Changing Lives Changing Times,The Development of the Social Model:The Thinking that made the Difference

Richard RieserCoordinator UK Disability History

Month info@ukdisabilityhistorymnth.com

UNITED NATIONS CONVENTION ON THE RIGHTS OF PEOPLE WITH DISABILITIES DEC. 2006:A NEW PARADIGM CENTERED ON THE PERSON WITH

DISABILITY

To

From Medical Model of Disability Problem in the Person.Cure, Fix or Separate

To Social Model of Disability based on Human Rights approach- Problem with Society that needs to be changed.AttitudesOrganisationEnvironment

155 signatories to the Convention115 ratifications of the ConventionOptional Protocol90 signatories65 ratifications

Shifting the Focus in UNCRPD

• “Recognizing that disability is an evolving concept and that disability results from the interaction of persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others.”

• Move from a dominant medical model to a social model approach- European Disability Strategy 2010

• http://www.un.org/disabilities/

Traditional views• Disabled people were evil or the

‘spawn of the devil’• Disabled people were not human• Disabled people were sinners• Disabled people were the way they

were because they, or their parents, had done something wrong

• Disabled people needed pity or charity• Disabled people were objects of fun or

the butt of jokes• Disabled people were unworthy of life• Disabled people were asexual and

incapable of relationships or perpetual children

• Disabled people were mendicants or liars to get ‘our’ sympathy and money

For thousands of years, in different cultures, all around the world, people believed that disabled people’s impairments -loss of bodily or mental function -was due to a wide range of inferred causes. These views were backed up by beliefs in myth, magic and religion that a powerful and negative impact on our lives.

Beginnings of the Medical Model

• To distinguish between the worthy poor and unworthy poor in the workhouse.

• Distinguish those with genuine loss of bodily or mental function and those who did not

• Went on to the view that disabled people could rehabilitate and make normal

• Incurables-Eugenics view keep in institutions• Linked with growth of Charity

Medical model 1900s

Bodies and minds to be fixed/cured

Roots: professionalism

Problem: individual and lack of function/ways we are not viewed as ‘normal’

Solution: rehabilitation, drugs, therapy by professionals who ‘know what’s best’, hospitalised, locked away.

Paul Hunt writes to Guardian September 20th 1972

From this the Union of the Physically Impaired Against Segregation is Formed UPIAS -The Social Model is invented.

“I am proposing the formation of a consumer group to put forward, nationally, the views of actual and potential residents of these successors of the workhouse. We hope in particular, to formulate and publicise plans for alternative kinds of care.

I should be glad to hear from anyone who is interested to join or support this project-yours faithfully

Yours faithfully Paul Hunt”

Changing Lives Changing TimesThe Thinking that made the Difference

Edits ‘ Stigma’ 1966

“Disability is something imposed on top of our impairment by the way we are unnecessarily isolated and excluded from full participation in society.

Disabled people are therefore an oppressed group in society”

Union of Physically Impaired against Segregation

“It is of course a fact that we sometimes require skilled medical help to treat our physical impairments - operations, drugs andnursing care. We may also need therapists to help restore or maintain physical function, and to advise us on aids to independence and mobility. But the imposition of medical authority, and of a medical definition of our problems of living in society, have to be resisted strongly.”

UPIAS Principles 1974/76

“Impairment is the functional limitation within the individual caused by physical, mental or sensory impairment.

Disability is the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers” .

By 1981 The British Council of Disabled People is formed and Adopts distinction between impairments and disability

Social Model 1970s/1980s

Those with impairments disabled by society’s attitudes and barriers

roots: disabled activists and academics

Problem: social and attitudinal barriers, capitalism/corporatism

Solution: activism, policy change, independent user-led organisations active in leading challenges

Impacts • BCODP formed 1980• Disabled People International

adopt 1981• Disability Living Allowance• Motability• Independent Living Fund• Disability Discrimination Act 1995 (

passed on 17th attempt)• Section M Building Regulations• SEN and Disability Act 2001• Disability Amendment Act 2005• Life Chances Report Equality 2025• Equalities Act 2010 • UN CRPD

CHILD DEVELOPMENT TEAM SPECIALISTS

GPs

OCCUPATIONAL THERAPISTS

SPEECH THERAPISTS

BENEFITS AGENCY

DISABLED PEOPLE AS PASSIVE RECEIVERS OF SERVICES AIMED AT CURE OR MANAGEMENT

SHELTERED WORKSHOPS

DOCTORS

TRAINING CENTRES

SPECIAL SCHOOLS

EDUCATIONAL PSYCHOLOGISTS

SPECIAL TRANSPORT

SURGEONS

SOCIAL WORKERS

The dominant view is the Medical Model.

