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Theories of Disability: Findings From an Analysisof Textbooks on Human Behavior and the SocialEnvironmentAllison Ruby Reid-Cunningham a & Victoria C. Fleming b ca School of Social Welfare, University of California , Berkeley, Californiab Homeless Outreach Stabilization Team, Bonita House Inc. , Oakland, Californiac University of California , Berkeley, CaliforniaPublished online: 21 Feb 2009.
To cite this article: Allison Ruby Reid-Cunningham & Victoria C. Fleming (2009) Theories of Disability: Findings From anAnalysis of Textbooks on Human Behavior and the Social Environment, Journal of Human Behavior in the Social Environment,19:1, 10-25, DOI: 10.1080/10911350802616181
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Journal of Human Behavior in the Social Environment, 19:10–25, 2009
Copyright © Taylor & Francis Group, LLC
ISSN: 1091-1359 print/1540-3556 online
DOI: 10.1080/10911350802616181
Theories of Disability: Findings From anAnalysis of Textbooks on Human Behavior
and the Social Environment
ALLISON RUBY REID-CUNNINGHAMSchool of Social Welfare, University of California, Berkeley, California
VICTORIA C. FLEMINGHomeless Outreach Stabilization Team, Bonita House Inc., Oakland,
California and University of California, Berkeley, California
Physical, mental, learning, and developmental disabilities are im-
portant contributors to our understanding of human behavior
and the social environment of these disabilities. This article is an
analysis of disability contentin 14 frequently used textbooks on
human behavior and the social environment and is built upon
three approaches to curriculum content: life cycle theory, psy-
chodynamic theory, and systems theory. Our analysis indicates
that disability is well represented in some texts, under-represented
in others, andbarely mentioned in others. Overall, the subject of
disability rarely receives a comprehensive treatment with respect
to its impact on human behavior and its role in the social envi-
ronment. This analysis concludes with implications for the future
development of theories to inform social work practice.
KEYWORDS Disability, HBSE, theory
INTRODUCTION
Disability is an important subject area for social workers to understand,especially the different ways in which theories of disability may informpractice and future research. This analysis explores the relationship between
We acknowledge and thank the following doctoral colleagues who conducted the
preliminary assessments of the textbooks reviewed in this analysis: Mary Ager, Yolanda Anyon,Ryu Cheng, Sara Kimberlin, Carol Peng, and Sarah Schulz.
Address correspondence to Allison Ruby Reid-Cunningham, 2430 Dwight Way #304,
Berkeley, CA 94704. E-mail: [email protected]
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Theories of Disability 11
theories of disability and the themes used in major textbooks on humanbehavior and the social environment.
The criteria used for this analysis were based on a broad definitionof disability including physical or sensory disability, developmental delay,cognitive impairment, mental retardation, chronic illness, learning disabili-ties, mental illness, and work-related disabilities. Taylor, Austin, and Mulroy(2004) identified the most frequently used textbooks for master’s-level hu-man behavior and the social environment (HBSE) texts in schools of socialwork across the United States. They clustered the textbooks into three cate-gories: life cycle, systems theory, and theory (Taylor et al.). The categoriesof life cycle, systems, and theory are used to organize the analysis of HBSEtextbooks. The ‘‘life cycle’’ textbooks featured developmental stages of thebiological human. The systems textbooks emphasized systems within thesocial environment related to individuals, families, groups, or communities.The theory textbooks featured structural functionalism, conflict theory, andempowerment theory.
Each textbook was examined with regard to its treatment of disabilitycontent by examining the table of contents, preface, chapter and sectionheadings, text, indexes and illustrations. The main focus of the analysisincluded six areas of disability: (1) physical and sensory, (2) mental illness,(3) developmental delay and mental retardation, (4) learning disabilities, (5)work-related disabilities, and (6) chronic illness. Other key words related todisability concepts and terms included handicap, impairment, deaf, blind,physically challenged, wheelchair, mental illness, and psychosis.
DISABILITY THEORY
Disability can be understood through a number of useful theoretical modelsdrawn from the social sciences, including anthropology, sociology, psychol-ogy, economics, and political science. Theories from these social sciencedisciplines form the basis for social welfare’s understanding of disability.Several important theoretical models of disability are explored to illustratethe range of thought and discourse on disability. One distinction that maybe drawn between these frameworks is an individual-societal dichotomy.
