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15. FamilyCaregiving
IrmoMariniandMichaelJ Millington
16 CounselingintheContextofFamilyIdentity
MichaelJ MillingtonandRosamondH Madden
PARTIV:INTERVENTIONSANDRESOURCES
17 TreatmentforSubstanceUseDisorders
LloydR Goodwin,Jr
18. WorkingWithTrauma-RelatedMentalHealthProblemsAmongCombatVeteransoftheAfghanistanand IraqConflicts
LindseyN Cooper,RyanP Holliday,NicholasD Holder,JamylahJackson,CarolS North,andAlinaM Surís
19 UsersofAssistiveTechnology:TheHumanComponent
MartinG.Brodwin,FrancesW.Siu,andElizabethCardoso
20 ReligionandDisability:Clinical,Research,andTrainingConsiderationsforRehabilitationProfessionals
BrickJohnstone,BretA Glass,andRichardE Oliver
21 RehabilitationProfessionalsandAbuseofWomenConsumers
MartinG.BrodwinandFrancesW.Siu
PARTV:NEWDIRECTIONS:ISSUESANDPERSPECTIVES
22 ApplicationofWell-BeingTherapytoPeopleWithDisabilityandChronicIllness
BarryNierenberg,GillianMayersohn,SophiaSerpa,AlexiaHolovatyk,EvanSmith,andSarahCooper
23. ClassifyingFunctioning,Disability,andHealth:TheICF
DavidB.Peterson
24 FromEmpathyFatiguetoEmpathyResiliency
MarkA.Stebnicki
25. ObesityasaDisability:Medical,Psychosocial,andVocationalImplications
MariaG RomeroandIrmoMarini
26. Immigrants,Refugees,andAsylumSeekers:ThePsychosocialCostofWaronCivilians MarkA.Stebnicki
27. KeyConceptsandTechniquesforanAgingWorkforce
SusanneM Bruyère,DebraA Harley,CharleneM Kampfe,SaraVanLooy,andJohnS Wadsworth
28 RiskandResilienceinMilitaryFamiliesExperiencingDeployment:TheRoleoftheFamilyAttachment Network ShelleyA RiggsandDavidS Riggs
29 SocialJustice,Oppression,andDisability:CounselingThoseMostinNeed IrmoMarini
30 ReflectionsandConsiderations IrmoMariniandMarkA.Stebnicki
APPENDIXA:PERSPECTIVEEXERCISES PerspectiveExercise1 CommonPain,MutualSupport PerspectiveExercise2 WhoNeedsThisKindofHelp? PerspectiveExercise3 IsthePersonWithaDisabilityMoreImportantThantheFamily? PerspectiveExercise4 EnoughIsEnough PerspectiveExercise5 Fragile:HandleWithCare PerspectiveExercise6
ix
APPENDIXB:PERSONALPERSPECTIVES
ChrisandHisMother:HopeandHome
ChrisMoy
Karen MyDaughterForever
LindaStacey
LivinginSpiteofMultipleSclerosis
ToscaAppel
SurvivingAmyotrophicLateralSclerosis:ADaughter’sPerspective
JudyTeplow
MyLifeWithaDisability:ContinuedOpportunities
PaulEgan
ExperiencingSexualityasanAdolescentWithRheumatoidArthritis
RobertJ Neumann
MyLifeWithMuscularDystrophy:LessonsandOpportunities
RobertP.Winske
LifeLessonsTaughttoMebyMyDisability
AlfredH DeGraff
Index
Contributors
Richard F. Antonak, PhD ViceProvostforResearch DepartmentofCounselingandSchoolPsychology UniversityofMassachusetts Boston,Massachusetts
Tosca Appel, MS Newton,Massachusetts
Michael R. Benz, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
Martin G. Brodwin, PhD, CRC CaliforniaStateUniversity LosAngeles,California
Susanne M Bruyère, PhD, CRC Director,Yang-TanInstituteonEmploymentandDisability ILRSchool CornellUniversity Ithaca,NewYork
Elizabeth Cardoso, PhD, CRC HunterCollege NewYork,NewYork
Lindsey N. Cooper, PsyD StaffPsychologist VeteransAffairsNorthTexasHealthCareSystem Dallas,Texas
Sarah Cooper, PhD ClinicalPsychologyPostDoctoralFellow PSIMEDCorrections,Inc. NovaSoutheasternUniversity FortLauderdale,Florida
Sergio Cuevas, PhD PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley
Edinburg,Texas
Alfred H DeGraf, EdD FortCollins,Colorado
Paul Egan, MS Dracut,Massachusetts
Danielle D Fox, PhD PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Bret A Glass, PhD DepartmentofEducational,School,andCounselingPsychology UniversityofMissouri Columbia Columbia,Missouri
Lloyd R Goodwin, Jr , PhD, LCAS, CRC, MAC, CCS, ACS Professor DepartmentofAddictionsandRehabilitationStudies EastCarolinaUniversity Greenville,NorthCarolina
Noreen M. Graf, RhD, CRC SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Cheryl Grenwelge, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
Debra A Harley, PhD, CRC DepartmentofSpecialEducationandRehabilitationCounseling UniversityofKentucky Lexington,Kentucky
Nicholas D Holder, BS DoctoralCandidateinClinicalPsychology VeteransAffairsNorthTexasHealthCareSystem UniversityofTexasSouthwesternMedicalCenter Dallas,Texas
Ryan P Holliday, MA DoctoralCandidateinClinicalPsychology VeteransAffairsNorthTexasHealthCareSystem UniversityofTexasSouthwesternMedicalCenter Dallas,Texas
Alexia Holovatyk, BS CenterforPsychologicalStudies
NovaSoutheasternUniversity FortLauderdale,Florida
Jamylah Jackson, PhD, ABPP DirectorofPsychologyTrainingandAssociateProfessorofPsychiatry VeteransAffairsNorthTexasHealthCareSystem UniversityofTexasSouthwesternMedicalCenter Dallas,Texas
Brick Johnstone, PhD DepartmentofHealthPsychology UniversityofMissouri Columbia Columbia,Missouri
Charlene M. Kampfe, PhD ProfessorEmeritus UniversityofArizona Tucson,Arizona
Hanoch Livneh, PhD, CRC ProfessorEmeritus PortlandStateUniversity Portland,Oregon
Rosamond H Madden, MSc, AM SeniorResearchFellow CentreforDisabilityResearchandPolicy UniversityofSydney Sydney,NewSouthWales,Australia
Irmo Marini, PhD, DSc, CRC, CLCP Professor SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburgh,Texas
Gillian Mayersohn, PhD CenterforPsychologicalStudies NovaSoutheasternUniversity FortLauderdale,Florida
Michael J. Millington, PhD, CRC SeniorLecturer RehabilitationCounselling UniversityofSydney Sydney,Australia
Gerardo Mireles, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
Chris Moy, MS Scranton,Pennsylvania
Robert J. Neumann Chicago,Illinois
Kim Nguyen-Finn, PhD, LPC-S PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Barry Nierenberg, PhD, ABPP CenterforPsychologicalStudies NovaSoutheasternUniversity FortLauderdale,Florida
Carol S. North, MD, MPE MedicalDirector,TheAltschulerCenterforEducation&Research MetrocareServices
TheNancyandRayL.HuntChairinCrisisPsychiatryandProfessorofPsychiatry Director,DivisionofTrauma&Disaster UniversityofTexasSouthwesternMedicalCenter Dallas,Texas
Margaret A Nosek, PhD CenterforResearchonWomenWithDisabilities DepartmentofPhysicalMedicineandRehabilitation BaylorCollegeofMedicine Houston,Texas
Richard E Oliver, PhD, FASAHP DeanEmeritus SchoolofHealthProfessions UniversityofMissouri Columbia Columbia,Missouri
David B Peterson, PhD, CRC, NCC LicensedClinicalPsychologistandProfessor CaliforniaStateUniversity LosAngeles,California
Rick Peterson, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
Michael A. Rembis, PhD DirectoroftheCenterforDisabilityStudies UniversityofBuffalo(SUNY) Buffalo,NewYork
J. Aaron Resch, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
