Disability and Social Work Practice PDF

Disability and Social Work Practice  Outline Defining disability Theorizing disability Categorizing disability Prevalence of disability in Canada History of disability policy in Canada Social work practice with individuals with a disability Defining...

Disability and Social Work Practice  Outline Defining disability Theorizing disability Categorizing disability Prevalence of disability in Canada History of disability policy in Canada Social work practice with individuals with a disability Defining Disability  Defining Disability No universal definitions of disability exist in Canada Definitions of disability can shape policies, programs, and services Different government agencies define disability in various ways – Definitions of disability for surveys (e.g., to determine prevalence rates of disability) will differ from definitions of disability for redistribution of benefits (e.g., to determine income tax credits) Theorizing Disability  The Medical Model of Disability Also known as the biomedical, disease, clinical, or individual model Views disability as an individual deficit and conceptualizes disability as being fundamentally biological in origin Pathology or deviance from normality is “diagnosed” by “experts,” who serve as gatekeepers to services Shortcomings of the medical model: – Disability is viewed as a set of static, uniform, and pathological characteristics – It serves to objectify the individual – It does not consider the social or environmental factors of disability  The Social Model of Disability Emerged in response to the medical model Views individuals with disabilities as an oppressed group and seeks to reconceptualize disability, distinguishing impairment from disability – Impairment is a result of a physical limitation whereas disability is a result of oppression and social exclusion Disability is created or constructed by social factors such as the economy, culture, and language Shortcomings of the social model: – It risks discounting the individual entirely – It assumes that all people with disabilities are oppressed and does not acknowledge how this group differs from other oppressed groups – A barrier-free world is virtually impossible  The WHO’s International Classification of Functioning, Disability and Health "Disability is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in  A View of Disability https://www.ted.com/talks/stella_youn g_i_m_not_your_inspiration_thank_yo u_very_much How does the speaker challenge your ideas around disability? How does this fit in with the medical vs social models of disability? Categorizing Disability  The Categorical or Diagnostic Approach Predicated on the identification of the cause and effects of any deviation from normal bodily structures and functions Seeks to identify and classify these deviations based on findings from tests and assessments (e.g., brain scans, hearing and vision tests, behavioural assessments, etc.)  The Categorical or Diagnostic Approach, cont’d Benefits: – Provides standardized care across contexts – Allows medical specialization and expertise – Allows clinical research to study specific groups – Permits the collection and tracking of public health statistics – Permits community building among those with a shared diagnosis Challenges: – May diminish the differences between individuals with a shared diagnosis and the commonalities between individuals with different diagnoses – Clinical studies cannot explore the experiences of rare disorders (due to small sample sizes)  The Non-Categorical or Functional Approach Suggests that level of functioning, rather than diagnostic label, has a greater impact on participation and outcomes for individuals with disabilities and can tell us more about how limitations in the body interact with activities associated with certain social roles Disability involves the interaction of impairment in bodily structure and function, activity limitations, restriction in social participation, and environmental factors such as physical, social, and attitudinal settings  The Non-Categorical or Functional Approach, cont’d Benefits: – Acknowledges the interaction between the impairment in bodily structure and function and the environment – Reduces stigma attached to specific diagnoses – Provides tangible, individualized areas for intervention that are grounded in the day-to-day lives of people with disabilities Challenges: – Complicates classification (medical intervention and clinical research) – May be time-consuming and difficult to apply in practice (as an awareness and understanding of how the impairment fits within the context of the individual’s life is needed) Prevalence of Disability in Canada  Prevalence of Disability in Canada Canadian Survey on Disability (CSD) – Measures disability according to the severity and frequency of experienced activity limitations due to a physical, mental, or other health-related condition (non-categorical) Canadians experiencing disabilities in 2017: – 22.3% of all Canadians aged 15+ (6.2 million) – 24.3% of women and 20.2% of men aged 15+ – 37.8% of individuals aged 65+ – The majority of individuals with disabilities identified family members or friends as their most common source of help History of Disability Policy in Canada Early Beliefs about Individuals with Disabilities Types of disabilities, both physical and mental, have been viewed differently based on societal norms of the time – E.g., ancient Greeks viewed physical impairment as punishment by the gods for sinful acts of ancestors Provision of care for individuals with impairments began in churches and other religious entities Prisons, workhouses, and almshouses housed individuals who “looked, acted, or behaved differently” In Canada in the early 1800s, there was no state support for those who were historically termed as “lunatics” or “the insane”  Asylum, Confinement, and Institutionalization The Provincial Lunatic Asylum opened in the Toronto City Jail in 1841 – Commitment followed two routes: (1) designation by two physicians; or (2) statement from a justice of the peace Asylum system used as a “catch all” for unwanted people of any description Eugenics: – the practice of selecting desired human traits to improve the genetic stock of the population and prevent the breeding of those with undesired traits (e.g., “feeble- mindedness”) – Early 1900s – Alberta and British Columbia passed sterilization legislation  Deinstitutionalization 1970s–80s: shifts in care and support of individuals with disabilities Patients moved from custodial institutions to hospitals and then to community living arrangements Movement to community living resulted in a drastic decrease in funding for people with disabilities This lack of service was partially addressed by non- governmental organizations As a social reform, the deinstitutionalization movement identified the segregation of individuals as oppressive and acknowledged that the needs and rights of individuals with disabilities could be better met within their home communities The Independent Living Movement and the Dignity of Risk Independent Living emerged in North America in the 1970s The IL movement