Individual models conceive of disability as a problem of the person whocarries the disability, and they may be based on the assumption that peoplewith disabilities have something inherently wrong with them. ‘‘Causation,blame, and responsibility’’ are considered the sole responsibility of the indi-vidual (Rothman, 2007, p. 3). Examples of the individual model include themoral model, the deficit model, the survival-of-the-fittest model, the eugenicsmodel, and the medical model.
The moral model draws upon religious tenets that associate disabilitywith sin or punishment for wrongdoing. Other moral models propose a
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12 A. R. Reid-Cunningham and V. C. Fleming
religious or spiritual imperative to care for people with disabilities. Themodern medical model is derived from the earlier deficit model that viewspeople with disabilities as ‘‘imperfect’’ and focuses scientific technology andintervention on ‘‘perfecting’’ people with disabilities (Rothman, 203, p. 6).This model considers disability to be a functional impairment that representsa deviation from an assumed norm of human form and functioning that canlead stigma and oppression. The social Darwinist survival-of-the-fittest andeugenics models view disabilities as evolutionary deficits to be corrected bythe elimination or abandonment of people with disabilities (e.g., selectiveabortion, forced sterilization, institutionalization, and extermination).
Societal models of disability view disability in terms of the natural andbuilt environment, values, institutions, social groups, media and public im-ages, and cultural perceptions of disability (Rothman, 2003, p. 3). People withdisabilities are seen as a group of individuals within society who are treateddifferently (Rothman, 2003). The most prominent societal models include theoppression model, the diversity model, and the social construct model.
The oppression model is based on the societal perception of peoplewith disabilities as ‘‘others’’ that can cause them to become ‘‘psychologically,socially, and economically oppressed’’ (Rothman, 2003, p. 9). They becomeinvisible to the dominant society and not recognized by others in societyand, as a result, can internalize dehumanizing discrimination as a form ofoppression.
The diversity model features the shared and unique experiences ofgroups of people with multiple cultural or societal identifications (e.g., eth-nicity, socioeconomic status, age, and disability). Cultural characteristics in-clude a shared ‘‘a way of thinking, a way of feeling, a way of understandingevents and the world around them’’ (e.g., culture of Deaf people) (Rothman,203, p. 11).
In the social construct model the problem of disability is seen as society’sinability to address the needs of its members by removing environmentaland social barriers to participation and institutional benefits. The concept ofuniversal design that provides access to all people reflects the social constructmodel.
LIFE CYCLE TEXTS
The four life cycle textbooks reflect the different levels of attention to un-derstanding disability throughout the life cycle.
Life Cycle Textbook 1
The textbook by Ashford, Lecroy, and Lortie (2001), Human Behavior in
the Social Environment: A Multidimensional Perspective, uses a multidi-
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mensional framework (biophysical, psychological, and social functioning)to describe the stages of life from infancy to late adulthood. The develop-mental nature of the textbook reflects primarily a psychological perspectiveof human behavior with less attention to the social environment.
The content area of disability is addressed in terms of human develop-ment (e.g., physical, mental, developmental, and learning) with little atten-tion to work-related disabilities. In terms of physical disabilities, the textbookprovides an overview of major chronic diseases (i.e., cancer and AIDS) alongwith in-depth discussions of their causes, incidence, and prevalence. Thetextbook also mentions various genetic disorders (e.g., sickle-cell anemia,Down syndrome, and hemophilia) and briefly mentions the chronic healthproblems of late adulthood (e.g., arthritis and hypertension).
In contrast to physical disabilities, mental disabilities across the lifespanare given more attention. For example, attention deficit disorders are thecentral theme of children’s mental health with considerably less attentionto mental disability among adolescents. However, there was an extendeddiscussion about serious mental illness during young adulthood, includingpresumed causes, prognosis, assessment, and appropriate interventions. Thetext focused on Alzheimer’s disease in older adults. Depression and suicidewere also described in detailed presentations. Case examples highlighteddepression and schizophrenia, noting developmental, biophysical, and psy-chological considerations.
