Professional Documents
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Forber-Pratt. A. J., Mueller, C.O., & Andrews. E. E., (in press). Disability identity and allyship in
rehabilitation psychology. Rehabilitation Psychology. doi: 10.1037/rep0000256
© 2018, American Psychological Association. This paper is not the copy of record
and may not exactly replicate the final, authoritative version of the article. Please
do not copy or cite without authors' permission. The final article will be available,
upon publication, via its DOI: 10.1037/rep0000256
DISABILITY IDENTITY AND ALLYSHIP 2
Abstract
Purpose/Objective: The purpose of this conceptual paper is to put forth a call for
their clients, and to understand this action as a form of allyship towards the disability
community.
Method: This conceptual paper is organized to engage existing disability and disability
identity literature and its clinical implications. Practical tools and skills are offered for
presented based on a literature review. Conversation starters and two activities are presented
for providers to develop and engage with clients about their disability identity. Descriptions
and social model and argues that thinking about disability identity requires attention to the
social model of disability. This attention is important, because it allows providers to think
about themselves as allies to a particular community, rather than experts who must only “fix”
clients’ disabilities in order to elicit positive identity development. This shift towards
experience.
Impact:
● This article provides a clinical context for addressing disability identity in rehabilitation
and psychology.
● Providers should be able to differentiate between adjustment to disability and the process
of disability identity development and are encouraged to elicit discussions about disability
● Disability allyship involves critical self-reflection, attitude adjustment and social action.
DISABILITY IDENTITY AND ALLYSHIP 4
Introduction
Disability identity is a “sense of self that includes one’s disability and feelings of
connection to, or solidarity with, the disability community” (Dunn & Burcaw, 2013, p. 148).
As three disabled women in academia, the authors experience these complex ideas about
identity as salient in our own everyday lives and careers. The purpose of this conceptual
paper is to argue for rehabilitation psychology providers to consider their role in developing
disability identity in their clients, and to understand this role as a form of allyship towards the
disability community.
Disability scholarship has been shaped by multiple philosophical approaches that have
an impact on clinical practice and treatment (defined broadly) involving disabled people.
Two important approaches are the medical model and the social model of disability. The
traditional empirical focus in rehabilitation has been on individual adaptation and functional
adjustment, which stems from the medical model (Andrews, 2016). Providers and researchers
alike study the degree to which an individual copes and functions following acquired
disability. The goals of the medical rehabilitation model of disability are to minimize the
impact that disability has on the person’s life; in other words, to prevent disability from
interfering with daily activities and role participation. Because the medical model is
overwhelmingly the lens through which disability is seen in the world, the majority of
separate, personal medical experience. Rehabilitation psychology, like other fields that are
primarily responsible for the medical treatment and therapeutic support of disabled people,
has also focused heavily on adjustment or adaptation to disability, which is a related but
Disability identity is rooted in the social model of disability, and its descendant the
diversity model of disability (Andrews, 2016; Gill, 1997; Linton, 1998). The social model of
DISABILITY IDENTITY AND ALLYSHIP 5
disability focuses on the ways in which environmental barriers create disablement and
disability. It emphasizes the ways that particular contexts, societal structures (including
macro-level structures like capitalism), and inaccessible environments are the source of the
problem and simultaneously addresses the ways that disabled people continue to be
marginalized (Barnes & Mercer, 2004; Charmaz, 1995). The diversity model of disability
(Andrews, in press; Mackelprang & Salsgiver, 2016) also recognizes the inaccessible and
often oppressive environments that surround people with impairments. It differs from the
social model in that it situates disability as a unique cultural group as a result of the
complicates the social model in that it recognizes the unique human variations that disabled
people hold both in their bodies and, subsequently, as part of their identities. The diversity
cultural outputs – unique contributions made because of, rather than in spite of, the position
and identity of disabled people. In this way, disability is not viewed from a deficit-based
overall richness (Connor & Gabel, 2009; Connor, 2012; Erevelles, 1996).
