Conceptualising Abnormal Behaviour and Disability

Abnormal behaviour is statistically and clinically defined behaviour that deviates from social norms, is maladaptive, causes distress or impairment, and may pose risk to self or others — judged within cultural context.

Criteria for "Abnormality"

1. Statistical deviance from the average.
2. Maladaptiveness and interference with daily functioning.
3. Personal distress or suffering.
4. Norm violation / social unacceptability.
5. Dangerousness to self or others.

Diagnostic Frameworks

• DSM-5-TR (categorical with specifiers and the dimensional-impairment rating).
• ICD-11 (WHO classification).
• The medical model (disorder-based) versus the biopsychosocial framework (bio + psycho + social).

The Biopsychosocial Framework in Assessment

The biopsychosocial framework assesses biological (genetics, neurochemical), psychological (cognition, emotion, coping), and social (family, culture, environment) dimensions — the professional foundation for the strengths-based approach.

Study Points

1. Contrast the four indicators of abnormality.
2. How does the biopsychosocial framework differ from a purely medical model?

Major Diagnostic Categories and Presentations

Core Categories

• Anxiety and trauma- and stressor-related disorders: GAD, panic, phobias, PTSD, and acute stress — avoidance, hyper-vigilance, re-experiencing.
• Depressive and bipolar disorders: persistent sad/fatigue (depression) and manic/hypomanic episodes (depressive disorders).
• Schizophrenia spectrum and other psychoses: hallucinations, delusions, disorganised speech and negative symptoms.
• Obsessive–compulsive disorder: obsessions and compulsions.
• Substance use and addictive disorders, feeding/eating disorders, personality disorders (Cluster A/B/C), and neurodevelopmental disorders (ASD, ADHD).

Diagnosis and Stigma

Diagnosis shapes intervention but may stigmatise; strengths-based practice looks beyond labels to client capabilities and resources.

Study Points

1. Identify key features of PTSD, major depression, and schizophrenia.
2. Discuss the intended and adverse effects of diagnostic labels in social work.

Strengths-Based Intervention for People with Disabilities

Disability and Functional Impairment

Disability encompasses physical, sensory, intellectual/cognitive, psychosocial, and multiple impairments. Impairment (a loss of function) is distinct from disability (a social restriction produced by the environment) in the social model of disability.

The Medical vs Social Model

• Medical/individual model: impairment as an individual deficit to fix.
• Social model: impairment rendered disabling by barriers, attitudes, and failed design; the environment is what needs fixing.

Functional Assessment and adaptive life skill

Assessment considers daily living, work/study, mobility, and communication; supports include assistive technology, environmental/custom modifications, and decision support.

Strengths-Based Intervention Framework

1. Screen for strengths (skills, resources, support networks, resilience).
2. Empowerment & self-determination in decisions.
3. Accommodations and barrier removal to enable participation.
4. Inclusion in education, employment, community life.
5. Family and caregiver support.

Review Points

1. Contrast the medical model with the social model of disability.
2. Describe three strengths-based accommodations for a physically disabled job-seeker.

Psychological Interventions and Community Rehabilitation

Evidence-Based Therapies

• CBT: restructuring maladaptive thoughts/behaviours.
• Dialectical behaviour therapy (DBT): skills for emotional regulation in BPD.
• Person-centred and strength-based counselling.
• Psychoeducation for the individual and family.
• Pharmacological adjuncts prescribed by clinicians (not social workers).

Rehabilitation Approaches

• Psychosocial rehabilitation and supported employment/education.
• Community reinfection: deinstitutionalisation, community-based and family care.
• The biopsychosocial plan: life-coaching, occupation, participation, and inclusion.

Barriers to Care

Stigma, cost, service fragmentation, and the shortage of nearby, culturally acceptable practitioners.

Review Points

1. Design a psychosocial rehabilitation plan for a person with chronic schizophrenia.
2. How can community care replace institutional care?
3. What is the role of the multidisciplinary team in mental health recovery?