On stacking books in the library, and undoing my own ableism

1600x1200-4235386-pile-of-old-leather-bound-books
Note for screenreader: A stack of antique leather-bound books, such as one might find in a library (Image credit: http://autodo.info/pages/o/old-leather-bound-book/)

 

By Sara Ghalaini, M.S.W. Candidate

Salem State University

My first job right out of high school was working in a public library. I was one of three library pages who would put books away in order to maintain the book shelves. A majority of the library staff watched me grow up in that building, and I was given my first opportunity at an internship the year before. I was very bonded to the staff and to the building itself. Working there reminded me a great deal of my childhood.

“Violet” was one of the book pages I worked alongside. For as long as I can remember, she had always worked at the library, it was almost as if she came with the building. Violet retired the year the building was given a grant to be rebuilt, which I always found to be appropriate timing. As a child, I could always count on Violet to be in the fiction section of the library. Walking in, I knew I would find her pursing her lips and mumbling to herself while she put the cart of books away. Typically, she would stop me, and let me know I looked just like my mother and would then ask after her, right before complimenting me for the season I reminded her of, Autumn. By the time I began to work at the library, Violet was an elderly woman. She would come into the library every morning at 8:45 a.m. with fifteen minutes to spare, so she could sit on the ratty old orange couch in the staff lounge for ten minutes and then spend the last five minutes greeting staff as they came in before getting to her book cart.

Violet was meticulous at keeping time and budgeted herself to shelving two carts for the three hours she would work every day. Some days she was overly ambitious and was able to complete two and a half carts, but that was rare. Once she finished her shift she would grab her things from the staff lounge and go home. Later I learned Violet had a schedule she followed daily, consisting of breakfast at the Tea Cup Café, a walk to work, completion of her shift and then a return to the Tea Cup Café before going home. She lived alone and had a visiting nurse who would come to her home twice a day, once in the morning and once in the afternoon.

Once I had gotten really efficient at keeping my shelves well maintained, I would go down and help Violet with her books. At this point I was shelving three to four carts an hour. Many times, I would put Violet’s books in alphabetical order for her on the cart so all she had to do was shelve while I walked around after her and fixed her shelves to make them look as “fronted and faced” as mine. After several weeks of doing this I was taken aside by my supervisor and asked that I not help Violet because Violet was capable of doing her own work and she took the time she did because she had schizophrenia. I was not aware of this, and always felt I was doing what was “right” because Violet was elderly and honestly, seemed to me to present as not very aware of her surroundings. It wasn’t until I was told of Violet having a diagnosis of schizophrenia that I realized why she presented the way she did.

I learned later on that she had been institutionalized for many years as a young woman until her brother and sister were old enough to discharge her from the facility she was in. Violet came from a time where health practitioners believed it was best to lock away persons with disabilities and forget them. This process is consistent with the manifestation of oppression through containment (Mackleprang and Salsgiver, 2015). Society would rather hide Violet away than have her become a productive member of society or teach her skills because her life was less valuable than that of a person without a disability.

Violet and I never discussed her past or her diagnoses for the four years she and I worked together. After learning of Violet’s diagnosis, I realized I had been practicing ableism by doing her work for her and immediately stopped. I was not allowing Violet to do the work she was capable of because I assumed she couldn’t do it. Following this incident, I learned to ask before assisting her because I wanted to ensure I was respecting her ability work at her own pace and do what she had been doing for thirty plus years.

The irony of it all is my brother has schizophrenia and it wasn’t until I met Violet. that I realized the importance and effectiveness of a routine but also, knowing Violate gave me hope that my brother might someday find himself in a similar position where he could function independently from my parent’s care. The last year I worked at the library, Violet could no longer live independently due to needing around the clock assistance and eventually moved to a nursing home where she passed away some years ago. Every so often I visit the library and think of the woman who taught me about resiliency but also gave me a perspective that I keep with me always.

Sara Ghalaini
Sara Ghalaini is an M.S.W. candidate at Salem State University. Note for Screenreader: Image of a smiling young woman dressed in hijab


Sara Ghalaini 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 Psychology from The University of Massachusetts, Amherst. She is currently working on multiple initiatives including functioning as an LGBTQ Liaison for children in the care of the Department of Children and Families, building awareness between social workers and refugee families working with DCF and creating a chapter for disability issues under DCF’s Diversity Leadership. She hopes to continue her career in social work as a leader in community initiatives. Ms. Ghalaini chose to study social work practice with people with disabilities because she found a lack of cultural awareness between social workers and the clients they serve. Ms. Ghalaini can be reached at sara.ghalaini@state.ma.us.