both a personal and a collective concept; it involves the extent to which one feels shame or
takes pride in disability, the degree to which one has integrated disability into one’s sense of
self, and the type of contact, camaraderie and engagement one has with the larger disability
community (Caldwell, 2011; Darling & Heckert, 2010). Importantly, the disability
community itself is not a homogenous group; understanding it in this way can perpetuate
harmful ideas about individual disability experiences and identity. The disability community
is group of people who experience impairment and societal discrimination on the basis of that
DISABILITY IDENTITY AND ALLYSHIP 6
impairment; the community is large and represents many different intersectional identities
identity have developed from the work of Erickson (1968) and largely fall into two types:
identity status models and narrative models. Identity status models typically describe
emphasize the creation of the disabled person’s story and exploring the way(s) in which
disability is embedded throughout. The most well-developed models are not linear, have no
endpoint, are developmental in scope, and emphasize that disabled people exhibit different
responses in different areas of their lives, in different contexts. Among the first to research
disability identity were Carol Gill (1997; Gill, Kewman & Brannon, 2003), Kathy Charmaz
indicating that individuals move from one stage of identity development to the next. The
stages in this model include: coming to feel we belong, coming home, coming together and
coming out. Charmaz (1994, 1995) focuses on people with acquired chronic illnesses and
identified four major “processes” in the identity dilemmas of chronically ill men: awakening
to death after a life-threatening crisis; accommodating to uncertainty as men realize that the
crisis has lasting consequences; defining illness and disability’ and preserving self to
Frank’s rhetoric of self-change. Frank (1993) describes using “illness narratives” that
are constructed or represented by both the person with the disability, but also the people
around them: family, medical professionals, and other providers. These illness narratives or
fall under three “storylines”: restitution, chaos, and quest. These narratives help us
DISABILITY IDENTITY AND ALLYSHIP 7
understand the different ways that illness is understood by the person, including its relation to
the person’s life. These narratives are important because they are co-constructed by both the
individual and the people who are in their lives, but they have a significant impact on an
framework with six positions based on qualitative research with leaders in the disability
community describing disability identity. The first position in Weeber’s (2004) model is
essentially rejection of disability, followed by the second position in which the disabled
person gains awareness of social inequities toward people with disabilities. In Weeber’s
(2004) third position, the person begins to forge alliance with others with similar disabilities,
and by the fourth position, a disabled persons expands allegiance to the broader disability
community. In the fifth position, the disabled person elects not to “pass” as nondisabled even
when possible. In this position, Weeber (2004) postulates that self-confidence and sense of
belonging increases, and that by the final position, the individual begins to support and advice
These earlier perspectives on disability identity reveal not only the shifting nature of
identity work itself, but also the need for multiple perspectives on disability identity. Rather
and practical tools that might have an impact on those experiences directly. Importantly, this
work is not new: Gill, Kewman and Brannon (2003) challenged the field of psychology to
reframe both its general ways of seeing disability, as well as the roles that psychologists of all
types play in developing disability identity and resolving what they termed “disability
problems” (p. 306). Recent models of disability identity development seem to incorporate
this.
DISABILITY IDENTITY AND ALLYSHIP 8
disability identity formation among disability leaders, but rather than a linear model, he
developed a set of themes that were common links among participants. The first of Calwell’s
(2011) themes is initial resistance to disability associated with shame, which over time
evolves into questioning of societal devaluation of disability and finding worth as a person.
Caldwell’s (2011) next theme is connection with disability community and development of a
shift toward embracing disability and externalizing oppressive thoughts and feelings that
were once internalized. Next, Caldwell (2011) identified a theme of self-examination and
identification of one’s own biases, toward others with disabilities and broader social identity
statuses. Caldwell’s (2011) final theme is accepting interdependency and bonding with the
Development. In Forber-Pratt and Zape’s model (2017), four developmental statuses are
disabled individual and those close to them acknowledging and embracing the disability.
The relationship status is about the disabled person constructing a network by meeting other
people with disabilities, particularly similar disabilities, and forming relationships to learn the
ways of the group. The adoption status is about adopting core values of disability culture and
serves as an interim between simply meeting with other persons with disabilities and
engaging with the community. The engagement status is about becoming a role model and
helping others who are still learning the ways of the group and giving back to the disabled
community.
