Cripping Rehabilitation: A Disability Justice Approach to Research and Practice

Abstract

Purpose:

Despite increased recognition of the necessity of inclusive research and writing to encompass the diversity of human experience, discrepancies regarding how we conceptualize and describe disability persist. Differences in language signify differences in thinking, yet there also exist opportunities for reconciliation that center disability justice as a core tenet of rehabilitation research and practice. The purpose of this article is not merely to encourage academics to use the “right” language, but to question how we think about disability in our work and world.

Research Design:

Bringing together literature from rehabilitation and critical and feminist disability studies, we propose a crip reimagining of rehabilitation research and practice. Rooted in feminist and queer theory, “to crip” means to apply a disability justice lens and unsettle ableist assumptions.

Results:

Incorporating approaches from disabled scholars and activists encourages the adoption of a disability justice framework that centers the desires and needs of disabled people. In yet another political moment when disabled people face existential threats to their lives and well-being, it’s essential that rehabilitation psychologists and other professionals follow the lead of disabled people to advance efforts for disability justice.

Implications:

Disability justice demands not the eradication of disability, but the creation of a world in which disability is recognized as part of human variation, an effort that starts without our own discipline. We must find ways to continue recognizing and promoting possibilities for treatment and support, while also understanding that many disabled people live meaningful, fulfilling lives with or without our assistance.

“It is the story that made the difference. It is the story that hid my humanity from me [….].”

– Ursula K. Le Guin (1989)

Introduction

“Amputee. Some assembly required.” The phrase, emblazoned on the man’s t-shirt, isn’t the first thing I noticed upon entering the exam room, but it’s one of the more memorable. Phil¹, an amputee due to cancer treatment, doesn’t hide his prosthesis. He readily describes himself as an amputee, rather than a “person with an amputation.” Whether Phil is aware of it or not, his shirt makes a statement about disability language and reveals something about his identity as a disabled person.² Phil’s willingness to embrace his identity as an “amputee” fundamentally reaffirms the notion that disability is part of life, a critical part of identity, and a natural part of human variation.

In this political moment, recognizing disability as part of human variation and reaffirming our commitment to disability justice is vital. Despite the persevering work of those engaged in disability justice, marginalized groups are under threat. Cuts to social services and civil rights protections threaten the lives and well-being of people regardless of their disabled or nondisabled status. While the media has long engaged in inaccurate representations of disability (Andrews et al., 2019; Garland-Thomson, 1997), current national discourse, led by the Trump Administration, only reinforces ableist stereotypes (Shapiro, 2025). Disabled people face purging of references to disability from federal agencies and initiatives (Yourish et al., 2025), removal of sign language interpreters from the White House, fundings cuts to the Department of Veterans Affairs and the disbanding of the Department of Education—both of which provide essential services and protections to many disabled people—and proposed cuts to Medicaid that threaten the ability of disabled people to access healthcare (Bennett & Cuevas, 2025). Cuts to social services and civil rights protections threaten the lives and well-being of people whether they identify as disabled. These threats also further complicate claiming disabled identity as a source of pride and opportunities to advance disability justice through social mobilization (Armour, 2025; Nović, 2025).

Though critical theorization related to disability can at times seem like an academic pursuit separate from most people’s day-to-day lives, disabled and nondisabled people make choices everyday based on their explicit and implicit assumptions regarding the possibilities for disabled life. As a field, rehabilitation psychology intentionally connects disabled people to their social environments, though, as an allied health science, it may also inadvertently engage in medical stereotypes of disability focused more narrowly on diagnosis, treatment, and cure (Perrin, 2019). Bringing together rehabilitation psychology (Andrews et al., 2019; Dunn and Andrews, 2015) and critical and feminist disability studies (Garland-Thomson, 2005; Goodley, 2017), we propose how we can center disability justice in rehabilitation research and practice, including in our language, conceptualizations of disability, clinical treatment plans and interventions, and by reimagining a crip rehabilitation that centers disability justice.

