As the United States becomes increasingly diverse, the challenge to provide culturally relevant services to individuals of diverse backgrounds becomes even more critical to human service professionals (Alston, Harley, & Middleton, 2006; Carney & Cobia, 1994; Thomas & Alfred, 2008). Cultural refers to more than ethnic or racial heritage; cultural also includes social and interpersonal relationships, institutions, language and communication, values, age, gender, religion, belief systems, occupations, sexual orientations, disabilities, and appearance (Baruth & Manning, 2003; Corey, 2005; Gopaul-McNicol & Thomas-Presswood, 1998). The importance of understanding service professionals' perceptions of cultural diversity in a pluralistic society is especially significant for human service professionals and those who prepare future human service professionals (Curtis, 1998; Shippen, Crites, Houchins, Ramsey, & Simon, 2005). For the purposes of the current study, this understanding begins with a deconstruction of the term disability and what it means.
Societal constructs include the many ways that society refers to the concept of disability. Disability is a broad term that encompasses ideologies that refer to a "non-normative" existence and a "departure from that which is ideal" (Robinson-Wood, 2009, p. 253). The term has also been socially constructed from a devaluing of "bodies that do not conform to cultural standards" (Robinson-Wood, 2009, p. 252) of normalcy. The conceptual understanding of disability has been shaped by language and other sociocultural practices, by institutions, and by politics (Moore & Feist-Price, 1999). Having a disability can include a myriad of physical, cognitive, sensory, developmental, psychiatric, or multiple conditions. These multiple identities and how people are socialized to think and feel about disability affect the quality of life and life satisfaction of individuals with disabilities (Alston et al., 2006; Larkin, Alston, Middleton, & Wilson, 2003). People with disabilities face discrimination resulting from negative opinions, beliefs, attitudes, and perceptions held about disabilities (Biklen, 1986; Biklen & Bailey, 1981; Bogdan & Knoll, 1995; Bowe, 1978, 1990). In fact, Fleischer and Zames (2001) have defined handicapism as a set of assumptions and practices that promote the dissimilar and unequal treatment of people on the basis of differences that are physical, mental, or behavioral in nature. These differences can be either apparent or assumed of individuals. Often, people with disabilities may be perceived as a threat to the physical safety of individuals without disabilities because of assumed violent, destructive, aggressive, and antisocial behavior on the part of the individual with a disability (Hyler, 1988; Hyler, Gabbard, & Schneider, 1991). Additional assumptions may be that individuals with a disability are dangerous because they are contagious or can contaminate others with their disability (Mackelprang & Salsgiver, 1999).
Even at the professional level, people with disabilities may find that they are attributed with negative or greater limitations than those actually experienced because individuals without disabilities are unsure how to respond to them (Smart, 2009). This discomfort and ambiguity, or interaction strain (Fichten, Robillard, Tagalakis, & Amsel, 1991; Gouvier, Coon, Todd, & Fuller, 1994), is often experienced by individuals without disabilities as decreased interaction with people with disabilities, including fewer conversations and less physical and eye contact (Livneh, 1982, 1983, 1991). To some individuals without disabilities, the effects of the disability are overgeneralized (or spread) to all aspects of the individual with the disability to the point that such individuals are discounted or underrated in general (Wright, 1988).
Aggravating the impact of interaction strain and spread is the "hierarchy of stigma" (Smart, 2009, p. 34) associated with four primary categories of disabilities:
In ascending order, this is the hierarchy of stigma: Individuals with physical disabilities have the least amount of stigma directed toward them; individuals with cognitive disabilities have more stigma; individuals with intellectual disabilities experience even more stigma; and, finally, those with psychiatric disabilities experience the greatest degree of stigma. (pp. 197-198)
The impact to those who experience the hierarchy of stigma is felt in employment, friendships, romantic relationships, and one's social life in general (Bell & Klein, 2001; Richardson & Ronald, 1977; Smart, 2009). Smart (2009) also noted that
those with physical disabilities experience the least degree of stigma and prejudice, probably because these types of disabilities are the easiest to understand. The cause, the onset, the course, and the limitations are easier for most people to comprehend. Simply stated, physical disabilities do not have the degree of ambiguity that other types of disabilities do. (p. 200)
The enactment of laws through social policy and legislation has provided individuals with disabilities protection from discrimination. These social justice efforts have had an impact on stigma, affected access, influenced inclusion, and shaped understanding through civil rights (Moore & Feist-Price, 1999).
Federal legislation has been enacted to help circumvent the impact of negative attitudes and the resulting discrimination experienced by many people with disabilities (Rabren & Curtis, 2007). In the mid-20th century, as groups of marginalized people in American society began to seek redress regarding their civil rights, individuals with disabilities began to form partnerships and associations that targeted their specific need (Martin, 2007; Smart, 2009). Indeed, the beginning of the disability rights movement closely mirrored that of the civil rights movements for many Americans and resulted in the furtherance of civil rights that were undergirded by the passage of federal legislation ensuring such rights. A small number of the significant laws that have helped to form the foundation and movement of civil rights for individuals with disabilities include the Community Mental Health Centers …