Across the research, identity is considered highly personal and intrinsic to the
individual. However, identity is also communal and shared, because people are by nature
DISABILITY IDENTITY AND ALLYSHIP 9
group identity development. Thus, identity is both socially, individually, and historically
constructed and encompasses aspects of gender, social class, age, sexual orientation, race and
ethnicity and ability. Distinctions between the individual and the communal, the internal and
disability: as a problem within an individual’s body or mind that should be investigated and
normalized, or as the product of an interaction between an individual and his or her social and
physical environment (Shakespeare, 2010). As the usage and understanding of these identity
models are becoming more widespread, there is an increasing body of research that explores
these interactions as well as the impact of particular aspects of disability identity on other
psychological outcomes. For example, Bogart (2018) has studied the impact of disability
pride on self-esteem and suggested that clinical interventions focusing on disabled people
should include personal and environmental factors, such as social support, that bolster pride
in disability.
psychology and practitioners in the field to engage? In one of the seminal discussions of
disability identity and disabled activists, Hahn and Belt (2004) ask their participants a
provocative question: if a magic pill existed that could cure their disability, would they want
to take it? While a medical model perspective on disability would consider this question to
have a foregone conclusion, participants answered in a way that should inform rehabilitation
psychology in general and the providers who work in the field in particular. Participants who
had “stronger positive affirmation of personal identity as being disabled are more likely to
reject a cure because curing their disability takes away their source of self-affirmation” (Hahn
& Belt, 2004, p. 460). What does this finding tell us about disability identity in the context of
DISABILITY IDENTITY AND ALLYSHIP 10
rehabilitation psychology? Individuals who have a strong disability identity, or “sense of self
that includes one’s disability and feelings of connection to, or solidarity with, the disability
community” (Dunn & Burcaw, 2013, p. 148), may be more equipped to cope with the
structural challenges of their disability and, thus, experience better health outcomes than
those who reject their disability. Thus, it is important for health care providers who work with
individuals with disabilities (e.g., physicians, nurses, physical therapists, counsellors, medical
social workers, etc.) to be able to assess the disability identities of the patients they serve.
Gill, Kewman and Brannon (2003) note that, discipline wide, “the idea that life with a
disability can be a distinct cultural experience or the basis of a positive minority identity is
rarely represented in psychology training” (p. 309). Social identity, as suggested by Gill,
Kewman and Brannon (2003), consists of both the knowledge that one belongs to a social
group and the significance that one ascribes to their membership in that group (Tajfel, 1972).
Social identities have important health implications, as they “can be associated with positive
or negative health outcomes” and can explain and influence “the way in which individuals
understand and respond to the social structural conditions in which they find themselves”
(Haslam, Jetten, Postmes, & Haslam, 2009, p. 6). This is particularly important for members
developmental trajectory for both adults and youth. An understanding of disability identity
development would enable professionals to more effectively interface with individuals with
disabilities and their families. This is especially important given significant medical advances
which has resulted in infants born with various birth anomalies having longer, healthier and
more interdependent and independent lives; the field is challenged to support these
While there are several important practical reasons that rehabilitation psychologists
should engage disability identity in their work, there is also an important body of emerging
literature that supports a theoretical discussion and framing of disability identity from a wide
variety of perspectives. These theories often focus on different aspects of disability identity to
make their claims, and represent many different approaches to thinking about the construct of
identity itself: as often a non-linear, complicated, and messy. Broadly, though, a coherent
disability identity is believed to help individuals with disabilities navigate related social
stressors and daily hassles (Forber-Pratt & Zape, 2017). Disability identity has also been
explored in relation to mental health outcomes (Bogart, 2015); attitudes towards cure (Hahn
& Belt, 2004); and even political activism (Putnam, 2005; Schur, 1998). Hahn and Belt’s
(2004) work operates under, and challenges, the assumption that disabled people desire
improvements in their functional abilities or even cures. The model also explores how
disability relates to individual senses of identity, positive disability identity, and belonging in
the disability community. The findings of this model suggest that for those who have a strong
disability identity, “curing” their impairment is neither a goal or a focus of everyday life;
instead, people with strong disability identities focus on removing societal, physical, and
Putnam (2005) offers a framework for disability that has the potential to improve
understanding of the role of disability status in identity politics, based on the need for a
common language from which to discuss disability identity and to then guide empirical
analysis. Putnam (2005) outlines six potential construct domains for political disability
identity and their subdomains, including: self-worth, pride, discrimination, common cause,
policy alternatives, and engagement in political action (p. 190). Schur (1998) linked political
around disability activism, is discouraged when disabled people are isolated from each other
DISABILITY IDENTITY AND ALLYSHIP 12
and are primarily subject to efforts from others to normalize their impairments. When
disabled people are politicized; that is, when they advocate for disability issues and organize
with other people who have disabilities, they express a greater sense of personal control and
efficacy, and also identify discrimination and stigma more frequently in their environments.
