Stephen French Gilson a & Elizabeth DePoy b a School of Social Work, University of Maine, 5770 Annex C,

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1 This article was downloaded by: [University of Central Florida] On: 19 July 2015, At: 13:49 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: Registered office: 5 Howick Place, London, SW1P 1WG Journal of Social Work Education Publication details, including instructions for authors and subscription information: Theoretical Approaches to Disability Content in Social Work Education Stephen French Gilson a & Elizabeth DePoy b a School of Social Work, University of Maine, 5770 Annex C, Orono, ME, b School of Social Work and coordinator of research and evaluation, Center for Community Inclusion, University of Maine Published online: 18 Feb To cite this article: Stephen French Gilson & Elizabeth DePoy (2002) Theoretical Approaches to Disability Content in Social Work Education, Journal of Social Work Education, 38:1, To link to this article: PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content ) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at

2 THEORETICAL APPROACHES TO DISABILITY CONTENT IN SOCIAL WORK EDUCATION Stephen French Gilson University of Maine Elizabeth DePoy University of Maine This article presents an analysis of disability theory and content in the social work curriculum and advances a theoretically expansive approach to disability that is consistent with social work's commitment to diversity and the elimination of oppression. A careful examination of relevant social work literature reveals that disability is generally discussed and treated from a diagnostic perspective. We suggest shifting the approach to disability content in social work curricula from one that emphasizes individual deficiency to one that addresses disability as the interaction of a medical condition or diverse conditions with disabling environments. OVER THE PAST SEVERAL DECADES, theoretical perspectives on disability have undergone a major paradigm shift. Traditionally viewed as a deficit, disability is now more commonly understood as an element of human diversity. Concurrently, on university campuses, definitions of disability have been revised to locate disability within the discourses of multiculturalism and diversity. However, despite the foundational focus on diversity and social justice in the social work curriculum, discussion and analysis of disability in social work courses typically occur through a deficit-treatment lens. In this article disability is defined as the interplay of diverse human conditions with environmental barriers to full community inclusion. This con temporary view of disability, although consistent with the mission and values of social work, receives limited attention in social work curricula (DePoy & Miller, 1996; Liese, Clevenger, & Hanley, 1999). Beginning with a review of the literature on disability and the positioning of disability theory within academic discourse, this article goes on to examine disability content in social work curricula and literature. Finally, a framework is presented to guide social work educators in addressing disability as an element of human diversity. Literature Review Disability Perspectives Historically, disability has been explained and understood from a variety of perspectives. These views of disability span a continuum from a diagnostic-medical perspective to a complex, interactive person-in-environment perspective (Stiker, 1999). Simply put, the diagnostic-medical explanation of disability places the locus of disability internally, within Journal of Socia/ Work Education Vol. 38, No. 1 (Winter 2002). Copyright 2002 Council on Social Work Education, Inc. All rights reserved. 1.53

3 154 JOURNAL OF SOCIAL WORK EDUCATION understandings of disability. However, two broad definitions of disability predominate: one locating disability as internal to individuals, and one identifying disabling factors in environments external to individuals. Therefore, we propose that social work students be introduced to these two distinct ways of conceptualizing disability. The Diagnostic Approach to Disability The diagnostic approach to disability is based on medical explanations of individual human conditions. In this perspective disability is defined as a long-term to permanent physical, behavioral, psychological, cognitive, or sensory impediment that renders individuals less able than those who are free of such impediments, or those with impediments from, which they can recover (Mackelprang & Salsgiver, 1997). This perspective both essen- tializes disability and locates it within the individual (Shakespeare, 1996). Interventions provided by disability services are designed to be curative. That is to say, services are aimed at remediating the disability (Mackelprang & Salsgiver, 1997). In large part, the diagnostic approach is based on the historic notion of illness advanced by Parsons in the early 1950s. According to Parsons (1964), illness releases the sick person from compliance with socially enforced behavioral norms. In exchange for release from behavioral obligations, the individual who is ill is expected to be compliant with, and appreciative of, medical intervention designed to cure. Not unexpectedly, the diagnostic approach to disability does not bode well for those with conditions that cannot be cured, modified, or changed by professional intervention (Quinn, 1998, p. xix). In this view, the an individual who has experienced illness, insult, or anomaly. This internal focus results in an interpretation of the disabled individual as defective with reference to normative physical, behavioral, psychological, cognitive, or sensory being. The interactive, person-in-environment lens, on the other hand, looks at the interaction of internal and external factors in an individual's life that creates a disabling condition. Between these two views, numerous other explanations and understandings