David S. Riggs, PhD DepartmentofMedicalandClinicalPsychology UniversityServicesUniversityoftheHealthSciences Bethesda,Maryland
Shelley A. Riggs, PhD DepartmentofPsychologicalScience UniversityofNorthTexas Denton,Texas
Maria G Romero, PhD, CRC DepartmentofPsychology UniversityofTexas RioGrandeValley Edinburg,Texas
Breeze Rueda, PhD, LPC PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Sophia Serpa, MS CenterforPsychologicalStudies
NovaSoutheasternUniversity FortLauderdale,Florida
Manisha Sharma, PhD PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Frances W. Siu, PhD, CRC CaliforniaStateUniversity LosAngeles,California
David W Smart, PhD ProfessorEmeritus CounselingandPsychologicalServicesCenter BrighamYoungUniversity Provo,Utah
Julie F Smart, PhD, CRC ProfessorEmeritus DepartmentofSpecialEducationandRehabilitation UtahStateUniversity Logan,Utah
Evan Smith, MS CenterforPsychologicalStudies
NovaSoutheasternUniversity FortLauderdale,Florida
Linda Stacey Framingham,Massachusetts
Mark A. Stebnicki, PhD, LPC, DCMHS, CRC, CCM, CCMC ProfessorandCoordinator,MilitaryandTraumaCounselingCertificateProgram DepartmentofAddictionsandRehabilitation EastCarolinaUniversity Greenville,NorthCarolina
Alina M Surís, PhD, ABPP SeniorClinicalPsychologistResearcherandProfessorofPsychiatry VeteransAffairsNorthTexasHealthCareSystem UniversityofTexasSouthwesternMedicalCenter Dallas,Texas
Judy Teplow, MSW Canton,Massachusetts
Chia Vang PhDCandidate SchoolofRehabilitation UniversityofTexas RioGrandeValley Edinburg,Texas
Sara VanLooy, BA ResearchAssistant Yang-TanInstituteonEmploymentandDisability ILRSchool CornellUniversity Ithaca,NewYork
John S Wadsworth, PhD, CRC CollegeofEducation TheUniversityofIowa IowaCity,Iowa
Robert P. Winske, MS Boston,Massachusetts
Beatrice A Wright, PhD UniversityofKansas Lawrence,Kansas
Dalun Zhang, PhD CenteronDisabilityandDevelopment DepartmentofEducationalPsychology TexasA&MUniversity CollegeStation,Texas
Foreword
In reviewing the seventh edition of The Psychological and Social Aspects of Illness and Disability I have come to believe that the publication of this updated edition could not come to the field of rehabilitation counseling at a more important time This book provides a much-needed comprehensive discussion and analysis regarding the importance of the interaction between the psychological and social aspects that impact individuals and their rehabilitation outcomes. One might say that as this book is in its seventh edition, this type of discussion has already occurred That is true, but the timing of the release of this updated version is important because the text indirectly provides a conceptual framework to guide rehabilitation counseling practitioners and students in developing an understanding of how psychological and social factors interact to impact individuals and their rehabilitation outcomes. In reviewing this seventh edition, several things stood out that make the book important, timely,andasignificantcontributiontotheliteratureonrehabilitationcounseling
The first thing I did as I examined the text, was to look back at the previous editions and their forewords, several written by Professor Art Del Orto, who was one of the original editors of this book In Professor Del Orto’s initial edition and subsequent forewords, he provided a very rich review of the emergence of the research related to psychological and social aspects of disability, the key figures in this research, and how this research and those important figures impacted him as a scholar By reexamining this informative history, one gains an understanding of how this important area of study emerged and has contributed to rehabilitation counseling research and practice. Understanding history is important because it grounds us and helps us appreciate our roots and our identity as a profession Addressing how psychological and social factors interact with one ’ s level of functioning to impact societal participation is one of the key pillars that distinguishes rehabilitation counseling fromotherhelpingprofessions However,onethingthatstruckmeasIwasreviewingtheseventheditionwashow this current text informs the future by providing direction to rehabilitation counseling students, practitioners, and researchers This text provides new and emerging information regarding how personal and environmental factors interact across the spectrum to impact individuals and outcomes This text brings to life the International Classification of Functioning, Disability, and Health (ICF; World Health Organization, 2001) for rehabilitation counselors and provides contemporary information that can be used to educate, guide practice, and provide the foundation for emerging research related to the psychosocial aspects of disability and chronic disease Emerging areas, such as working with veterans, refugees, and the aging workforce, along with many others, are covered and provide important information for rehabilitation counselors to use to address the emerging psychosocial issues and needsoftheindividualstheyserve.
Building on my initial reaction, my second thought, maybe even more relevant, was that by indirectly grounding this text in the ICF framework, this book directly minimizes the medical model that unfortunately still guides rehabilitation counseling today. This text highlights the importance of psychological and social factors in human behavior, while eliminating the need to focus on identifying the appropriate and highly valued diagnosis to explain behavior and guide treatment This text provides rehabilitation counselors with the necessary knowledge needed to conceptualize how personal, environmental, and functioning impact behavior and encourage rehabilitation counselors to develop and implement interventions that leverage resources, empower individuals, and ameliorate environmental barriers. This is in stark contrast to the medical model, which places a premium on establishing the correct diagnosis, using the derived diagnosis as the foundation of treatment, and focusing interventions exclusively on the individual This difference is important and timely as students, practitioners, and scholars are continually having to deal with mixed messages from professional organizations and accreditation and licensure bodies that may cloak themselves in the guise of rehabilitation values while truly espousing the fundamental tenets of the medical model This text provides a powerful and informative resource for students, practitioners, and scholars in developing and reinforcing rehabilitation counseling principles that guiderehabilitationcounselingeducation,practice,andresearch.
