2012, p. 178).” This point has huge relevance for advocating for how others see our social work clients.

I would also like to recommend a disability culture-related resource to social workers practicing with people with disabilities. This resource is Emotions Anonymous (EA),. Emotions Anonymous was created in the 1970’s and is similar to groups such as Alcoholics or Narcotics Anonymous, but instead of focusing on substance use disorders, they focus on feelings and emotions. According to the EA website, ” …members come together in weekly meetings for the purpose of working toward recovery from any sort of emotional difficulties. EA members are of diverse ages, races, economic statuses, social and educational backgrounds. The only requirement for membership is a desire to become well emotionally” (EA, 2017). EA provides members with a support system as well as a day-to-day programs to attend in order to help cope with strong emotions. Mostly, however, EA helps members find that they are not alone in their struggle. This resource can help me to support my work around cultural competence with people with mental health disorders as this group opens new doors to understanding emotions in a different way than I have in the past. Many members from the partial hospitalization program I work in have similar difficulties in processing emotions.

As my clients have voiced that they are afraid no one else understands what they are going through, this resource is a great 12-step program for understanding how to cope with strong emotions. This resource is also helpful to me as a social worker in my efforts to be culturally responsive , as while I learn about the program, I can better understand the difficulties some clients may go through with coping with their emotions. Learning more about EA will also help me to develop my skills in cultural humility as most of the time I think it is very easy for me to share my emotions so when I hear that someone is having a hard time sharing their emotions I think that it can be silly and maybe all they need to do is share. This resource can help me understand that it is not always that easy to share emotions and some people need extra support.

In summary, I feel that by taking the time to learn more about disability culture-specific resources, I may be able to be a better social worker for my clients with disabilities.

BIO photo
Sage Lucas, MSW Candidate at Salem State University (Note for screenreader: Image of a young white woman smiling, in a car)

Sage Lucas is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. She holds a Bachelors in Social Work, with minors in Criminal Justice and Psychology from Salem State University, and Sage also holds a certificate in Childhood Studies from Salem State University. She hopes to continue her career in social work, working in the mental health field. Ms. Lucas chose to study social work practice with people with disabilities because she found a gap in her knowledge as a social work, and wanted to be as well rounded a social worker as possible. Ms. Lucas can be reached at s_lucas1@salemstate.edu

Social work practice with a child with ADHD: Applying the medical and social models of disability

Graduate social work students working with Dr. Elspeth Slayter were asked to reflect on the ways in which they do their work with clients with disabilities. Specifically, they were asked to reflect on what aspects of their practice were “under” the medical model of disability and which were “under” the social model of disability. Students were first introduced to the medical model of disability, in which the person’s impairment was the focus of the model. Then, students were introduced to the social model of disability, in which society is seen as the disabling factor as opposed to the person with the impairment. In order to begin to re-visualize what social work practice with a client with a disability would look like, students were asked to answer the following question:

“How can social workers approach the needs of people with disabilities without perpetuating the negative impacts associated with the medical model of disability?  Provide a case example and then describe how you would engage in medical model-informed practice and social model-informed practice with that client.”

By Erica Chepulis, MSW Candidate

Salem State University

For my consideration of the medical and social models of disability as they relate to social work practice, I will describe a summer camp member who I worked with last summer, who I will call Nicholas. Nicholas is a 9-year-old boy who is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). For Nicholas, his ADHD manifests as having a short attention span during activities, great fluctuations in emotions, and heightened sensitivity to loud noises or crowds.