of disability exist, including spiritual demonization or glorification of individuals with disabilities (Gilson & DePoy, 2000b ). Contemporary theorists, influenced by pluralism, a perspective which posits the phenomenon of multiple realities (DePoy & Gitlin, 1998), view disability within the complex and diverse universe of human experience, and from this perspective understand disability as a multilevel social justice concern embedded within particular cultural, sociopolitical, economic, and relational environments (Gilson & DePoy, 2000b; Linton, 1998; Oliver, 1996; Scotch, 1984). Contemporary legislation and protection prohibiting segregation and externally imposed control over the lives of people with disabilities have emerged from this perspective (Americans with Disabilities Act of 1990, 1990; Rehabilitation Act of 1973, 1978). But even these laws advance diverse definitions of disability. For example, Social Security defines disability as the inability to engage in remunerative employment as a result of a disabling condition (Kiernan & Stark, 1986), whereas the Americans with Disabilities Act (ADA) defines disability more broadly as limitation in life activities due to impairment. The literature reveals the complexity and conceptual confusion regarding definitions and

4 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 155 individual who cannot be "fixed" remains deficient in the sense that the person appears to function in ways outside of socially acceptable norms (Longmore, 1997; Mackelprang & Salsgiver, 1997). The diagnostic approach to understanding disability, then, classifies an individual as a deviant or as noncompliant with conventional behaviors. The concept of reha bili ta tion underlying a wide variety of interventions is firmly situated within the diagnostic approach, in that most interventions are aimed at improving the function and well-being of individuals with medical diagnoses (Granger & Fiedler, 1997). While fields such as occupational therapy and vocational rehabilitation are concerned with the elimination oral tera tion of environmental barriers that impede individual function, these fields are still based on the diagnostic approach, to disability. This orientation is apparent in these fields' concern with addressing diagnostic-functional abnormality (developmental disability, psychosis, and so forth), regardless of the locus of the interventions. An individual is referred to rehabilitation because of what is perceived to be.a medical condition that limits function, and this view of disability frames the work of the rehabilitation professional, even if modification of the individual's environment is the intervention. Within this perspective, rehabilitation practice can range from adapting an environment to fit individual limitations to w orking with individuals to adapt to an environment and exhibit more normative function (Johnston, Steinman, & Velozo, 1997). Disability as a Construct From a constructionist approach, disability is viewed as a phenomenon constructed by factors and forces in the ex ternal environment rather than as a physical, behavioral, psychological, cognitive, or sensory inadequacy (Shakespeare & Watson, 1997). For many people with disabilities, while physical, behavioral, psychological, cognitive, or sensory anomalies are acknowledged, they are not necessarily seen as undesirable, in need of remediation (Quinn, 1988), or even relevant to understanding the circumstance and experiences of disabled people. Central to this approach is the notion of human diversity. A fundamental question raised by constructionist approaches to disability is why a condition such as impairment of an individual's ability to walk, which requires the use of adaptive equipment, is perceived as a disability, and a condition such as mild nearsightedness, which also requires the use of adaptive equipment, is not. In constructionist approaches to disability, language or the terms that one calls oneself are determined by the disabled person reflecting that individual's interpretation of his or her connection to the social, political, economic, physical, cognitive, and sensory environment. Because disability is seen as a social" construction" rather than a condition which is located "with" an individual, the admonitions by professionals, and even scholarly writing venues, for those not using person-first language are not appropriate. The individual is "disabled" by a socially created set of circumstances and has the right to declare or define himself or herself as "disabled" by an environment rather than living with a disability (DePoy & Gilson, 2001). Unlike the rehabilitation approach, which can also address the environment as the needed locus of change, constructionist approaches to disability attribute an individual's incapacity to function to a disabling environment in which

5 156 JOURNAL OF SOCIAL WORK EDUCATION barriers are socially erected and maintained (Hahn, 1993). Negative attitudes, limited or nonexistent physical and communication access, and the denial of rights and privileges are examples of just some of the barriers that interfere with a disabled individual's potential to actualize desired social roles such as student, partner, parent, etc. (Barnes, Mercer, & Shakespeare, 1999). Thus, disability is seen as inequity in how an environment responds to and interprets human diversity, rather than as a deficit to be cured, remediated, or fixed (Barnes et al., 1999).It is not surprising that individuals with disabilities have advanced this notion of disability in direct response to models that devalue them (Oliver, 1996). Within constructionist conceptualizations of disability, there are many different emphases, each of which has been posited as a model of disability in and of itself. For example, in the view of those who see disability as a political construction, the barrier creating the disabling condition is disempowerment caused by unequal earning opportunities