Developmental delay or mental retardation is covered in the section onchildhood along with the incidence and characteristics of communicationdisorders with autism and learning disabilities briefly addressed as one ofthe identifying features of expressive language disorder.
Though the text encourages a strengths perspective, the chapters arereplete with sections on ‘‘Biophysical Hazards,’’ ‘‘Psychological Hazards,’’and ‘‘Social Hazards’’ that reflect the ‘‘deficit’’ model as families deal with amultitude of problems and stressors (e.g., developmental delays).
Life Cycle Textbook 2
Germain and Bloom’s (1999) textbook, Human Behavior and the Social
Environment: An Ecological View, is divided into two parts, with Part Onefocused on people in the context of the social environment (from individualsand families to large communities) and, in Part Two, the life cycle perspectivefeaturing families as members moving through the stages of life. This textalso features the relationships between people and groups and people andenvironments.
Disability is introduced in a condensed three-page description of theory,current issues, politics, legislation, problems, and disagreements within thefield. In this subchapter, Able-ism (Disempowerment Based on Disability), theauthors cited statistics that indicate 14.5% of Americans living with disabilities
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14 A. R. Reid-Cunningham and V. C. Fleming
are at risk of unfair discrimination and includes a discussion of the indepen-dent living movement, the Americans with Disabilities Act, and persons withdevelopmental disabilities and disempowerment.
Disability is first presented in the context of other oppressions (e.g.,racism and sexism). The problems that people with disabilities face werepresented as stemming from societal stress within the social environment,and these experiences can bond them together in a shared culture of dis-ability based on a shared experience of oppression and marginalization fromthe mainstream society. These oppressive social conditions exaggerate thelimitations of people with disabilities, exacerbate stigma, and highlight theproblems that the physical and social environment may create for peoplewith disabilities.
There are brief references to adolescents who had been paralyzed;genetics and disability with reference to eugenic movements, as they canbe tested in the fetus and early childhood; the most common ethnicallyrelated genetic diseases (e.g., Tay-Sachs, PKU and sickle cell anemia); chil-dren with learning disabilities; and attention deficit hyperactivity disorder(ADHD). The brief discussion of deafness features a discrete cultural groupand a sociopolitical force wherein deaf people are as capable of complexcommunication and abstract thought as the general population.
With respect to aging, declining health and abilities and increasingimpairments are balanced with the positive notion that ‘‘adulthood is notmerely a grand engagement with nature, society, and self; it is also a plannedadaptation to changes in one’s person and one’s environment’’ (Germain &Bloom, 1999, p. 337).
Life Cycle Textbook 3
Hutchinson’s (2003a) textbook, Dimensions of Human Behavior: Person and
Environment, uses a ‘‘person and environment’’ framework to contextualizethe discussion of disability related to the physical person and the physicalenvironment. Theories of the person include the biological, the psychologi-cal, the psychosocial, and the spiritual. Theories of the environment includethe physical and social environment, culture, social institutions and socialstructure, families, small groups, formal organizations, and communities. Thediscussion of disability is limited to physical disabilities, including the medicalmodel, the humanistic framework based on client strengths, social systemsthat address social and environmental factors, and the social-constructivistperspectives based on the cultural, political, social, and economic contextsin which disability occurs.
Despite the attention to the political, social, and economic meanings ofdisability, little attention is given to the theories of disability from the majorsocial science perspectives.
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Life Cycle Textbook 4
Saleebey’s (2001) textbook, Human Behavior in Social Environments:
A Biopsychosocial Approach, features several person-in-environment con-ceptual frameworks related to such perspectives as paradigm change,postmodernism, meaning-making, strengths and resilience, biopsychoso-cial concepts, and nature and nurture. Mental illness and aging-relatedneurological problems were the only types of disability mentioned in thetext.
The discussion of mental illness as psychological disability is framedin terms of biological, psychological, and social theories. The biologicaldiscussion on mental illness focused on the growing trend of overemphasison biological causality. Psychological disabilities were explained in terms ofillness, treatment, recovery, and healing. The text reflects a social psycho-logical perspective on mental illness, citing the impact of multiculturalismand social tolerance on society’s view of illness, specifically schizophrenia.The textbook illustrates the malleability of conceptions of psychosis acrosstime and culture through a presentation of a spectrum of views about mentalillness placed in a historical perspective.