Rooted in feminist and queer theory, “to crip” means to apply an anti-ableist disability justice lens and question assumed paradigms (Taylor, 2017; McRuer, 2018). By cripping rehabilitation, we apply disability justice to our disciplinary worldview, questioning medical assumptions and ableist norms to confront stigma and discrimination that can lead to social isolation; hindered access to healthcare; barriers to education and employment; delayed health-seeking; and internalized stigmatization (World Health Organization [WHO], 2022). By cripping rehabilitation, we can begin to better understand the structural, social, and health system factors that drive health inequities for disabled people and practice the principles of disability justice. As a feminist medical anthropologist and disabled woman whose research spans rehabilitation, public health, and critical and feminist disability studies, and a rehabilitation psychologist whose clinical work includes brain injury, multiple sclerosis, and other disability experiences, we invite colleagues in rehabilitation to learn from these disciplines and from disabled people to begin to imagine the possibilities for a crip rehabilitation rooted in health equity. By imagining the possibilities for a crip rehabilitation psychology, we not only invite the potential to further transform the discipline in line with the principles of disability justice but also construct rehabilitation psychology as a model of reform for other health professions.

Beyond Saying the Word: Introducing “Crip”

While much has been said on disability language and change has been made, in part due to the #SaytheWord movement and the work of rehabilitation scholars, we still lack consistency (Andrews et al., 2019; Andrews et al., 2022; Crocker & Smith, 2019; Dunn and Andrews, 2015; McDermott & Turk, 2014; Gernsbacher, 2017). Though the American Psychological Association’s (APA) Inclusive Language Guide recognizes the acceptability of both person-first (i.e., “people with disabilities”) and identity-first (i.e., “disabled people”) language, academic and scholarly organizations often recommend person-first language as a safer, more correct choice (APA, 2023). The exclusive use of person-first language was long promoted to recognize the personhood of disabled people. However, following the lead of disability activists, since the late 2010s, the importance of identity-first language—such as “disabled person,” to foreground disability as an essential part of one’s identity—has become more widely recognized (Andrews, 2020; Dunn and Andrews, 2015; Zajic and Gudknecht, 2024). Despite this broader recognition, confusion regarding disability language persists. This confusion indicates fundamental challenges conceptualizing and speaking about disability that must be addressed.

Despite criticism, person-first language remains dominant in the United States today, particularly in the health sciences (Andrews et al., 2019; Andrews et al., 2022; Zajic and Gudknecht, 2024). Person-first language became popular in the 1990s and prominent in the 2000s, largely due to the advocacy efforts of people with intellectual and developmental disabilities and the 2009 “Spread the Word to End the Word” campaign by Special Olympics, to recognize that people are not defined by their disabilities (Stephens, 2021; Taboas et al., 2023). While person-first language may sometimes be appropriate, many disability advocates have described “people with disabilities” as an overcorrection that diminishes the importance of disability to their lives and sense of self (Andrews, 2020; Andrews et al., 2022; Collier, 2012; Forber-Pratt et al., 2020; Kasnitz, 2020; Gernsbacher, 2017). Identity-first language centers disability as an important part of one’s identity—not something to hide. Identity-first language has been embraced by scholars and activists as a means to confront ableist assumptions about disability as shameful, though there remains no singular language recommendation from disabled people (Andrews, 2020; Andrews et al., 2022). Notably, those who use person-first and identity-first language have the same goal: to refer to people with dignity and respect (Taboas et al., 2023). With this goal in mind, we recommend reviewing best practices for disability language found in the Americans with Disabilities Act’s (ADA) National Network’s Guidelines for Writing About People With Disabilities (ADA Knowledge Translation Center, 2018) and other sources (Andrews, 2020; Andrews et al., 2022; Sins Invalid, n.d.).

Beyond debates of person- or identity-first language, disabled scholars and activists have adopted “crip.” Used as an adjective, noun, or verb, crip comes from queer theory and critical disability studies as a reclamation of the derogatory “cripple” to affirm disability identity and pride (McRuer, 2018; Shildrick, 2019). Queer theory has critically interrogated ideas of normativity, fluidity, and temporality, often in relation to the AIDS crisis, to reexamine cultural constructions of the body and possibilities for life (Edelman, 2004; Kafer, 2013). Building on this theoretical lineage, crip is a more expansive term than legal or medical definitions of disability, including “non-normative or nonrepresentative disabilities—disabilities, shall we say, that would never be legible beneath the universal access symbol for disability” (McRuer 2018, p.19), such as chronic pain, obesity, trans identity, and other forms of non-normative embodiment (Kafer, 2013). Similarly, mental health activists have reclaimed the word “mad” to challenge mental health stigma, foster community, and celebrate the diversity of minds (Curtis et al., 2001; Glaser, 2008). Notably, crip and mad are insider reclamations and terms of empowerment used by disabled people about their own communities. While they can be appropriate for non-disabled people to use in academic settings, it is not suitable for use by outsiders to the disability community in everyday speech (Dunn, 2015). At the same time, caution in using these words must not be taken as discouragement from adopting the values of disability justice it entails. We all must consider how to apply disability justice in our work.

