CITATION:
Andrews, E. (2020). Disability as Diversity: Developing Cultural Competence. Oxford University Press, New York.
SUMMARY:
In Disability as Diversity, Dr. Andrews moves the reader beyond a mere understanding of current knowledge of cognitive, emotional, and social understanding of people with disability to a realization of the important and unique cultural contributions of the disabled community. Combining an in-depth analysis of the literature in rehabilitation psychology with the work of disabled activists and her own personal experiences, the text is a rich source of information for those who work with people who are disabled and those who are members of the disability community. Moreover, it is well grounded by theoretical models of disability that provide a framework for her analysis.
The book begins with a brief history of the disability rights movement and legislation beginning in the late 1800’s and an analysis of the events that lead to the landmark Americans with Disabilities Act, with a clear description of priorities moving forward. Throughout this opening chapter and the following one on models of disability, she presents a clear vision of where we have been and where we need to go, highlighting the important work of disabled activists each step of the way.
In the chapters on disability culture, disability language, and disability identity development Andrews provides a framework for understanding the rich and varied aspects of disability culture and the ways that individuals who are disabled develop an identity as a disabled person. Here she stresses two themes. One is that, as with any culture, there is considerable variability within the disability community members, and individual groups (for example, the deaf community has a unique and developed culture). The second is that disability can be an identity that occurs after having not been disabled. Thus time, adaptation, and developmental stage all play a role in identity. She provides a comprehensive review of disability identity theories and concludes with clinical recommendations, including the need to understand the difference between adjustment to disability and disability identity formation.
Andrews’s review of cultural competence and cultural humility is a real strength of the book. She walks the reader through definitions of both cultural competence and cultural humility. She also provides practical advice for increasing cultural humility at the individual, institutional, and community levels. This includes concrete suggestions for activities such as hiring and retention. Here and throughout the book she takes a hard look at ableism within the profession, but also at more subtle issues such as microaggressions, inspiration porn, disability simulations, etc.
The concluding chapters provide both an analysis and some practical examples for improving teaching, assessment, intervention and research settings. Framed within ethical, legal, and policy standards, Dr. Andrews describes examples for universal design, adaptive suggestions for therapy, and evidence-based interventions. For those in a research setting she reviews issues around participant inclusion, the limitations of traditional RCT’s, and the strengths of participatory action research. She ends this chapter with a checklist about ensuring cultural competence in disability research that includes inclusion, dignity, equity, and accessibility, as well as a reminder to consider intersectionalities, and the need for a meaningful analytic framework.
This book does not attempt to provide simple answers to clinicians or researchers. Rather Andrews outlines the complexity inherent in disability culture, as with any culture, and provides direction and theoretical frameworks to help guide both clinical work and research programs. She moves the reader to understand the rich contributions of disability culture to the field and the community as a whole. She respects the diversity of opinions within this culture by switching between terminology (person-first and identity-first; client and patient) as a model for an inclusive approach that stresses, as she says, openness and flexibility.
THIS REHABILITATION SCIENCE SPOTLIGHT was chosen by:
Sarah Raskin, Ph.D.
Professor of Psychology and Neuroscience
Trinity College