This Disability Pride Month we explore the holistic and socially-conscious approach of the social model of disability and highlight how it complements the person-focused interventions of occupational therapy
Any occupational therapist will be familiar with the concept of a model; they form the backbone of many approaches and interventions which allow OTs to help their clients achieve independence. The Kawa River Model, PEOP, biopsychosocial model - they all allow occupational therapists the theoretical framework required to approach a practical solution for their clients’ needs.
When we speak about disability, there are two frequently contrasted models, each with a seemingly polarised view on how disability relates to the wider world. These are the medical model and the social model of disability. The former looks at disability from a biomedical perspective, and assumes that a disability will inherently reduce a person’s quality of life, but with the intervention of a medical professional, this can be reduced or “corrected”. The focus of the medical model is on the presence of a cure, and aims to bring disabled people closer to what is considered to be a “normal life,” with the medical professional’s ability to “fix” them being centred in the narrative.
In the medical model of disability, someone might say that a person is “suffering” from their disability, and that chronic illness or injury would, in an ideal world, be “cured”. Many disability campaigners, alongside charities like Scope, do not support the way that the medical model views disability, noting that it emphasises what is “wrong” with the person, and not what they need. On their website, Scope writes that they believe the medical model “creates low expectations, and leads to people losing independence, choice, and control in their lives.”
The social model of disability provides an alternative to the medical model of disability which complements the holistic approach of occupational therapy, and its patient-centred approach to care. It recognises that people are disabled by barriers in society, not by their impairment or difference.
The social model takes its roots from the disability rights movement in the UK, which further emphasises its holistic, “nothing about us without us” approach to care for disabled people. In 1975, the Union of the Physically Impaired Against Segregation wrote that they believed it is society which disabled people by excluding them from fully participating in the world around them, a view that would form the backbone of the social model. It was disabled academic Mike Oliver who took these ideas and developed them into a well fleshed-out academic model, contrasting the individualistic nature of the medical model of disability to the community-based social model of disability. His book, The Politics of Disablement, released in 1990, is considered one of the major moments in the social model’s adoption by wider society. From there, the social model has been adapted and expanded on to include people who live with learning difficulties or disabilities, and people with emotional or mental health conditions, too.
What approach does the social model of disability recommend, then? In simple terms, the social model tells us that a situation where a disabled person is not able to engage with society around them is not the fault of the disabled person, but society itself. As a comparative example, say a disabled person would like to enter a building where there are only stairs to reach the main entrance, but they are a wheelchair user, and cannot safely use the stairs. The medical model sees a disabled person unable to engage with “normal” society, and seeks to correct the problem by focusing on their ability to physically climb up the stairs. The social model, on the other hand, asks instead why the building does not have a ramp.
In this scenario, per the social model, the person’s impairment continues to exist, but their impairment does not prevent them from engaging with the rest of society, and their ability to simply enter a building.
For non-disabled people, the social model is a way to challenge internal prejudices regarding disability, and unlearn thought patterns and stereotypes which are harmful to the disabled community. It emphasises that disabled people should always have equal opportunities and access: it challenges the notion that disabled people can’t have sex, work, live independently, or have children, and gives us the tools to confront any ableist ideals which we may have inadvertently learned throughout our lives.
The social model of disability is not without its criticisms: as Inclusion London notes, the model can sometimes fail to explain or address the needs and experiences of specific groups of disabled people, but its approach to disability directly parallels the OT’s own holistic methods of implementing adaptation and inclusion within people’s lives and communities.