802 Conceptual Paper.final

7/31/2019 802 Conceptual Paper.final

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Running head: SOWK802 Conceptual Model

SOWK802 Conceptual Model

David Hall

University of South Carolina


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Introduction

The goal of professional service provision to persons with disabilities is to facilitate and

enhance service recipients capacity and agency to achieve personal, social and economic

independence (ACA, 2005; NASW, 2008). Services intended to advance these aims have

historically been guided by medical model principles, and have produced equivocal and even

unintended negative results, and may in fact undermine routes to independence. This

manuscript presents a theoretically sound conceptual model that identifies advocacy-centered

service provision as an effective means of promoting personal agency among persons with

disabilities. In order that personal, social and economic independence is enhanced, the

development of agentic capacities is particularly salient for persons with disabilities given the

constraints and limitations that they face in their social environments. Drawing upon the extant

research, it is argued that these constraints, which include devaluation of social status, disability-

related stigma, stereotypic beliefs, paternalistic practices, and medical model rehabilitation

approaches result in disproportionate representation among persons with disabilities on several

important life satisfaction indicators, and affect the development of personal agency needed to

effect change on their own behalf

The following sections will present several working definitions of the notion of

disability, and will provide pertinent descriptive data that establishes the importance of

generating research that may inform the means by which to reduce disparities in health and well

being for this population. Next, a description of the 802 Conceptual Model, which situates

persons with disabilities in an ablest environmental context that may impede the development of

agentic traits in individuals with disabilities, is introduced and described. The conceptual model

illustrates the hypothesis that participation by persons with disabilities in organizations that


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utilize an advocacy-orientation to service delivery will result in the promotion of personal

agency, mediated by the development of emancipatory values orientation and subsequent

agency-promoting strategies. Concurrently, the model suggests that participation of persons with

disabilities in an advocacy-centered service organization will interrupt a stagnation-trajectory of

adaptation mechanisms (Welzel & Inglehart, 2010) predictive of groups afforded low status and

restricted opportunity within the social structure. The manuscript concludes with a discussion of

the potential utility of the conceptual model, its limitations and challenges in ultimately yielding

empirical findings, and areas for future study related to the model.

Conceptualizing and Defining Disability

Collectively, persons with disabilities constitute the largest single minority group in the

United States, totaling approximately 36 million individuals that comprise 20% of the total

population (Drum, McClaine, Horner-Johnson & Taitano, 2011). Persons with disabilities

constitute a highly diverse population inclusive of physical, psychiatric/emotional, cognitive and

behavioral conditions, and which span racial, gender, class, ethnic, sexual orientation and age

dimensions. The shear the size and expansive spectrum of this population, in addition to

discipline and interest-group-specific orientations to the notion of disability, underlie why a

universally agreed upon definition of disability remains elusive. While there does exist a

continuum of perspectives that inform how disability is understood and subsequently approached

by professional service providers working with this population, two foundational perspectives,

the medical model and the social model of disability, prevail as polar conceptualizations of

disability.


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The Medical Model Perspective of Disability

The medical community has traditionally defined disability as a medical condition or

illness that results in dependency that deviates from biological and social norms (Scullion, 2010).

A medical model definition of disability views the impairment and its resulting functional

deficits as the defining consideration, situating the cause or source of disability within an

objectified individual (Hughes, 2010). The corresponding approach to service provision is

characterized by service providers acting in the role ofexperts who seek to treat impairment-

related deficits in a way that fosters adaptation to the impairment/condition, and optimal

normalization to conventional social expectations (Scullion, 2010; italics added for emphasis).

The medical modelperception of disability as deficit is perhaps most clearly evidenced in the

utilization of Disability Adjusted Life Years (DALY) as a mechanism for cost effectiveness

analysis and epidemiological studies (Jelsma, De Weerdt, & De Cock, 2002). While the DALY

intended use is to promote preventive public health initiatives, its formulaic calculation of the

depreciation of a persons value of life given a particular disability status is premised on the

assumption that a life with disability is of less value than a life without disability.

The Americans with Disabilities Act (ADA), enacted in 1990 and most recently amended

in 2008, constituted an initial challenge to the predominant biomedical conceptualization of

disability in its regulatory provisions, yet retains a medicalized orientation in its oft-cited

definition of a person with a disability as someone who (1) has a physical or mental impairment

that substantially limits one or more major life activities; or (2) has a record of such an

impairment; or (3) is regarded as having such an impairment (ADAAA, 2008).


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The Social Model

The social model of disability (Oliver, 1983), a perspective developed and championed

by persons with disabilities in reaction to the medical model (Barton, 2009 as cited in Oliver &

Barnes, 2010), distinguishes between impairmenta long-term characteristic of an individual

that affects the body, mind or senses - and disability exclusion resulting from the barriers

imposed by, or ignored by, society. Proponents of the social model do not deny the reality or

related functional challenges resulting from the impairment, but argue that it is the environmental

barriers (social, physical, educational, economic, and attitudinal structures constructed in and by

society) encountered by persons with disabilities that constitute the primary source of limiations

(Iezzoni & Freedman, 2008; Hughes, 2010; Oliver, 1983; Oliver & Barnes, 2010; Scullion,

2010). The social model defines disability as occurring between the person and his/her

environment, and looks to the physical, social, political and economic structures of society as the

primary target for change. Aligning closely with a Freirean (1970/1993) perspective on the

dynamics of oppression,proponents of the social model contend that if disability exists, there

must also exist a disabler and a disabled (Scullion, 2010); the oppressor and the oppressed. The

World Health Organizations International Classification of Functioning, Disability and Health

(ICF) incorporates the social model perspective in its distinction between impairment

understood as the organic manifestation itself, disabilitythe restrictions in performing

developmentally-expected activities that result from an organic condition, and handicap - the

social consequences of deficient ability (WHO, 2001). This conceptual paper adheres to the ICF

definition, defining disability as an umbrella term for impairments, activity limitations and

participation restrictions [and] denotes the negative aspects of the interaction between an

individual and contextual factors (environmental and personal factors) (WHO 2001, 213).


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Persons With Disabilities as an At-Risk Population

While establishing a universally accepted definition of what constitutes and/or causes

disability remains a work in progress, evidence that the life experiences of persons with

disabilities are characterized by discriminatory practices, limited access to physical, social,

economic, and political resources and opportunities, and negative belief systemsall serving to

restrict opportunity for mobility within the socio-environmental structure across employment,

educational and health domains (Drum et al., 2011; Scullion, 2010) - is well supported in the

literature (Balcazar & Taylor-Ritzler, 2009; Brault, 2010; Chima, 2003; Drum et al, 2011; Nosek

& Simmons, 2010).

