Discipline Specific Elective

Paper-III
PSYCHOLOGY OF DISABILITY
UNIT-II (i) Theorizing Disability: Charity Model: Welfare Model; Medical
Model (ii) Social Model: culture as disability; Empowerment Model
 Medical Model
• The Medical Model of Disability relies on a purely medical definition of disability.
• This model is also referred as bio-centric model of disability. Thus equates the physical or mental impairment
from a disease or disorder with the disability that the person experiences.
• From a policy viewpoint, the person with disability is viewed as the “problem”, and in need of cure and
treatment. In terms of services, the general approach within this model is towards special institutions for people
with disabilities, e.g. special schools, sheltered workshops, special transport etc.
• The medical model approach to disability holds that disability result from an individual’s physical or mental
limitations. The development of medical science and curative approach of the physician has contributed the
medical model.
• Since many disabilities have medical origins the problems that are associated with disability are deemed to
reside within the individuals. The individual with a disability is in the sick role under the medical model. In
other words, if the individual is “cured” then these problems will not exist. On this basis persons with
disabilities are considered as ‘abnormal’ in comparison with ‘normal human being’. Such a view encourages
dependence on doctors, rehabilitational professional and charity. This approach thus lays all emphasis in clinical
diagnosis and medical treatment rendering the disabled individuals as the recipient of public assistance and
charity.
• The medical welfare approach offers four assumptions that:
• Disability is basically a disease state and absolutely falls under clinical framework
and essentially a problem focusing on the individual as a deviation from the norm,
the role of the medical and paramedical professionals is to cure and ameliorate this
problem in order to enable them to be as normal as possible;
• There is an objective state of normality which within the medical profession
entrusts professionals, a crucial role and leaves little scope for the disabled and
their families to participate in the decision making process;
• The disabled individuals are biologically and psychologically inferior to their able
bodied counterparts and they are, thus, not treated as fully human and by
implication, lack the competence to decide for themselves, and;
• The phenomena of disability is visualized as a personal tragedy, which
occasionally affects individuals.
• Medical model support the postulate that persons with disabilities are biologically and psychologically inferior to other able
bodied counterparts. So they are not treated as fully human because they lack the competence to decide for themselves. This
model reduces disability to impairment and sought to locate it within the body or mind of the individual while the power to
define, control and treat disabled individual was located within the medical and paramedical professionals. This model restricts
the rehabilitation efforts to medical treatment in terms of protection and care.
• Such an approach towards the disability may be regarded matter of personal tragedy which encourages dependence on medical
and paramedical professional, rehabilitational professionals and charity. Obviously, the medical paradigm stigmatizes the
disabled people by describing them as not normal. The medical welfare approach to disability has been well represented by the
World Health Organisation. The classification of disability made by World Health Organisation in 1980 also supports the
medical welfare approach which lays all emphasis on clinical diagnosis and medical treatment rendering the disabled individual
as recipient of public assistance and charity.
• Disability is seen as a medical problem that resides in the individual.
• It is a defect in or failure of a bodily system and as such is inherently abnormal and pathological.
• The goals of intervention are cure, amelioration of the physical condition to the greatest extent possible, and rehabilitation (i.e.,
the adjustment of the person with the disability to the condition and to the environment).
• Persons with disabilities are expected to avail themselves of the variety of services offered to them and to spend time in the role
of patient or learner being helped by trained professionals.
• The medical model of disability is sometimes also referred to as the ‘personal tragedy’ model (Thomas & Woods 2003:15),
because it defines disability in a fundamentally negative way. Disability is regarded as objectively bad, as a pitiable condition, ‘a
personal tragedy for both the individual and her family, something to be prevented and, if possible, cured
• As Carlson points out, this negative conception of disability has contributed to some of the questionable medical treatments
performed on PWDs, including, for example, involuntary sterilisation and euthanasia
• Medical professionals who subscribe to the medical model tend to treat people as
problems to be solved, often failing to take into account the various aspects
related to the person’s life as a whole (Thomas & Woods 2003:15).
