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.