Finally, a major strength of this book is its focus on new directions that will impact the provision of rehabilitation counseling education, practice, and research Providing scholarly discussions of emerging issues,
such as empathy resilience, and emerging populations, such as refuges and those who are obese, provides rehabilitation counselors at all levels with important information that will guide future education, practice, and research In addition, the rich discussion of areas of grief, sexuality, family, culture, social justice, parenting, trauma, veterans, and religion allows students to be grounded in both theoretical and practical issues that impact overallpsychosocialfunctioning.Finally,providingthehistoricalcontextofhowpeoplewithdisabilitieshavebeen treated and the impact of individual and societal attitudes are critical so that emerging trends can be fully appreciated and all levels of rehabilitation professionals have a comprehensive foundation for understanding the psychosocial aspects of disability and the impact that rehabilitation counseling, when guided by conceptually sound principles, can have on maximizing societal participation of those with chronic health conditions and disabilities
Overall, I would like to offer my sincere appreciation for the editorial work of Irmo Marini and Mark Stebnicki, as they have done a masterful job in collecting a group of chapters that provide contemporary, cuttingedge information regarding psychological and social aspects of chronic health and disability in a historically and theoretically relevant context This book will become the formative text that guides the education of a new generation of rehabilitation counselors while informing current rehabilitation counseling practice and research It is important to note that this book provides all levels of rehabilitation counselors with the much-needed resources necessary to begin to fulfill an ICF-based approach to chronic health and disability while minimizing a diagnostically based conceptualization that unfortunately still permeates much of today’s education, research, and practice
DavidR Strauser,PhD DepartmentofKinesiologyandCommunityHealth CollegeofAppliedHealthSciences UniversityofIllinoisatUrbana–Champaign Champaign,Illinois
REFERENCE
WorldHealthOrganization (2001) Internationalclassificationoffunctioning,disabilityandhealth:ICF Geneva,Switzerland:Author
Preface
It was the fall of 2010 when we first received a call from Art Dell Orto, the original coeditor of the first five editions of The Psychological and Social Impact of Illness and Disability (1977, 1984, 1991, 1999, and 2007), who asked us to carry on this work Art indicated that he was not only retiring after an outstanding career at Boston University, but also retiring from many of his professional projects as well The original edition of this work began with Art Dell Orto, professor, Boston University, and Bob Marinelli, professor, West Virginia University, who edited the first four editions, then Paul Power, professor emeritus, University of Maryland, workedonthefifthedition IrmoandIhavebeenfriendswithArtandmanyofhiscolleaguesoverourcareersand were flattered, grateful, and honored to be asked to continue editing this exceptional work When the book first appearedin1977,fewbooksexistedonthetopicofpsychosocialaspectsofchronicillnessanddisability.Irmoand I had written several chapters in the previous editions of this work based on our research and practice within this speciality area However, to be asked to edit and bequeathed this work is much like Captain Kirk of the Starship Enterprise asking Lt Commander and First Science Officer Mr Spock to take over the helm Indeed, this body of work had to continue through the constellation of books on rehabilitation, counseling, and psychology with full thrustersandwarp-drivefullon
Irmo hired and mentored me in my first job as an assistant professor in the Department of Psychology and Counseling at Arkansas State University I was fortunate to be hired directly out of my doctoral program at the Rehabilitation Institute, Southern Illinois University, Carbondale, back in 1995. As any doctoral candidate can attest,itiscriticaltohavegoodmentorstoguideyouthroughtheprocessofteaching,research,andservice,andto prepare you for a publish-or-perish job at a teaching institution It is equally important that one ’ s first experience in academia also have good mentors to guide one through the real-world experiences of teaching, research, and service.
At my first job in academia, after 11 years of working in rehabilitation, counseling, and behavioral health, I met Irmo, an outstanding mentor; our personalities meshed into one unified brain, we thought, felt, and behaved in the same way on virtually every topic We never perceived our time together at Arkansas State or currently as simply being “working colleagues”; our friendship runs deep and there are no real boundaries between work and play It is a culture that few are fortunate to experience, where metaphorically work-is-play and play-is-work Within a culture like this, the end product usually results in the second edition of a book being better than the first,andtheseventheditionbeingbetterthanthesixth
This brings us forward to the seventh edition, in which we developed materials based on the talents of many authors and communicated this in a readable and usable manner Approximately two thirds of the chapters are new and/or updated In keeping with the formula from previous editions, we have maintained the foundation of seminal works of early authors; many present-day authors have leaned on these works for theoretical constructs, models, and practice with the intention of working with persons with chronic illnesses and disabilities Other sections of The Psychological and Social Impact of Illness and Disability feature emerging populations, for whom services are required to support the mental, physical, and spiritual well-being of the individuals and groups who are aged, disabled, or have acquired disabilities because of extraordinarily stressful and traumatic events such as combator, natural disasters, and critical incidents such as terrorism. It also addresses the negative impact of societal inequities, oppression, poverty, and disability on those most in need Overall, this text addresses the medical, physical, psychosocial, and vocational aspects of a rather unique culture of individuals Living with chronic illnesses and disabilities is a daily challenge, but one that many meet with resilience and perseverance. It is anticipated that this nexus of material enrich the knowledge, awareness, and skills of both studentsandinstructorsinthefieldsofrehabilitation,counseling,psychology,andthealliedhealthsciences
Finally, a psychosocial text concerning illness and disability would not be complete without the stories and perspectives of resilient persons with disabilities who have lived the experience. Irmo and I have retained the majority of these poignant personal accounts written by persons with disabilities and/or their loved ones who care for them Based on these revealing personal accounts and experiences of disability, each section of the book
contains keystone and foundational material that has good intentions for learning and professional practice The Appendices contain exercises to enhance learning The insights shared in the seventh edition continue to give studentsandpractitionersadifferentperspectiveoflifewithachronicillnessanddisabilityintheUnitedStates
SupplementalmaterialsintheformofanInstructor’smanualandPowerPointpresentationsareavailablefor qualifiedinstructorsandcanberequestedbyemailing:textbook@springerpubcom
Acknowledgments
We would like to most humbly thank several key people who made this book possible. Editorial Director of Behavioral Sciences extraordinaire, Sheri W. Sussman, who has guided and supported us through several SpringerPublishingbooks,madethisexperienceasstress-freeaspossiblewithhersarcastichumorandtremendous wisdom We would like to also thank Assistant Editor Mindy Chen for diligently keeping us organized, updated, and on time. Accolades as well go to Joanne Jay, VP of Production, and her production team for the nuts-andbolts support, all in all making yet another Springer product a flawless work of knowledge A special thank you to a most respected colleague, Arthur Dell Orto, who, after 35 years entrusted us to carry on with his, Bob Marinelli, and Paul Power’s best-selling textbook Dr Dell Orto’s numerous book contributions to the field span his career and have elevated thousands of educators and counselors alike in various disciplines. This seventh edition maintains at least a third of these scholars’ previous ideas from earlier editions We also would like to acknowledge Darlene Marini, who once again took on the tedious task of inputting the reference lists for certain chapters In addition, Irmo is also appreciative of his two research assistants doctoral student Breeze Rueda and graduate student Rigel Pinon their assistance in scouring the literature for the most up-to-date, relevant publications for his chapters Finally and most important, we acknowledge the select group of authors who have contributed to this seventh edition Their expertise and field research elevates the social consciousness on disability studies Similarly, we would like to thank the authors for their personal stories regarding the lived experience of having a disability or sharing a life with someone who is disabled. The seventh edition of this textbook would not have beenassuccessfulwithoutthesepersonalperspectives
IrmoMarini MarkA.Stebnicki
The Psychological and Social Impact of Illness and Disability, Seventh Edition
HistoryofTreatmentTowardPersonsWithDisabilitiesinAmerica
DANIELLE D. FOX AND IRMO MARINI
Despite the common ideal that the United States is a land of opportunity, the early history of America was not necessarily a welcoming one for everyone The fear of diluting American bloodlines with potential hereditary diseases or illnesses had a huge impact on public and governmental beliefs and attitudes This fear, combined with the eugenics movement of the early 19th century, led American lawmakers to pass laws that specifically restricted certain people or groups from entering the United States and, within some city ordinances, even kept them out of publicview EarlyAmericanlawmakersbelievedthatbydoingthis,theywereprotectingthewelfareofthecountry and Americans as a whole The purpose of this chapter is to review the history of treatment toward people with disabilities(PWDs)intheUnitedStates.