The medical model views disabilities as “biological dysfunction[s]” and suggests that service professionals utilize interventions to try to “fix” the disability (Mackelprang & Salsgiver, 2015, p.103). In contrast, the social model views disability as a result of the social and physical world that isolates and is not built to accommodate people with disabilities (Shakespeare, 2013). While there are many criticisms of the medical model due to its deficit-based perspective of people with disabilities, there are also criticisms of the social model. Weaknesses of the social model include its simplicity and its establishment by mainly white, heterosexual men with physical disabilities and spinal cord injuries, a group whose perspectives are not representative of collective population of people with disabilities (Shakespeare, 2013). Criticisms of the social model also include its lack of acknowledgement that disability can be an important part of people’s lives and identities, its definition of disability as inherent oppression, and its ideal vision of a barrier-free world which does not consider natural environmental barriers (Shakespeare, 2013).

The social model would be helpful in working with Nicholas by allowing me to understand that the routine and activities of our summer camp were designed with a bias toward non-disabled children. The social model would suggest that I adjust Nicholas’s schedule as well as plan more inclusive activities that would be safer for him and give him equal opportunity to succeed.

While the social model is more strengths-based and does not ask that Nicholas change something about himself, the medical model may be more helpful in a few ways. The social model suggests that the ideal world is one in which people with disabilities do not experience barriers in their daily lives; however, this model does not take into account non-human constructed barriers (Shakespeare, 2013). For instance, Nicholas has difficulty with sensory processing, so loud noises such as thunderstorms are stressful and upsetting to him. We were able to follow the social model and accommodate Nicholas by providing him with warning when we knew there would be loud sounds, making sure there was an exit nearby and a designated room he could sit in if the noises were overwhelming, and creating a safety plan regarding who would accompany him and what activities could be done to help him feel calm. However, the noise could still be bothersome to Nicholas and impact his functioning regardless of our plans. In this case, the medical model may be helpful in providing interventions that can be used to help him through this environmental barrier. If I were Nicholas’s clinician, I might suggest listening therapy or psychotherapy to help him in ways that he could not otherwise be accommodated by the physical and social world around him. The social model is certainly more strengths-based, but it may be helpful to supplement it with the medical model to ensure that all of the client’s needs are met.

Mackelprang, R.W. & Salsgiver, R.O. (2015). Disability: A diversity model approach in human service practice (3rd ed.). Chicago, IL: Lyceum Books.

Shakespeare, T. (2013). The social model of disability. In Ed., Davis, L. (2013). The Disability Studies Reader, Fourth Edition. New York: Routledge

Erica Chepulis is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. She holds a B.A. in Social Work from Wheelock College. She hopes to continue her career in working with youth in programs that support their educational, social, and emotional growth and encourage them to reach their full potential. Ms. Chepulis chose to study social work practice with people with disabilities to learn how to most effectively and respectfully advocate for youth with disabilities and their families. Ms. Chepulis can be reached at e_chepulis@salemstate.edu.

 

How the medical and social models of disability play out in adoption social work

social vs. medical model
Image from Bluestockings Magazine (For screenreader: Image shows a cartoon that explains the difference between the medical and social models of disability. Specifically, it shows a person in a wheelchair at the bottom of the steps.  On the right is a caption saying “they should build a ramp” and on the left is a caption saying that the “impairment is the problem”)

Graduate social work students in Dr. Elspeth Slayter’s course on social work practice with people with disabilities were asked to reflect on the ways in which they do their work with clients with disabilities. Specifically, they were asked to reflect on what aspects of their practice were “under” the medical model of disability and which were “under” the social model of disability. Students were first introduced to the medical model of disability, in which the person’s impairment was the focus of the model. Then, students were introduced to the social model of disability, in which society is seen as the disabling factor as opposed to the person with the impairment. In order to begin to re-visualize what social work practice with a client with a disability would look like, students were asked to answer the following question:

“How can social workers approach the needs of people with disabilities without perpetuating the negative impacts associated with the medical model of disability?  Provide a case example and then describe how you would engage in medical model-informed practice and social model-informed practice with that client.”

By Janelle Cassola, MSW Candidate

Salem State University

For my consideration of how the medical and social models of disability play out in my social work practice, I will explore the scenario of a child with a disability, “Sara,” who is receiving services through my current field placement at an adoption agency.  Although the scenario is not a true situation, it is plausible.