 

 

A teacher’s response to Charlottesville for social workers in practice with people with disabilities

White nationalists from Jerusalem Post
Photo description: Segment of a large crowd of white men holding torches at a nighttime “Unite the Right” rally organized by White nationalists and Nazis on August 12, 2017. (Image from the Jerusalem Post)

I am currently teaching a course on social work practice with people with disabilities.  The course uses an intersectional lens, acknowledging the fact that people have many intersecting social identities that can result in varying types of privilege and oppression.  As such, I had to provide some venue for my students to address the Charlottesville violence and hate speech.  The following is a discussion prompt I provided for them to respond to, and I thought other social work educators might be interested in seeing this so that they could use it and/or modify it for their own courses.  Feedback welcome!

Discussion prompt: As we are part of a course on social work practice with people with disabilities in the United States of America, I would be remiss not to address the events of this past weekend in Charlottesville, Virginia. As you have already likely gathered, there are important links between the White nationalist/Nazi actions in Virginia, and the work we do as social workers with people with disabilities – who often have intersecting marginalized social identities. Many of the perspectives held by members of White nationalist/Nazi groups are clearly identifiable as racist, sexist, homophobic, anti-Semitic and even Eugenic in nature.  Therefore, as social workers practicing under our particular Code of Ethics, we need to respond. If you need some quick resources to learn more about the dynamics that led to the Charlottesville rally and violence, you can check out the “Charlottesville Syllabus” at this link.

As disability-aware social workers training to view the world with an intersectional lens, we need to acknowledge and act on what has happened in Charlottesville. That means that we need to engage in discussions – often difficult in nature – with our families, our co-workers and with our clients. Let’s start with our work with clients. One prominent disability civil rights activist, Rebecca Cokley, has noted that when terrorist incidents like this occur, people with disability count the minutes until ableist claims about the ‘crazy’ person who engaged in terrorist acts roll in. That may be an important place for you to start a conversation with a client with a disability in a week like this one. In this essay, Ms. Cokley points out another important link between disability and trauma.  She calls for the disability community (and disability service providers) to reach out to those whose disabilities came about as a result of trauma, such as the people who were injured and impaired by the car driven by the White nationalist/Nazi from Ohio. Her essay is short, easy to read and compelling and you can find it here.

It is also important to remember, however, that our work is not just direct care work. Remember, the NASW Code of Ethics states that we must fight for social justice, as it is a core value in our profession. We need to do more than discuss these difficult topics amongst ourselves, we also need to take a stand on them. I am fond of the idea that if we are not part of the solution, we are part of the problem. It is important to move beyond ideas of ourselves as “good” people, and work towards actively addressing the webs of oppression that exist in our world, little bit by little bit. Here is an example about how ADAPT, the national disability civil rights organization, has taken a stance on the events in Charlottesville. Where might you be able to stake your claim to your own stance?  Check out these ideas for 10 ways to fight hate from the Southern Poverty Law Center.

Finally, I want to leave you with a challenging set of questions. Although there are many facets to the NASW Code of Ethics, let us remember that the mission of the social work profession is rooted in a set of core values, including the idea that there is dignity and worth in every person.  How would you respond to a client with a disability who actively identified as a White nationalist/Nazi if you were to be assigned such a client today? What if she didn’t want to work with you because you were a woman of color?  What if she had been arrested for street fighting during the “Unite the Right” rally and was open about her wish to “hurt Leftists?”  Based on your training thus far in this social work program, how would you approach your work with this client?

Please leave your comments about this discussion prompt and how it might be improved or expanded upon.  All feedback is welcome.

How my part-time job helped me to confront my own ableism

Root beer in a mug
Note for screen reader: A frothy mug of delicious root beer, image from http://www.cottoncravings.com

By Sage Lucas, M.S.W. Candidate

Salem State University

I never thought that my part-time job as a waitress could possibly inform my social work practice in any way. Recently, in my disability and social work course, I was asked to consider my own ableism. After some reflection, I realized that, unfortunately, I have recently engaged in ableism at my job. While waitressing, many times during the day, a person with a disability will come in either on their own or with a family member or friend.