An overview of mental, neurological, and physiological disabilities ispresented from a neurological perspective in relationship aging (e.g., Alzheimer’sand Parkinson’s disease). The author cautions that in spite of the biologicalinfluences on disease, they should not discount the developmental, emo-tional, cognitive, environmental, spiritual aspects that are inseparable fromthe person and his or her particular illness. The perspective of families ofpeople with disabilities is mentioned because families may be the unfairtarget of blame for psychopathology among their offspring. Finally, thehistorical relationship between disability and the social environment providesan important perspective on the malleability of perception across time andculture.
Life Cycle Textbook 5
In Urdang’s (2002) textbook, Human Behavior in the Social Environment:
Inner and Outer Worlds, human behavior is viewed from biopsychosocialand life cycle perspectives that features theories, behaviors, systems, andgroups. The life cycle discussion is divided into infancy and childhood,middle childhood and adolescence, and adult development. In the SpecialIssues section, the following concepts are addressed: life transitions, crisesand loss, illness and disability, and mental health problems. The chapteron disability and illness covered a range of specific disabilities, social at-titudes and systems, and clinical perspectives. Mental disabilities includeschizophrenia, depression, borderline personality disorder, anxiety disorders,addictions, and developmental disabilities.
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Urdang’s life cycle textbook includes substantial coverage of disabilityas it relates to HBSE in chapters devoted to physical illness and disability andmental health problems. Physical, psychological, and developmental disabili-ties were treated similarly by exploring the primary physical or psychologicalmanifestations of the disability and the biopsychosocial consequences.
Though human behavior is the primary focus of the textbook, someattention is paid to the social environment, especially services and accom-modations for individuals with disabilities. The categorization of disabilities isbased on DSM-IV, with developmental delay/mental retardation and autismplaced in the chapter titled ‘‘Mental Health Problems,’’ separate from thephysical/sensory disabilities in the chapter on ‘‘Illness and Disability.’’
In general, sociological perspectives are presented most often in con-junction with psychological approaches, with less attention to theories fromanthropology, economics, and political science. There is some discussion ofthe impact of disability on family members and the role of parents and otherfamily members of individuals with disabilities. This textbook employs themedical-deficit model almost exclusively and emphasizes individual and psy-chological perspectives. There is limited attention to alternative theoreticalconceptions of the societal dimensions of disability (e.g., the social constructor diversity models), and the book provides little historical context for theevolving societal conceptions of the rights of individuals with disabilities.
The presentation of disability in separate chapters indicates the impor-tance of the topic but can also undermine the normalization of disabilityand people with disabilities who experience the same life cycle concerns asnon-disabled individuals.
Life Cycle Textbook 6
Zastrow and Kirst-Ashman’s (2001) text, Understanding Human Behavior
and the Social Environment, approaches the explanation of human behav-ior from a life-cycle perspective (e.g., infancy and childhood, adolescenceand young adulthood, middle adulthood, and later adulthood), featuringperspectives from biology, psychology, and social systems. The section onyoung adulthood covered topics including ethnocentrism, gender roles, andsexism, while the section on middle adulthood presented discussion ofsexual orientation.
Disability was presented in the context of the life cycle but often limitedto specific disabilities (e.g., Down syndrome, spina bifida, cerebral palsy, andAIDS).
There is a comprehensive discussion of mental illness, utilizing themedical model to describe concepts while challenging its ultimate useful-ness. The authors call for a focus on environmental and biological factors.Psychological and sociological perspectives of mental illness, including thetheory of mental illness as a social construction, are presented as a foundationfor understanding disability.
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The discussion of developmental delay and mental retardation is alsocomprehensive and includes a description of developmental delays (e.g.,mild, moderate, severe, profound) with a focus on the strength-based andcommunity treatment models. Similarly, learning disabilities are discussedwith respect to risk factors, definitions, treatment effects, and macro-systemsresponses.
This textbook highlighted multiple perspectives of disability and reliedprimarily on the discipline of psychology for its theoretical orientation(e.g., psychodynamic, psychoanalytic, and phenomenological approaches)with less attention to social forces that may impact the lives of individualswith disabilities. It featured a strengths-based approach to disability and iscritical of a focus on problems, deficits, and inability. The authors also usewords such as normal and average in quotations consistently throughoutthe text, which implied the need to be aware of the precarious natureof such categories and their potentially damaging effects. In this text,there was a significant focus on individuals, particularly children, withdisabilities.