Givemeyourtired,yourpoor,yourhuddledmassesyearningtobreathefree,thewretchedrefuseofyour teemingshore Sendthese,thehomeless,tempest-tossttome (Lazarus,1883)
This is a section of the 14-line sonnet that is engraved on the Statue of Liberty in New York City The statue was completed in 1886 and the verse was actually inscribed on her in 1945 These words symbolized an American ideal against oppression to all immigrants who entered the United States during the early 20th century In reality, however, American immigration legislation and practice during that time was in direct opposition to the intended messageengravedontheStatueofLiberty
EARLY IMMIGRATION LEGISLATION
“It is often said, and with truth, that each of the different alien peoples coming to America has something to contribute to American civilization. But what America needs is desirable additions to, and not inferior substitutions for, what it already possesses ” (Ward, 1924, p. 103). 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. It was after 1838, when a large influx of immigrants came to the United States, that the issue of disability became more pressing to the early American settlers(Treadway,1925)
Antidisability legislation began in 1882 and continued through 1924, with some of the original laws in effect until the 1980s. The concept behind early immigration legislation was to prevent the immigration of people who were considered undesirable Early Americans believed that preventing people considered undesirable from entering the United States was a means of protecting not only the people but also the welfare of the country as a whole (Ward, 1907) Baynton (2005) states, “disability was a crucial factor in deciding whether or not an immigrant would be allowed to enter the United States” (p. 34). The term “undesirable “ was used to describe people from any race, ethnicity, or religion, and/or with a disability, who were believed to be more likely to pass on less-than-desirable traits to their offspring The purpose of early immigration legislation was to protect the Americanbloodlines,and,accordingtoearlylawmakers,thismeantexcludingpeoplebasedonanytraitthatcould beconsideredasundesirable.Baynton(2005)states,
Oneofthedrivingforcesbehindearlyfederalimmigrationlaw,beginningwiththefirstmajorImmigration Actin1882,wastheexclusionofpeoplewithmentalandphysicaldefects(aswellasthoseconsidered criminalorimmoral,problemsseenatthetimeascloselyrelatedtomentaldefect).(p.32)
ThismarkedthebeginningoftheexclusionofPWDsinAmerica.
In the years following 1882, early American lawmakers became more and more concerned about the
bloodlines of immigrants seeking entrance into the United States and their possible effect on the bloodlines that were already present With the 1891 revised Immigration Act, a key wording change made restrictions even more discretionary regarding excluding PWDs Baynton (2005, p 33) notes that the original 1882 law wording was “ any lunatic, idiot, or any person unable to take care of himself or herself without becoming a public charge”; the phrase changed in the 1891 law from unable to “likely to become a public charge.” In 1894, the Immigration Restriction League (IRL) was established in Boston The primary focus of the IRL was to “ carry on a general educational campaign for more effective restriction and selection” (Ward,1924, p 102) According to Ward, the league’s fears were that the United States was becoming an “asylum for the poor and the oppressed of every land” (p.100).Wardwentontoexplain:
Americansbegantorealizethattheidealoffurnishinganasylumforalltheworld’soppressedwascoming intoconflictwithchangedeconomicandsocialconditions Thecoldfactswerethatthesupplyofpublicland waspracticallyexhausted;thatacutelaborproblems,aggravatedbytheinfluxofignorantandunskilledaliens, hadarisen;thatthelargecitieswerebecomingcongestedwithforeigners;thatlargenumbersofmentallyand physicallyunfit,andoftheeconomicallyundesirable,hadcometotheUnitedStates.(p.102)
As such, by 1896, literacy requirements were imposed on all immigrants entering the United States, and then from 1903 through 1907, immigration laws were broadened and became more restrictive in scope. However, it was only after the 1917 revisions to the 1907 Immigration Act had occurred that more specific and harsher discriminatory language appeared in legislation Before this, in 1903, persons with epilepsy were added to the list, as well as individuals who met the 1903 wording: “ persons who have been insane within 5 years previous [or] who have had two or more attacks of insanity at any time previously” (Baynton,2005, p. 33). Treadway (1925) citestheexclusionarylanguageofthelawinthe1907Act:
5
Theinsane;idiots;imbeciles;feebleminded;chronicalcoholics;constitutionalpsychopathicinferiors;the mentallydefectivewhosedefectwouldmodifytheirabilitytoearnaliving;thosewithloathsomeor dangerouscontagiousdiseases,andthoseoversixteenyearsofagewhowerewithoutareadingknowledgeof somelanguage.(p.351)
The 1907 Act was also the first in which the law required a medical certificate for persons judged to be “mentally or physically defective, such mental or physical defect being of a nature which may affect the ability of suchalientoearnaliving”(Baynton,2005,p 33)
Thesubsequentyearssawincreasingrestrictions,includingfinancialpenaltiesontransportcompaniesandship captains for the transportation of immigrants considered “unfit” for entry into the United States (Barkan, 1991; Baynton,2005;Treadway,1925). In an attempt to gain better control of the immigration situation, ship captains at ports of entry were to examine prospective immigrants for “defects” Although they were neither physicians nor did they have any medical experience, the purpose of their inspections was to medically examine the immigrants If a disability, either mental or physical, was observed or perceived, the ship captain at transit or the inspector at entry ports was authorized to either deny departure from the immigrant’s country of origin or deny entry into the United States If an immigrant was granted departure from his or her country of origin and, on arrival, entry into theUnitedStateswasdenied,theimmigrantwastobedeportedbacktohisorhercountryoforiginattheexpense of the transport company that brought the individual (Baynton,2005) For this reason, many ship captains in all likelihood denied numerous individuals for various vague reasons in order to not be fined or potentially lose their jobs Bayntonnotes:
