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 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.