In all of these theoretical frames disability shapes how individuals see themselves,
their bodies, their ways of interacting with and advocating in the world, and how they
function. Disability occurs across the lifespan, can be readily apparent or hidden, and is
and researchers. Additionally, disability is cross-cultural in that it is not the only identity
claimed; disabled people are also part of diverse racial, ethnic, gender identity, and sexual
orientation communities. While the ultimate goal should be to develop interventions to help
support individuals to make meaning around their own disability and assist families to
support disabled members, quality scholarship in this domain requires more robust
is significantly understudied (Forber-Pratt, Lyew, Mueller & Samples, 2017), and lags behind
research and identity development investigation into other aspects of identity (and
intersectional identities), such as racial and sexual orientation identity development. This
interdisciplinary scholarship explores the impact of identity or identities across all aspects of
life – personal, social, academic, and professional. Often missing from the extant research on
Because of the lack of attention paid to disability identity, providers may experience
discomfort or overlook the concept in clinical practice. We suggest that the lived experience
of individuals with disabilities, including activist groups’ calls for community and solidarity
(for example, Sins Invalid’s Disability Justice Primer) is reason for providers to not only
DISABILITY IDENTITY AND ALLYSHIP 13
consider disability identity in clinical practice, but to continue to build robust, critical and
in harmony with and complement strategies and recommendations for discussions in the
clinical setting. In the research, disability identity development has been studied primarily
through qualitative methods that focus on individual experiences, in part because of a lack of
robust measurement tools (Forber-Pratt, Lyew, Mueller, & Samples, 2017). Both qualitative
and quantitative methods are needed to research this understudied phenomenon. Through a
recent systematic review of the literature, only three general measures of disability identity
(i.e., those that are not specific to a particular impairment) were identified (Forber-Pratt,
Lyew, Mueller, & Samples, 2017). These include: the Disability Identity Scale (Chicago
Center for Disability Research, n.d), the Personal Identity Scale (Hahn & Belt, 2004), and the
Questionnaire on Disability Identity and Opportunity (Darling & Heckert, 2010). It is unclear
whether these tools are used in the clinical setting, but have been used in rehabilitation
psychology research (Bogart, 2014, 2015, 2018) In this way, even if rehabilitation
disability identity research, they would still lack the practical tools and skills to help develop
conversations with clients about disability identity. Clinicians hold immense power in
settings that serve people with disabilities, including providing access to services, particular
tools or resources, and overall knowledge about disability. This places the clinician in a
unique role: as both an expert, and a learner. This dynamic becomes even more important
DISABILITY IDENTITY AND ALLYSHIP 14
when considering the significance of identity development, its often intensely personal
components, and the ways that a particular clinician’s awareness and orientation towards
disability identity development can shape their client’s. In order to critically and consciously
enter into this space, and since disability is a component of diversity (Andrews, in press;
Mackelprang, & Salsgiver, 2016), clinicians must explore their own potential biases,
worldviews and meaning-making around and about disability. Previous literature has framed
this exploration as part of building cultural competence through the usage of a multicultural
Therefore, in order to work with clients with disabilities, clinicians must acquire
awareness, knowledge and skills related to disability as they would with any other cultural
(MSJCC) were recently updated to provide guiding principles to the broader field of
counseling to address issues of diversity and the role of advocacy and allyship within the
field (Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2016). The MSJCC argues in
alignment with what diversity leaders Sue and Sue have asserted for some time: that
clinicians should possess awareness, knowledge, and skills in order to engage in action that
support clients from diverse communities (Ratts et al., 2016). This action is demonstration of
allyship.
standard, and that the gold standard is actually that of allyship. To be an ally requires more
than basic awareness, knowledge and skills--rather, allies use their social privilege to support
DISABILITY IDENTITY AND ALLYSHIP 15
and advocate for the marginalized community (Hipolito-Delgado, 2014). This sentiment is
echoed by Melton (2018) who asserts that “multicultural competencies hold psychologists to
a high standard to ally with, advocate for, and, at times, become activists in using
psychological science to improve the condition of individuals, organizations, and society” (p.