Inspectorspridedthemselvesontheirabilitytomakea“snapshotdiagnosis”asimmigrantsstreamedpast themsinglefile Formostimmigrants,anormalappearanceusuallymeantanuneventfulpassagethroughthe immigrationstation Anabnormalappearance,however,meantachalkedletterontheback Oncechalked,a closerinspectionwasrequired Lforlameness,Kforsuspectedhernia,Gforgoiter,Xforsuspectedmental illness,andsoon (p 37)
This process allowed for the discrimination and/or refusal of immigrants based on suspected impairments whether or not any impairment was present The commissioner general of immigration in his 1907 report regarding the governing immigration laws essentially laid out that the primary reason for the laws was to exclude anyone with a disability or anyone perceived as having a disability The commissioner wrote, “The exclusion from this country of the morally, mentally, and physically deficient is the principal object to be accomplished by the immigration laws” (Baynton, p 34) In order to exclude those with physical disabilities, the regulations stated that inspectors were to observe individuals at rest and then in motion to detect any irregularities or abnormalities in gait Again,thewordingforexcludingindividualswasvagueandgrantedtheinspectorsfulldiscretioninexcluding anyone they wished. Baynton wrote about an Ellis Island medical inspector whose job was to “detect poorly built, defective or broken down human beings” (p 34) A few examples of the physical impairments listed included
spinal curvature, varicose veins, poor eyesight, hernia, flat feet, bunions, deafness, arthritis, hysteria, and, simply, poor physical development Once again, as with all age-old debates on eugenics, ethnocentricity, and exactlywhowasconsideredtheweakerspecies,therewasnoconsistentconsensus
During this period, individuals were often excluded based on size or physical stature, or lack thereof, and abnormal sexual development. In addition, the commissioner and IRL, among others, were concerned about the public charge or becoming an economic drain because of perceived discrimination from employers in hiring The surgeongeneralinalettertothecommissionernotedthatsuchpersonswere:
Abadeconomicrisk knowntotheirassociateswhomakethemthebuttofcoarsejokestotheirown despair,andtotheimpairmentoftheworkinhand.Amongemployers,itisdifficultfortheseunfortunatesto getorretainjobs,theirfacialandbodilyappearanceatleastinadultlife,furnishingapatentadvertisementof theircondition (Baynton,2005,p 38)
In all, it is difficult to determine exactly how many immigrants were excluded either before or on entering the UnitedStates Baynton(2005) cites statistics that increased over the years and notes that the actual numbers were likely much higher The number of individuals excluded because they were likely to become a public charge or werementallyorphysicallydefectivein1895was1,720;in1905thenumberwasgreaterthan8,000,andby1910 it rose to more than 16,000. Individuals from certain countries in particular were denied more often than the others Individuals from Slovakia were viewed as slow witted, Jews were seen as having poor physique and being neurotic,andthoseofPortuguese,Greek,orSyrianethnicityweredescribedasundersized(Baynton,2005)
For those individuals who were somehow allowed entry to the United States, or were born in the United States with any type of perceived or real impairment, life was not generally favorable regarding societal attitudes. Specifically, Longmore and Goldberger (2000) noted court rulings in which railroads and public transit systems were essentially granted permission to deny access to transportation for these impaired people School laws were upheld segregating PWDs by not alllowing them to attend school or requiring that they be taught in a segregated room.Employerswerealsopermittedtodiscriminateinhiringthosewithdisabilities,andallpublicvenuessuchas restaurants, theaters, and so on, could deny access and frequently did so For all intents and purposes, many of those with disabilities during the early 20th century were relegated to being shut-ins in their own homes, and whenventuringoutweresubjecttoridiculeandindignantcomments.
Many PWDs were outraged by these political and societal attitudes and the blatant efforts to prejudice and discriminate against them For many, it was not only the negative attitudes of being devalued and dehumanized, but also the discrimination of being excluded from the workforce Longmore and Goldberger (2000) cite the historic accounts during the spring of 1935 after 5 years of the Great Depression, in which a number of persons with physical and other disabilities demanded their voices be heard and protested against New York City’s Emergency Relief Bureau demanding jobs Forming the League of the Physically Handicapped (LPH), this group focused on discrimination issues as opposed to their medical impairments Media coverage back then was also largely discriminatory and prejudiced. Longmore and Goldberger cite how media and popular culture portrayals during the 1920s and 1930s perceived PWDs as villains, victims, sinners, charity cases, unsightly objects, dangerousdenizensofsociety,andunworthycitizens(p 896)
Franklin D Roosevelt was a member of the LPH, and although he largely hid his own paralysis from polio at age 39 years, he strived for the rehabilitation of those with disabilities. He epitomized what persons with a disability“can”doandisarguablyoneofAmerica’sgreatestpresidents,havingpresidedfor12yearsovertroubling times, including the Great Depression, the signing of the 1935 Social Security Act, and World War II (Gallagher, 1994) In his book, FDR’s Splendid Deception, Gallagher cites how Roosevelt was intuitively awareofthenegativesocietalattitudestowarddisabilityandawarethatifthepublicknew ofboththeextentofhis disability and chronic pain, he would be perceived as a weak, ineffective leader As such, Roosevelt had agreements with the media not to photograph or film him in his wheelchair or while ambulating with his leg braces Ironically,hedidnotreallyhaveadisabilityagendaandinfacttriedtoreducevocationalrehabilitationfundingby 25%,whichwasultimatelynotsupportedbyCongress(Gallagher,1994).