Employment

Current research suggests that employment opportunities are disproportionately denied to

persons with disabilities (Balcazar & Taylor-Ritzler, 2009; Brault, 2010; Drum et al, 2011),

placing them at risk for both economic and social marginalization. Several studies (e.g., Brault,

2010; Drum, et al., 2011; Nosek & Simmons, 2010) report that only 1/3 of all persons with

disabilities find sustained employment, as compared to 72-75 percent of people without a

disability; a proportion that is essentially the same as it was in 1990 prior to the enactment of the

ADA (Chima, 2003). Similar to trends within the non-disabled population, persons of color and

women with disabilities experience greater barriers to employment. Balcazar & Taylor-Ritzler

(2009) report that persons of color with disabilities are less likely to be employed than are whites

with disabilities, while Parish, Rose and Andrews (2009) found that, among all subgroup

populations explored, women with disabilities experienced the lowest employment rates and

highest reliance on Supplemental Security Income (SSI).


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Poverty and Economic Well-being

Related, individuals with disabilities are reported to be nearly twice as likely to live in

poverty than are those without disabilities (Nosek & Simmons, 2007), with some studies as high

as a 27% poverty rate (Erickson and Lee, 2008). Women with disabilities are more likely than

men to live below the poverty level (Nosek & Simmons, 2007), and are reported to experience

hardships including food and housing instability, inadequate health care, and loss of phone

service at higher rates than non-disabled women (Parish,Rose & Andrews, 2009). Data suggests

that persons with cognitive/intellectual (Mercier & Picard, 2011) and psychiatric/mental

disabilities (Cook, 2006) suffer disproportionately more chronic and severe levels of poverty

relative to the non-disabled population as well as compared to persons with non-intellectual and

non-psychiatric disabilities. Soffer, McDonald & Blanck (2010) point out that the economic

disparities experienced by persons with disabilities are in part associated with the higher costs

related to living with a disability (e.g. assistive technology, physical and behavioral health care,

accessible housing and transportation). Not surprisingly, a majority of persons with disabilities

fall within what is considered to be the asset poor, meaning that their access to economic

resources is insufficient to sustain themselves for a limited period of time (Oliver & Shapiro,

1995; Havemann & Wolff, 2004).

Health Disparities

While persons with disabilities are not formally acknowledged or included as a

population at risk by Federal health disparity efforts (Nosek & Simmon, 2007), research suggests

that this population is in fact over represented across numerous health conditions, and constitute

a highly vulnerable group. Drum and colleagues (2011) used data from the Behavioral Risk

Factor Surveillance System (BRFSS), a public health survey established by the Centers for


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Disease Control and Prevention (CDC), to compare self-reported prevalence rates of various

health indicators among working aged (18-64) persons with disabilities with those of other

minority populations in the United States. The authors report that persons with disabilities are in

fact at greatest risk relative to other marginalized groups in regard to prevalence rates on ten of

fourteen health indicators as reported in the Health Disparities Disability and Rehabilitation

Research Project database. Relative to other minority populations, persons with disabilities have

experience a higher prevalence rate of obesity, diabetes, heart disease, and stroke, and experience

the greatest financial barriers to health care (Drum et al, 2011).

Persons with disabilities are also at risk for secondary emotional/psychiatric conditions

that result from intra-psychic and/or socio-environmental responses to the organic condition.

Several studies (Brown & Turner, 2010; Mirowsky & Ross, 1999; Turner, Lloyd & Taylor,

2006; Turner & Noh, 1988; Turner & Turner, 2004) have explored the relationship between

disability and depression, and report up to a three-fold increase in depressive symptoms among

persons with a physical disability. Brown and Turner (2010) report that low level of mastery and

self esteem were the strongest predictors of depression levels. deRoon-Cassini, de St. Aubin, &

Valvano (2009) explored the factors that contribute to perceived quality of life following spinal

cord injury, and report that it is the perception and internalized beliefs related to perceived loss

of physical resources rather than the severity of the impairment itself that was most predictive of

self-reports of psychological well-being. Of significant relevance to the current study, well-

being was partially mediated by the nature and level of global meaning making, a concept whose

defined as clear and personally valued, coherent goals/aims in life, and a sense that these goals

had been achieved (deRoon-Cassini, de St. Aubin, & Valvano, 2009), parallels the construct of

agency, defined later in this manuscript.


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Effectiveness of Service Provision in Advancing Well-Being

In addition to concurring with the social model perspective that would argue that the

descriptive statistics pertaining to the plight of persons with disabilities presented above are in

large part the result of an ablest social structure that restricts the range of life opportunities for

this population, it is further contended that the nature and effectiveness of medical model-

oriented service organizations which dominate service options for persons with disabilities

(Beauchamp-Pryor, 2011; Marini & Chacon, 2002; Oliver & Barnes, 2010; Patchner, 2005;

Scullion, 2010; Tilsen & Nylund, 2008) are also complicit in the generation of these data.

Medical model-oriented services place the client/patientin the role of passive participant who

defers to the expertcounselor, whose rehabilitative goals center on curing, fixing or facilitating

adaptation of the person to better fit in an ablest society (Patchner, 2005; Rothman, 2008). In

placing the person with a disability in a passive role in regard to his/her own treatment, the

dominance of the medical model across service options for persons with disabilities may well

serve to reify a deference orientation (Welzel, Inglehart and Klingemann, 2003), a key

consideration that predicts low individual agency in the 802 conceptual model presented later in

this manuscript.

Considerable literature (e.g. Barnes, 2007; Bircher, 2000; Gallagher, 2001; Hughs, 2000;

Oliver, 1983; Oliver & Barnes, 2010; Tilsen & Nylund, 2008) refers to the rejection of the

medical model by persons with disabilities. Tilsen & Nylund (2008), for example, in arguing in

favor of greater counselor-client collaboration in the rehabilitation counseling process, report that

the medical model of care has engendered service recipients with a sense ofhopelessness and

voicelessness (pp. 340). Other studies reviewed (e.g. Barnes, 2007; Bircher, 2000; Gallagher,

2001; Hughs, 2000; Oliver, 1983; Oliver & Barnes, 2010; Tilsen & Nylund, 2008) relate that the


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historical dominance of a medical model orientation in service delivery has served to invalidate

bodies and minds that do not conform to social norms, confer lower status upon persons with

disabilities, and shape both intrapersonal and societal perceptions and expectations about

disability. Social model proponents maintain that the dominance of the medical model has, in

this sense, contributed to societys restriction of opportunities and exacerbation of stereotypes

and belief systems that impede inclusion of persons with disabilities participation in mainstream

social, economic and political activities (Oliver & Barnes, 2010).

