Academic journal article British Journal of Occupational Therapy

Can Disability Studies Contribute to Client-Centred Occupational Therapy Practice?

Academic journal article British Journal of Occupational Therapy

Can Disability Studies Contribute to Client-Centred Occupational Therapy Practice?

Article excerpt

Introduction

Occupational therapy asserts that 'client-centred' practice is core to its philosophy (Canadian Association of Occupational Therapists 1997, 2002). We argue that, in order to practise client-centred occupational therapy with disabled people, occupational therapists need to have an appreciation of the concept of 'disability' from the viewpoints of disabled people.

One way of gaining an appreciation of disabled people's points of view is to embrace the academic discipline of disability studies, which is 'the study of disabled people's lifestyles and aspirations' (Finkelstein 1998, p33).

Throughout this article, we use the term 'disabled people' rather than 'people with disabilities'. This is out of deference for the contemporary debate in the field of disability studies, which questions the appropriateness of using 'people-first' language. Albrecht et al (2001, p3) declared that some disability studies scholars claim that the term 'people with disabilities' is an offensive term, promoted by powerful nondisabled people to emphasise that disability is part of the person rather than a social construct. This argument has also been articulated by some occupational therapy scholars, such as Kielhofner (2005) and Hammell (2006). The term 'disabled people' is preferred because it evokes the oppression that people with impairments experience due to a 'disabling' society. In other words, 'people with disabilities' suggests that the person is the one with the disability; a disabled person is someone who is disabled, for example by the environment.

This opinion piece defines disability studies, discusses occupational therapy and disability, outlines 'client-centred practice' and then proposes how disability studies and disability theory can contribute to client-centred practice with disabled people.

Disability studies

Disability studies is an 'interdisciplinary academic discipline drawing on sociology, linguistics, economics, anthropology, politics, history, psychology and media studies' (Swain et al 2003, p33) that 'reframes the study of disability by focusing on it as a social phenomenon and social construct' (Linton et al 1994, quoted in Pfeiffer and Yoshida 1995, p480).

With an ever-increasing number of programmes of study ranging from bachelor's and master's to PhD degrees in disability studies, this academic field is contributing substantially to the exploration of the environmental factors that disable people and to the examination of social, cultural and political methods of intervention that can confront barriers to disabled people's occupational engagement and social inclusion.

A core premise of disability studies is that it challenges the view of disability as an individual deficit or defect that can be remedied through medical intervention or rehabilitation by 'experts', such as occupational therapists: 'This shift of emphasis from a prevention/treatment/remediation paradigm to a social/cultural/political paradigm both emanates from and supports the Disability Rights movement' (Linton et al 1994, quoted in Pfeiffer and Yoshida 1995, p480) and underscores the 'discipline's commitment to advancing the social and political rights of disabled people' (Hammell 2006, p11).

Occupational therapy and disability

Within disability studies, there are explorations of a dichotomy between the perspectives that health professionals have of disability and the perspectives that disabled people have of disability (Abberley 1995, Beresford 2004, Gillman 2004, Shakespeare 2006).

Trickett et al (1994, p18, quoted in Linton 1998, p527) described the rehabilitation professions as 'person-fixing rather than context-changing'. In fact, some scholars argue that occupational therapy is oppressive owing to its tendency to adopt a medical model of disability to inform its practice (Jongbloed and Crichton 1990, Hunt 1996, Abberley 2004). …

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