The Social Model of disablement focuses on the barriers

DISABLED PEOPLE AS ACTIVE FIGHTERS FOR EQUALITY WORKING IN PARTNERSHIP WITH ALLIES.

LACK OF USEFUL EDUCATION

INACCESSIBLE ENVIRONMENT

DE-VALUING

PREJUDICE

INACCESSIBLE INFORMATION

INACCESIBLE TRANSPORT

‘BELIEF’ IN THE MEDICAL MODEL

POVERTY

SEGREGATED SERVICES

DISCRIMINATION IN EMPLOYMENT

MEDICAL MODEL THINKING SOCIAL MODEL THINKING

Person is faulty Person is valued

Diagnosis Strengths and needs defined by self and others

Labelling/Deficit Identify barriers and develop solutions

Impairment becomes focus of attention

Outcome based programme designed

Assessment, monitoring, programmes of therapy

imposed

Resources are made available to ordinary services

Segregation and alternative services

Training for disabled people, parents and professionals

Ordinary needs put on hold Relationships nurtured

Re-entry if normal enough OR permanent exclusion

Diversity welcomed and person is included

Society remains unchanged Society evolves

Medical /Social Model thinking[1]

[1] Adapted from M. Mason 1994, R. Rieser 2000 http://www.worldofinclusion.com/res/altogether/AltogetherBetter.pdf

Thinking/Model

Characteristics Form of Education

1 Traditional DP a shame on family, guilt, ignorance. DP seen as of no value.

Excluded from education altogether.

2 Medical 1 Focus on what DP cannot do. Attempt to normalize or if cannot make to fit into things as they are keep them separate.

Segregation

Institutions/ hospitals

Special schools (with ‘expert’ special educators)3 Medical 2 Person can be supported by minor

adjustment and support, to function normally and minimize their impairment. Continuum of provision based on severity and type of impairment.

Integration in mainstream:-

a)At same location-in separate class/units

b)Socially in some activities e.g. meals, assembly or art.

c)In the class with support, but teaching & learning remain the same.

What you cannot do determines which form of education you receive.

Social Model Barriers Identified-solutions found to minimize them. Barriers of attitude, environment and organization are seen as what disables and are removed to maximize potential of all. DP welcomed . Relations are intentionally built. DP achieve their potential. Person centred approach.

Inclusive education- schools where all are welcomed and staff, parents and pupils value diversity and support is provided so all can be successful academically and socially. This requires reorganizing teaching, learning and assessment. Peer support is encouraged.

Focus on what you can do.

Types of thinking about disabled people and forms of education.

Segregation

Integration

Inclusion

EnvironmentOrganisation,

Teaching &Curriculum

School

Find Barriers and thenAfter film Solutions

Medical, Personal & Equipment Needs

Attitudes & Culture

THE CONTINUUM OF PROVISION

SCHOOL WITH OWN RESOURCES

SCHOOL WITH EXTRA RESOURCES FROM LEA

SPRECIAL UNIT ATTACHED TO MAINSTREAM

SPECIAL DAY SCHOOL

INDEPENDENT SCHOOL (LEA funded)

SPECIAL RESIDENTIAL SCHOOL (weekly or full boarding, up to 52 weeks a year)

SECURE UNITS

line of invisibility

The Constellation of Services

CHILD

TEACHER

Transport Department

LearningSupport Assistant

Friends

Brothers and Sisters

Visually Impaired

service

Individual Support Teacher

SENCO Aids AdvisorVoluntary

Sector Specialists

Parents

Head teacher

Educational Psychologist

LEA Inclusion Officers

Physiotherapist

VolunteersSpeech

TherapistBehaviour

Support Team

Hearing Impaired

Service

Inclusive Education -UNESCO

Inclusive Education -UNESCO sees inclusive education as a process of addressing and responding to diversity of needs of all learners through increasing participation in learning, cultures and communities, and reducing exclusion within and from education. It involves changes and modifications in content, approaches, structures and strategies, with a common vision which covers all children of appropriate age range and a conviction that it is the responsibility of the regular system to educate all children.

Bio-psychosocial model 1990sDeveloping a ‘can do’

attitude, ‘work can set you free’

Roots: private insurance, corporatism, welfare reform/cuts

Problem: individual, welfare ‘dependency’, adopting a ‘sick role’

Solution: remove social/financial support, promote ‘work as therapy’ and bizarre ‘think yourself well’ mantras

Bio-psychosocial model 1990sDeveloping a ‘can do’

attitude, ‘work can set you free’

Roots: private insurance, corporatism, welfare reform/cuts

Problem: individual, welfare ‘dependency’, adopting a ‘sick role’

Solution: remove social/financial support, promote ‘work as therapy’ and bizarre ‘think yourself well’ mantras

The Struggle The Struggle for Equality for Equality ContinuesContinues