Concern regarding the efficacy of medical model service provision, and the impetus for

exploring the efficacy of an advocacy-centered approach to service, is further motivated by the

fact that medical model treatments have been shown to yield ambiguous outcomes. While

literally hundreds of studies investigating the effects of specific clinical treatment approaches are

found in the professional literature, their overall impact on well-being, as evidenced in part by

the data described in the Persons With Disabilities as an At-Risk Population section of this

manuscript, is equivocal. A good example of these indefinite findings is reflected in Wampolds

(2001) study of the effect of therapy on persons with mental health diagnoses. Wampold reports

that, despite therapy-centered treatment having an overall positive effect size of between .7 and

.8 on advancing desired outcomes, it is client-related factors (e.g., optimism, persistence,

resources, environmental context) rather than the expertise of the clinician or the effectiveness of

the clinical approach, that account for 87% of improvement observed in the course of therapy.

Thus, only 13% of desired change is associated with the medical-model rehabilitation approach

employed. While the fore-mentioned research begins to indicate the shortfalls of medical model

services in advancing well-being among persons with disabilities, empirical investigation of the

effects of an alternative model of advocacy-centered service is lacking. Multiple searches across


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social science, social work, psychology, and medical databases uncovered no empirical

investigations that examined the effects on participation in an advocacy-centered service

programs on well-being at the individual level of analysis.

Introduction of the Conceptual Model

As indicated in the previous section, medical model rehabilitative approaches to service

provision with persons with disabilities has provoked strong criticism from consumers and

advocates within the disability-service field, while concurrently yielding unconvincing outcomes

in regard to intrapersonal and social justice needs of this population. The following section

presents the 802 Conceptual Model, represented in Figure One, that identifies advocacy-centered

service provision, characterized by Freirean and social model principles, as an alternative to

medical model-oriented rehabilitation for persons with disabilities. Specifically, this model is

intended to provide a foundation for further exploration of the question: what is the effect of

participation in advocacy-centered service programs on the development of individual agency

among persons with disabilities? The model visually and conceptually illustrates the hypothesis

that participation by persons with disabilities in organizations that utilize an advocacy-

orientation to service delivery will result in the promotion of personal agency, mediated by the

development of emancipatory values orientation and subsequent agency-promoting strategies.

Concurrently, the model suggests that participation of persons with disabilities in an advocacy-

centered service organization will interrupt a stagnation-trajectory of adaptation mechanisms

(Welzel & Inglehart, 2010) predictive of groups afforded low status and restricted opportunity

within the social structure. The models components as well as the propositional relationships

are explained in detail below.


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Explanation of the Conceptual Model

This section provides an overview of the 802 Conceptual Model; each component,

designated by the boxed shapes, and proposed relationships indicated by letter/numbered arrows

between components is explained, with supporting relevant literature provided. The model

situates persons with disabilities in an ablest social structure that often places limits on the range

and quality of opportunities for persons with disabilities. These limitations may be evidenced in

paternalistic attitudes, manifest in formal and informal policies, observable in interpersonal and

social relations, and/or experienced in the physical structure in which persons with disabilities

interact on a daily basis. The conceptual model draws heavily upon two theoretical frameworks;

the Evolutionary Human Development model, developed by Welzel, Inglehart and Klingemann

(2003) and Welzel & Inglehart (2010)1, and Freires (1970/1993) conceptualization of

conscientization, to explain the relationship between participation in advocacy-oriented service

programs and the development of individual agency among persons with disabilities.

1It should be noted here that the original Human Development model as designed by the Welzel, Inglehart &Klingemann was used to describe collective changes in human development at the international/societal level. Theauthors viewed the process of societal human development as unfolding in evolutionary fashion in response to

changing macro level contexts (e.g., globalization, regime change, technological advances). Welzel, Inglehart and

Klingemann (2003) and Welzel & Inglehart (2010) attribute societal change in large part to an emerging citizen-

level emancipatory orientation, resulting from the benefits of socio-economic development that result from these

contextual changes. An emancipatory orientation is founded on increased freedom of choice and access to new

opportunities that become available within the social, economic and political structure. Societies and populations

within them who begin to experience greater opportunity, according to the authors, eventually shed their deference

orientation that resulted from a survival/basic needs focus, as legitimate freedoms for opportunity pursuits

emerge.An orientation of possibility promotes appraisal of existing opportunities, goal setting, and engagement in

strategies (e.g. skill building) that increase the likelihood of goal attainment.


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In the section below, I first introduce the consequent variable, human agency, identified in

the model as the purple box, situated on the far right. Next, using Welzel et als (2003; 2010)

framework of Evolutionary Human Development as a foundation, the relationships between the

environmental structure (situated far left in model, maroon box), which is understood to include

physical, social, economic, cultural and political domains, and two human development

trajectories, one that promotes thriving and optimal agentic development (trajectory A(1-4),

green arrows/boxes), and one characterized by a stagnation (trajectory B(1-4), brown

arrow/boxes) are explained. Finally, a third potential trajectory (C(2-4), red arrows) emerging as

a result of participation in an advocacy-oriented service organization (the intervening variable) is

described.

The Consequent Variable: Human Agency

I begin by defining the desired end-result, the development of human agency. Among the


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publications reviewed (Alkire, 2005; Bandura, 1989, 1997; Frost & Hoggett, 2008; Kotan, 2010;

Ryan & Deci, 2000; Schwartz, 1992; Sen, 1999; Welzel & Inglehart, 2010) several closely

related definitions, often employing unique terminology, were uncovered. Kotan (2010), for

example, describes an agentic individual or group as one who demonstrates the ability to exert

power so as to influence the state of the world, and to do so in a purposeful way that advances

self-established objectives. Similarly, Sen (1999) defines a human agent as someone who acts

and brings about change, and whose achievements can be judged in terms of her own values and

objectives (p12). Central to each of these definitions is the notion of self-directed action

intended to advance a self-determined objective.