• Kasser and Lytle (2005:11) highlight the medical model’s exclusive focus on the
limitation(s) associated with a person’s disability, which essentially ‘[disregards]
environments that might intensify or adversely affect a person’s functional
abilities’. Accordingly, the medical model tends to regard the person with disability
as the one who needs to change or be fixed, not the conditions that might be
contributing to the person’s disability (Kasser & Lytle 2005:11)
• The medical model of disability assigns tremendous power to the medical
professionals who diagnose people using criteria, because the very criteria being
used for diagnosis have been developed from the perspective of what is
considered ‘normal’ in society
‘Many disabled people are
not sick, but have ongoing impairments that do not present
as daily health problems’
 Charity Model: Welfare Model
• Charity model of disability also views the person with disabilities as the problem and dependent on the sympathy of others to provide assistance in a charity or
welfare.
• This model treats the disabled as dependent upon the society. It has an emotional appeal towards the disabled.
• The disabled are treated as helpless victims needing ‘care and protection’.
• Under this model disabled people are depicted as people deserving pity. The charity model approach makes the disabled as individuals powerless instead of
empowering them. Employers will view disabled people as charitable cases. Instead of addressing the issue by creating a suitable work environment for people with
disabilities, the employer may donate money and avoid responsibility.

Charity model is driven largely by the emotive appeals. This model relies heavily on the charity and benevolence rather than justice and equality.
• The sentimental appeals motivate much of the model of charity.
• This paradigm is firmly focused on charity and benevolence, not on fairness and equity. This paradigm accepts the isolation from institutional arrangements and
public service by people with disabilities.
• The charity paradigm justifies the absence from formal schooling and work by people with disabilities. Entitlement privileges are supplemented with relief
initiatives establishing, based upon either the state funds or charitable people, a fighting forces of helpless entities lacking any influence or negotiating power.
• This paradigm argues for a mechanism to provide social care for disadvantaged individuals. This model was focused on the original efforts of both the government
and individuals.
• The government dedicated a substantial portion of the fund to the care of disadvantaged citizens. The NGOs working to help people with disabilities still depend on
contributions and government grants
• Charity model justifies the exclusion of persons with disabilities from the mainstream education and employment. Entitlement rights are substituted by relief
measures creating an army of powerless individuals, without any control or bargaining power, depending either on the state allocated fund or benevolent
individuals.
• This model asks for social support mechanism for the benefit of person with disability. Initial efforts of the government and individuals were based on this model.
Government was allocating large chunk of fund for the welfare of persons with disabilities. The non-governmental organisations’ working for the benefit of persons
with disabilities also relies on the donations and government grants.
Social Model
• The emergence of the disability political movements of the 1970s in Britain
reconceptualized disability from a ‘personal tragedy’ to a complex form of social
oppression (Abberley, 1987).
• This has seen the emphasis move from the individual’s impairment, their ‘personal
tragedy’ as the ‘victim’ (Oliver, 1990, 1996) to the disabling social environment and
prevailing ‘hostile social attitudes’ (Barnes, 1996, p. 43).
• In contrast, disability advocates argue that disability is imposed on top of their
impairment not because of their impairment but due to socially constructed barriers
and attitudes (Barnes, Mercer, & Shakespeare, 1999).
• A person with an impairment need not acquire a disability if enabling environments are
developed through the incorporation of economic, political and social structures
(Swain, Finkelstein, French, & Oliver, 2004).
• Instead of the ‘fault’ residing in the individual, the disability becomes part of the social
constraints imposed on those with impairments through the lack of inclusive accessible
built environment, transport, service attitudes and employment practices. As a number
of studies have shown, where these discriminatory environments constrain the
citizenship of people with disabilities generally and in a tourism context (Darcy &
Taylor, 2009; Goodall, Pottinger, Dixon, & Russell, 2004).
• The earliest articulation of this social construction of disability was through the Union
of the Physically Impaired Against Segregation (1975), which defined impairment and
disability as:
• “An impairment is lacking part of or all of a limb, or having a defective limb, organism or
mechanism of the body” (Union of the Physically Impaired Against Segregation, 1975).
