Conceptualizations of Disability and their Effects on Disability Disclosure Anju Khubchandani, MA Director, Office on Disability Issues American Psychological Association akhubchandani@apa.org

Presentation Outline Presentation Outline

MEDICAL MODEL OF DISABILITY

IMPACT ON DISABILITY

DISCLOSURE

SOCIAL MODEL OF DISABILITY

BIBLIOGRAPHY

PARADIGM SHFT

Major disability models

Versus

MEDICAL MODEL OF DISABILITY Experience of disability is

inherently negative Focus is on disadvantaging

impact of physical or mental impairment rather than that of the environment in which they operate (LoBianco & Sheppard-Jones, 2007)

Disability is a deficiency or abnormality (Albrecht, 2006)

Disability resides in the individual (Albrecht, 2006)

The remedy for disability-related problems is cure or normalization of the individual (Burch & Sutherland, 2006)

Disability derives from interaction between the individual and society Redirects attention to the environment surrounding disabled person

Social Model of Disability Disability is normal part of

human experience, and is one form of diversity Redirects attention to the

environment surrounding disabled person (Oliver, 1980) Shifts causal responsibility

for disadvantage from individual to architectural, social, political and economic environment (Darling & Heckert, in press)

Shapes institutional response and provisions for disabled students Frequently sets the tone for institutional policies

and practices (e.g., enrollment forms, application forms, requests for accommodations)

• Disability was ignored or not believed • Discriminated against • Suggesting that the student should not be on

campus or proposing alternative course of study • Lack of understanding or support • Faculty thought less of me • Lowering expectations of the student • Elicited feelings of pity towards student Source: APA Office on Disability Issues, Barriers to Training Survey, 2008

“Entering the classroom with a cane, it takes courage! Entering the class almost after a year you learn with

them, and not all the students are aware (of the impairment), not because you do not want to (tell), because what? You go with a sign? ... A cane is some

kind of statement ... a lot of times people make implications from what is seen. I was afraid of that

moment of using the cane, because then people will associate me with the stigma, and I am not what the

stigma symbolizes.” Source: Personal Correspondence

• Am I disabled or not? (Olney & Brockelman, 2003; Werner, 2001)

• Do other people think I have a disability? (Becker et al., 2002; King, 2004; Lambeth et al., 2005; Megivern, 2001; Olney & Brockelman, 2003)

• Whose opinions matter to me? (Barga, 1995; King, 2004; Lynch & Gussell, 1996; Weiner, 1997)

• How do I feel about the fact that a certain person believes I have or do not have a disability? (Center for Psychiatric Rehabilitation, 2001; Olney & Brockelman, 2003; Werner, 2001)

How will others respond if I tell them? (Becker et al., 2002; King, 2004; Megivern, 2001; Olney & Brockelman, 2003; Werner, 2001) When should I disclose? To whom should I

disclose? (Lambeth et al., 2005; Megivern, 2001; Olney & Brockelman, 2003; Ralph, 2002; Roessler et al., 1999; White et al., 2005; Werner, 2001) What is the purpose of disclosing to this person?

(Ralph, 2002; White et al., 2005)

The social model: Requires a change in the way disability is conceptualized Asks us to examine and change our attitudes, policies, and

practices to reflect this paradigm shift Promotes social change through challenging long-standing

societal norms, beliefs, and values that are strongly skewed against individuals without disabilities (Mitra, 2006) Advances the belief that disability is overcome when physical

and social barriers in the environment are removed

“ The design of products and environments to be usable by all people, to the greatest extent possible, without the need for

adaptation or specialized design.”

The Center for Universal Design, 1997

“The design of products and environments to be usable by all

people, to the greatest extent possible, without the need for

adaptation or specialized design.” Source: The Center for Universal Design, 1997

Models of Disability

Positive or Negative

Issues Effects on Disclosure

Models of Disability

Positive or Negative

Issues Effects on Disclosure

Moral Positives Relationship to God, being chosen, increased faith

Would disclose to select few (e.g., others with disabilities, family, faith group)

Negatives Shame, sin, stigma to self and family, adverse effects on marriageability

Unlikely to disclose

Models of Disability

Positive or Negative

Issues Effects on Disclosure

Moral Positives Relationship to God, being chosen, increased faith

Would disclose to select few (e.g., others with disabilities, family, faith group)

Negatives Shame, sin, stigma to self and family, adverse effects on marriageability

Unlikely to disclose

Medical Positives Clear role as patient, decreased stigma, encouragement to live ‘normal’ life

Very select disclosure, as mostly trying to ‘pass’ as ‘normal’

Negatives Patronizing, body divided into ‘good’ and ‘bad’ parts, little integration of disability into self-concept

Only likely to disclose in situations where something is needed (e.g., an accommodation)

Models of Disability

Positive or Negative

Issues Effects on Disclosure

Moral Positives Relationship to God, being chosen, increased faith

Would disclose to select few (e.g., others with disabilities, family, faith group)

Negatives Shame, sin, stigma to self and family, adverse effects on marriageability

Unlikely to disclose

Medical Positives Clear role as patient, decreased stigma, encouragement to live ‘normal’ life

Very select disclosure, as mostly trying to ‘pass’ as ‘normal’

Negatives Patronizing, body divided into ‘good’ and ‘bad’ parts, little integration of disability into self-concept

Only likely to disclose in situations where something is needed (e.g., an accommodation)

Social Positives Integration of disability into self-concept, empowerment, identity with group, pride

Likely to disclose to most/all

Negatives Victimization, problems of stigma and discrimination too large to manage

Likely to disclose in venues seen as ‘safe’

Some of us walk differently, nevertheless we are the same. ~Unknown

Irving Kenneth Zola, Missing Pieces: A Chronicle of Living with a Disability (Philadelphia: Temple University Press, 1982), 206.

• Brockelman, Karin, Chadsey, Janis, Loeb, Jane (2006). Faculty perceptions of university students with psychiatric disabilities. Psychiatric Rehabilitation Journal 30: 23-30.

• Brockelman, Karin (2009). The interrelationship of self-determination, mental illness, and grades among university students. Journal of College Student Development 50: 271-286 Brockelman, Karin (2003). Out of the disability closet: Strategic

use of perception management by university students with disabilities. Disability & Society 18: 35-50 Corrigan, P.W. (2005). On the stigma of mental illness: Practical

strategies for research and social change. Washington, DC: American Psychological Association.

Gill, Carol (1995). A psychological view of disability

culture. Disability Studies Quarterly, vol. 15, no 4. Hahn, Harlan (1985). Toward a politics of disability:

Definitions, disciplines, and policies. University of Southern California. Linton, S. (1998). Claiming disability: Knowledge and

identity.” New York: New York University Press. Morris, Jenny ( 1991). Pride against prejudice:

Transforming attitudes to disability. New Society Publishers: Philadelphia, PA. Zola, Irving K. (1982). Missing pieces: A chronicle of living

with a disability. Philadelphia: Temple University Press.