Sens reference to the relationship between agency and values is an important one that is

echoed in much of the literature. Schwartz (1992) defines values as desirable trans-situational

goals, varying in importances, that serve as guiding principles in the life of a person or other

social entity (p. 37). Values, in this sense, serve to motivate human choice and direction

central components of agentic behavior (Welzel, Inglehart & Klingemann, 2003). Schwartz

identifies the value of self-direction, the agentic capacity for independent thought and action that

advances valued objectives, as one of ten universal values that apply across cultures. Similarly,

Ryan & Deci (2000) contend that autonomyones self-determined, willing behavior that is

congruent with the individuals interests, values and desires- is one of three basic psychological

needs that determines psychological growth, integrity and well-being.

Alkire (2005), like Ryan & Deci, elaborates on the relationship between agency and well-

being, arguing that well-reasoned self-direction, a characteristic she relates to the exercise of

agency, may also, to the degree that it fosters intrinsic satisfaction, serve as one of several

dimensions that enhance or inform well-being. She adds that agency can also cause well-being


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as individuals exercise agentic capacities to advance other dimensions of their lives that

contribute to overall life satisfaction. Welzel and Inglehart (2010) analyzed the effects of agency

on well-being at both a societal and individual levels of analysis. On both a collective and

individual level, a positive and significant relationship was demonstrated between level of

perceived agency and well-being.

While the studies reviewed offer different lenses in defining the term, the importance of

agency as a vital aspect of human development and well-being is widely espoused across these

studies, positioning it as a meaningful focus of investigation in this and future studies. Welzel

and Inglehart (2010) for example, describe agency as the primary human trait, suggesting that

human development itself is best understood as the maturation of a persons agentictraits (44).

The authors argue that it is agency that allows for instrumental adaptation to changing social,

political, economic and environmental conditions, and which explain both individual and societal

change over time. Agency, according to Welzel and Inglehart (2010), is the primary mechanism

by which humans adapt to their environmental contexts in order to meet both the demands and

needs for survival and to take advantage of opportunities that allow us to thrive.

As suggested earlier in this manuscript, several studies (e.g., Barnes, 2007; Bircher, 2000;

Gallagher, 2001; Hughs, 2000; Oliver, 1983; Oliver & Barnes, 2010; Tilsen & Nylund, 2008)

suggest that the medical model approach has served to impede the development of agency among

persons with disabilities by instilling a sense of deference, voicelessness, and diminished social

status in recipients of services. By contrast, advocacy centered service organizations are by

design oriented toward engagement with its members in a transformative process that raise

critical consciousness regarding status quo practices that limit inclusion of persons with

disabilities; develop skills of advocacy; promote leadership capacities; enhance perceived self-


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efficacy; and develop the collective capital across its membership (Pyles, 2009). These domains

of individual capacity derived through the experience of advocacy initiatives, are in turn

hypothesized to cultivate the development of personal agency.

Socio-Environmental Structure

The Evolutionary Human Development Model, with particular attention to the relationship

between status-dependent opportunities and restrictions inherent in the environmental structure,

and the Welzel et al. conceptualization of sequential adaptive mechanisms (Welzel & Inglehart,

2010; Welzel, Inglehart and Klingemann, 2003), provides sound contextual framework for

explaining the moderating effect of ones environmental structure on agency development. The

802 Conceptual Framework situates the environmental context as a moderating variable in that

an individuals status and experience within the environment is assumed to, in most cases, affect

the strength and direction (positive or negative) of the real and/or perceived access to

opportunities for thriving.

In modifying the Welzel et al. (2003; 2010) Evolutionary Human Development model

from an international/societal perspective of the socio-political-economic structure to a

community level frame of reference, the 802 Conceptual Model draws upon Germain and

Gittermans (1995) conceptualization of ecological systems framework (ESF) (also referred to as

person-in-environment (PIE) in the social work literature). ESF offers a perspective by which

we can examine the reciprocal relationships and interactions between a person and

environmental domains within which s/he interacts, makes choices, acts, and develops. Welzel

and Inglehart (2010) refer to the physical, social, economic, political and cultural domains of the

environment and - the practices that occur within them - as existential conditions, and argue

that they define the availability of opportunities to thrive. It is argued here that the employment,


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economic, and health disparities experienced by persons with disabilities described earlier in this

manuscript serve as sound evidence that the existential conditions and the essential resources and

opportunities provided through them are disproportionately denied to this population.

Individual and Group Fit Within the Social Structure and Agency

Both Welzel and Inglehart (2010) and Germain and Gittelman (1995) highlight the

importance of a persons status in gaining access to these opportunities, associating resource

access with the persons environmental fit (817). Environmental fit describes how a given

person or groups needs, rights, goals and capacities are perceived to contribute to - and be

supported by - the operations of the environment. Favorable fit suggests adequate adaptation

between the environment and the person, and promotes continued development and satisfying

social functioning, while poor fit impairs or impedes individual and group development, health

and social functioning ( Germain & Gitterman, 817). The notion of environmental fit is

further informed by Welzel & Inglehart (2010) who posit that the processes of stratification and

socialization serve to legitimize ideologies, beliefs, and practices that benefit the elite and

maintain a stratified status quo. A legitimized status quo defines a persons fit within the social

environment, and dictates what is and is not viable within a given social group.

Central to our study is Germain and Gittermans (1995) contention that status and fit within

the community directly impact a persons capacity to act in a self-directed, agentic way (818).

Germain and Gitterman (1995), who in referring to low status populations relationship to

environmental fit, write: [P]eoples life circumstances may be such that few options exist in

their environment, so personal choice and decisions are meaningless. If people have no control

over undesirable life events or financial security, then self-direction is threatened (818).

Several studies (Balcazar & Taylor-Ritzler, 2009; Chima, 2005; Turner & Turner, 2010) concur


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with the premise forwarded in the 802 Conceptual model that environmental constraints, notably

negative societal attitudes and valuation about persons with disabilities among the general

public, prospective employers and even rehabilitation professionals, undermine social and

economic opportunities across the social structure for persons with disabilities. Welzel and

Inglehart (2010) succinctly summarize, characterizing stratification and socialization processes

as potentially caging human agentic capacities (p. 47).