• “Disability is the disadvantage or restriction of activity caused by contemporary
organisation which takes no or little account of people who have physical impairments
and thus excludes them from the mainstream of social activities” (Union of the
Physically Impaired Against Segregation, 1975).
• This definition of disability reflects the socially constructed nature of disability and the
resultant exclusion. The degree of exclusion becomes dependent on the type of
impairment and the level of support the person requires for social participation in all
areas of citizenship. These further layers of complexity will be discussed later in the
chapter as part of the disability statistical framework.
• The social model defines disability as a product of the socially constructed disabling
environment and prevailing hostile social attitudes that oppress, exclude and
marginalize disabled people from social participation (Oliver, 1990, 1996).
• The defining element of the social model lies in the transformation of an impaired person to a
disabled person as a product of the ways in which society is organized (economic, social,
cultural, transport, built environment, leisure services etc.).
• This social organization is discriminatory because it is based on a non-disabled interpretation
of what is ‘normal’.
• The social model views disability as having a social dimension and regards impairment as part
of human diversity. These socially constructed barriers affect an individual’s social
participation, create disability on top of a person’s impairment and discriminate against a
person because of their impairment
• The social model rejects the notion that people with disabilities are in some inherent way
"defective" from the benchmarked yet elusive norm. Over lifespan most people will
experience some form of disability, either permanent or temporary, from the beginning of
their lives or acquiring it during their life course through traumatic injury or the side-effects of
illness. There is a well defined correlation between ageing and disability, with disability rates
significantly higher as people age. Given this reality, if disability was more commonly
recognized and accepted in the way that society designs environments or systems, it would be
regarded as normal
• The social model of disability does not deny an individual’s impairment but strongly states that
the resultant disabilities are a product of socially constructed barriers that exclude or
segregate people with impairments from participation in mainstream social activities. It firmly
places disability in the social, economic and political agendas rather than locating disability as
the fault of an individual’s body.
• The social model informs an understanding of tourism by suggesting that the socially
constructed relationships developed from three elements:
• 1. experiences of disabled people;
• 2. identifying disability as the combination of impairment and socially constructed
barriers; and
• 3. part of a conceptual clarification designed to facilitate a scientific attack on the
constraints and barriers that oppress disabled people and therefore lead to their
impoverishment and social dysfunction.
• The important change in orientation of the third point is that it directs scientific
attention toward the disabling barriers (Swain et al., 2004) that are the sites of
oppression that actively produce disabled people. It changes the focus from the
individual’s ‘problem’ or ‘personal tragedy’ to that of the socially constructed barriers
that produce disability. These disabling barriers have physical, social, economic and
political contexts.
• The social structures are a product of historical development and cannot be divorced
from their cultural context. The cultural context involves both a material and
ideological transformation of the way people with impairments are treated by society
• Therefore, the overall aim of this model is
to move the whole society to a more
positive understanding of what it means
to live with a disability and to adapt the
environment accordingly.
• Further, since disability is regarded as
socially constructed then there has to be
a social solution.
• By creating more accessible social
structures people with disabilities are not
only able to participate in their rights of
citizenship but become active agents in
affecting social change.
• In Western nations many nondisabled
people support these notions as
evidenced by the Eurobarometer study
(Europeia, 2001) where 97% of the
Europeans state that something should
be done to ensure better integration of
people with disabilities into society.
 The cultural model: Disability as culture
• The cultural model of disability developed in the North American context, where disability studies have been
approached in an interdisciplinary manner by a number of scholars working in the social sciences and
humanities (cf. Michalko 2002; Titchkosky 2007).
• While the medical model and the social model each focus on only one factor in their approach to disability, the
cultural model focuses on a range of cultural factors. Such factors may include medical and social factors but are
by no means limited to these factors. Accordingly, the cultural approach does not seek to define disability in any
specific way but rather focuses on how different notions of disability and non-disability operate in the context of
a specific culture.
