Page 513 - ILAE_Lectures_2015

Chapter 59

Social work support in the community

HELEN O’BRIEN

Sir William Gowers Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire

What is a social worker?

The British Association of Social Workers states: ‘Social work practice addresses the
barriers, inequities and injustices that exist in society. It responds to crises and emergencies
as well as to everyday personal and social problems. Social work utilises a variety of skills,
techniques, and activities consistent with its holistic focus on persons and their environments.
Social work interventions range from primarily person-focused psychosocial processes to
involvement in social policy, planning and development. These include counselling, clinical
social work, group work, social pedagogical work, and family treatment and therapy as well
as efforts to help people obtain services and resources in the community. Interventions also
include agency administration, community organisation and engaging in social and political
action to impact social policy and economic development. The holistic focus of social work
is universal, but the priorities of social work practice will vary from country to country and
from time to time depending on cultural, historical, legal and socio-economic conditions.’1,2

Within the field of social work with disabled people there are a number of models of theory.
These include:

Medical model
A medical practitioner may view a physical disability as a dysfunction or abnormality located
within an individual’s body. Within medicine there are different ways of categorising
disability: in terms of specific medical diagnosis; the bodily system affected; functional loss.
Each of these forms of categorisation provides different kinds of information. What unites all
the systems is the focus on pathology. However when looking at the nature and variability of
impairments it becomes clear that for some conditions the degree of physical impairment
cannot be predicted by the medical diagnosis as the physical consequences vary from person
to person. The experience of the impairment also varies within the same person, as
impairment is rarely fixed. Historically, disabled people came to be perceived as sick and as
in need of a cure.3,4

Psychological models
Many, but not all, psychological approaches to disability share with the medical model a
focus on the individual. Traditionally the role has been to assist the disabled person to adjust
to their impairment. Therapeutic work based on behavioural or cognitive perspectives may
focus on improving coping strategies.

Social model
In contrast to the medical and some psychological models, in 1983 the disabled academic
Mike Oliver coined the phrase ‘social model of disability’. Oliver locates disability within
society, in the built environment and the values and social practices which discriminate
against people with certain differences. The social model of disability is based on a distinction
between the terms ‘impairment’ and ‘disability’. Impairment is used to refer to the actual
attributes (or lack of attributes), i.e. the abnormality, of a person, whether in terms of limbs,
organs or mechanisms, including psychological. Disability is used to refer to the restrictions