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Disability Paradigms and Models and Rehabilitation Practice

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... (Jordan, 1998b; Jordan & Kaiser, 1996; Parr et al, 2003; Pound et al, ... Parr S et al eds (2003) Aphasia Inside Out, Open University Press, Maidenhead ... – PowerPoint PPT presentation

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Title: Disability Paradigms and Models and Rehabilitation Practice


1
Disability Paradigms and Models and
Rehabilitation Practice
  • Lesley Jordan
  • School of Health and Social Sciences
  • Middlesex University

2
Issue and Aims
  • Issue
  • Engaging social model with rehabilitation
    services
  • Aims
  • Provide a framework for analysis (illustrated by
    aphasia therapy)
  • Raise questions about-
  • - Distinction between individual and
    social
  • model services
  • - Social aspects of rehabilitation services
  • - Application of social model values within
  • services concerned with impairment

3
Individual and Social Models of Disability
4
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5
Applying disability paradigms to aphasia therapy
activities
  • BODY Therapies to improve functional
    communication
  • PSYCHOLOGY/IDENTITY Dealing with psychological
    aspects of aphasia affecting 1 above

    Self-advocacy courses Identity projects (Connect
    website)
  • SOCIAL STRUCTUREAdvocacy/facilitation to enable
    a man with severe aphasia to give evidence in
    court (Hovard, 1997) 
  • CULTURETraining in strategies/techniques to
    facilitate interaction for
    Care workers (e.g.
    Jordan, 1998a) Volunteers (e.g. Kagan Gailey,
    1993)

6
Applying the paradigms to therapy activities
  • Activities can be analysed in terms of
  • (a) Their specific content
  • (b) Their meaning/emotional tone
  • - messages conveyed to person with
    aphasia / others
  • Both affected by therapists underlying values

7
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8
1i Body activities / Individual model
values
  • Focus on
  • (a) Impairment rather than the whole person
  • OR
  • (b) Client as a disabled person
  • Therapist as best assessor of clients needs
  • Professional powerful
  • Client subordinate

9
1s Body activities / Social model
values
  • Client a person with a life to live and multiple
    roles
  • Professional expertise used to aid clients in
    achieving their goals
  • Problem-solving approach, led by the client
  • Balanced partnership between therapist and client

10
2i Psychology activities /
Individual model values
  • Assist client in accepting their impairment and
    coming to terms with themselves / their position
    as a disabled person
  • Emphasis on client being realistic about
    themselves and their limitations
  • Sympathetic to carers burden

11
2s Psychology activities / Social Model values
  • Assist clients in developing a positive identity
    as a person with aphasia
  • Self-advocacy courses for people with aphasia
  • Educating communication partners about
    facilitating communication
  • Training volunteers to facilitate communication
    with specific client

12
3i/3s Social structure
  • Therapists activities
  • Professional opinion / advocacy / facilitation in
    relation to e.g. benefits / courts / education /
    employment
  • Independent living provisions (adaptations /
    aids, etc) and information about them
  • Individual model values
  • General assumption that the disabled person is
    the problem. Rationale humanitarian
  • Social model values
  • Assumption that society is the problem, so
    expectation of adjustments, modifications of
    procedures, etc. Rationale citizenship

13
4i/4s Culture
  • Therapists Activities
  • Influencing media representations of people with
    aphasia
  • Providing education via publications and mass
    media
  • Increasing awareness of aphasia (e.g. Corker
    French, eds, 1999 Swain et al, eds, 2004)
  • Training other service providers and members of
    general population in facilitation
  • Provider Values
  • Content and delivery likely to reinforce
    individual model of disability unless explicit
    exposition of social model at every stage

14
Conclusions and Further Issues
  • Potential for social model rehabilitation?
  • (Possibly) increasing compatibility between
    professional values and social model of
    disability (RCSLT, 1991, 1996)
  • Examples of NHS aphasia therapists working in
    partnership with clients
  • Some professional education takes social model on
    board (e.g. City University Birmingham
    University)
  • Voluntary sector practice and courses informed by
    the social model (e.g. Connect)
  • Social model of disability in aphasia therapy
    literature (Jordan, 1998b Jordan Kaiser, 1996
    Parr et al, 2003 Pound et al, 2000)

15
Conclusions and Further Issues
  • Problems for the social model in rehabilitation
  • Dominance of individual model of disability in
    society
  • Possible reinforcement from patients and their
    families/friends of individual approach
  • Lack of clear distinction between illness and
    disability
  • NHS culture
  • Scarce resources
  • Issues
  • How can NHS therapists be encouraged to base
    their impairment level activities on social
    model values?
  • How to ensure that therapists disability level
    activities are based on social model?
  • Appropriateness of framework for rehabilitation?

16
Gearing the Framework to Rehabilitation
Activities
Personal Change
Environmental Change
17
References
  • Connect The Communication Disability Network
    www.ukconnect.org
  • Hovard, L. (1997) The speech therapists
    experience as facilitator, In Action for
    Dysphasic Adults Legal/Medical Advocacy Day, Full
    Transcript, ADA, London
  • Jordan, L. (1998a) Carers as Conversation
    Partners Training for Carers of Communicatively
    Impaired People, Care The Journal of Practice
    and Development, 6(3), May, 45-59
  • Jordan, L. (1998b) Diversity in Aphasiology A
    Social Science Perspective Aphasiology, 12(6),
    June, 474-480
  • Jordan, L Kaiser, W (1996) Aphasia A Social
    Approach, Stanley Thornes, Cheltenham
  • Kagan, A Gailey, P (1993) Functional is not
    enough Training of conversation partners for
    aphasic adults, in A L Holland M M Forbes,
    eds, Aphasia Treatment World Perspectives,
    Chapman Hall, London

18
References continued
  • Parr S et al eds (2003) Aphasia Inside Out, Open
    University Press, Maidenhead
  • Pound C et al (2000) Beyond Aphasia Therapies
    for Living with Communication Disability,
    Speechmark, Bicester
  • Priestly, M (1998) Constructions and creations
    idealism, materialism and disability theory,
    Disability Society, 13, 75-94
  • Priestley M (2003) Disability A Life Course
    Approach, Polity, Oxford
  • Royal College of Speech Language Therapists
    (1991, 1996) Communicating Quality, RCSLT, London
  • Thomas, C (1999) Female Forms Experiencing and
    Understanding Disability, Open University Press,
    Buckingham
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