• The work of Snyder and Mitchell (2006) has played a critically important role in shaping the theoretical contours
of the cultural approach to understand disability. Snyder and Mitchell (2006) argue that particular ‘cultural
locations of disability’ have been created on behalf of PWDs, locations where PWDs ‘find themselves deposited,
often against their will’. Some of these ‘cultural locations’ include:
• nineteenth century charity systems; institutions for the feebleminded during the eugenics period; the international disability research
industry; sheltered workshops for the ‘multi-handicapped’; medically based and documentary film representations of disability; and
current academic research trends on disability. (p. 3)
• The primary problem with these manufactured locations is the modernist assumptions which underpin them,
specifically the strategy ‘to classify and pathologize human differences (known today as disabilities) and then
manage them through various institutional locations’ (Snyder & Mitchell 2006:4–5). Nevertheless, such artificial
or manufactured locations of disability knowledge should be distinguished from ‘more authenticating cultural
modes of disability knowledge’, which are necessary and important ways of understanding disability, for
example, ‘the disability rights movement, disability culture, the independent living movement, and other
experientially based organizations of disabled people’ (Snyder & Mitchell 2006:4).
• The cultural model of disability is gaining increasing acceptance in the disability community, especially through
its adoption by a number of deaf culture theorists (cf. Holcomb 2013; Lewis 2007).
 Empowerment Model
• The empowering model of disability allows for the person with a disability and
his/her family to decide the course of their treatment and what services they
wish to benefit from. This, in turn, turns the professional into a service provider
whose role is to offer guidance and carry out the client's decisions. In other
words, this model "empowers" the individual to pursue his/her own goals.
• Understanding Barriers to Participation:
• There are four main barriers that prevent individuals with disabilities from successfully
participating in community based physical activity programs: (1) lack of programs/
opportunities, (2) fear on the part of the participant, parents, as well as the instructors;
(3) lack of training and knowledge on the part of the instructors; and (4) concerns about
liability
• Lack of opportunities.
• When it comes to a participant without disabilities playing a sport in which he or she is interested,
the options are endless. The contrary is true for participants with disabilities. Finding a team or
activity that is a “good fit” is not always a simple task as there is a lack of options in both the
schools and community for organized physical activity for individuals with disabilities
• Fear
• Participants and their parents experience fears of their own when it comes to community-
based physical activity programs. Often parents refuse to enroll their child with a disability in
community programs due to these fears
• Parents are afraid their child will fail. Individuals with disabilities have also expressed the
fear of being unable to accomplish the same skills as other participants, making them
reluctant to even try
• Lack of knowledge/training on accommodation
• many instructors lack the knowledge and the training to appropriately meet the needs of
participants with disabilities. Most have never received any formal training on disabilities or
special education, let alone how to meet the needs of these populations
• Liability
• Positive effects of participation in sports can be as powerful for individuals with disabilities
as it is for individuals without disabilities. Unfortunately, those with more significant
disabilities such as physical, visual, or intellectual disabilities or autism are excluded from
participation
• In some cases instructors may be concerned with the liability of having a participant with a
disability participate in and perhaps get hurt during a practice or game
• What is Empowerment?
• Empowerment involves a process of giving power or control over one’s own life to an individual or
group that has traditionally been marginalized or had control of their own life limited or surrendered
• Empowerment involves a strengths based approach, viewing individuals as having competencies and
the right to function autonomously, yet needing opportunities and resources in the external
environment to manifest those.
• It goes beyond simply giving an individual rights, but also provides the needed social structure and
resources to live those out, demonstrating one’s abilities and exerting control over one’s life.
• When support is provided, it is done from the perspective of collaboration, not professional expertise.
This is in contrast to a needs-based approach, which relies on experts to provide a solution or prevent
problems for the individual
• Empowerment theory (Perkins & Zimmerman, 1995; Sadan, 1997; Zimmerman 1995, 2000)
encompasses both processes and outcomes. Relevant processes include those activities, structures, and
actions that are empowering to someone or some group by enabling them to develop skills and obtain
resources to solve problems affecting them
• Outcomes include the measurable level of empowerment an individual, organization, or community
experiences as a result of an intervention that was designed to empower. Some potential outcomes
might include increased feelings of perceived control, use of newly developed skills, changes to
organizational policy in response to identified concerns, or increased accessibility of community
resources
• Both processes and outcomes operate at multiple ecological levels (i.e., in individuals, organizations,
and communities), and may manifest differently in different contexts and with different population
• Empowerment for individuals with disabilities:
• Consistent with empowerment theory, recent work with individuals with disabilities
has moved away from focusing on individual deficits to focus instead on removing
environmental (e.g., physical accessibility) and psychosocial barriers (e.g., lack of
inclusive organizational programs and practices, fear) that constrain an individual’s
ability to function independently
• Individuals with disabilities often experience very little control over their own lives.