83, Melton, 2018). An ally can be defined as “an individual in a sociopolitical demographic
group on the upside of power who actively advocates for individuals or classes of individuals
in a different sociopolitical demographic group on the downside of power” (p. 107, Mio &
Roades, 2003). Psychologists have an inherent ethical obligation to function in the role of an
ally, activist and advocate as part of professional responsibility and identity as a psychologist
(Melton, 2018). Through this demonstration of allyship with disability competency at the
foundation, rehabilitation psychologists are in the prime position to truly advocate for the
clients they serve and promote exploration of their clients’ disability identity with the goal of
Clinical Implications
The field lacks a clear understanding of how disability identity can be utilized in
clients with disabilities to a certain stage of identity development, but doing so is not only
premature but could circumscribe the individual into preconceived notions based on theory
rather than the person’s reality. Instead, disability identity concepts can be used more broadly
understand that it is totally normal for disabled people to have a point in their lives where
they reject disability as part of their identity, and avoid affiliation with other disabled people
and the disability community (Gibson, 2006; Weeber, 2004). It is useful not to pathologize
those experiences. Similarly, feelings of anger and resentment toward societal barriers and
prejudicial attitudes, from a disability identity perspective, may not only be justified and
DISABILITY IDENTITY AND ALLYSHIP 16
expected, but also psychologically adaptive (Caldwell, 2011; Gill, 1997; Putnam, 2005). This
rejection of disability as a part of a person’s identity is, importantly, a result of a culture and
medical context that emphasizes appearing normal as the primary goal, and a historical and
current attitude of healthcare providers that focuses on “fixing” people and implying or
outright naming the things that are wrong with particular bodies and minds. For clinicians,
interrupting this cultural and medical context and acknowledging the harmful ways that the
medical model of disability has shaped many disabled people’s ideas about themselves and
others is an important initial step in bringing in ideas about identity development into clinical
work.
How can practitioners begin to think about development of disability identity over
time in their clients? Developmental statuses allow for both progression and regression
among statuses and may be more appropriate than stages of disability identity development.
This fluidity accounts for the fact that an individual may experience more than one status
simultaneously (Forber-Pratt & Zape, 2017). Competent providers are mindful of this, and
careful not to force clients into a particular mold. Instead, exploring disability identity
development is a client-centered task, by allowing clients to direct the conversation and share
his or her natural progression on the disability journey. Clinicians may feel pulled to
challenge or disrupt harmful messages about disability that clients may be internalizing or
client stances that distance them from disability identity. Rather than attempting to dispel
myths or educate clients about the possibilities and positives of life with a disability, the
clinician can work within their theoretical or therapeutic approach to facilitate the client’s
own exploration of the origin and veracity of ableist beliefs. For example, using a cognitive-
behavioral therapy (CBT) framework, a clinician can help the client identify negative
automatic thoughts and core beliefs related to disability, and teach the client to assess the
accuracy of such cognitions and work on skills to develop more accurate and balanced
DISABILITY IDENTITY AND ALLYSHIP 17
conclusions (Butler, Chapman, Forman, & Beck, 2006; Ehde & Jensen, 2004). Integrating
disability identity work into cognitive restructuring does not require a new set of therapeutic
skills, but rather a keen awareness and ability to identify salient content with which to work.
Narrative identity models are focused on the creating and recreating the disabled person’s
personal story, and the ways in which disability is integrated into the plot (Dunn & Burcaw,
2013). In the case of acquired disability, for example, a disabled person’s story may evolve
from disability as tragedy to one of personal resilience and strength (Ellis-Hill, Payne &
Ward, 2008). This approach lends itself well to psychotherapy, where clients are bringing
together pertinent pieces of their lives to recreate their self-narratives. Providers can
encourage self-reflection and making meaning from disability by inviting clients to discuss or
write about their experiences or conversely, to read the works of others people with the lived
experience of disability (Dunn & Burcaw, 2013). Rather than try to influence a client’s story,
providers well versed in disability identity development are able to notice and reflect back
details about how the client views him or herself in relation to his or her disability, and with
respect to the broader disability community. This awareness can also assist providers in
identity, sexual identity, gender identity, or spiritual identity may be explored with a client.
