Constructivist model/framework of disability

In recent years, there has been a move towards the application of a social constructionist framework to disability (Borden, 1992; Brzuzy, 1997; Ringma & Brown, 1991). Witkin (1990) described constructionism as a theory that seeks to “elucidate the sociohistorical context and ongoing social dynamic of descriptions, explanations, and accountings of reality” (p. 38). Rather than taking theory and the dominant forms of understanding as definite conclusions, implicit in social constructionism is the idea that knowledge is not an objective entity, but rather a social creation (Levine, 1997). Constructionism devotes particular attention to the ways in which knowledge is historically situated and embedded in cultural values and assumptions, sociocultural norms, and language (Patterson, 1997). From the constructionist perspective, language serves as a method for producing meaning and generating knowledge rather than a representation of an objective “truth”. Constructionism as an epistemology, therefore, contributes a liberating quality to the social sciences by way of alteration to the monolithic landscape of positivism and scientific inquiry (Witkin, 1990). Social constructionism can offer significant insight to contemporary conceptualizations of disability. Most individualistic (personal-tragedy) accounts of disability fail to recognize that even the most objective of disorders, such as visual impairment, do not exist independent of culture and society. The contemporary language of disability, with its individualistic representations of personal tragedy suggests that disability and impairment exist independent of cultural, historical, or other contexts (Brzuzy, 1997). While the emphasis on the influence of society and culture on human behavior (ex. anthropology, cultural criticism, sociology), social workers and other human service professionals seem to unquestioningly believe the objective “truth” of disability and impairment, thereby neglecting environmental factors (Raske, 2005). The constructionist perspective asserts that a disability-related impairment comes from the relationship of the person with a disability to the socio-cultural environment; thereby the environment is seen as the primary target of intervention. This framework stands in sharp contrast to the position taken by social work education regarding disability, where the emphasis is on rehabilitation, adaptation, and mitigation (Gilson & DePoy, 2002). Drawing from cultural studies, the cultural construction of disability questions the enlightenment idea of a rational, progressive human actor in society. It scrutinizes extant knowledge to deconstruct the unstated assumptions about disability and people with disabilities. The subjective experience of disability and both the explicit and implicit assumptions that shape the disabled experience have been suggested by a large number of ethnographic studies undertaken by anthropologists (e.g. Groce & Scheer, 1990; Ingstad & Reynolds-Whyte, 1995; McDermott & Varenne, 1996). Social work in an increasingly multicultural North America poses the question of how disability is understood in different cultures. How are deficits of the body and mind interpreted and dealt with in different societies? How is an individual’s identity as a person affected by the cultural connotations of disability? How do processes of cultural transitions shape the local understanding of disability? Definitions of disability in terms of measurable functional limitations fail to recognize that culture permeates the variations of the human condition with consequences much deeper than the simple ability to perform a given task (Ingstad & Reynolds-Whyte, 1995). Objective criteria of functional limitations do not answer the question of how important is individual ability as a source of social identity in different cultures. The experience of disability, too, varies across cultures. For example, Edgerton (1985) showed attitudes toward people with impairments varied greatly in non-Western cultures, from negative discrimination, to acceptance, and to positive attribution of supernatural powers. Locust (1985) explores the differences in Native American beliefs about “unwellness” across cultures such as the Hopi, Apache, Yagui, and Navajo. One telling case example is that of Piki Maker, an expert bread maker whose physical differences in back structure and arm length are promoted by her community as assets that allow her to produce bread at a more efficient rate than anyone else in the tribe. Disability is, therefore, hardly a unitary concept: in many cultures one cannot be “disabled” because “disability” as a distinct category does not exist. The term “disabled” does not translate into many languages, although there are terms for people with visual, hearing and cognitive impairments (Ingstad & Reynolds-Whyte, 1995). The lack of a universal definition of disability throughout history indicates a tenuous relationship between the disabled individual and society. Understanding disability as a socially and culturally constructed phenomenon, rather than as an inherent objective “reality” calls into question the presuppositions of the medical model that form the foundation of social work practice with people with disabilities. Most of the theoretical leanings that under gird social work assumptions and practice with disabled populations at the levels of treatment, counseling, rehabilitation, service provision, case management, research, and policy analysis have been borrowed from medicine and psychiatry; as such they often lack conformity between social work code of ethics and an agenda of human rights/social justice (Brzuzy, 1997). In this regard, constructionism provides a theoretical framework to rethink disability in liberating and empowering terms.