for individuals with conditions that are socially constructed as disabilities. Discrimination and exclusion from the workplace limit the disabled individual's capacity to exchange earned resources for pri vileges, goods, and services. For disabled people political life is an economic life wherein the discrimination, exclusion, and disenfranchisement are experienced as an increased probability of substandard wages and poverty. According to Oliver (1996), the political understanding of disability, and we would suggest an economic understanding of disability, while not equivalent to policy, legislation, or social change, does provide direction for future political action. Another important focus within constructionist approaches to disability is the view of disability as culture. This focus suggests that all individuals who define themselves as disabled belong to a unique group, which shares circumstances, experiences, tacit rules, language, and discourse. In this view, the notion of disability is one of group belongingness and distinction from other groups who do not share the disability identity (Mackelprang & Salsgiver, 1997). That is to say, anyone who identifies as disabled is disabled. Who belongs and does not belong to the culture is therefore not based on diagnosable condition, since diagnosis is irrelevant in this approach to determining who is disabled and who is not. Those individuals who perceive themselves to be unfairly treated and perceived as undesirable by dominant social institutions are therefore members of the culture of disability in that 1 they share disadvantage and curtailment of civil rights (Linton, 1998). Within this framework, issues involving race, class, gender, sexual orientation, and disability identification are important determinants of the shared experiences that bind people together in single, identifiable communities of concern (Charlton, 1998). Linton (1998) notes, we [disabled people] are bound together, not by... [a]list of our collective symptoms but by the social and political circumstances that have forged us as a group. We have found one another and found a voice to express not despair at our fate but outrage at our social positioning. (p. 4) This outrage is tied not only to the political position of disabled people, but from a materialist analysis, which identifies the "economic restrictions imposed on the individual that disable him or her" (Rioux, 1994, p. 5).

6 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 157 Disability Content in Social Work Curricula For the most part, the academy has taken the diagnostic approach to disability, viewing disability as a medical phenomenon to be understood by professionals and treated through the provision of services and supports that counterbalance personal deficits. Thus the primary study of disability has been limited to such academic disciplines as education, health, and human services. And, according to Linton (1998), the current division of disability into specialized applied fields in higher education (e.g., rehabilitation, special education, health, and so forth) perpetuates the view of disability as pathology. One way to assess disability content in social work education is to look at the Council groups." Placing disability solely within the category of at risk groups leads one toquestion, "at risk for what?" The implicit answer is that the condition of disability places one "at risk" for failure in one or more essential life functions as a result of an intrinsic pathological condition. Thus, services and protection from professionals are asserted as necessary by the categorical placement of disabled people in anticipated jeopardy even when no such condition should be ascribed. It is of great concern that disability in social work curricula is primarily presented and examined through a diagnostic lens, not only because of the current academic trends towards pluralism, but also because of the fundamental commitment of social work to eradicating oppression, promoting equal opon Social Work Education's 1992 Curriculum, portunity, and advancing self-determination. Policy5tatement(CPS)andthe1994Handbookof Accreditation Standards and Procedures. Both reveal an ambiguous approach to disability definition and content requirements. Prior to the most recent CPS, social work programs were guided to organize their curricula around either populations or problem areas. In this taxonomy, disability was included under problem areas, while other vulnerable groups were included in populations. Thus disability was seen as an individual deficit rather than as a group characteristic. The 1992 CPS reflected some attempt to more thoughtfully or progressively address the issue of disability. However, in addition to the term" disability," the use of phrases such as "populations at risk" (B6.6), which deny positive experiences of disability and position it within a medical and pathological perspective continued to be used without further positioning disability in the category of diverse populations along with other devalued "at risk While we do not suggest that the diagnostic approach to disability be entirely eliminated from social worked uca tion, we offer an ed ucational model below that critically examines each perspective of disability and applies it thoughtfully to the curriculum areas of human behavior in the social environment, practice, research, and policy. Model Disability Curricula As presented in Table 1, the two views of disability correspond to different theoretical, methodological, and action approaches in the primary social work curriculum areas. The social work curricular content areas on which we focus are human behavior and the social environment (HBSE), social work practice, social welfare policy and services, and research. We have not included a section on the field practicum, due in part to the great number of practicum settings in which students are placed, and because this ed uca tiona! component tends