THE EUGENICS MOVEMENT IN AMERICA
Driving the ideology of the early immigration Acts was Charles Darwin’s highly influential 1859 book, On the Origin of Species by Means of Natural Selection, or the Preservation of Favored Races in the Struggle of Life, which initially set out to explain the concept of heredity in plants and animals. Darwin refrained from applying his beliefs to humans out of fear of the reaction from the ruling religions. Sir Francis Galton, a cousin of Darwin’s, whose own studies primarily focused on mathematics and meteorology, was inspired by Darwin’s work and the implicationsofit Galtonappliedmathematicstothestudy ofheredityasawhole, andthroughthisapplicationhe
Wegreatlywantabriefwordtoexpressthescienceofimprovingstock,whichisbynomeansconfinedto questionsofjudiciousmating,butwhich,especiallyinthecaseofman,takescognizanceofallinfluencesthat tendinhoweverremoteadegreetogivetothemoresuitableracesorstrainsofbloodabetterchanceof prevailingspeedilyoverthelesssuitablethantheyotherwisewouldhavehad Thewordeugenicssufficiently expressestheidea;itisatleastaneaterwordandamoregeneralizedonethanviriculturewhichIonce venturedtouse.(p.112)
The concept of eugenics reached America around 1900, and many prominent politicians, physicians, and academics agreed with Galton’s premise of essentially restricting the promulgation of those considered the weaker species The notion of protecting and preserving healthy American bloodlines for the betterment of future generations was idealistic in theory and would later prove extremely difficult to implement The central question contemplated for these powerful and predominantly Caucasian White males was to decide who exactly was the weaker species, and how exactly could these undesirables be restricted from bearing children (Marini, 2011a). President Theodore Roosevelt also embraced eugenics in the United States along with other highly influential peoplesuchasAlexanderGrahamBell,JohnHarveyKellogg,andJ C Penney,tonameafew(Pearson,1995)
STERILIZATION IN THE UNITED STATES
8 established not only some of the techniques of modern statistics but also the basis for what he later called eugenics (Pearson,1995) Galton, who coined the term eugenics in 1883, believed that natural selection could rid mankind of problems such as disease, criminality, alcoholism, and poverty (Farrell, 1979) Farrell states that when Galton introducedthewordeugenicsin1883hedidsowiththefollowingexplanation:
Evidence of eugenic ideals became more obvious with the passage of sterilization laws in the early 20th century, the primary goal of which was to “improve the quality of the nation’s citizenry by reducing the birth rate of individuals they considered to be “feebleminded” (Largent, 2002, p 190) The term feebleminded was used at this time to describe anyone with any type of observed or perceived mental or physical disability Eugenics continued to gain strength and support through the first quarter of the 20th century with 27 of the 48 states adopting sterilization laws (Farrell,1979) The state of Indiana was at the forefront of the sterilization movement, beingthefirsttoimplementeugenicsterilizationlawsin1907
Although the first sterilization law was passed in 1907, Osgood (2001) noted that unauthorized sterilization of theso-calleddefectiveshadalreadyoccurredininstitutionsinseveralstatesasearlyasthe1890s(p. 257). In1909, the state of Oregon also implemented eugenic sterilization laws, 5 years after Dr Bethenia Owens-Adair had proposed sterilization in Oregon as a means of dealing with persons considered to be criminals and/or insane (Largent,2002).Noll(2005) reports that the use of intelligence testing in the 1920s allowed medical and mental health doctors to more accurately identify “feeblemindedness.” As the years progressed, more states adopted eugenic sterilization laws, and, as the United States entered World War II, the nation’s state mental health and prison authorities reported more than 38,000 sterilizations (Largent, 2002, p 192) In the 1920s, the most notable Supreme Court sterilization case was Buck v. Bell. In 1927, Carrie Buck, a 17-year-old Virginia girl, became pregnant and was institutionalized by her foster parents in the Virginia State Colony for Epileptics and Feeble-Minded Carrie’s mother had already been committed and was deemed feebleminded and subsequently sterilized Because Carrie’s mother was deemed feebleminded, Carrie was also deemed feebleminded and was sterilized as well. Carrie had a younger sister who, under the pretense that she was undergoing an appendectomy, was also sterilized as a result of her mother’s perceived mental capacity. Although there was no evidence to the accusations that Carrie Buck was promiscuous, the case went to the US Supreme Court where Judge Oliver Wendell Holmes, Jr, reported in an 8 to 1 decision that the state of Virginia was supported by its sterilization law and further stated, “three generations of imbeciles are enough” (Carlson, 2009, p. 178). The case of Carrie Buck wasnotanisolatedincidentatthetime,andalthoughothercasessimilarinnaturewerefoundinotherstatestobe unconstitutional, Buck v Bell was never overturned Despite the injustice associated with forced sterilization of people considered to be developmentally disabled, mentally ill, or simply criminals, sterilization laws lasted well into the 1980s in some states (Largent,2002). Although there was a focus on eugenic sterilization laws, other laws thatspecificallytargetedpersonswithmentalandphysicaldisabilitieswerebeingpassed.
THE UGLY LAWS
Anypersonwhoisdiseased,maimed,mutilatedorinanywaydeformedsoastobeanunsightlyordisgusting object,oranimproperpersontobeallowedinoronthestreets,highways,thoroughfaresorpublicplacesin
thiscityshallnotthereinorthereonexposehimselforherselftopublicviewunderpenaltyofonedollarfor eachoffense Ontheconvictionofanypersonforaviolationofthissection,ifitshallseemproperandjust, thefineprovidedformaybesuspended,andsuchpersondetainedatthepolicestation,whereheshallbewell caredfor,untilhecanbecommittedtothecountypoorhouse.(Coco,2010,p.23)
This was a City of Chicago ordinance, originally passed in 1881. Unsightly beggar ordinances passed between the years 1867 and 1913 were otherwise known as Ugly Laws. The first unsightly beggar ordinance was passed in San Francisco in 1867 Although these ordinances had been in place for 14 years before the passage of the Chicago ordinance, it is the most well known and considered “the most egregious example of discrimination against peoplewithphysicaldisabilitiesintheUnitedStates” (Coco,2010, p. 23). The passing of these ordinances and laws allowed some insight into how disability was perceived. PWDs were generally thought of as a burden to society as they lacked the ability to care for themselves or contribute in any way to society This perception, however, was largely contingent on one ’ s social standing and social contribution (Schweik,2009, as cited in Coco, 2010). Although unsightly beggar ordinances were commonplace in cities throughout the country, Chicago’s unsightlybeggarordinanceremainedonthelawbooksuntil1973(Coco,2010).