There are practical ways to accomplish this goal that can be utilized by providers in sessions
with clients, which will be explored in depth below. However, an important caveat is that just
because a client has a disability, does not mean that disability identity is a struggle or that the
reason for seeking help has anything at all to do with disability (Artman & Daniels, 2010). A
DISABILITY IDENTITY AND ALLYSHIP 18
common mistake is to assume that a client with a disability wishes to focus primarily on the
disability or its effects (Olkin & Pledger, 2003). Psychologists must assess the presenting
issues and set goals for treatment together with the disabled client. It is important not assume
that just because client has a disability that they are experiencing difficulty with disability,
even if the disability is newly acquired. Our understanding of disability identity is that it is
more expansive and complicated than as solely a clinical goal: while this article focuses
specifically on the relationship between clinical work and disability identity and the ways that
providers can properly address disability identity in clinical settings, there are other contexts
in which disability identity can and should be developed. For example, engaging with
disability community in activism or building relationships and support systems that include
disabled people are all positive ways that individuals can develop their own sense of
responsive to the ways that the individual client would like to develop and participate in that
process.
Initiating a conversation about disability identity in clinical settings can feel awkward,
perhaps even more so if the provider does not identify as disabled. Often, disabled people are
used to discussing disability with providers in medical and functional terms and language.
For these reasons, this shift in conversation might feel simultaneously new, and welcome, for
both parties involved. Having a few starter conversation questions ready may help to
facilitate this dialogue. A provider could start by asking a client the following questions, after
· What do you remember being taught (formally or informally) about disability growing up?
· What do you think of when you hear the term “disability identity”?
· If there was a magic pill that would take away your disability, would you take it? Why or
why not?
DISABILITY IDENTITY AND ALLYSHIP 19
· How do your multiple identities (e.g., as a woman of color, a husband, etc.) impact your
· How and where do you seek out connections to or with the disability community?
Some clients may benefit from a tangible activity to guide the conversation. Two
potential activities that practitioners could use with clients are the Disability Identity Circle
(See Figure 1) or the Who Am I? Activity (See Figure 2). These activities were developed by
one of the authors and have been used in both individual and group settings with youth and
adults as well as workshops and professional development seminars. The Disability Identity
relation to themselves. This activity can reveal where individuals place their disability
conscious thought?
[Insert Figure 1]
The Who Am I activity includes a series of reflective questions about the individual’s
personal sense of self. It asks participants to quickly list their most relevant identities, and
then reflect on their inclusion of disability and disability identity as part of that list. This
[Insert Figure 2]
respond. When working with clients over time, it may be helpful to repeat an activity 6
DISABILITY IDENTITY AND ALLYSHIP 20
months or a year later and then compare with the client what aspects have remained constant
and which have evolved over time. Anecdotally, individuals who have completed the
Disability Identity Circle activity in a small group setting as part of a workshop on disability
identity reported liking the visual representation of their disability identity and this sparked
conversation about how their responses to this may be different on a different day or at
fundamental responsibility for those who work in positions that directly impact disabled
people, given the immense impact their practices and ways of seeing disability can have on
the individual. It is important to understand one’s own biases, which all professionals have
recommended that the psychologist answer the aforementioned “conversation starters” for
themselves as a point of critical reflection. While we see allyship as less a set of behaviors
and discussions and more a critical way of being and understanding the world, we also
recognize that this way of being is made up of particular moves and moments that, often, are
considerations for psychologists and professionals who are non-disabled and for those who
[Insert Figure 3]
multiple identities, when in actuality intersectionality is the interplay of identities and their
1989). There are many different kinds of disabilities, impairments and ways of being
represented in the disability community, each with their own nuances and even sub-disability
identity cultures, and there are also important intersectional identities whichare often not
considered in discussions that are already made complex by thinking about disability itself.