Sara is a two-year old girl who was born with a unilateral cleft lip and a cleft palate due to her mother’s substance use during pregnancy.  Sara’s cleft lip was corrected at the age of 3 months and her palate was corrected at the age of 7 months.  The surgeries went well but they were unable to repair the full cleft lip so Sara still has a slight cleft.  Sara was removed from her mother at birth due to a positive toxicology screen at birth.  She was placed in foster care and has remained in care of child welfare services since then.  During this time, Sara’s mother was unable to consistently follow the goals on her family reunification service plan. Eventually, the child welfare authority changed Sara’s goal from permanency through family reunification to permanency through adoption.

Since Sara was born, she has had multiple ear infections that have affected her hearing.  Her first foster home placement did not attend to these ear infections in a timely manner, which had a great effect on Sara’s hearing.  As a result, she has been diagnosed slight hearing loss. Sara also has been diagnosed with a speech delay due to the combination of her hearing loss and cleft palate.  She receives therapeutic services through a speech-language pathologist and an audiologist in addition to her ear, nose, and throat doctor.

Now that Sara’s goal has been changed to adoption, her social worker has started recruiting for an adoptive family for Sara.  Her social worker could approach her recruitment of families and the information she gives them through medical model-informed practice or social model-informed practice. I will play out each scenario below.  If, as Sara’s social worker, I decided to provide information to the prospective family through medical model-informed practice I would focus on the interventions that are currently in place in order to help “heal” Sara.  According the Mackelprang and Salsgiver (2015) the medical model believes that specialists such as speech and occupational therapists are those who should control how people with disabilities are seen.  Therefore, when speaking with the potential adoptive family about Sara, I would inform them about her impairments, and would share that she has multiple different specialists who are working towards making her “normal”. By doing so, it would be the hope of a medical model believer that the family would be more willing to take Sara into their home if they knew she had a chance of “losing” her disability.

On the other hand, as a social worker looking to recruit a home for Sara through social model-informed practice, the focus would be different.  I would still inform the family of Sara’s supports and the specialists that she is currently seeing.  However, since the social model asserts that society is the disabling factor, I would introduce their services as optional (Shakespeare, 2013).  I would focus more on what the family would have to do in order to change their social environment so that Sara would be supported.  This would mean speaking with extending family members and friends and discussing how their views on a person with impairments is really what is disabling to Sara.  Unfortunately, if a child’s medical needs were presented to a family in that way and the family chose to discontinue her services, it could hinder Sara’s development.  Shakespeare (2013) acknowledges this weakness of the social mode in his article “The Social Model of Disability.”

In summary, I would most likely take a mixed approach when working with Sara and her potential adoptive families, drawing on the best of each model.

Mackelprang, R. & Salsgiver, R.  (2015). Disability: A diversity model approach in human service practice, 3rd edition.  New York: Lyceum Books.

Shakespeare, T. (2013). The social model of disability. In Ed., Davis, L. (2013). The Disability Studies Reader, Fourth Edition. New York: Routledge.

Janelle Cassola is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. She holds a B.A. in Urban Studies from Worcester State University. She hopes to continue her career in the field of adoption. Ms. Cassola chose to study social work practice with people with disabilities to become better informed of this community, the barriers that they face, and the practice frameworks regarding people with disabilities. Ms. Cassola can be reached at j_cassola2@salemstate.edu.

Social model or medical model? How to implement one or the other in a group home setting

Graduate social work students at Salem State University were asked to reflect on the ways in which they approach their work with clients with disabilities. Specifically, they were asked to reflect on what aspects of their practice were “under” the medical model of disability and which were “under” the social model of disability. Students were first introduced to the medical model of disability, in which the person’s impairment was the focus. Then, students were introduced to the social model of disability, in which society is seen as the disabling factor as opposed to the part of the person with the impairment. In order to begin to re-visualize what social work practice with a client with a disability would look like, students were asked to answer the following question:

“How can social workers approach the needs of people with disabilities without perpetuating the negative impacts associated with the medical model of disability? Provide a case example and then describe how you could/do/would engage in medical model-informed practice and social model-informed practice with that client.”