SYSTEMS TEXTS
In addition to the six life cycle textbooks, a total of five systems textbookswere reviewed. Each takes a slightly different approach to framing the rolesof individuals, groups, organizations, and communities within the context ofhuman behavior and the social environment.
Systems Textbook 1
After providing an overview of the life course perspective, the text on Di-
mensions of Human Behavior (Hutchison, 2003b) follows the human lifecourse from conception to death. Each chapter focused on a particular timeof life, and applicable theories of human behavior and the social environ-ment were presented in a developmental context. This approach providesan understanding of certain types of disabilities in the context of humandevelopment and the life course.
Physical and sensory disabilities, developmental delay, cognitive impair-ment, mental retardation, chronic illness, learning disabilities, and mentalillness are discussed in the context of the human biological and social lifecourse. Physical and sensory disabilities are discussed at length with littleattention to work-related disabilities. Developmental delay and mental illnessare discussed in the contexts of early childhood and aging, respectively.Attention deficits are the primary focus of the discussion on learning dis-abilities along with an in-depth description of attention deficit disorder andADHD. Chronic illness was discussed in the context of aging and end-of-lifechallenges.
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Physical disabilities receive the most significant attention, although thetext focused on aging-related disabilities that occur in middle and late adult-hood. In the chapter on middle adulthood, the field of disability was men-tioned in a discussion of changes in health status and biological functioningthat occur as human beings enter middle and advanced ages. Physical dis-ability is also discussed as one of the ‘‘Special Challenges’’ of middle schoolbecause of the increased attention middle school children pay to physicalchanges and development.
Mental illness discussed in the context of aging was not expressly linkedto disability. In the sections on late and very late adulthood, the discussionof mental illness focuses on dementia. Although the text described howdepression, anxiety, delirium, substance abuse, and other mental healthproblems affect older populations, mental illness in childhood, adolescence,and early and middle adulthood were not addressed.
Despite the discussion of physical disability throughout the lifespan,there was incomplete coverage of different types of disabilities at variousstages of the life cycle. Although each area of disability except work-relateddisabilities was mentioned, the developmental model of the textbook mayhave placed limitations on the discussion of disability. For example, develop-mental delays were discussed in the context of childhood but not adulthood,whereas mental illness was discussed only in later adulthood, although theseare issues that occur and may persist throughout the life cycle. The text didnot offer a theoretical framework for understanding these disabilities overthe span of a person’s life course. Though theoretical models of disabilityare not expressly presented in the text, the disease model and the strengthsperspective are most often utilized in practice.
Systems Textbook 2
Kirst-Ashman’s (2000) text, Human Behavior: Communities, Organizations
and Groups in the Macro Social Environment, deals largely with social func-tioning in the context of groups, organizations and communities. Theoriesare presented in a single chapter, and the text concludes with a discussionof disenfranchised groups and the macro-environment. Using sociology,economics, and political science as the primary disciplinary lenses, the textexamines human behavior in the context of the social-political environment.The text focuses on structural and ecological perspectives and on socio-psychological explanations of human behavior. The concepts of power andempowerment form a baseline for the discussion of HBSE.
The empowerment lens is applied to clients who have disabilities by de-scribing them as independent consumers with choices and options. Familiesare viewed as a major source of support for people with disabilities. Oneparticular chapter is devoted to people with developmental disabilities asthey interact with communities and organizations. Developmental disabilities
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are defined as including visual and hearing impairment, cognitive disabilities,cerebral palsy, epilepsy, orthopedic problems, and autism. In a comprehen-sive chapter, the text clearly identifies the problems, challenges and strengthsof developmental disability using an empowerment perspective.
Systems Textbook 3
Longres’ (2000) textbook, Human Behavior in the Social Environment, usesa systems approach related to communities in society, family life, large andsmall groups, and individuals. Disability is mentioned in nearly every chapterof the book, which describes disability as an element of human diversityrather than as a deficit or life-defining deviance. A variety of theoretical ap-proaches to disability are described by drawing upon psychology, sociology,anthropology, and political science, with little mention of economics.