is often not considered in designing tools, practices, and research agendas. The experience
framework for thinking about oppression and identity development because, as Crenshaw
(1991) asserts, “the problem with identity politics is not that it fails to transcend difference, as
some critics charge, but rather the opposite—that it frequently conflates or ignores intra
with a client who is a Deaf wheelchair user, or a transgender client who uses a power
researchers and disabled researchers and practitioners, it is especially important for disabled
disability identity narrative. Given that disability is often stereotyped as a primarily physical
phenomenon, with visible tools that “mark” the person with a disability (i.e., a person in a
wheelchair), disabled practitioners should be especially conscious of the ways that their
conversations about disability might marginalize, silence, or even trivialize other disabilities
action without inclusivity is not social justice. Social justice is justice for all. All means all.
motivated this career path, some do not. Yet, rehabilitation psychologists, by definition, work
extensively with disabled clients. It is through these interactions and years in the field that
many, anecdotally, report learning more about the disability community by adopting
additional roles and responsibilities as advocates (Gill, Kewman & Brannon, 2003). It is
limited glimpse of one individual’s stage and experience of a lifetime with disability, and
experiences with clients do not always generalize to the broader disability community.
Instead, non-disabled practitioners should think of their relationships to clients and the
disability community as one of allyship. There are some specific recommendations that
Ask and respect choice of terminology. If you are ever unsure of: acceptable language,
understandable, and often invited. Some disabled individuals may prefer identity-first
language (Dunn & Andrews, 2015) reflects shifts in language-use led by the disability
respect the client’s answer to preferred language use, regardless of the provider’s preferences.
Alternatively, it is appropriate to listen to how the person uses language and follow their lead.
Embrace principles of universal design. The more service providers think proactively
about disability, from a universal design perspective, the less hassles and frustrations disabled
clients will face. While this perspective does not have an immediate impact on identity
development, universal design serves to remove the physical and social barriers that make
consultants are likely to be most highly sought after by consumers” (Gill, Kewan, &
Brannon, 2003, p. 308). Providers should work to be as inclusive as possible from the start,
without disabled persons having to make additional requests upfront. This is especially
important if disabled people are a key demographic served in your practice. Providers should
ask themselves reflective questions like: Does your website include access notes about
accessible parking, path of travel, alternative formats of intake forms? If a person calls your
office, are they able to easily and efficiently receive answers to these questions? If the
elevator is being serviced, were all clients called ahead of time and rescheduled? At a
minimum, is there a sign on the ground floor with a phone number to call and a plan in place
to relocate? Disability should not be an afterthought, and universal design serves to ensure
that clients can access the physical spaces they need quickly, easily, and with minimal
frustration that might cause them to want to distance themselves from a label or a disability
identity.
Act as an ally. As a professional serving the needs of persons with disabilities, what
actions are taken to demonstrate this allyship publicly? For example, what are the ways in
which allyship could be demonstrated if there is a vehicle blocking a ramp or access aisle,
regardless of if there is a person with disability nearby? Or, if there is a disabled person
inaccessible, what might be done to act as an ally? An example of allyship might be asking
not there will be budget dollars to provide support for a personal care attendant if an invited
speaker requires one to travel. There are also ongoing bias checks What assumptions do you
make about a colleague who takes extra time to write his/her/their notes? A trainee whose
first report drafts are riddled with grammatical errors? These scenarios, which may feel easy
to overlook in the face of larger injustices that affect disabled peoples’ health, are also places
DISABILITY IDENTITY AND ALLYSHIP 24
where using individual privilege and practicing allyship is crucial. Learning to be an ally to
the disability community as a whole also means learning to be an ally to individuals with
disabilities in the moment, where appropriate. Teaching Tolerance (Gaffney, 2016) has
created a list of short “allyship reminders” that can support people who would like to be allies
to many different marginalized people, and these reminders can also support disabled people.
[Insert Figure 4]
deficit that can and must be overcome through the display of physical prowess (Grue, 2016).
More specifically, inspiration porn can be described as a common tendency in which able-
bodied people condescend disabled people by suggesting they are brave or special just for
labeled by disabled activists to highlight the objectification of disabled people (Young, 2012).
