New Zealand Rehabilitation Association, Inc.

Perspectives on Disability & Rehabilitation: Contesting Assumptions; Challenging Practice. (2006). Karen W. Hammell. Churchill Livingston, Elsevier: Edinborough. ISBN 13: 9780443100598. 9 (Softcover).

Price: $73.00 (incl. GST) Australian Dollars

Available from Elsevier Australia

This textbook – or rather a textbook on this topic – has in some ways been a long time coming.  The author notes in her preface to the book that ‘Despite a recent explosion of publications emanating from the social sciences, humanities – and particularly from within Disability Studies – that contest, critique and challenge the way in which disability is understood and “managed”, this burgeoning literature has been virtually unnoticed by [health professionals]’ (p.ix).  This textbook therefore challenges clinicians to scrutinise traditional perspectives on rehabilitation services: the way they are structured, the way they are researched, the way they are run, and the way clinicians engage with disabled people who enter them.

The textbook is divided into 11 chapters.  These cover a wide range of topics including (but not limited to): normality and the classification of difference (Chapter 2), theoretical models of disability and deviance from the ‘norm’ (Chapter 3 & 4), cultural perpetuation of disability (Chapter 5), perspectives on the body and physical impairment (Chapter 6), liminality, biographical disruption, and oppression (Chapter 7), ideology, power, and clinical reasoning (Chapter 8), the client-centred philosophy and privilege (Chapter 9), and research methods for investigating disability and rehabilitation (Chapter 10).

Hammell provides a well-referenced catalogue of sociological arguments related to disability and rehabilitation.  No subject is considered too sacrosanct to contest.  The International Classification of Functioning, Disability and Health (ICF) for instance come under fire for its limited capacity to explore in depth the wider socio-political, legal or economic factors which impact on the lives of people with disabilities.  (While the ICF does contain reference to environmental factors, these – Hammell argues – are much less developed as instruments of categorisation and inquiry than the factors relating to impairments, activity limitations and participation restrictions.)  The very nature of the ICF as a tool to classify ‘deficits and deprivations’ (p18) is questioned:  Hammell cites Hurst (2000) as having stated that ‘no other minority group has been subjected to such sustained appraisal, such… in-depth classification of individual differences… nor would this be deemed acceptable for people from ethnic minorities, women, or any other minority group’ (p18).

These sociological theories and perspectives on disability and rehabilitation are not presented in an idealistic fervour however.  Hammell maps out and critiques with equal detail the arguments levelled against various theories.  Debate around the Social Model of Disability for example is discussed at some length.  To this debate Hammell contributes (and provides evidence to support) her own unique criticism – that the Social Model is limited in its application to people with disabilities in rural settings – an urban-centric model of disability perhaps? Furthermore, Hammell points out that where most disability theorists live in the urban areas of developed countries, 80% people in the world with disabilities do not.

I would say this book is a must-read for anyone working in the rehabilitation sector.  You may not agree with all of its content, but knowledge of these alternative perspectives should increasingly be a part of undergraduate and postgraduate training for all health professionals.  This textbook is full of interesting titbits of information and insights – with a great many links for those wishing to pursue further reading on these topics.  Hammell’s writing – which is well laid out and easy to read – will be assessable for those unfamiliar with the territory, but of equal interest to ‘experts’ in the field.  Definitely worth a look.