The presentation of a variety of theoretical models includes social con-structionism, the diversity model (with respect to deaf culture), and themedical model (from a critical standpoint) in detail. The text briefly mentionsother conceptions of disability, such as the moral model (disability as pun-ishment for sin) and the pre-Freudian view of mental illness as possession bydemons. Though the text emphasizes societal views of disability, individualperspectives are not included.
Physical disabilities are discussed in the contexts of self-image, copingwith a disabled child, D/deaf culture, discrimination, and political action.Psychological disabilities are discussed in terms of gender disparities, label-ing of mental disorders, the prevalence of mental illness among homelessindividuals, and whether depression is more common among elderly people.Developmental disabilities were mentioned on a more limited basis withrespect to normalization through advocacy and the ADA.
Systems Textbook 4
Human Behavior in the Social Environment: Families, Groups, Organiza-
tions, and Communities (Pillari & Newsome, 1998) uses a systems approachto understanding human behavior across diverse systems (e.g., families,groups, organizations and communities). With respect to disability, the au-thors include a subsection entitled ‘‘Mental and Physical Disabilities’’ inthe context of the family along with a limited focus on the physical anddevelopmental disabilities of children and their impact on the family. Theconcept of ‘‘rehabilitation’’ and ‘‘habilitation’’ in the context of meeting theneeds of mentally challenged (disabled) are notable but brief. Specific mentalhealth and psychiatric disabilities were not discussed explicitly. Although theword disability is not specifically in the discussion of the psychological andphysical needs of the elderly and AIDS victims, psychological problems andmedication issues are noted.
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The perspectives on disability presented in the text are rooted in thediscipline of psychology using a deficit model rather than strength-basedapproach to disability. For example, in the discussion of mental and physicaldisabilities, the authors note that when disability is discovered in a child, ‘‘aveil of despair, confusion, and disappointment may descend on the family’’and ‘‘the family also suffers from chronic sorrow, which persists as long as thechild lives’’ (Pillari & Newsome, 1998, p. 54). This text offers a limited viewof disability in the context of human behavior and the social environment.
Systems Textbook 5
Schriver’s (2001) textbook, Human Behavior and the Social Environment:
Shifting Paradigms in Essential Knowledge for Social Work Practice, iden-tifies the various traditional and modern ways that systems are conceptual-ized and analyzes groups of diverse sizes and demographic attributes. Thistextbook examines disability in the context of individuals, families, groups,and communities from various theoretical perspectives, including the socialenvironment (e.g., changes in government policies) and human behavior(e.g., people living with disabilities).
Though this text effectively contextualizes physical disability within apsychosocial framework of human behavior and the social environment,there is little discussion of learning, psychological, or work-related disabili-ties. Beyond the biopsychosocial perspective, the political science perspec-tive is reflected in the discussion on the provisions of the ADA and the socialmobilization leading to its enactment. The historical perspective is used toexplore the development of perceptions of developmental disabilities fromthe 1700s to the present time. Overall, the text focused on the perspectivesof theorists and public policy makers.
Disability is viewed within the context of human diversity, similar togender, sexual orientation, or religion. Disability is referred to as a part ofidentity development that interacts with other aspects of how people viewthemselves and are viewed by others. Disability is considered to be part ofthe natural genetic variability among humans, not a problem or deficit. Thetheme of disability as an identity is viewed in a similar way to race, age,or social class as part of a shared identity wherein people create groups ofcommunities to promote consciousness raising, treatment, or social action.
The author objects to the construct of ‘‘normal’’ development and theassertion that people with disabilities may be labeled ‘‘abnormal.’’ Given theauthor’s view that there are no universal developmental ‘‘norms,’’ develop-mental tasks need to be reframed to be inclusive of people with disabilities.For example, the major concepts of the independent living perspective chal-lenge the traditional conceptions of disability by focusing on the capabilitiesof persons with disabilities and the environmental and social constraints thatneed to be addressed. This perspective supports the rights of people with
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disabilities to self-determination and empowerment, including the ability tomake decisions about their lives related to and the selection, development,and provision of their own care. Disabilities are presented in the text asopportunities to develop alternative coping and adaptive strategies, ratherthan as problems, challenges, or deficits.
