Occupational therapy has historically developed alongside biomedical approaches to health, where disability was often understood primarily through the lens of diagnosis, pathology and impairment. While medical knowledge remains important, contemporary occupational therapy recognises that disability is not experienced solely because of changes within an individual’s body or mind.

Rather, disability emerges through the interaction between a person’s characteristics, their environment, societal expectations and opportunities for participation.

This distinction is particularly important within assistance animal practice because assistance animals are frequently considered in response to disability. Without an appropriate understanding of disability, there is a risk that recommendations become focused only on diagnosis or impairment reduction rather than meaningful participation.

Occupational therapists working in assistance animal practice must therefore move beyond asking:

“What condition does this person have?”

and instead ask:

“How does this person experience disability within their everyday occupations, and what barriers affect their participation?”

The Medical Model of Disability

The medical model conceptualises disability primarily as a consequence of disease, disorder or impairment within the individual.

Within this model, the focus is often placed on:

• diagnosis;
• symptoms;
• deficits;
• treatment;
• rehabilitation;
• correction or management of impairment.

The medical model has contributed significantly to advances in healthcare by improving understanding of conditions, developing treatments and identifying support needs.

However, when applied alone, it can provide an incomplete understanding of disability because it may overlook:

• environmental barriers;
• social exclusion;
• accessibility issues;
• discrimination;
• personal identity;
• individual strengths;
• meaningful life goals.

For example, a person may experience difficulty accessing employment.

A purely medical interpretation may focus on:

“The person cannot work because of their impairment.”

An occupational therapy perspective asks:

“What factors are limiting participation in employment, and what changes could support this person’s occupational goals?”

The difference is subtle but significant.

The Social Model of Disability

The social model of disability developed in response to limitations of purely medical explanations.

The social model proposes that disability is created not only by impairment, but also by barriers within society.

These barriers may include:

• inaccessible environments;
• negative attitudes;
• discrimination;
• exclusionary systems;
• lack of reasonable adjustments.

For example:

A person who uses a wheelchair may experience disability not because of their mobility impairment alone, but because buildings lack accessible entrances, workplaces fail to provide adjustments, or transport systems are inaccessible.

The social model shifted attention from:

“How do we fix the person?”

towards:

“How do we remove barriers to participation?”

This perspective strongly aligns with occupational therapy’s focus on participation, inclusion and occupational justice.

The Human Rights Model of Disability

Contemporary disability practice increasingly incorporates a human rights approach.

The human rights model recognises disabled people as rights holders rather than individuals requiring correction or charity.

This approach emphasises:

• dignity;
• autonomy;
• equality;
• inclusion;
• participation;
• freedom of choice.

Within assistance animal practice, this means recognising that people with disability have the right to:

• make informed decisions about supports;
• participate in their communities;
• access reasonable accommodations;
• have their preferences respected.

However, a rights-based approach also includes responsibilities.

Respecting a person’s autonomy does not mean automatically approving every requested intervention.

Ethical practice requires balancing:

• the person’s rights and preferences;
• evidence-informed practice;
• professional responsibility;
• animal welfare.

The Occupational Therapy Perspective: Participation as the Central Focus

Occupational therapy bridges these perspectives by focusing on occupational participation.

Occupational therapists recognise that disability affects people through disruption to meaningful occupations.

A person may experience barriers in:

• self-care;
• education;
• employment;
• relationships;
• recreation;
• community participation.

The role of occupational therapy is not simply to reduce impairment.

It is to enable people to participate in the occupations that are meaningful to them.

This makes occupational therapy particularly relevant to assistance animal practice because assistance animals are intended to support participation.

The central question becomes:

“How can this person participate more fully in the occupations that matter to them?”

Implications for Assistance Animal Practice

The model of disability used by a practitioner influences the quality of assistance animal recommendations.

A purely medical approach may lead to assumptions such as:

• people with certain diagnoses require certain types of animals;
• symptom severity determines assistance animal need;
• the animal’s purpose is to compensate for impairment.

A participation-focused occupational therapy approach instead considers:

• what occupations are affected;
• what barriers exist;
• what environmental factors contribute;
• whether an assistance animal could meaningfully reduce those barriers.

For example:

A person with post-traumatic stress disorder may not require an assistance animal simply because they have a diagnosis.

The occupational therapist would explore:

• What activities are restricted?
• What situations create barriers?
• What strategies are already effective?
• What role could an assistance animal realistically play?

The focus shifts from diagnosis to participation.

Avoiding the “Fix the Person” Approach

A critical aspect of contemporary disability practice is recognising that disabled people do not need to be “fixed” in order to participate.

Assistance animals should not be framed as correcting a person’s disability.

Instead, they may be viewed as one possible support that:

• reduces barriers;
• enhances participation;
• increases access;
• supports autonomy.

The person is not the problem.

The occupational challenge arises from the interaction between:

• the person;
• their environment;
• occupational demands;
• available supports.

Disability Identity and Individual Choice

Occupational therapists must recognise that people have diverse relationships with disability identity.

Some individuals may view disability primarily through a medical lens.

Others may identify strongly with disability culture, neurodiversity or disability rights perspectives.

A person-centred approach respects these differences.

The occupational therapist’s role is not to impose a particular philosophical model of disability.

The role is to understand how the person experiences disability and ensure recommendations support their goals and rights.

The Importance of This Perspective in Assistance Animal Recommendations

Moving beyond the medical model helps prevent several common errors:

Diagnosis-Based Recommendations

Assuming that a diagnosis automatically indicates an assistance animal need.

Impairment-Focused Goals

Focusing only on reducing symptoms rather than improving participation.

Task-First Thinking

Selecting animal tasks without understanding the occupational purpose.

Individualising Social Problems

Expecting an assistance animal to compensate for inaccessible environments or discriminatory systems.

Key Practice Principles

1. Disability Is More Than Diagnosis

A person’s disability experience cannot be understood through medical information alone.

2. Focus on Participation Rather Than Impairment

Assistance animal recommendations should be linked to meaningful occupational outcomes.

3. The Person Is Not the Problem

Occupational barriers often arise through the interaction between individuals and their environments.

4. Assistance Animals Are Supports, Not Fixes

An assistance animal may reduce barriers but does not remove disability or replace broader accessibility changes.

5. Respect Different Disability Perspectives

Person-centred practice requires understanding the individual’s own experience and identity.

6. Apply Rights-Based and Ethical Reasoning Together

Supporting autonomy must be balanced with professional responsibility and animal welfare.

Moving beyond the medical model of disability allows occupational therapists to approach assistance animal practice through a participation-focused lens. By understanding disability as an interaction between the person, environment and occupational demands, practitioners can develop recommendations that promote autonomy, inclusion and meaningful life participation rather than simply attempting to compensate for impairment.

Spotlight 3 – Occupational Justice and Assistance Animals
Placement: Topic 1.1 – Occupational Therapy Models.