In the realm of sports, decisions are made for them simply by the lack of
opportunities to engage in sport due to physical and/ or social barriers. Thus, in a
social context such as community-based physical activity programming, the
empowerment process may involve providing opportunities and creating settings for
individuals to affirm their athletic abilities and develop those further
• This model addresses each of the barriers and then uses the foundation of
empowerment theory to demonstrate how one can empower participants with
disabilities, instructors, and community organizations to overcome the barriers that
inhibit individuals with disabilities’ participation in community-based programs
• The model has the three unique elements of programming, training, and support.
Even though each element plays an essential role in the success of each participant,
the implementation of the model indicates it is the interaction of these elements
that facilitates successful participation and true empowerment.
• The first element, Programming, referred to as the
“continuum of opportunity,” suggests a community should
consider providing a selection of options that align with the
current ability levels (physical, cognitive, and social) of all
individuals. This continuum would allow participants to
select a program that allows them to participate
successfully. The continuum of opportunities may exist
within one organization or throughout multiple
organizations in one community.
• The programming element considers two main factors:
setting and group make-up
• In terms of setting, programs can range from taking place
in closed or controlled settings to taking place in open or
uncontrolled settings. In terms of group make up,
programs can be specialized (only for participants with
disabilities), reverse inclusion (mostly participants with
disabilities, but a few peers without disabilities are enrolled
as role models and participants), or full inclusion
(participants with and without disabilities are enrolled).
• The design of the continuum provides opportunities for
mastery and advancement (moving to the next level of
programming) once skills, knowledge, and appropriate
behaviors are attained
• The second element of the model is Support, which is referred to as “Helping Hands.” This element
acknowledges that some level of support may be desired on the part of the participant or requested by the
parent/guardian or the instructor/organization. The model considers three main factors as it relates to
support: who needs the support, type of support needed, and the level of expertise required
• Support can be provided directly for the participant or the instructor. The type of support needed could be direct
or indirect. Direct support means a supporting individual is present during each session. Indirect support can be
given in the form of observation or consultation but the supporting individual is not physically present during
each session. Finally, the participant may require an individual with disability-specific expertise (trained) or
simply a volunteer or peer (untrained) who is instructed to stay with the participant and help keep them on task
• The third element of the model is Training, referred to as “Strategies of Success” (SOS).
• Turning Barriers Into Possibilities Through Empowerment
• Creating opportunities.
• Providing support; addressing fears:
• Once the participant has identified the most appropriate program, he or she along with the parent(s) must look at
the next element of the model and begin communicating with the instructor/organization to ensure the participant
has adequate support.
• The participant wants to ensure he/ she is going to be successful. The parents want to know that the
organization/instructor understands the needs of their child. The instructor and/or organization wants to
adequately address the needs of the participant.
• While choosing an appropriate program is an important first step, being able to overcome the aforementioned fears
to do so is dependent upon whether the appropriate type or level of support is available as part of that program
• The type of support should be dictated by the needs of the participants, the knowledge and skills of the instructor,
and the complexity of the setting
• Providing knowledge/training on addressing individual needs:
• Addressing liability: Providing programming for all.
• It is extremely important for any organization to obtain as much information as possible regarding all participants,
but especially participants with disabilities.
• The organization needs to know any relevant medical information (e.g., disability, allergies, seizures), any
contraindications (e.g., behavior triggers, relevant side effects of medications), as well as any information that will
help the instructor or helping hand successfully work with the participant (e.g., participant’s interests, preferred
method of communication, behavior/reward system used at home).