The author challenges traditional definitions and assessments of intelli-gence in the discussion of learning disabilities by noting that IQ tests provideonly limited information about a person’s capabilities or intellectual capabili-ties and then calls for an alternative definition of intelligence that focuses onmultiple abilities, talents, or skills in the context of ethnic/cultural differences.The reader is cautioned against the use of inappropriate language aboutindividuals with disabilities that may reinforce stereotypes and equate peoplewith their disability (e.g., the use of terms such as afflicted, comparisons withable-bodied people, or the disabled instead of people with disabilities).
THEORY TEXTS
In contrast to the multiple life cycle and systems textbooks, only three theorytexts are reviewed, related to their limited use in foundation courses onhuman behavior and the social environment.
Theory Text 1
In Bloom and Klein’s (1997), textbook, Controversial Issues in Human Be-
havior and the Social Environment, the editors present 20 debates andrebuttals in three sections: (1) philosophical, theoretical, and empirical issuesin HBSE; (2) substantive content issues in HBSE; and (3) teaching andlearning issues in HBSE.
Disability is featured in the question, ‘‘Should the HBSE core curriculuminclude developmental disabilities?’’ Interestingly, this is the only argumentthat the editors participate in, and their stance on the topic is that HBSEcurriculum should not include developmental disabilities. The authors citedthat there is not enough time to go into developmental disabilities in anydepth and that such disabilities do not warrant the space to address themproperly. Further, the authors stated that to do so would require expertinformation that cannot be reasonably expected of an HBSE instructor andthat the topic should be taught separately to students who have an interestin developmental disabilities. The pro-developmental author, Audrey Begun,argued that including developmental disabilities is vital to the biopsychoso-cial perspective and can also address systems of oppression and vulnerablepopulations.
The focus of the debate is almost exclusively on developmental dis-abilities without attention to the range of disabilities that affect individuals.
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The authors employed a biopsychosocial approach to understanding de-velopmental disabilities along with a way of understanding diversity andsystems of oppression. The authors suggested that social workers should treatthose with developmental disabilities much like other oppressed groups andsupport both macro- and micro-efforts to remove barriers, promote individualgrowth, and empower people with disabilities to reach their greatest potentialas seen in disability rights movement and the disability culture.
Theory Textbook 2
Greene’s (1999) textbook, Human Behavior Theory and Social Work Prac-
tice, identifies the theoretic underpinnings of HBSE by focusing primarily onpsychological theories (e.g., psychoanalytic theory, Eriksonian theory, Roge-rian theory, and cognitive theory) followed by more recent theories (e.g.,systems theory, ecological theory, social construction theory, feminist theory,and genetic, environmental, and developmental theory). The textbook offersan overview of the major theories for practices. Human social functioningis seen as highly related to physical and environmental circumstances. Theperson-in-environment framework is applied to disability and derived fromsociology (e.g., social construction theory, ecological theory) and genetics.There is some discussion of physical disabilities, mental illness, and develop-mental and learning disabilities but little attention to work-related disability.
The chapter on cognitive theory provides a description of dementia anddiscusses how the way individuals process the world around them can definetheir experience in the external environment. The concepts related to mentaland learning disabilities are used to illustrate how socially construed labelssuch as ‘‘learning disabled’’ can be pathologizing and segregating. Physicaldisabilities are discussed in the context of the impact of genetics and theenvironment on human development.
The social constructionist perspective is used to feature a strengthsapproach whereby individuals with disabilities can be encouraged to re-construct their personal narratives, socially reexamining the misconceptionsand/or myth-conceptions that have caused their segregation (Green, 1999).Similarly, the tools of practice (e.g., DSM-IV) are embedded within politicaland cultural contexts that can create power differentials between practition-ers and their clients.
The chapter about genetics, the environment, and development em-phasized physical disabilities, especially conditions linked to genetics (e.g.,Down syndrome, sickle-cell anemia, cystic fibrosis, Tay Sach’s disease). Thechapter described how environmental factors can interface with geneticpredispositions, causing damage and disability, as in the case of phenylke-tonuria. Included in this discussion is the ‘‘nature vs. nurture’’ debate and theadditive and interactive effects that exist between genetics and the environ-ment. The discussion of genetic and environmental factors in the develop-
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Theories of Disability 23
ment of mental disabilities is limited to schizophrenia and dementia. Mentalillness and mental disabilities are also discussed in the chapter focusing onecological theory regarding the interconnections between the physical worldand an individual’s social/psychological environments.
