The individual model of disability

The individual model of disability
The individual model sees the problems that disabled people experience as being a direct consequence of their impairment. The mojor task of the professional is therefore to adjust the individual to the particular disabling condition. There are two aspects of this: first there is physical adjustment through rehabilitation programmes designed to return the individual to as near normal a state as possible; and, second there is psychological adjustment which helps the individual to come to terms with the physical limitations. It is not just that social work had accepted the dominant, individual model of disability which is deeply embedded in social consciousness generally, but also that the struggle for professional status and acceptance has been involved: 'In a search for professional status, social work has emphasised a medical, psychotherapeutic, individualised model of work because that seemed the best way of asserting its expertise and professionalism'.
It is possible to be critical of both these aspects of adjustment, and it is the latter which will be focused upon as it is of most relevance to social work, though there have been criticisms of the former also. In order to criticise the psychological adjustment assumptions based on the individual model of disability, spinalcord injury and blindness will be the impairments from which evidence will be drawn, though similar points can also be made about other conditions.
Starting from the assumption that something happens to the mind as well as to the body, a number of psychological mechanisms of adjustment have been identified, or more appropriately borrowed from other areas such as death and dying. Disabled individuals are assumed to have undergone a significant loss, and as a result depression may set in. In order to come to terms with this loss, a process of grieving or mourning will have to be worked through in a similar manner to those who must mourn or grieve for the loss of loved ones. Only when such processes have been worked through can individuals cope with death or disability.
Some writers have seen these mechanisms as a series of stages or steps which have to be worked through. A study by social workers in New York University Hospital identified a four-stage process by which newly disabled paraplegics come to terms with their disability:
STAGE 1 SHOCK. The immediate reaction to the physical and psychic assault of spinal-cord injury often characterised by weeping, hysteria, and occasionally psychosis with hallucinations.