7 158 JOURNAL OF SOCIAL WORK EDUCATION to have an experiential rather than didactic focus. Our discussion considers baccalaureate and foundation-year master's content. The Diagnostic Approach to Disability and Social Work Curricula Human Behavior and the Social Environment. As mentioned above, the diagnostic approach to disability defines disability as a long-term or permanent, physical, behavioral, psychological, cognitive, or sensory impediment to be treated by working with individual recovery or adaptation, or both (Longmore, 1997; Mackelprang & Salsgiver, 1997; Shakespeare & Watson, 1997). Given this definition, disability can be examined in the HBSE curriculum area through developmental, psychodynamic, biological, behavioral, and psychopathological theories. That is to say, these theories provide the "normal backdrop" from which disability can be distinguished. By "normal backdrop," the authors are referring to the set of norms that provide the boundaries for what is considered to be typical as well as acceptable. Anything existing outside of those boundaries is therefore deviant. Medical model theories that are studied within the HBSE curriculum provide a foundation for assessing functional adequacy and providing intervention for individualimprovement. This foundation provides a framework for viewing individuals in direct practice, policy practice, and research practice. The theoretical frameworks studied in HBSE courses posit normative behaviors that differentiate age-related phases from one another. Those who do not fit within the norms are labeled on a continuum from eccentric or ~ odd to deviant or dysfunctional. These theo- TABLE 1. Diagnostic and Constructionist Approaches to Disability Content across Four Major Curriculum Areas HBSE Practice Policy Research Diagnostic Developmental Clinical intervention Rational models Clinical, outcomes oriented Psychodynamic Psychopathology Behavioral Biological Case management Constructionist Systems Problem Solving Rational and Integrated nonrational models Sociohistorical / Community I group Critical theory economic context organization approach Social construction Humanistic Psychoeducational Participatory Ethnography Multiculturalism Legislative intervention Direct action (e.g. lobbying, civil disobedience)

8 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 159 ries serve to identify those who are in need of bilitation would focus on teaching compensatory skills to the individual with the head professional guidance at the clinical or institutional levels and provide a set of normative injury, modifying the environment to accommodate the individual's condition, and, to the outcomes to which an individual should be professionally directed. extent possible, restoring normative roles. Social Work Practice. Guided by the diagnostic approach, direct practice education diagnostic-based model include community Additional practice modalities guided by the would center on teaching clinical strategies to case management and case coordination "normalize" or "fix" disabled individuals to (Gilson, 1998; Gilson & Casebolt, 1997; Netting, Kettner, & McMurtry, 1998). the degree possible. These strategies may be collaboratively developed with clients, but also Social Welfare Policy and Services. In the may be.determined as best practice by the social welfare policy sequence, rational models of policy, practice policy, or policy imple social worker, professional team, or both. To illustrate we focus on a typical sequence mentation analysis and development are often of hospital-based practice, followed by reha- taught. Rational models of policy developbilitationsettings,andspecializedclinicalcom- ment, implementation, and analysis tend to munity outpatient service experienced by a approximate both linear-based reasoning and young adult who has sustained a closed head an ideologically conservative framework of trauma. This vignette or illustration reflects a, thought. While this characterization may not composite characterization of individuals with always be an absolute, these models tend to brain trauma with whom one of the authors share more commonalities with traditional worked. The hospital social worker is involved medical models of analysis and determination primarily as educator to the family, and secondarily to the individual, and as discharge ting et al., 1998). These models of policy and than a nonrational model (Jansson, 1994; Net planner. Within a diagnostic model, social work administrative management analysis, development, and implementation are grounded on practice wouldjocus on the individual's adjustment to the illness experience and the assumptions that: (a) theindividualsexchange family's adjustment to the change in the status, productivity for privilege and (b) individual role, and functioning of the individual. If the self-interest is a given. Because of this exchange, social worker is practicing from a family the social worker would advance policy to strengths perspective (Freedman & Boyer, promote maximum function for disabled individuals but would also maintain clinical con 2000), it is likely that the family would be perceived in the. role of caregiver and, by extension, as a part of the treatment team (par continuation of valued productive function on ta ct as a mechanism to supervise the ticularly in the presence of severe disability). the part of the disabled individual. Within Social work direct practice tasks might typically involve assisting the individual and fam therefore advance policies through an approach disability practice, the social worker would ily with the acquisition of equipment, social to agency management that promotes the maximumfunctioning of a disabled individual for the service supports, educational interventions, and linkages to specialized clinical community least social/ economic cost, while maintaining outpatient services and support groups. Reha- clinical models of professional intervention.