However, the soldiers returning from World War II with various disabilities provide a good example of how some PWDs were perceived For example, soldiers were often viewed with sympathy but were nevertheless respected because of their contribution, whereas a civilian born with a disability would often not be perceived in the same way. The Industrial Revolution in the United States further increased the number of Americans with disabilities, as factory workers began to sustain injuries leading to chronic conditions Without effective workers compensation laws early on, injured workers had to sue their employers, with the vast majority often losing their suits for contributory negligence and for knowingly accepting the hazards of the job, otherwise known as “assumptionofrisk”(Marini,2011b)
For some PWDs with facial or physical deformities, performing in circus freak shows became the only employment they could obtain These PWDs appeared to be more highly regarded and were often considered to be prominent citizens despite the fact that in certain parts of the country, where Ugly Laws were adopted, they wereunabletoshowthemselvesinpublic
MOVEMENT TOWARD EQUALITY
As disability discrimination and sterilization laws were being passed concerning PWDs, helpful legislation was also being passed. The 1920s brought about the Smith–Fees Act (P.L. 66–236), allowing services to PWDs such as vocational guidance, occupational adjustment, and placement services. In 1935 the Social Security Act (P.L. 74–271) was passed and the State-Federal Vocational Rehabilitation Program was established as a permanent program (Parker, Szymanski, & Patterson, 2005) Despite this early legislation and numerous additional laws over time designed to protect and employ PWDs in the workforce, the unemployment rate for PWDs has been dismally heldataround70%.Yelin(1991) noted that the lowest unemployment rate for PWDs was actually during World War II because many able-bodied Americans were involved in the war and manufacturing jobs for the war effort increased dramatically Once the war was over, however, tens of thousands of able-bodied men and women in the armed services returned home looking for work, and thousands of workers with disabilities were subsequently replaced and suddenly unemployed. There was a shift in who was entering the workforce in the United States (Longmore&Goldberger,2000)
The year 1943 marked the passage of landmark legislation with the Vocational Rehabilitation Act Amendments (P.L. 113), essentially increasing the amount of state vocational services available to PWDs (Parker etal,2005) The Vocational Rehabilitation Act Amendments also broadened the definition of disability, allowing persons with mental illness or psychiatric disabilities to be eligible for services Disability rights continued to make progress for the next 30 years without much fanfare, but unemployment rates remained relatively thesameastheyaretoday.
The 1973 Rehabilitation Act was also considered to be landmark legislation for PWDs, especially since President Nixon was considering abolishing the state/federal Vocational Rehabilitation program altogether After much debate and considerable outcry from disability groups, President Nixon signed into law what is believed to be the first civil rights laws for PWDs, from which the 1990 Americans with Disabilities Act (ADA) was designed. Again, there was increased funding for public vocational rehabilitation programs and affirmative action in the hiring of federal employees (Parker et al, 2005) Although this landmark employment legislation was unprecedented, it was extremely difficult for employees to sue and win their claims against discriminatory employers. Colker (1999) noted that 94% of all court trials were decided in the employer’s favor. The statistic remains high even today, as much of the burden of proof lies with the suing employee Separately, sections 501 to
504 of the Act also addressed access to transportation, removal of architectural barriers, and physical access to all newly constructed federal buildings Perhaps one of the most criticized aspects of the 1973 Act was the fact that therewasnoenforcemententitydesignedtocheckwhetherpolicieswerebeingfollowedorimplemented
In 1975, the Rehabilitation Act was combined with the Education for All Handicapped Children Act (P.L. 94–142), now known as the Individuals with Disabilities Education Act (IDEA). IDEA allowed for opportunities such as equal access to public education for all children with disabilities in the least restrictive environment IDEA also allowed for children with disabilities to be tested through multiple means, such as being tested in their native language. The law also gave parents the right to view their children’s school records (Olkin, 1999). The 1986 revision of IDEA extended services to provide early intervention for children from birth to preschool, help with equipmentpurchases,andprovidelegalassistancetofamilieswithchildrenwithdisabilities(Olkin,1999)
Perhaps the single most important legislation to date concerning the civil rights of PWDs was the 1990 passage of the Americans with Disabilities Act (ADA) by President George H. W. Bush. The Act contains five titles: employment, extended access to state and federal government services including public or paratransit transportation access, public accommodations for physical access to all public venues (eg, restaurants, theaters, sporting events), access to telecommunications (eg, closed captioning, theater audio loops), and a miscellaneous title. The ADA has arguably been deemed a success as far as making communities more accessible; however, there continues to be complaints and lawsuits filed daily owing to employers and businesses that continue to knowingly or unknowingly discriminate (Blackwell, Marini, & Chacon, 2001) Some PWDs continue to see the glass as half empty regarding physical access and societal attitudes; others see it as half full (Marini, 2001) The United States Equal Employment Opportunity Commission’s charge statistics website (n.d.) indicates that since 2009, there havebeenover20,000to25,000fileddisabilityemploymentdiscriminationclaimsannually
CURRENT PULSE ON AMERICA REGARDING DISABILITY
Attitudes, physical access, and the laws regarding PWDs have unquestionably improved in the last century 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 (Marini, 2011a) In America, many eugenicists realized that this extremist version was essentially a slippery slope and that continued forced sterilization, as well as forbidding those with epilepsy, mental illness, or mental retardation frommarrying,couldpotentiallyleadthemdownasimilarpath.
11
Current attitudes of Americans without disabilities toward those with disabilities suggest contradictory sentiments of both admiration and pity (Harris,1991) Most likely influenced by media portrayals, the sentiment of admiration can be easily explained when we watch a documentary on FDR, Wilma Rudolph, Christopher Reeve, or Stephen Hawking. Conversely, the pity sentiment occurs when one watches any televised charitable event, particularly Jerry’sKidsMuscularDystrophy Labor Day telethon Although Americans generally believe that it is right to hire a qualified individual with a disability, many nondisabled persons still believe that PWDs are fundamentally“different”fromthosewithoutdisabilities(Harris,1991)
As previously noted, how much better conditions and attitudes toward those with disabilities have become is still open to debate Although many outside observers anecdotally argue that PWDs get free benefits and health care without making a contribution to society, others are quick to point out a different reality Specifically, with an approximate 65% unemployment rate and two thirds of those with disabilities indicating they would work if they could, this population has one of the highest poverty rates in America (Rubin & Roessler, 2008). Single minority females with children having a disability have the highest rate of poverty, along with single minority femaleparentswithadisability(Brault,2012) Morethan25%ofAfricanAmericansandHispanicsliveunderthe federal poverty rate, and approximately 30% of caregivers who have a child with a disability live in poverty as well (Annual Disability Statistics Compendium, 2014; United States Department of Health and Human Services, 2014) Thisiscomparedtoapproximately13%ofthoseCaucasianfamilieswithoutadisabledlovedone
Although physical barriers and community access have improved exponentially since the 1990 ADA, several studies of persons with physical disabilities suggest that the United States still has a long way to go to become barrier free. Specifically, two recent studies have found that even 22 years after the ADA was signed into law, persons with physical disabilities still cite physical access barriers as the number one frustration (Graf, Marini, & Blankenship, 2009; Marini, Bhakta, & Graf, 2009) Negative and ambivalent societal attitudes were not far behind in the rankings as perceived by those with disabilities Although many outsiders or those without disabilities and no experience with disability view the proverbial glass as half-full, many persons with disabilities (insiders who live the experience) continue to see the glass as half empty (Marini, 2011a) Many experience daily frustrations with health care, education, public accommodations, transportation, and employment These are amongtheongoingdailyhasslesmanyAmericanswithdisabilitiesface(O’Day&Goldstein,2005).