Effect of Environmental Fit on Intrapersonal Perceptions

Ones the environmental context, including the socialization received within that context,

also serves to influence intrapersonal perceptions and beliefs about oneself and ones referent

group(s) in relation to the larger society (Chima, 2005) which also affects the development of

agentic capacities (Welzel, Inglehart and Klingemann, 2003). Chima (2005) found that persons

with disabilities interpreted interactions with persons without disabilities to terminate sooner,

entail greater physical distancing during engagement, to be generally more negative, and to

produce greater levels of distress than did interactions with others with disabilities. Chima

(2005) suggests that consistent interactions of this nature may negatively influence self-concept,

leading to self-doubt fear of taking risks, fear of making mistakes, feeling inadequate, and

concerns about what others think (48). The environmental context is thus understood for its

biased utility in providing and dispersing resources and opportunities as well as for its effect on

individual and group psyche. Livingston & Boyds (2010) meta-analysis investigated the

relationship between internalized stigma related to mental illness and its various correlates and

consequences. Internalized stigma is defined by the authors as

a subjective process, embedded within a socio-cultural context, which may be

characterized by negative feelings (about self), maladaptive behavior, identity


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transformation, or stereotype endorsement resulting from an individuals experiences,

perceptions, or anticipation of negative social reactions on the basis of their mental

illness (2151).

The authors report that higher levels of internalized stigma was negatively and robustly (r-values

range from -.28 to -.58) related to lower reported measures of hope, empowerment, self-esteem,

self-efficacy, quality of life, and social support.

Welzel and Inglehart (2010) further suggest that existential conditions shape intrapersonal

perceptions about if and how a given opportunity makes sense given the socio-economic

environmental considerations, including ones likelihood of capitalizing on an opportunity given

his/her socio-cultural status. As a point of example, we might consider the utility of a woman

receiving professional training for work outside the home if she is situated in a highly patriarchal

society in which cultural values and practices heavily endorse the male breadwinner, female

motherhood paradigm. Under these environmental conditions, even if the opportunity for such

training became accessible, the slim likelihood of applying those skills in a way that might foster

thriving, significantly reduces the trainings utility. Accordingly, it is not just access to

opportunities, but also the calculation of the degree to which the opportunity holds utility to

advance thriving, given ones station in the social strata, that contributes to ones overall outlook.

The authors refer to the association between existential conditions and real or perceived

opportunities as the environment-utility link.

The underlying theory advanced by Welzel et al. (2003; 2010) suggests that the degree of

access or barriers and value of opportunities that exist within the social environment for a given

individual/group set in motion a sequence of adaptive beliefs and behaviors that reflect and

predict thriving or stagnating trajectories, which in turn predict the level and nature of agency


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developed. These sequences are described in the section below.

Sequence of Adaptive Mechanisms: Thriving Trajectory

The 802 Conceptual Model illustrates two general trajectories of human agency

development; the thriving and the stagnating sequence of adaptive mechanisms. The thrive

trajectory is situated at the top of the 802 model, and is identified by green boxes and arrows

designated A1-A4; the stagnation trajectory is situated at the bottom of the model, and is

identified by brown boxes and arrows designated B1-B4. A third trajectory emerging from the

blue box labeled Advocacy Oriented Service Provision, this studys predictor variable, is

explained later in this manuscript.

Thrive Perception: As discussed earlier, each trajectory is in large part determined by the

environmental conditions (opportunities/restrictions, socialization patterns) afforded a given

person or group in a stratified social structure. The model illustrates that individuals and groups

afforded high levels of opportunity and access due to their social positioning, privileges of race,

gender, and non-oppressed status, are more likely to have developed an optimistic perception of

the life options available to them. Welzel and Inglehart (2010) term this a thrive perception.

Emancipation Orientation: Bountiful opportunities, permissive conditions for choice, and

importantly, the existence of either formal protections (e.g., rights, laws) or informal norms of

acceptance, connectedness (e.g., social capital) that ensure equitable access to opportunities, in

turn, nourish the perception of possibility and vision for an autonomous, self-directed life (arrow

A2), referred to as an emancipation orientation (green box, top center) in the 802 model.

Welzel, Inglehart and Klingemann (2003) maintain that as opportunities for individual well-

being increase in an environmental structure, greater valuation on the development of individual


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and horizontal social capital emerges, while reliance on vertical authority relations that restrict

human autonomy (341), diminishes.

Promotion Strategies: An orientation that views the world as offering a range of viable

opportunities leads to (arrow A3) a prioritization of those opportunities, and the promotion of

strategies (green box, top right) that enrich human capital considered necessary to maximize the

successful attainment of valued goals. The process of establishing objectives and exercising

ones capacity and power in the attainment of those objectives enhances human agency (arrow

+A4) (Welzel, Inglehart and Klingemann, 2003; Welzel and Inglehart, 2010). Higher levels of

human agency generally creates a yet wider range of options for thriving, offering further

opportunity for development, and thus establishing a self-perpetuating cycle.

Sequence of Adaptive Mechanisms: Stagnating Trajectory

Threat Perception: Conversely, groups experiencing historic and contemporary oppression and

pressing existential conditions that restrict opportunities for thriving and impose conditions that

orient attention to survival/basic needs satisfaction are predicted to promote the development of

threat perceptions (arrow B1) among persons embedded in these environmental conditions.

Perceived threats may include concerns that are of economic, physical, social and/or political

nature. Mpofu and Wilson (2004) argued that a communitys opportunity structure, understood

as the mix of opportunities and related resources within a setting that are differentially

distributed relative to status (e.g. social class, ethnicity/race, physical/mental state), orients each

person to viable goals and strategies available to attain a desired end (e.g., employment). In

considering the effect of environmental structure on students with disabilities, the authors add

that that both real and perceived adverse societal attitudes, barriers to inclusion, and paternalist


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perspectives pose threats that negatively influence the students internalized belief systems about

disability, which serve to further narrow the scope of perceived opportunities within this

oppressed population (Mpofu & Wilson, 2004).

Deference Orientation: Viewing ones world through a lens that primarily focuses on threats to

survival and limitations for mobility advances a self-protective orientation and a valuation of

deference (arrow B 2) to the status quo, authority, and compliance with within-group norms

(Welzel & Inglehart, 2010; Welzel, Inglehart & Klingemann, 2003). Welzel, Inglehart and

Klingemann (2003) argue that the publics prevailing value orientations reflect the constraints

imposed upon human autonomy by greater or lesserpressing social conditions (347). The

authors contend that the social structure, the degree of opportunity afforded a particular group,

and that groups perception of access to opportunities for thriving shapes value orientation

(Welzel, Inglehart & Klingemann). Specifically, the authors contend that pressing social

conditions and the resulting threat perception that prevails serve to restrict the range of human

choice, and in doing so, reduce the expression and valuation of emancipatory ideals in favor of a

deference and conformity oriented perspective.

