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This chapter reviews the history of treatment toward people with disabilities (PWDs) in the United States. Early immigration literature and the apparent attitudes and treatment toward PWDs, as well as certain other immigrant populations, were blatantly prejudiced and discriminatory. Antidisability sentiment became more evident with immigration restriction, which began as early as the development of the first North American settlements. The eugenics movement essentially died down after World War II, primarily because of Social Darwinism and the Nazi extermination of an estimated 250,000 German citizens and war veterans with disabilities. The survival-of-the-fittest concept and natural selection in the 21st century appear to have morphed into a survival of the financially fittest ideology. With the aging of America and millions of baby boomers moving into their golden years, the financial portfolios of these individuals dictate what the quality of their lives will be, like at no time before in American history.
In the past quarter of a century, several attempts have been made to categorize the different sources of negative attitudes toward individuals with disabling conditions. This chapter integrates the major approaches in the domain of attitudinal sources toward people with disabilities and offers a new classification system by which these attitudes can be better conceptualized and understood. Some of the major categories included are: (a) conditioning by sociocultural norms that emphasize certain qualities not met by the disabled population; (b) childhood influences in which early life experiences foster the formation of stereotypic adult beliefs and values; and (c) psychodynamic mechanisms that may play a role in creating unrealistic expectations and unresolved conflicts when interacting with disabled persons. Parental and significant others’ actions, words, tone of voice, gestures, and so forth, are transmitted to the child and tend to have a crucial impact on the formation of attitudes toward disability.
The chapter explores the history from the middle ages to the present day, noting the trials and tribulations of a population that continues to remain poorly understood and misperceived by the general public. Conditions for people with psychiatric disabilities did not fare much better in the American colonies. Similar to the circumstances during the Middle Ages, care for this population was the family’s responsibility if they had a family to care for them. Moral treatments began to decline in the second half of the 19th century in favor of somatic therapies and behavioral control techniques. Although psychiatrists initially scoffed at the notion that the quality of the care they provided in mental hospitals was subpar, research was conducted in the treatment of mental illness that brought about improvements. Physicians continued to develop and work toward improvement of somatic treatments for psychiatric disabilities in the early part of the 20th century.
The conceptualization of disability as an attribute located solely within an individual is changing to a paradigm in which disability is thought to be an interaction among the individual, the disability, and the environment. This chapter draws both theoretical and practice implications, which may assist practitioners and educators in gaining a clearer understanding of counseling clients who have disabilities, from four broad models of disability. Intended as a broad overview of the major models and an introductory discussion of ways in which these models can affect the profession of counseling, the chapter presents several different ways of conceptualizing the experience of disability. The four broad models are: (a) the biomedical model, (b) the functional model, (c) the environmental model, and (d) the sociopolitical model. The functional model and the environmental model are presented together because both are interactive models; stated differently.
Accepting the handicapped person as a full human being means accepting him or her as having the full range of human needs. The location of institutions and the houses in which handicapped people can live becomes important because their location within communities enables participation of the handicapped in community offerings. Architectural barriers become an issue because their elimination enables people with a wide range of physical abilities to have access to events within buildings at large. The lives of handicapped people are inextricably a part of a much wider socioeconomic political and ethical society affecting the lives of all people. It is therefore essential for all of us to remain vigilant to protect and extend the hard-won gains of recent decades and to be ready to counter undermining forces. Vigilance requires thoughtful action guided by continuing reevaluation of the effectiveness of present efforts and alertness to needs of changing conditions.
This chapter provides the reader with an overview of (a) the dynamics (i.e., process) of psychosocial adaptation to chronic illness and disabilities (CID), (b) methods commonly used to assess psychosocial adaptation to CID, and (c) intervention strategies applied to people with CID. The chapter groups the psychosocial adaptation to CID under three headings: basic concepts such as stress, loss and grief, and quality of life, CID-triggered reactions, and CID-related coping strategies. The literature on CID-related coping strategies is vast. The chapter describes only a cursory overview of the most commonly reported strategies, directly related to coping with CID. It first briefly discusses the concept of coping and illustrates its relevance to CID. Over the past half century, a large number of measures of psychosocial adaptation to and coping with CID have been reported in the literature. The chapter reviews only those psychometrically sound measures most frequently reported in the literature.
This chapter explores one of the most profound and important empirical questions that researchers have regarding the psychological and sociological impact of disability: How do persons with disabilities react to their situation, and why do some actually excel, whereas others become indefinitely incapacitated both mentally and physically? The chapter explores seven common theories of adaptation to a traumatic physical disability. Some proposed theories have stronger evidence-based empirical support, whereas others rely on more qualitative and case study accounts, as well as clinical observation. The chapter first explores persons born with a congenital disability, and questions whether such individuals actually experience any type of adjustment process since they have no preinjury, nondisabled experience with which to compare their situation. It then explores the seven theories of adjustment: stage models, somatopsychology, the disability centrality model, ecological models, recurrent or integrated model, transactional model of coping, and chaos theory.
Women with disabilities constitute one of the largest and most disadvantaged populations in the United States. This chapter helps rehabilitation counselors understand the myriad factors that affect the psychological and social health of women with disabilities. After giving some background on the historical roots of the rehabilitation response to women and a description of the demographic and health characteristics of this population, the chapter presents a heuristic, holistic model for understanding the reality of our lives and strategies for helping us achieve optimal health. It first discusses the pivotal construct of self-esteem, followed by social connectedness, its polar opposite abuse and the consequences of disparities stress and depression. The chapter ends with recommendations on strategies that the rehabilitation researchers and practitioners can use to include gender in their examination of individual and program outcomes, and thereby advance the field.