Eugenics has taken a different form in the 21st century. Today, scientists are improving medical technology to remove the so-called defective genes responsible for various neuromuscular diseases while an unborn fetus is still in theembryostage(Marini,2011a) Likewise, parents are now able to abort a fetus that may result in a child having a developmental disability and essentially start over. Roberts,Stough,andParrish(2002) found that when referred by their physician for genetic testing in relation to potential fetus birth defects, 65% of mothers elected to abort such a child However, when mothers were provided with information and educational counseling about the disease or disability, many changed their minds The authors found little effort to educate and counsel expectant motherstakesplaceingenetictestingclinics.Designerbabiesarealsomedicallypossiblenow,meaningparentscan select gender, eye, and hair color. In one extreme example of the quest for the perfect human, a Playboy photographer auctioned off a supermodel’s egg and 5 million people visited the website in one morning, offering $42,000 for the egg (Smart, 2009) For those who can afford to pay for a designer baby, the option has arrived.
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 The ramifications of the 2008 Great Recession, continual middle-class decline into poverty, and historical government actions to cut social programs like Social Security, Medicare, and Medicaid ultimately leave those who need the most assistance to fend for themselves (Huffington, 2010; Reich, 2010) Today the have-nots are no longer sterilized or exterminated, but live on the fringe of society with poor living conditions, poor health care access and treatment, unemployment or underemployment, and food insufficiency Indeed, the most disenfranchised of us, largely including those minorities with disabilities, may see their life expectancy shortened by 20+ years depending on one ’ s ZIP Code (Bloch et al., 2017). 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 Although Americans are living longer and healthier lives, those with disabilities and little income may face even greater precarious times ahead.
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Barkan, E (1991) Reevaluating progressive eugenics: Herbert Spencer Jennings and the 1924 immigration legislation Journal of the History of Biology,24(1),91–112
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Blackwell, T M, Marini, I, & Chacon, M (2001) The impact of the Americans with Disabilities Act on independent living Rehabilitation Education,15(4),395–408
Bloch, J, Holzmann, C, Koczan, D, Helmke, B M, & Bullerdiek, J (2017) Factors affecting the loss of MED12-mutated leiomyoma cells during invitrogrowth Oncotarget,8(21),34762–34772
Brault,M W (2012) Americanswithdisabilities:2010 InCurrentpopulationreports(ReportNo P70-131) Washington,DC:US CensusBureau Carlson,E (2009) Threegenerations,noimbeciles:Eugenics,theSupremeCourt,andBuckv Bell QuarterlyReviewofBiology,84(2),178–180 Coco, A P (2010) Diseased, maimed, mutilated: Categorizations of disability and an ugly law in late nineteenth-century Chicago JournalofSocial History,44(1),23–37
Colker,R (1999) TheAmericanswithDisabilitiesAct:Awindfallfordefendants,HarvardCivilRights–CivilLibertiesLawReview,34,99 Darwin, C (1859) Ontheoriginofspeciesbymeansofnaturalselection,orthepreservationoffavouredracesinthestruggleforlife (American ed) New York,NY:D Appleton&Co
Farrell,L A (1979) Thehistoryofeugenics:Abibliographicalreview AnnalsofScience,36(2),111–123 Gallagher,H G (1994) FDR’ssplendiddeception Arlington,TX:Vandamere
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Largent,M.(2002).Thegreatestcurseoftherace:EugenicsterilizationinOregon1909–1983.OregonHistoricalQuarterly,103(2),188–209. Lazarus,E (1883) Thenewcolossus Retrievedfromhttp://xroadsvirginiaedu/~CAP/LIBERTY/lazarushtml
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OntheOriginsofNegativeAttitudesTowardPeopleWithDisabilities
HANOCH LIVNEH
n the past quarter of a century, several attempts have been made to categorize the different sources of negative attitudes toward individuals with disabling conditions Among these attempts, the works of Gellman (1959); Raskin (1956); Siller, Chipman, Ferguson, and Vann (1967); and Wright (1960) are often singled out In addition, a plethora of theoretical and empirical work has been directed toward the narrower goal of advancing and supporting a specific cause (often referred to as root or base) for negative attitudes toward disability (see Goffman,1963;Meng,1938;Parsons,1951;Schilder,1935)
The main objective of this chapter is twofold: to integrate the major approaches in the domain of attitudinal sources toward people with disabilities and to offer a new classification system by which these attitudes can be betterconceptualizedandunderstood.
Of the four main classifications, earlier attempts by Raskin (1956) and Gellman (1959) were more narrowly conceived Both offered a fourfold classification system for the roots of prejudicial attitudes toward those who are blind (Raskin) and those who are disabled in general (Gellman) Raskin perceived these attitudes to be determined by psychodynamic, situational, sociocultural, and historical factors. Gellman, on the other hand, viewed the prejudicial roots as stemming from social customs and norms, child-rearing practices, recrudescence of neurotic childhood fears in frustrating and anxiety-provoking situations, and discrimination-provoking behavior by persons withdisabilities
Wright(1960), in a comprehensive literature review, discussed attitudes toward atypical physique according to the following categories: general requiredness of cause–effect relations (ie, phenomenal causality between certain “sinful behaviors” and disability as an “unavoidable punishment”), negative reaction to the different and strange, childhood experiences, and prevailing socioeconomic factors. Siller and colleagues (1967), based on their extensive attitudinal study, reported the existence of 13 aversive content categories toward those with disabilities, using both empirical and clinical findings Their discussion, however, often confuses components of attitudinal correlates (such as functional limitations or attribution of negative qualities) with attitudinal sources (eg, aesthetic–sexualaversion,fearitcouldhappentoself).
This chapter attempts to deal exclusively with attitudinal sources. In other words, only approaches both theoretical and empirical that can be perceived in terms of cause (attitudinal source or root) and effect (negative or aversive reaction or attitude) relationships will be dealt with Also, the classification system of the different attitudinal sources combines both process- (psychodynamic mechanisms) and content- (sociocultural factors) relatedformulations.Itwasfeltthatanyattempttoseparatethetwowouldberatherarbitrary.
SOCIOCULTURAL CONDITIONING
Pervasive social and cultural norms, standards, and expectations often lead to the creation of negative attitudes towardthedisabledpopulation.Amongthefrequentlymentionedcontributingfactorsare:
1 Emphasis on concepts such as “body beautiful,” “body whole,” youth, health, athletic prowess, personal appearance, and wholeness: These highly stressed societal standards are often institutionalized into cultural customs, which are to be conformed to by members of society (Gellman, 1959; Roessler & Bolton, 1978; Wright,1960).
2 Emphasis on personal productivity and achievement: Individuals in most Western countries are judged on the basis of their ability to be socially and economically competitive (Hanks & Hanks, 1948; SafiliosRothschild,1968).
3. Prevailing socioeconomic level: The importance of socioeconomic factors in creating an atmosphere within