9 160 JOURNAL OF SOCIAL WORK EDUCATION On an agency level, macro practice may take the form of working to extend individual and family services for a specific individual, family, or a subset of individuals with disabilities, such as individuals diagnosed with developmental or mental disabilities or individuals with multiple sclerosis. For the micro-focused social worker, policy concerns are commonly limited to a program and agency base of practice. Practice policy guided by the diagnostic approach takes the form of advocating for goods and services for the immediate need( s) of individuals and families. Examples of this approach include working with third-party payers to purchase a wheelchair, medications, secure educational or vocational evaluation and services, or modify the home environment to improve function. Research. In the diagnostic approach, research methods that examine disability from a researcher-driven perspective are emphasized in the research sequence. In particular, clinical outcome research relying on predetermined, standardized testing is indicated. Social work students are taught strategies such as single case study designs, experimental, quasi-experimental, and nonexperimental approaches to examining client and family outcome (Yegidis, Weinbach, & Morrison-Rodriguez, 1999). Research methods to maintain accountability and measure the outcomes of interventions are emphasized, along with cost-benefit investigation strategies. The Constructionist Model of Disability and Social Work Curricula Human Behavior and the Social Environment. As discussed above, in the constructionist model, while an individual's anomalous physical, behavioral, psychological, cognitive, or sensory conditions may be acknowledged, they are not necessarily perceived as undesirable, in need of remediation (Quinn, 1988; Shakespeare & Watson, 1997), or even relevant to disability. Rather, individuals are perceived to be disabled by marginalization, oppression, and hostile environments-those characterized for example by a lack of ramps, limited attention to alternative formats for printed material, and a severe shortage of sign language interpreters, as well as any number of forms of social, political, and economic devaluation. Taught from the constructionist view of disability, the HBSE curriculum would be informed by several perspectives. A broad systems perspective extending beyond individuals and their families to their interactions with multiple sociocultural systems would be most 1 useful in examining disability as a construct. These interactions with sociocultural systems would be examined to discover the extent to which they are disabling to particular groups and individuals. Targets of change would be the negative attitudes, discrimination, oppression, limitations in civil rights, devaluation, and limited access to resources, privilege, and community life experienced by individuals and groups stigmatized on the basis of anomalous physical, behavioral, psychological, cognitive, or sensory conditions. Several theories would serve as lenses through which to examine disability and the marginal social/ cultural positioning assigned to individuals and subgroups whose physical, behavioral, psychological, cognitive, or sensory conditions are perceived as "disabilities." These would include social learning theory, social construction, pluralistic perspectives, and multiculturalism. A specific focus on social, economic, political, cultural, and environmen-

10 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 161 tal barriers that prevent individuals from full community participation might be a point from which to define and examine disability (Hutchison, 1999). Further examination of disability as minority culture would not only include analysis of members of disabled groups as marginalized, but also would include looking at disability, race, gender, and class as interactive factors that serve as barriers to civil rights and social justice. In such an examination disability would be located within the larger discussion of domination and oppression experienced by marginalized cultural groups. An example of how social work practice might unfold if approached from a constructionist view of disability can be seen by reconsidering the individual who has been hospitalized after sustaining a closed head in-, jury. A social worker practicing from this perspective would use medical information to understand the conditions of head injury. With that knowledge, attitudes towards individuals with head injuries, their recovery environments, and their social limitations would be examined through the lenses of systems theory ( Chetkow-Yanoov, 1992), social learning theory (Gambrill, 1997), and postmodern constructionist and deconstructionist theories (Pease, 1999). These views would inform a broad understanding and analysis of the social positioning, advantage, and disadvantage likely to be experienced by the disabled individual. Social Work Practice. Practicing from a constructionist