Many of you will know of the Social Model of Disability, and some will have followed the work of its founder Mike Oliver. We approached Mike to write a post for criticalphysio blog a few weeks ago. This is Mike’s response to the challenge of the social model of physiotherapy for future practice.
It’s more than thirty years this year since I published a book introducing the social model of disability onto an unsuspecting world (Oliver 1983). The idea behind it stemmed from the Fundamental Principles of Disability document first published in the mid-1970s (UPIAS 1976) which argued that we were not disabled by our impairments by the disabling barriers we faced in society. A couple of years later I was teaching the first masters course in what has now come to be called disability studies in the UK. The course was for qualified social workers and other professionals and I wanted to help my students to develop a means of translating that simple idea into their everyday work with disabled clients and their families.
So in the early 1980s I introduced both the individual and social models of disability (Oliver 1983) aimed largely at professionals. I suggested that until that point those professionals working with disabled people had operated largely within a framework based on the individual model and that in order to make their practice more relevant to the needs of disabled people, they needed to re-orient their work to a framework based upon the social model. At no point did I suggest that the individual model should be abandoned nor did I claim that the social model was an all encompassing framework within which everything that happens to disabled people could be understood or explained.
Subsequently however the social model took on a life of its own and it became the big idea behind the newly emerging disability equality training. It also soon became the vehicle for developing a collective disability consciousness and helped to develop and strengthen the disabled peoples’ movement which had begun to emerge a decade earlier. Armed with the idea that we needed to identify and eradicate the disabling barriers we had in common, the disabled peoples’ movement forced the media to change their images of us, transport providers to open up many of their services to us, public buildings became much more accessible and the legal system changed to make it illegal to discriminate against us (see Oliver 2014).
However as the social model was developed originally as a means to reconstruct professional practice, in this article I want to consider the response of physiotherapy to its appearance. While there has been some ongoing dialogue between disabled people and social workers, teachers, occupational therapists about the social model, physiotherapists along with doctors seemed to have virtually ignored it in the past thirty years.
My own thoughts on this are that both physiotherapists and doctors see their practice as placed within the individual model of disability and are constrained by seeing the body as a physical and mechanical entity which, when it is need of repair, falls within the domain of their own practice. Neither profession sees modifying physical, cultural, political and other barriers as something they should be involved in as practitioners.
While I’ve never directly addressed physiotherapy in my own work my critique of conductive education (Oliver 1989) and my deconstruction of walking (Oliver 1996. 2009) has some direct relevance to the profession. Neither, as far as I am aware, has attracted much attention from physiotherapy although, of course, I have had some discussions of my work with individual physiotherapists.
At this point we might pose the question, what would a reconstructed physiotherapy based upon the social model look like? It might, I suggest, base itself on the work I and others did on trying to reconstruct the relationship between disabled people and disability researchers, which in the 1980s and 90s had reached crisis point (see Disability, Handicap and Society 1992. Vol 7, No 2).
My own contribution to this project was to suggest that we develop emancipatory research by changing what I called the social relations of research production. This was an attempt to challenge the imbalance of power which structures all professional practice; the professional imposing their view of the world on the patient, client, user, customer etc. Testament to this is that we don’t even have a language that enables us to talk about the relationship between the professional and the user of their services in a non-hierachical way.
Changing the social relations of physiotherapeutic practice would entail physiotherapists giving up or, at least, sharing some of their power and placing their skills and knowledge at the disposal of disabled people. I further suggested that such emancipatory practice in research should be judged by three specific criteria; what I called reciprocity, empowerment and gain, both for the researcher and the disabled person.
Whether such criteria are relevant to physiotherapists wanting to critically reflect on their own practice is not for me to say. Further I do not underestimate the difficulties involved in this as I painfully discovered when I dissected a piece of my own research using the criteria suggested above (Oliver 1997).
Whether physiotherapy needs reconstructing or not is not for me to say either but the existence of a website like Critical Physiotherapy suggests that all is not well within the profession. Further whether the direction I have suggested is the right one, is not something I have a view on. Indeed whether the tools built for a different profession are relevant to any such reconstruction is something for the profession itself to consider, hopefully in dialogue with disabled people.
Finally these tools were built at a time when the global economy was in boom mode and optimism and faith in the future extended to professional practice. Moving on twenty years this is no longer the case with the global economy in a severe downturn and the private market having a critical impact on all professional practice, but the question I once asked myself still needs to be asked, “emancipatory (physiotherapy practice): is it a realistic goal or an impossible dream?”.
Mike Oliver is Emeritus Professor of Disability Studies and was Professor of Disability Studies at the University of Greenwich and Chair of the Research Sub-Committee of the British Council of Organisations of Disabled People. He was also co-founder and executive editor of the international journal Disability and Society and was a member of the Social Research Advisory Panel of the National Lottery Charities Board. He is an internationally recognised academic and political commentator, having participated in several major policy reviews in education, health and social services and published numerous books and articles on disability and other social policy issues over the last 15 years. He has also made many appearances on national and regional television and radio. He was also an active member of the disabled peoples’ movement for more than 40 years. Prior to his retirement he undertook consultancy work with many health and local authorities an d he was appointed to the Board of the Social Care Institute for Excellence (SCIE). In 2003 he was voted 7th most famous disabled Briton, level with then Home Secretary David Blunkett. Of those still living, only Stephen Hawking and Tanni Gray-Thomson were voted higher.
Oliver, M. 1983: Social Work with Disabled People. Basingstoke: Macmillan.
Oliver. M, (1989) ‘Conductive Education: If It wasn’t So Sad, It Would Be Funny’ Disability, Handicap and Society. Vol 4 No 1
Oliver, M. (1992) ‘Changing the Social Relations of Research Production’ Disability, Handicap and Society. Special Edition Researching Disability 1992. Vol 7, No 2).
Oliver, M. (1996) Understanding Disability: From Theory To Practice (Basingstoke: MacMillan)
Oliver, M. (1997) ‘Emancipatory Research: Realistic Goal or Impossible Dream?’ in Barnes, C. and Mercer, G. (eds) Doing Disability Research (Leeds: The Disability Press)
Oliver, M. (2009) Understanding Disability: From Theory To Practice: 2nd Ed (Basingstoke: Palgrave)
Oliver M (2014) The Social Model Of Disability: Thirty Years On Disability And Society Vol 28 No 7
UPIAS. 1976: Fundamental Principles of Disability. London: Union of the Physically Impaired Against Segregation.