A deference value orientation, in this sense, may be manifest acceptance of ones position

and life circumstance, foreclosure on opportunities that are perceived to be out of reach, and

centering of attention on complying with authoritative entities (e.g. county, state social welfare

providers) who possess the power to grant or impede access to resources needed for basic

survival needs satisfaction. Such a response is well understood through the lens of Maslowian

(1988) theory, which suggests that, in the light of pressing survival needs, people will adjust their

aspirations to focus thinking and actions on meeting the most basic needs first, rationally

choosing to forego energy expenditure on goals that, in the present context, appear unattainable


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or of secondary importance (Maslow, 1988). Deference may also occur in relation to ones

primary reference group. This is reflected in the findings reported Quane and Rankin (1998)

who found that African American males residing in impoverished environmental contexts

characterized by low employment, low parental educational attainment, and high levels public

welfare utilization report homogenous peer group orientation in regard to skepticism related to

the utility of academic attainment as well as low expectations pertaining to acquiring

employment.

Prevention Strategies: Adaptation under restrictive environmental conditions dispose individuals

to engage in the development of what Wenzel and Inglehart (2010) refer to as prevention

strategies (arrow B3). Prevention strategies, which flow directly from ones orientation

regarding what is possible and viable given environmental opportunities and constraints, refer to

a focal interest in avoiding failure, and are characterized by downward aspiration and action

adjustment (Costa, McCrae & Zonderman, 1987) and implementation of survival-centered

strategies (Maslow, 1988). As indicated by the negative symbol associated with propositional

arrowB4, it is contended (Wenzel & Inglehart, 2003) that while prevention strategies may well

serve to alleviate perceptions of threat, they do not promote a valuation of emancipation that

leads to strategies to enhance human agency (arrow -B4).

Several studies have reported on the impact of the social environment and ones position

within it on expectations for the future. For example, Turley, Santos and Ceja (2007) effectively

argued that the colleges to which a student applies suggests what that student believes to be

realistic and expected, rather than what is aspired to, given their individual academic

performance as well as their social origin and status. The authors found that high levels of

parental education and family assets were associated with applications to prestigious schools,


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while lower family SES, as well as female gender, was associated with applications to less

prestigious colleges (Turley, Santos & Ceja, 2007). Turley et als (2007) study reflects how

relative perceived status in the environment shapes intrapersonal perceptions and expectations

regarding what is possible and viable within the environmental opportunity structure.

The Intervening Variable: Participation in Advocacy-Oriented Service Organization

By itself, Welzel and Ingleharts (2003) evolutionary model ofhuman development might

be interpreted as highly deterministic in nature; that once a trajectory has been embarked upon,

the outcome is a fait accompli, at least in the relative short term. It is suggested here that there is

nothing inherent in the Welzel et al. (2003; 2010) theoretical or conceptual framework that

precludes the introduction of a catalytic mechanism, such as participation in an advocacy-

centered service organization, to determine its effect on redirecting an individuals trajectory and

consequent development of human agency. As indicated in the 802 Conceptual Model, it is

argued that participation in a Freirean-informed advocacy program (positioned in the center of

the model, blue box) that incorporates a social model orientation may interrupt a presently

experienced deference trajectory (arrow C 1 -), and promote an emancipatory perspective and

value orientation (arrow C 2 +).

As an explanation of process, it is suggested here that an advocacy program that

incorporates a social model perspective and a Freirean (1970/1993) approach that emphasizes the

development of critical consciousness and praxis, termed conscientization (67), will promote the

insight, motivation, skill development and action necessary to redress social inequities

experienced within the social environment. Freires (1970/1993) conceptualization of

conscientization, which is itself grounded in Marxist critical theory, is comprised of two central

processes. The first entails a sequential process by which subjugated groups develop an increased


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level of critical consciousness through reflective discourse. This has been termed a

transformational process (e.g. Pyles, 2009). Horizontal, non-hierarchical dialogue is purported

to promote (1) enhanced awareness of shared conditions and consequences among members of

an oppressed group, (2) the identification of the structural causes that undergird these

conditions, (3) a vision of an alternative, more just arrangement of conditions, and (4) an

individual and collective inclination to confront the oppressive structure in the pursuit of the

alternative vision (Freire, 1970/1993).

The second component of Freires (1970/1993) process of conscientization is praxis

reflective action brought about as a result discourse (Freire, 1970/1993, p. 88) that is intended to

advance the process of changing the structural conditions that undergird the oppression

encountered by the group. An important tenet of Freires (1970/1993) model is that discourse

and reflective action must both occur if transformation is to be realized; while sacrifice of

discourse results in unreflective re-action that serves to divert subsequent dialogue (and thereby

impede deeper levels of critical consciousness), sacrifice of action following reflective discourse

amounts merely to empty verbalism.

Applied to the 802 Model, an individuals active participation in collective consciousness-

raising and advocacy-related actions are expected to: transform prior held beliefs and behaviors

that reflected, prior to participation, a deference orientation; facilitate the development of

individual and group objectives related to their shared experience of injustice; and reorient the

individual to opportunities to improve ones experience in the social environment that were not

evident prior. The process by which reorientation of perspective changes from deference to

emancipatory, the identification of group and individual objectives to address injustice, and

participation in advocacy-oriented action steps parallel the very definition of agency (Kotan,


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2010; Sen, 1999 ). These processes serve to catalyze the transformation of participants from

that ofobjects that unreflectively adapt to the conditions imposed upon them by the structures

and practices of a society, to more fully humanized subjects capable of envisioning and

potentially acting to advance the transformation of themselves and the world in which they co-

exist.

Discussion

The 802 Conceptual Model constitutes an initial effort to address a definitive gap in the

literature pertaining to the efficacy of participation in advocacy-centered services on the

development of individual agency among persons with disabilities. Several explanations,

including the relative deprivation theory (RDT) and the social identity theory (SIT) have been

forwarded to explain why people join in advocacy initiatives in the first place. The RDT posits

that people engage in collective advocacy in response to beliefs that their group has been treated

unjustly, or is deprived of certain rights and resources relative other groups (Runciman, 1966).

