Conceptualizing disability to inform rehabilitation: Historical and epistemological perspectives

In order to rethink rehabilitation — it is vital that we think about current rehabilitation — what it looks like and why. The dominant models that have emerged to guide development and practice, the frameworks that underpin compensation policies, funding for services, and indeed research, all have historical and political roots. If we better understand these models, their basis or foundation, their strengths and also their weaknesses, then perhaps we can better understand how to contribute to progress in the future. Our aim in this paper, therefore, is to discuss issues concerning how past, present, and future understandings of disability and related conceptual models might best inform rehabilitation strategies. The paper is composed of two main parts: Part 1 revisits the history of “conceptions of disability”. We broadly retrace how disabled people have been described and progressively identified as a specific population within society throughout modern Western history. We mainly focus on the changing social and political perspectives on poverty and assistance, out of which disability has been emerged as a social and medical issue. In the twentieth century, the social and political approach to disability, supported by the social movements of disabled people, challenged this medical approach, bringing about an ongoing debate on conceptual models of disability. Part 2 considers the merits of key contemporary disability and disablement models by challenging assumptions and “common” knowledge. We particularly focus on contemporary evolutions of disability models, from the 1960s to today, because in many ways, they reflect or react against prior approaches and underpin much of what is thought of as “modern rehabilitation”. Understanding these approaches, and their evolution, may help us better structure and plan future rehabilitation schemes, services, or evaluations. We conclude the paper by discussing and suggesting some future lines of reflection.