perspective a social worker might engage in advocacy, assurance of civil rights, and elimination of oppression. Whether in a central or peripheral role, the social worker's practice model would be based on theory in which disability is seen as a social construction within oppressive systems (Chetkow-Yanoov, 1997). Practice education would therefore include problem solving, emancipatory approaches (Gambrill, 1997) in which multiple systems would be challenged, and culturally competent methods to eliminate barriers to community inclusion and social justice for disabled individuals (Longres, 1995). Moreover, practice would be client/ consumer driven or directed, with the social worker acting collabora tivel y as facilitator and liaison to eliminate barriers, advance opportunity and choice for individuals, families, and groups of disabled individuals, and link disabled people together in arenas which promote the healthy celebration of disability identity and the advancement of self-determination (Gilson & DePoy, 2000a). Systems change and political action would be important elements of practice within the constructionist framework of disability. Intervention would be carried out through teamwork with other professionals, politicians, family, and community members who are involved in the life of the disabled individual. Intervention techniques might involve advocacy, psychoeducational groups, sharing of information with client sys terns, policy change, and collaborative political action. Social Welfare Policy and Services. Policy and services work framed within a constructionist model of disability would focus on a continuum ranging from rational to nonrational approaches, and would be carried out at multiple system levels (Stone, 1997). Work might begin at the local agency level and progress to the larger community, state, and federal systems levels. As described above, the rational model of policy analysis suggests a planned and linear approach to the develop-

11 162 JOURNAL OF SOCIAL WORK EDUCATION ment of policy. In contrast, in the nonrational perspective policy creation is viewed as a series of complex and nonlinear events and phenomena. Multiple and often competing value-based interests are viewed as important influences on the creation and revision of policy. Stone's (1997) model is based on the assumption that policy development, modification, and overturn occur within a paradoxical political environment in which personal values and stake-holding supercede evidence-based, reasoned policy change. The nonrational model focuses on social values, political decision making, community interests, and the polis. A more conservative rational approach within the constructionist framework would involve social workers assuring that disabled individuals could be included within existing services and supports of a particular client system. A social worker's analysis or interpretation of intervention and change strategies would combine a rational model (e.g., Jansson, 1994; Netting et al., 1998) and a nonrational model (e.g., Stone, 1997). While the rational approach would explain the reasoned, evidence-based foundation for policy, the introduction of a nonrational perspective would provide the social worker with an expanded view of social, civil, economic, and legal experiences of disabled people and communities of disabled people. Consistent with Schneider and Netting's (1999)' call for social workers to "embrace ambiguity and to connect the ofteninvisible struggles of individuals with the more public actions of decision makers in powerful positions" (p. 349), this viewpoint would help the worker begin to appreciate the multiple and competing meanings of social welfare policy and services as they affect individuals and communities. Considering disability as culture, Netting and colleagues (1998) suggest that policy work involves (a) identification of target population, (b) determining community characteristics, (c) recognition of differences, and (d) identifying structure. Further, the authors of this article believe that the addition and synthesis of Figueira-McDonough's approach (1993) provides a complementary policy analysis and practice perspective guiding the social worker to promote the acknowledgment of disability as a marginalized culture in need of protective efforts such as the ADA. Research. For students to be able to examine disability from pluralistic and multilevel viewpoints, both experimental and interpretive research methods (DePoy & Gitlin, 1998) would be taught. Experimental-type models <of research yielding quantitative findings might be most useful in concert with interpretive approaches. Using mixed methods would allow for the measurement of service needs and outcomes to be synthesized with a qualitative understanding of the attitudinal social context in which these needs and outcomes occur. These two important areas of know ledge would inform and advance social change in multiple social, political, and economic arenas. Research from a critical theory perspective-which is conducted for the purpose of political changewould guide inquiry towards the production of knowledge for social, political, and economic change (DePoy & Gitlin, 1998). Studies undertaken from this epistemological perspective would enhance understanding of power relationships and action strategies designed to provoke change. Traditional methods of ethnography (see Babbie, 2001) hold the members of a culture as experts in their own lives and experiences and, thus, the investigator would