One time in particular, it was a busy Saturday, and a young man and his grandmother came and sat down at my table. I went up to them and said hello. When the young man began to speak to me, I couldn’t understand what he was saying. He started to point at the pictures in the menu and he was making grunting sounds. I looked towards the grandmother and blatantly asked, “Do you know what he wants?” The grandmother gave me a strange look, pointed towards her grandson and said, “He will tell you what he wants, he can do that, you know.” I looked towards the man, feeling ashamed of myself, and apologized. Then, I asked him what he would like to drink. He took out a book of pictures with words underneath each picture. He flipped through the book until it got to the page with drinks and food on it. After looking and looking for the right picture, he finally pointed to one picture in particular and looked up at me and smiled. And I said, “Would you like a root beer?” He politely nodded and smiled at me and then pointed to a picture of popcorn and signed the word for please. I said, “Ok, why don’t I get your drinks and I’ll grab you some popcorn as well.”

In reflecting on this incident, I can see that I engaged in what Mackelprang and Salsgiver (2015) called “compartmentalization.” Compartmentalization is meant to stereotype people with disabilities and to place them in a ‘predominated’ category Indeed, many times before I have seen a person with a disability enter the restaurant and if they cannot speak, the person who is with them will speak for them to make things more convenient for the wait staff. After some reflection, it should not matter how quickly the person can tell me their order, nor how they do it. Rather, they should be allowed to order in their own way and on their own. I did not take the time to see that this young man could order on his own and that he did not need the assistance of his grandmother. Mackelprang and Salsgiver (2015) comment that “pity places people with disabilities in a totally powerless position. They are not in control of their own lives. They are childlike. They are dependent…” (Mackelprang & Salsgiver, 2015, p. 113). This relates to what I have observed in myself. I saw that this young man had a disability and I stereotyped him with other persons with disabilities I had seen, when in fact he was not dependent on his grandmother, he was quite independent.  Since then, I have taken the time to stop and analyze how I talk to people and to not rush through my day without thinking about what I say, or how I am thinking about a situation. Although our society is structured in an ableist way, making us all susceptible to ableism, I do not want to behave in an ableist manner. Rather, I want to be someone who supports people with disabilities.

As a social worker it is important to understand what ableism is and how we each engage in it in our daily lives. If we want to work with people with disabilities we need to understand a person’s rights to dignity of risk, and their right to engage in self-determination. Looking back at that day with the young man who loved root beer, I can tell you all the rest of the meal was much different from how it was at the beginning. I took my time in talking to the man, and only asked the grandmother if she needed something rather than asking if her grandson needed something. After this experience of being called out by the grandmother, I feel I am more aware of how I think about disability in the restaurant and in my social work practice.

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

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

 

 

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.

Moving beyond “fixing” people: Social work practice with people with disabilities

Graduate social work students in Dr. Elspeth Slayter’s courses 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 Ndia Olivier, MSW Candidate

Salem State University

Working on a boarding high-school campus, I have the opportunity to be exposed to different students. During my first year, one student, in particular, stood out. J.M. was a breakout basketball star and had dreams of going to the N.B.A. Unfortunately, in his junior year, he was in a terrible car accident and as a result was paralyzed from the waist down. Everyone on campus was affected by his accident because J.M. was such a bright presence on campus and when he came back, he was a different person. He was less interactive on campus and lost his love for basketball.

The adults who were working with him every day were so fixated on the medical model, they wanted to “fix” him as much as they could so he could be ‘normal’ again. They suggested to his mom to take him to the best doctors who specialize helping people who are paraplegic learn to walk through virtual reality. They were not focused on his direct needs because they did not ask him, and that was detrimental to his recovery.

In using the social-model informed practice, the adults working with J.M. should have discussed with him how he saw his recovery going. By placing the focus on him rather than his disability, J.M.’s confidence in recovering could have been more positive than negative. Disability studies scholar Tom Shakespeare discusses the importance of focusing on the individual and not the impairment in order to create a confident space (Shakespeare, 2016).

One of the limits in the social model approach, however, is the idea that individuals with disabilities should disregard their impairments. More specifically, it is stated that “the social model so strongly disowns individual and medical approaches, that it risks implying that impairment is not a problem (Shakespeare, 2016 p. 218)”.

The medical model is helpful when we are utilizing action practices that are suggested by the person with the disability and not the people around them who are looking at it like a problem that needs to be corrected. As social workers, it will only benefit the clients we are working with if we are their advocates and find a balance between the medical model and the social model.

