A man's reach should exceed his grasp

Abstract

Dr P. J. R. Nichols was the spark for two complementary initiatives, foundation of the Society for Research in Rehabilitation in Great Britain and establishment of this Journal. These initiatives were based on two insights, that rehabilitation would not make significant progress unless there was more rigorous and scholarly scrutiny of practice, and that responsibility for such advance would rest on multidisciplinary involvement. The development of the Society for Research in Rehabilitation is reviewed from these perspectives, and the Society's interaction with the relevant government department is examined. It is suggested that the focus on rehabilitation in the title of the Society poses problems, tending to foster differences between the various professional groups involved. The latter are reviewed in terms of their training and previous experience, making contrasts between an intellectual or scientific discipline and a branch of professional expertise; the dubious value of all-purpose research methods courses emerges from the analysis. There is a crisis in disability research -funding is hard to come by, there are no significant career prospects for those who might take up this work, and, in Great Britain at least, it has become increasingly difficult to make time for research because of the pressure of service commitments. At a deeper level, disability studies still await a paradigm; behavioural insights have yet to be assimilated fully, too often being regarded as factors to be woven into some mechanistic thread of understanding rather than appreciating that the challenge is existential rather than abstract. Such limitations also retard development of satisfactory outcome measures, one implication being that insufficient attention has been paid to the restrictions imposed by current social organization – which can be remedied only by greater involvement in the wider health care and social policy debates. It tends to be lost from sight that ideological commitment in research increases at times of political stress in society at large; research not merely reflects that stress, it contributes to it. Much greater effort is needed to tap the knowledge and judgements of people with disabilities and their carers, a hitherto largely uncharted area of outcome assessment, and education of funding agencies has to be attempted. Finally, it is submitted that the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps makes a contribution to understanding that behavioural influences mediate as much as modify the experience of disablement.

Key Words:

• Disability
• Interdisciplinary
• Medical model
• Outcome
• Paradigm
• Profession
• Research
• Scientific discipline