This text places an equal emphasis on individual and environmentallevels with respect to disability. The strengths approach is evident in thetext’s discussions of disability (e.g., how families of individuals with disabil-ities draw on their personal and community resources and how individualswith disabilities should be encouraged to redefine their own experiencesfor themselves apart from damaging social beliefs). Similarly, a strengthsapproach was utilized in a limited way when describing ‘‘abilities of thedisabled’’ and ‘‘extraordinary talents’’ of individuals with schizophrenia andtheir families. In summary, various types of disabilities are used to illustratethe person-in-environment framework.
Theory Textbook 3
Robbins, Chatterjee, and Canda’s (1998) textbook, Contemporary Human Be-
havior Theory: A Critical Perspective for Social Work, stresses the importanceand use of theories to inform practice. The various theories include feminism,empowerment, and psychological, psychoanalytic, social psychological, andtranspersonal theories.
The disability experiences of people living with cystic fibrosis are usedto illustrate the integration of various person-in-environment theories. Theauthors describe how the condition of cystic fibrosis may affect the livesand environments of people living with this disability as they navigate dif-ferent stages of life cycle development. The life cycle for people with cysticfibrosis is 28 years; thus, topics such as spirituality, physical decline, andthe psychological perspectives on death are often experienced earlier in theperson’s life. The social impact of frequent hospitalization and ostracismfrom mainstream cultural norms adds to the comprehensive picture of howperson-in-environment theory can be used to inform practitioners about theneeds of individuals living with disability.
The concept of stratification is presented in detail. Though the text notesthat stratification may be based on disability (among other criteria), otherfactors (e.g., gender, race, and sexual orientation) are described in moredepth. The chapters on empowerment theories, development theories, lifespan theories, and role theory did not use disability illustrations as part ofthe analysis.
CONCLUSIONS
It is important for students of HBSE to understand human behavior andthe social environment from the perspective of different conditions such as
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24 A. R. Reid-Cunningham and V. C. Fleming
poverty and disability. Though most of the textbooks in this analysis madesome mention of disability, very few of them provided theories of disabilitiesthat might inform practice. Irrespective of the focus of the textbooks (lifecycle, systems, and theory) the overall attention to people with disabilitieswas limited. When disability is included, it is often parenthetical or not theimmediate focus of the discussion. People with disabilities are frequentlydescribed as illustrations of a client population when describing a generalconcept that may or may not be related to disability theories.
Some texts included demographic description of a specific type of dis-ability or condition of living. Others mention disability briefly within a largerdiscussion about social identifiers, such as race, class, and gender. Sometexts mention disability only in the context of discriminatory practices, suchas relating disability to experiences of racism or sexism without mentioningpeople with disabilities in any empowered context.
Though some texts employ a strengths approach and explore theories ofdisability that are empowerment-based, many texts used a deficits or medicalmodel to present disability content.
Several of the HBSE textbooks seem more polemical by stressing theneed for social workers to understand or know certain things about peoplewith disabilities, such as their rights under the ADA. One of the textbooksdevoted a chapter to the proposition that disabilities content does not belongin a foundation HBSE course because it is a broad and complex topic worthyof its own course taught by those with an expertise not always found amongHBSE faculty.
Though it is generally reflected in the majority of textbooks reviewedin this analysis that people with disabilities deserve to be included in theHBSE courses, it is not clear that theories of disabilities were used to framethis perspective. In only a few textbooks was it recognized that disabilityitself could provide a lens through which to explore human behavior and thesocial environment. Because so much of disability is socially constructed, thedisability condition can be viewed from the perspective of various theoriesof human behavior and the social environment. It is the theories of disabilitythat need to be considered as fundamental components of the HBSE curricu-lum. Without this approach, it will be difficult to provide future practitionerswith theories for practice that reflect the strengths-based frameworks ofdifferent theories of disability.
REFERENCES
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Germain, C., & Bloom, M. (1999). Human Behavior in the Social Environment: An
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