Similary , the SIT describes the effect of oppressive inter-group dynamics that influence intra-

group coalescence and advocacy-oriented behavior (Tajfel, H., & Turner, J.C., 1979). While the

literature includes a body of work that has empirically investigated these and other theories

pertaining to the social, psychological and pragmatic motivations underlying why individuals

engage in advocacy-related actions, lacking are conceptual and empirical accounts that describe

the effect of participation on individual outcomes such as improved agency, self-efficacy, social

capital and general health and well-being.

Exploration of the relationship between participation in advocacy-centered services on the

development of agency is intended to produce knowledge that may be of practical value in the

design and orientation of services made available to persons with disabilities. Service strategies


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that employ Freirean processes of conscientization and a social model orientation of disability

may be more consciously and consistently incorporated into existing service models, including

those that currently reflect a medical model perspective. Such a transition in service orientation

may be viewed as a continuation of a slowly-developing paradigmatic shift away from strict

adherence to medical model tenets and top-down, expert-guided practices. This transition has

been evidenced by a growing recognition of the ethical significance and efficacy of client-

centered service, respect for consumer self-determination, and the ubiquitously-cited if at times

poorly defined goal of enhancing client empowerment. Advocacy, as understood through a

Freirean and social model lens, extends the notion of empowerment from that which is bestowed

upon a marginalized group (e.g., see Narayan, 2002) to that which humanizes and legitimizes

marginalized individuals and groups (Friere, 1970/1993) as a result of their own conviction and

action; their own agency. Alternatively, advocacy-centered service strategies, if demonstrated to

generate optimal outcomes, may be incorporated as the primary technology of a service

organization, resurrecting Gibelman and Krafts (1996) contention that advocacy should be

institutionalized and strengthened as a program of service(43), rather than appended as a

peripheral afterthought.

All this being said, there exists a selection bias limitation in regard to translating the 802

Conceptual Model into an empirically-testable framework. As indicated earlier, relative

deprivation and social identity theories each suggest that conditions of oppression and

marginalization promote involvement in advocacy-related initiatives, largely fueled by anger and

a sense of solidarity resulting from common experience. This premise, which is well supported

in the literature, runs counter to Welzel and Inglehart (2010) proposition that low social status

and limited access of environmental resources and opportunities promote an orientation of


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deference. Clearly, there exists a range of responses to oppressive conditions and practices. Some

individuals will be predisposed toward traditional rehabilitation and counseling services that

position them in a more passive client role, and others that inspire a person toward a service

technology that seeks to redress the oppression. Pre-existing emancipatory predispositions make

it difficult to determine the unique impact of participation in an advocacy organization.

Given the lack of empirical investigation in this area, the potential focus of future research

is rich with opportunity. While the 802 Conceptual Framework is, by design, highly inclusive

across types of disabilities and levels of severity, gender, age and ethnicity/race, it stands to

reason that each of these factors may well moderate the effectiveness of participation in

advocacy-centered organizations. Of particular interest will be the intersectionality of these

factors, as it is expected that such cross sections will differentially define status, and thus

perspectives and decisions about choice and mobility in the social environment.


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References

American Counseling Association (2005). ACA Code of Ethics. Alexandria, VA: Author.

ADA Amendments Act (ADAAA) of 2008, Public Law 110325, Section 9021b, (2008).

Alkire, S. (2005). Subjective quantitative studies of human agency. Social Indicators

Research, 74, pp 217-260.

Balcazar, FE & Taylor-Ritzler, T. (2009). Perspectives of vocational rehabilititation

counselors on the factors related to employment outcomes of racial and ethnic minorities

with disabilities.Journal of Social Work in Disability & Rehabilitation, 8, pp 340-354.

Bandura, A. (1997). Self-efficacy: The Exercise of Control. NY: Freeman.

Bandura, A. (2004). Health promotion by social cognitive means. Health Education and

Behavior, 31, pp. 143-164.

Barnes, C. (2007). Disability activism and the struggle for change: Disability, policy and politics

in the UK. Education, Citizenship and Social Justice, 2(3), 203-221.

Barton, L. (2009). Transcript of audio interview with Professor Len

Barton.www.informaworld.com/smpp/educationarena_interviewonline_interview5~db=

educ.

Beauchamp-Pryor, K. (2011) Impairment, cure and identity: where do I fit in?. Disability &

Society, 26(1), 5-17.

Brown, R.L. & Turner, R.J. (2010). Physical disability and depression: Clarifying racial/ethnic

contrasts.Journal of Aging and Health, 22(7), 977-1000.

Cook, J. A. (2006). Employment barriers for persons with psychiatric disabilities: Update


30/34


30

of a report for the President's Commission. Psychiatric Services, 57(10), 1391-

1405. doi:10.1176/appi.ps.57.10.1391

Costa, P.T., McCrae, R.R. & Zonderman, A.B. (1987). Environmental and dispositional

influences on well-being.British Journal of Psychology, 78; 299-306.

deRoon-Cassini, T.A., de St. Aubin, E., & Valvano, A. (2009). Psychological well being after

spinal cord injury: Perception of loss and meaning making.Rehabilitation Psychology,

54(3), 306-314.

Drum, C., McClaine, M.R., Horner-Johnson, W., Taitano, G. (2011).Health Disparities

Chart Book on Disability and Racial and Ethnic Status in the United States . Institute on

Disability, University of New Hampshire.

Erickson, W., & Lee, C. (2008). 2007 Disability status report: United States. Ithaca, NY: Cornell

University Rehabilitation Research and Training Center on Disability Demographics and

Statistics.

Freire, P. (1970/1993). Pedagogy of the Oppressed. New York: Continuum International

Publishing Group, Inc.

Gallagher, H. (2001). What the Nazi Euthanasia Program can tell us about disability

oppression. Journal of Disability Policy Studies, 12(2), 96-99.

Germain, C.B. & Gitterman, A. (1995). Ecological perspective. In Encyclopedia of Social

Work (19th edition), 816-824.

Haveman, R., & WolfF, E. (2005). Who are the asset poor: Levels, trends and

composition, 1983-1998. In M. Sherraden (E.), Inclusion in the American dream:

Assets, poverty, and public policy (pp. 6186). New York: Oxford University Press.