12 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 163 look to cultural members to answer questions about language, rules, traditions, rituals, etc. that would inform social work knowledge and practice in disability. Along with ethnographic approaches, participatory action research would be useful in identifying areas and methods for cultural and social change. Conclusion Disability content in social work education is taught largely from a diagnostic perspective. However, this approach is seriously outdated and does not encourage social workers to engage in practice, thought, inquiry, and policy change aimed at the eradication of social injustice resulting from discrimination towards disabled individuals. As indicated in the literature, disability coexists with poverty, limitations in civil rights, prejudice, and de- ' valuation. In concert with social work's mission to advance social justice and eliminate oppression are conceptualizations of disability which fall broadly within the constructionist a pproach.lt is critical that these conceptualizations of disability be included in social work curricula so that students can develop an informed, contemporary understanding of disadvantage resulting from disabling environmental factors. In this article we have examined multiple explanations for disability and have illustrated how the social work curriculum can be revised to integrate a -diagnostic approach into the broad perspective of disability as constructed by social, cultural, political, and economic factors. The knowledge, theory, and skills that would emerge from this complex, multifaceted, and contemporary treatment of disability would reflect social work's professional commitment to social justice and locate discussions of disability within the larger discourse on diversity. We do not deny that content on various physical, behavioral, psychological, cognitive, or sensory conditions is necessary to an understanding of disability. However, we assert that decreasing the emphasis on the diagnostic approach to disability and increasing the emphasis on constructionist approaches are essential if social work is to actualize its mission and values. Moreover, adopting an approach to studying disability that is similar to the approach that has been taken by other vulnerable groups is an important step in advancing civil rights for those who currently belong to this group and those who do not. Dissimilar to other groups such as women and ethnic minorities, the boundaries of the disability community are permeable. Anyone can become a member at any time, whether through injury or illness. Integrating disability into the dialogue on diversity and oppression therefore has a wide application for those who are currently disabled as well as for those who are not. References Americans with Disabilities Act of 1990, Pub. L. No , 104 Stat. 327 (1990). Babbie, E. (2001). The practice of social research (9th. ed.). Belmont, CA: Wadsworth. Barnes, C., Mercer, T., & Shakespeare, T. (1999). Exploring disability: A sociological introduction. Cambridge: Polity Press. Charlton, J. I. (1998). Nothing about us without us: Disability oppression and empowermen t. Berkeley: University of California Press. Chetkow-Yanoov, B. (1992). Social work practice: A systems approach. Binghamton, NY: Haworth. Council on Social Work Education. (1992). Curriculum policy statement for baccalaureate and

13 164 JOURNAL OF SOCIAL WORK EDUCATION master's degree programs in social work education. Alexandria, VA: Author. Council on Social Work Education. (1994). Handbook of accreditation standards and procedures (4th ed.). Alexandria, VA: Author. DePoy, E., & Gilson, S. F. (2001, July). Sticks, stones and Language. Paper presented at the Society for Disability Studies Annual Meeting, Winnipeg, Manitoba, Canada. DePoy, E., & Gitlin, L. (1998). Introdu ction to research: Understanding and applying multiple strategies (2nd ed.). Chicago: Mosby Yearbook. DePoy, E., & Miller, M. (1996). Preparation of social workers for serving individuals with developmental disabilities: A brief report. Mental Retardation, 34(1), Figueira-McDonough, J. (1993). Policy practice: The neglected side of social work intervention. Social Work, 38, Freedman, R.I., & Boyer, N.C. (2000). The power to choose: Supports for families caring for individuals with developmental disabilities. Health and Social Work, 25(1), Gambrill, E. D. (1997). Social work practice: A critical thinker~s guide. New York: Oxford