identifies that individuals with disabilities have the right to live in their communities despite societal barriers that impede their full and meaningful participation IL philosophy: – Those who best know the needs of individuals with disabilities and how to address those needs are persons with disabilities themselves – Need for integrated, comprehensive, and community-based services – Need for enhanced self-representation and self-determination through a de-professionalization of services and the involvement of individuals with disabilities in the administration of services – Services include peer support and direct funding so that The Independent Living Movement and the Dignity of Risk, cont’d Normalization principle (Bengt Nirje): – Availability of patterns of life and conditions of everyday living that are as close as possible to, or the same as, the regular ways of life of the community Social role valorization (Wolf Wolfensberger): – Access to valued social roles provides access to dignity, respect, participation, belonging, and opportunity – Opportunities for valued social role taking are enhanced and sustained through welfare programs that promote inclusion and provide support to individuals with disabilities  Progress and Development of Disability Rights in Canada 2010 1982 United 1961 Canadia Nations Vocational 1976 n Conventio Rehabilitati Council of Charter n on the on of Canadian of Rights Rights of Disabled s with and 1995 Persons Persons Act Disabilitie Freedom Employmen with s s t Equity Act Disabilities 1965 1981 1985 1998 The Internationa Canadian In Canada l Year of Human Unison Pensio Disabled Rights Report n Plan Persons Act  Social Work Practice with Individuals with a Disability  Health and Social Services for Individuals with Disabilities Federal and Provincial Resource Allocation – Provinces and territories are responsible for their own health care plans, but receive federal funding in the form of transfers – All provincial and territorial plans must include certain standardized features, but some offer additional benefits Universality of Equivalent Care – Specialized services are usually offered in large urban centres – Jurisdictional disputes between federal and provincial governments may impede timely decisions – Long waiting lists may delay or limit access to services Income Support – Programs such as the Canada Pension Plan Disability Benefit require a detailed application and proof of work history, financial status, etc. – Income support may also include specialized programs (e.g., to assist with housing needs)  Health and Social Services for Individuals with Disabilities, cont’d Specialized Services – Publicly-funded programs directed at specific populations (e.g., Ontario Autism Program) – May provide either direct service or direct funding options Educational Services – Mainstreaming seeks to integrate students into classrooms according to their age cohort, irrespective of their level of functioning (they may have an aide and follow an IEP) Non-Governmental Organizations – Vary in scope and size – Often founded by parents or people with a particular interest, and may receive government grants  Promoting Access to Specialized Care: Health, Rehabilitative, and Social Services Social workers may be involved in: – Intake and eligibility assessments – Assessment of the individual’s level of functioning – Assessment of psychosocial needs of both the individual and the family – Case management – Care coordination  Promoting Access to Educational Services, Employment, and Independent Living Social workers may: – Work within schools to ensure that students are provided the necessary modifications or accommodations to succeed – Work with people with disabilities in accessing meaningful employment opportunities and supporting their ongoing participation in the workforce (e.g., vocational assessments, job preparation, job coaching, mentoring and supervision, environmental modifications, assistive technologies, etc.) – Work with people with disabilities in fostering opportunities for independence (e.g., ensuring that the individual is involved in key decisions, working with the individual in coordinating accessible housing and transportation, etc.)  Supporting People with Disabilities in Rural or Remote Regions According to 2016 Census data, less than 17 per cent of Canada’s population live in rural and small-town areas Resources for people with disabilities are concentrated in urban areas Canadians with disabilities living in rural and remote regions may have less access to specialized care (health, rehabilitative, and social services), schools, transportation, etc. Individualized funding models may be useful in these contexts Social workers in rural or remote regions of Canada may benefit from connecting with peers in urban areas through networking opportunities, communication technology, and continuing education and professional development  Addressing Poverty: Access to Income Support Individuals with disabilities are more likely to live below the LICO (Low Income Cut Off) than those without disabilities In 2012, the median income of individuals with disabilities (15 to 64 years of age) was $10,000 less than the median reported by individuals without disabilities Social workers may: – Work with individuals and their families to identify and apply for key income support programs for which they are eligible – Act as advocates in practice, policy, and research,  Fostering Quality of Life Quality of life is a multifaceted construct comprised of both objective and subjective dimensions: – Interpersonal relations – Social inclusion – Personal development – Physical, material, and emotional well-being – Self-determination – Rights Social workers work within and across systems to address sites of oppression and marginalization and may work in ways that address not only physical and material well-being but also life satisfaction, self-determination, agency, citizenship, and social participation  Supporting the Transition to Adulthood The transition to adulthood for youth with disabilities involves both institutional and developmental transitions (e.g., pediatric to adult health and rehabilitative care, school system to community) Many institutional settings offer services and supports aimed at fostering a positive transition between institutions while addressing key psychosocial or developmental goals Social workers may help youth: – Prepare to manage their own health care – Practice independent living skills – Become involved in the community – Identify short- and long-term life goals  Addressing Caregiver Well- Being Caregivers may experience: – Financial strain – Negative impacts on employment – Marital or relationship difficulties – Role changes – Feelings of grief or loss Caregiver supports may include: – Respite – Counselling and therapy  Social Work Practice Guidelines Understand the interaction between impairment and the environment Understand ableism’s impact on individuals with disabilities and their families and challenge disability stereotypes Work in partnership with individuals, their families, and institutions Consider the life course of the individual