Hughes, B. (2000). Medicine and the aesthetic invalidation of disabled people. Disability &


31/34


31

Society, 15(4), 555-568.

Hughes, R. (2010). The social model of disability. British Journal of Healthcare Assistants,

4(10), 508-511.

Iezzoni LI, Freedman VA. (2008). Turning the disability tide: the importance of

definitions.JAMA, 299: 332-334.

Jans, L., Stoddard, S. & Kraus, L. (2004). Chartbook on Mental Health and Disability in

the United States. An InfoUse Report. Washington, D.C.: U.S. Department of Education,

National Institute on Disability and Rehabilitation Research.

Jelsma, J., De Weerdt, W., & De Cock, P. (2002). Disability Adjusted Life Years

(DALYs) and rehabilitation.Disability & Rehabilitation, 24(7), 378-382.

Kotan, M. (2010). Freedom or happiness? Agency and subjective well-being in the

capability approach. The Journal of Socio-Economics, 39(3), 369-375.

Lopez-Turley, R.N., Santos, M., & Ceja, C. Social origin and college opportunity expectations

across cohorts. Social Science Research, 36, 1200-1218.

Marini, I., & Chacon, M. (2002). The Implications of Positive Psychology and Wellness for

Rehabilitation Counselor Education.Rehabilitation Education, 16(2), 149-163.

Mirowski, J. & Ross, C.E. (1999). Well-being across the life course. In A.V. Horwitz & T.L.

Scheid (Eds.), Handbook for the study of mental health: Social contexts, thories, and

systems (pp. 328-347). Cambridge, UK: Cambridge University Press.

Mpofu, E. & Wilson, K. (2004). Opportunity structure and transition practices with students

with disabilities: the role of family, culture and community. Journal of Applied

Rehabilitation Counseling, 35(2), 9-16.

Murray CJL, Salomon JA, Mathers CD, Lopez AD, editors. Summary measures of


32/34


32

population health: Concepts, ethics, measurement and applications. Geneva: WHO; 2002

National Association of Social Workers. (2008). Preamble to the Code of Ethics. Retrieved

November 30, 2011, from http://www.socialworkers.org/pubs/Code/code.asp

Nosek, M.A. & Simmons, D.K. (2007). People with Disabilities as a Health Disparities

Population: The Case of Sexual and Reproductive Health Disparities. Californian

Journal of Health Promotion 5(Special Issue:Health Disparities & Social Justice), 68-81.

Oliver, M.L. (1983). Social Work with Disabled People. Basingstoke, MacMillan.

Oliver, M. L., & Shapiro, T. M. (1995). Black wealth/white wealth: A new perspective on racial

inequality. New York, NY: Routledge Press.

Parish, S.L., Rose, R.A., Andrews, M.E. (2009). Income poverty and material hardship among

U.S. women with disabilities. Social Service Review, 83(1), 33-52.

Patchner, LS. (2005). Social work practice and people with disabilities: Our future

serves. Advances in Social Work, 6, pp. 109-120.

Pyles, L. (2009). Progressive community organizing: a critical approach for a globalizing world.

New York: Routledge.

Quane, J. M., & Rankin, B. H. (1998). Neighborhood poverty, family characteristics, and

commitment to mainstream goals: the case of African American adolescents in the inner

city.Journal Of Family Issues, 19(6), 769-794.

Rothman, JC. (2010). The challenge of disability and access; Reconceptualizing the role

of the medical model. Journal of Social Work Disability & Rehabilitation, 9, 194-222.

Ryan, R.M. & Deci, E.L. (2000). Self-Determination theory and the facilitation of intrinsic and

extrinsic motivation, social development, and well being. American Psychologist, 55(1),

68-78.


33/34


33

Sen, A.K. (1985). Well-being agency and freedom: The Dewey Lectures 1984.Journal of

Philosophy, 82(4), 169-221.

Sen, A.,K. 1999. [2001].Development as Freedom. Oxford University Press, Oxford.

Soffer, M., McDonald, K.E., Blanck, P. (2010). Poverty among adults with disabilities: Barriers

to promoting asset accumulation in individual development accounts. American Journal

of Community Psychology, 46, 376-385.

Tajfel, H. & Turner, J.C. (1979). An integrative theory of intergroup conflict. In W.G.

Austin & S. Worchel (Eds.), The social psychology of intergroup relations (pp.33-

48). Monteray, CA: Brooks/Cole.

Tausch, N., Becker, J., Spears, R., Christ, O., Saaab, R., Singh, P., Siddiqui, R. (2011).

Explaining radical group behavior: Developing emotion and efficacy routes to

normative and nonnormative collective action. Journal of Personality and Social

Psychology, 101(1), 129-148.

Tilsen, J & Nylund, D. (2008). Psychotherapy research, the recovery movement and

practice-based evidence in psychiatric rehabilitation.Journal of Social Work in Disability

& Rehabilitation, 7(3-4), pp340-354.

Turner, J.B. & Turner, R.J. (2004). Physical disability, unemployment and mental health.

Rehabilitation Psychology, 49, 241-249.

Turner, R.J., Lloyd, D.A., & Taylor, J. (2006). Physical disability and mental health: An

epidemiology of psychiatric and substance disorders. Rehabilitation Psychology, 51, 2

223.

Turner, R.J. & Noh, S. (1988). Physical disability and depression: A longitudinal analysis.

Journal of Health and Social Behavior, 29, 23-37.


34/34


Welzel, C. & Inglehart, R. (2010). Agency, values, and well-being: A human

development model. Social Indicators Research, 97(1), 43-63. doi:10.1007/s11205-009-

9557-z.

Welzel, C., Inglehart, R., & Klingemann, H. D. (2003). The theory of human

development: A cross-cultural analysis.European Journal of Political Research, 42, 341

379.

Wompold, B.E., Ahn, H.A., & Coleman, H.L.K. (2001). Medical model as a metaphor: Old

habits die hard.Journal of Counseling Psychology, 48(3), 268-273

Wompold, B.E. (2001). The great psychotherapy debate: Models, methods, and findings.

Mahwah, NJ: Erlbaum.

World Health Organization. (2001).International Classification of Functioning,

Disability and Health (ICF). Geneva: World Health Organization.

Wright, S.C., Tahylor, D.M., Moghaddam, F.M. (1990). Responding to membership in a

disadvantaged group: From acceptance to collective protest.Journal of Personality

and Social Psychology, 58, 994-1003.

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