University Press. Gilson, S. F. (1998). Case management and supported employment: A good fit. Journal of Case Management, 7(1), Gilson, S. F., & Casebolt, G. M. (1997). Personal assistance services and case management. Journal of Case Management, 6(1), Gilson, S. F., & DePoy, E. (2000a, February). Disability as culture: Four didactic curriculum areas. Paper presented at the Council on Social Work Education Annual Program Meeting, New York, NY. Gilson, S. F., & DePoy, E. (2000b). Multiculturalism and disability: A critical perspective. Disability and Society, 15(2), Granger, C. V., & Fiedler, R. C. (1997). The measurement of disability. In M. J. Fuhrer (Ed.), Assessing medical rehabilitation practices: The promise of outcomes research (pp ). Baltimore: Paul H. Brookes. Hahn, H. (1993). The politics of physical differences: Disability and discrimination. In M. Nagler (Ed.), Perspectives on disability (2nd ed., pp ). Palo Alto, CA: Health Markets Research. Hutchison, E. D. (1999). Dimensions of human behavior: Person and environment. Thousand Oaks, CA: Pine Forge. Jansson, B. S. (1994). Social policy: From theory to policy practice (2nd ed.). Belmont, CA: Wadsworth. Johnston, M. V., Steinman, M., & Velozo, C. (1997). Outcomes research in medical rehabilitation: Foundations from the past and directions for the future. In M. J. Fuhrer (Ed.), Assessing medical rehabilitation practices: The promise of outcomes research (pp. 1-42). Baltimore: Paul H. Brookes. Kiernan, W. E., & Stark, J. A. (1986). Pathways to employment for adults with developmental disabilities. Baltimore, MD: Paul H. Brookes. Liese, H., Clevenger, R., & Hanley, B. (1999). Joining university-affiliated programs and schools of social work: A collaborative model for disabilities curriculum development and training. Journal of Social Work Education, 35, Linton, S. (1998). Claiming disability: Knowledge and identity. New York: New York University Press. Longmore, P. K. (1997). Conspicuous contribution and American cultural dilemmas: Telethon rituals of cleansing and renewal. In D. T. Mitchell & S. L. Snyder (Eds.), The body

14 DISABILITY CONTENT IN SOCIAL WORK EDUCATION 165 and physical difference: Discourses of disability (pp ). Ann Arbor: University of Michigan Press. Longres, J. F. (1995). Human behavior in the social environment. Itasca, IL: F.E. Peacock. Mackelprang, R. W., & Salsgiver, R. 0. (1997). Disability: A diversity model approach in human service practice. Pacific Grove, CA: Brooks/ Cole. National Organization of Disability. (1994). N.O.D./Harris survey of Americans with disabilities. New York: Louis Harris and Associates. Netting, F. E. (1992). Case management: Service or symptom? Social Work, 37, Netting, F. E., Kettner, P. M., & McMurtry, S. L. (1998). Social work macro practice (2nd ed.). New York: Longman. N.O.D. / Harris. (2000). The 2000 N.O.D./Harris Survey of Americans with Disabilities: Survey, program on participation and attitudes [Online]. Available at http: / / Oliver, M. (1996). Defining impairment and disability: Issues at stake. In G. Barnes & G. Mercer (Eds.), Exploring the divide: Illness and disability (pp ). Leeds, UK: Disability Press. Parsons. T. (1964). Social structure and personality. Free Press. Pease, B. (1999). Transforming social work practice: Postmodern critical perspectives. New York: Routledge. Quinn, P. (1998). Understanding disability: A lifespan approach. Thousand Oaks, CA: Sage. Rehabilitation Act of 1973, Pub. Law No , 87 Stat. 335 (1973) (codified as amended at 29 u.s.c. 701, 797 [1978]). Rioux, M. H. (1994). New research directions and paradigms: Disability is not measles. In M. H. Rioux, & M. Bach (Eds.), Disability is not measles: New research paradigms in disability (pp. 1-7). North York, Ontario, Canada: Roeher Institute. Schneider, R. L., & Netting, F. E. (1999). Influencing social policy in time of devolution: Upholding social work's great tradition. Social Work, 44, Scotch, R. K. (1984). From good will to civil rights: Transforming federal disability policy. Philadelphia: Temple University Press. Shakespeare, T. (1996). Disability, identity and difference. In G. Barnes & G. Mercer (Eds.), Exploring the divide: Illness and disability (pp ). Leeds, UK: Disability Press. Shakespeare, T., & Watson, N. (1997). Defending the social model. Disability and Society, 12, Stiker, H. J. (1999). A history of disability. Ann Arbor, MI: University of Michigan Press. Stone, D. A. (1997). Policy paradox: The art of political decision making. New York: W.W. Norton. Yegidis, B. L., Weinbach, R. W., & Morrison Rodriguez, B. M. (1999). Research methods for social workers. Boston: Allyn & Bacon. Accepted: 10/ 01. Stephen French Gilson is associate professor, School of Social Work, and Elizabeth DePoy is professor, School of Social Work, and coordinator of research and evaluation, Center for Community Inclusion, University of Maine. Address correspondence to: Stephen French Gilson, University of Maine, 5770 Annex C, Orono, ME 04469; stephen_gilson@umit.maine.edu.