It is common to find inspiration porn on social media, often through images that elicit pity.
Inspiration porn is present across almost all elements of society, and has “the dual function of
making the non-disabled feel better about themselves while simultaneously holding the
average disabled person to an impossibly high standard” (Serlin, 2015, p. 43). Inspiration
porn is not by, for, or even about disabled people, but rather a tool to make non-disabled
people feel better (Young, 2012). Recognizing and stopping the perpetuation of inspiration
knowledgeable and up to date about issues affecting the disability community is essential
disability rights issues might include reading blogs or news sites that curate issues related to
DISABILITY IDENTITY AND ALLYSHIP 25
healthcare, accessibility laws, or other broadly framed disability concerns. Psychologists and
allies ought to consider membership in disability rights and advocacy groups such as:
ADAPT, Disability Rights Education & Defense Fund (DREDF), the Association of
University Centers on Disability (AUCD) or the Center for Disability Rights. Additionally,
social media can be a good resource for quick and updated information; following
organizations like Helping Educate to Advance the Rights of the Deaf (HEARD), Rooted in
Rights, Autistic Self Advocacy Network (ASAN), American Association of Persons with
Disabilities (AAPD), National Federation for the Blind (NFB), or the Disability Visibility
Project on social media also serve as important ways to get informed about happenings in,
among and affecting the disability community. Importantly, clients will have their own
opinion and relationship to issues affecting the broader disability community; the provider
should be conscious of these issues through their own research, but should be sensitive and
open to hearing their client’s thoughts and perspectives on how those issues affect them
individually.
above, there are some additional considerations specifically for psychologists and
practitioners, as both members of the disability community and in a position to impact and
develop others’ disability identities in a clinical context, face an important set of concerns in
their practice.
disability biases and prejudices that can be harmful to people with disabilities, disabled
practitioners are also not immune from their own internalized, preconceived notions of
disability (Olkin, 1999). In fact, disabled practitioners have their own, individual
relationships to their disability and are negotiating the same set of societal assumptions and
DISABILITY IDENTITY AND ALLYSHIP 26
clinical expectations in their own lives that they are engaging with in their clients’ lives as
well. This makes disability identity development both an asset for disabled practitioners, and
a process through which they learn both about themselves and how to best serve their clients.
These practitioners must consciously and constantly challenge those ideas, including
privileging certain disability groups or ways of thinking about disability that hide other
professionals, who have often excelled in large part due to intellect, distance themselves from
those with cognitive or developmental disabilities. Social justice means that distinct groups
must elevate one another instead of standing on top of one another in an effort to champion
their causes.
honor the insights and participation of all of disabled community members. In particular, they
must commit “to breaking down ableist / patriarchal / racist / classed isolation between
people with physical impairments, people who identify as “sick” or are chronically ill,
“psych” survivors and those who identify as “crazy,” neurodiverse people, people with
cognitive impairments, and people who are of a sensory minority, as we understand that
In this paper, we have discussed the importance of disability identity in clinical practice
and the ways in which providers can recognize, honor, and support the development of this
identity in their clients. This kind of allyship and attention to identity will allow practitioners
to identify individuals who are at risk for poor health outcomes because they struggle with
integrating their disability and feel disconnected from the larger disability community.
Identifying such individuals will be informative to health care professionals as they develop
DISABILITY IDENTITY AND ALLYSHIP 27
treatment plans, providing perspective on which individuals may benefit from more intense
behaviors and mindsets from providers. Importantly, allyship for disabled and non-disabled
providers alike involves showing up for the disabled community in particular ways: through
action and modeling certain behaviors, but also through constant learning, shifting mindsets
and challenging dominant ideas about disability. Thinking and talking about disability from
this perspective also requires providers, and the field of rehabilitation psychology in general,
to shift their way of seeing disability from primarily medical lenses to social ones. If we are
listening to clients and their experiences around their own disability, this is not a difficult
clients, and the ways in which their disability identity, consciously or unconsciously, has
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DISABILITY IDENTITY AND ALLYSHIP 33
Figure 1.
Figure 2.
DISABILITY IDENTITY AND ALLYSHIP 34
Figure 3.
DISABILITY IDENTITY AND ALLYSHIP 35
Figure 4.