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

Ndia Olivier
This is Ndia Olivier, an MSW candidate at Salem State University’s School of Social Work. (Note for Screenreaders: Image shows a confident Black woman in a yellow dress who is smiling and standing in front of a river)

Ndia Olivier 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 Psychology from College of the Holy Cross. She hopes to do create change and be an advocate for the voiceless with this career. She wanted to study social work practice with people with disabilities to learn about a population she was unfamiliar with. She is striving to be a well-rounded social worker and learning about one of the minority groups in our society and becoming more self-aware, is key. Ms. Olivier can be reached at ndia.olivier@gmail.com.

“Letting” people who are non-verbal communicate in their own way: A challenge for social work practice

Graduate social work students in Dr. Elspeth Slayter’s courses 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 Kasey Soucy, MSW Candidate
Salem State University

While working at a disability group home agency, I came to know“ Jane,” a person with Rett Syndrome. Jane was non-verbal and was unable to walk independently. She used a specialized walker to move around. In addition, she developed her own sign language in order to communicate. During the day, Jane would attend a day program. That program gave all nonverbal clients computers that had the “Picture Exchange Communication System (PECS)” system on it. Jane was required to use it at the day program and was also encouraged to continue using it at the group home. Jane would take home the computer, but she would leave it in her bedroom. She did this because she didn’t like it, and was comfortable with her own form of communication. The day program became insistent on Jane using the computer at home, so the director asked Jane to use it. Jane refused to use the computer and threw it across the room because she was so upset about being asked to do so. The day program still required Jane to use the computer so she would comply, however once she was in her home she didn’t use it and the staff did not force her to do so.

As a social worker, and using what I know now from this course, I would first ask whether Jane wanted to use the PECS system. When disability studies scholar Tom Shakespeare was discussing the social model of disability, he pointed out the idea of this practice is to make society adapt to people with disabilities. This could include allowing for people’s own communication choice to be honored or it could include providing accommodations like the PECS system for non-verbal clients. One of the barriers of the social model (Shakespeare, 2006, p. 219) is trying to make accommodations for people with disabilities without choice. The PECS system might work well for one client who is non-verbal, but it did not suit Jane and she did not want to use it. Shakespeare described limitations with the social model-informed practice as assuming there could be a “utopia” for people with disabilities as there would be no barriers. People with disabilities do not all function or adapt the same way so it is unrealistic to be able to accommodate everyone and it is insulting to force accommodations on people with disabilities if they do not want to utilize that specific accommodation. If Jane was given the option to use or not use the PECS system then that would still be utilizing the social model-informed practice because society is making the change for her and not expecting her to change. By forcing the PECS system on Jane, it is reverting back to the medical model practice because the program is making Jane adjust instead of learning Jane’s sign language.

Jane also used a specialized walker. I would engage in medical model-informed practice by acknowledging it was Jane’s body part that was impaired, and therefore disabled her. This is another limit of the social model-informed practice. As Shakespeare (2006, p. 218), the social model-informed practice is so focused on society being the barrier that it does not always acknowledge that a person’s body can also be the barrier. The medical model-informed practice is what helped Jane receive the specialized walker because Jane’s body was the barrier and she wanted to walk as independently as she could. The social model-informed practice can also be used by ensuring there are ramps for Jane so she can have easy accessibility.

From the macro level of social work, I believe we are on the right track with the social-model informed practice, however as Shakespeare (2006) pointed out on page 220, this model is not complex enough to include everyone. Intersectionality does not seem to be taken in to consideration with this model, which is a complicating factor. A strong model needs to be developed to acknowledge the complexities of people and their disabilities. A person’s environment, gender, race and other social identities need to be considered when developing models (which was not the case since the group of activists who rallied for this model were white heterosexual men (Shakespeare, 2006, p. 217)). The first step to be taken by every social worker should be to ask the person with the disability “what can be done to support you?” or “what do you believe needs to be changed so you do not continue to feel oppressed or feel like your voice is not being heard?”

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

Kasey A Soucy
This is Kasey A Soucy, an MSW candidate at Salem State University’s School of Social Work. (Note for Screenreaders: Image shows a confident White woman in a beige sweater who is smiling and standing in front of a forest)

Kasey Soucy 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 Psychology from Salem State University. She hopes to continue her career with the Department of Children and Families. Ms. Soucy chose to study social work practice with people with disabilities so she can have a better understanding with the clients she works with. She also wants to work with her agency in providing a more inclusive solution for working with people with disabilities. Ms. Soucy can be reached at k_soucy@salemstate.edu.