By Daniel Fraser, MSW Candidate

Salem State University

Where I work at a group home for people with intellectual disabilities, we have a client, who for the purposes of this discussion, will be referred to as H.I. Several years ago, H.I. began to feel uncomfortable standing or walking on her own, or with a walker. She feared she will fall and hurt herself.  A wheelchair was provided for her, as a way to make her feel more comfortable with her mobility.  However, staff were encouraged to get H.I. to stand up and walk with assistance of a walker, instead of allowing her to remain in the wheelchair on a full-time basis.  Each time a staff member would attempt to encourage her to stand up and walk with assistance of a walker, H.I. would become upset, and refuse to attempt to stand up. It is noteworthy that H.I. is able to transfer herself from her wheelchair to other locations, such as a recliner, her bed, or even the toilet, but that is the extent to which she feels comfortable enough to stand on her own.

When I first started working at the home, the director tried to implement a plan where H.I. was supposed to transfer herself from the toilet seat to the shower seat, each time she went to take a shower (she needs full assistance in taking a shower).  Each time staff went to implement this protocol, it caused a great deal of stress for H.I., and she would refuse to take a shower.

Taking the social model approach, it would have been better for all of the staff members, the director included, to talk to H.I., and find out whether she would rather use her wheelchair to get around, or if she would rather try walking with the walker.  By doing this, we would effectively eliminate the barrier of using a walker or walking on her own, that separates H.I. from the mobility which she chooses (Shakespeare, 2006).  Allowing H.I. to choose the way that she would prefer to move around would also give her more of a sense of independence, and make her feel the power of being able to make her own decisions.  Discussing her option of mobility would also likely take away any behavioral consequences that resulted from staff trying to implement the protocol of having her stand up and walk when she does not feel comfortable doing so.

By taking the approach that was implemented by the director, we were taking part in medical model thinking.  I believe that according to disability studies writer Tom Shakespeare, by not giving H.I. the choice of using the wheelchair to move around, and also by trying to get her to walk from the toilet seat to the shower seat, we were in essence, trying to eliminate an aspect of her disability, in order to fit in with what we wanted for her instead (2006).  By taking this approach, we also encouraged the behavioral consequence that resulted, along with adding more stress to an already stressful situation for H.I.

It is argued that one of the main limitations of the social model is that it essentially further disables someone who is already disabled, by not properly identifying the disability (Shakespeare, 2006).  By doing this, we are taking away part of the person’s identity, and more or less telling the person that even though they may have a disability, they should not recognize that disability.  In the case of H.I., if we do not encourage her to at least attempt to stand up and walk on her own, or with the assistance of the walker, it could lead to much less leg functioning, which could further impair her functioning.  So essentially, by not encouraging H.I. to move around without the assistance of a walker, and just continue to use the wheelchair, we could potentially be further disabling her.

It is a complicated situation, but it helps to look at H.I.’s situation through several lenses!

Shakespeare, T. (2013). The social model of disability. In Ed., Davis, L. (2013). The Disability Studies Reader, Fourth Edition. New York: Routledge.

Daniel Fraser is a candidate for the degree of Masters in Social Work at Salem State University’s School of Social Work. He holds a B.A. in Social Work from Salem State University. He hopes to do clinical work with students who have varying degrees of cognitive and intellectual disabilities with his career. Mr. Fraser has always enjoyed helping people out, and since joining his current place of employment, has really found his niche, where he can help people, and advocate for independence within the disability community. Mr. Fraser can be reached at d_fraser2@salemstate.edu.