As a verb, “to crip” something means to apply an anti-ableist disability justice lens (Taylor, 2017). Cripping does not necessarily entail a set point where justice has been achieved, but an imagining of what something might become, and the transformations required to move towards justice (McRuer, 2018). The goal of cripping is to reveal the assumptions within able-bodiedness and able-mindedness: “to crip something does not mean to break it but to radically and creatively invest it with disability history, politics, and pride while simultaneously questioning paradigms of independence, normalcy, and medicalization” (Taylor, 2017, p.12). Crip theorists have written of crip times, (McRuer, 2018), crip time and futures (Kafer, 2013), cripping the new normal (Ginsburg and Rapp, 2017), crip kin (Kafer, 2019), crip wisdom (Nishida, 2022) and crip horizons (Shildrick, 2019), among other concepts that unsettle and twist expectations to uncover ableist assumptions. Crip as an identity or description and cripping as a verb and process have been embraced as a generative analytic for anti-ableist imaginings. However, crip remains an inaccessible identity for many confronting stigma (Baynton, 2013; Taylor, 2017).

As part of efforts to combat persistent ableism, language has become a key venue to promote change (Andrews, 2020; Dunn and Andrews, 2015). Depending on relevant community preferences, either person-first or identify-first language may be appropriate, and they can also be used interchangeably (Andrews et al., 2022). Context matters: adoption of person-first, identity-first, or crip language must consider the risks and benefits of each’s use, as well as the recognition that there is no one right answer and disabled people have diverse preferences (Best et al., 2022; Shakes and Cashin, 2020). Language use should seek to honor and respect the preferences of the community or population with which you work (Grech, 2022; Patten et al., 2024). Our conventions must expand to recognize the plurality of acceptable possibilities that honor the identities and dignity of disabled people. However, while attention to language is necessary, it can oversimplify the complex theories, debates, and tensions that underlie its choice. Inclusion is not created by merely using the right words. Saying disability is the start (Andrews et al., 2019), a necessary first step, but not the solution.

Conceptualizing Disability

Disabled people remain one of the world’s largest equity-denied groups (Banerjee, 2025). The World Health Organization estimates that 16% of the world’s population, or 1.3 billion people, live with disability (WHO, 2022). Despite their greater likelihood to develop chronic physical and mental health conditions, be unemployed, have low socioeconomic status, and die prematurely, disabled people receive fewer preventive services and face significant barriers to access healthcare or healthcare training (Clarke, 2023; Engelman et al., 2019; National Institutes of Health, 2022). While some rehabilitation psychologists, including many cited in this paper, identify as disabled, strikingly little information exists regarding the prevalence of disability among rehabilitation psychologists, though, among physicians in the United States, it is estimated only 3.1% of physicians are disabled (Nouri et al., 2021), and disabled rehabilitation psychologists report experiencing disability-related discrimination and not disclosing disability, likely due to potential stigmatization (Lund et al., 2014). Endemic ableism in medicine persists, including the marginal inclusion of disabled people in healthcare training and governance; stigma, discrimination, and systemic barriers to accessibility; as well as the long-lasting legacies and present violence of colonialism, racism, and capitalism that enshrine notions of biomedical and cultural deficiency associated with race or ethnicity, sex, gender, sexuality, and ability (Banerjee, 2025).

Different uses of language confer different conceptualizations of disability, what it means to be disabled, and the possibilities for disabled people. Disparate understandings of disability are rooted in various models, including the moral model, medical model, social model, and minority model, in addition to various psychosocial and ecological models (Andrews, 2020; Andrews et al., 2013; Dunn and Andrews, 2015; Kafer, 2013; Levine and Breshears, 2019; Taylor, 2017).

The oldest of these models, the moral model associates disability, regardless of cause, with moral shortcoming, portraying disabled people as “cripples” who are physically, morally, and socially inferior (Dunn and Andrews, 2015). The moral model is also closely associated with early public health and medical efforts that perceived certain bodies as normal and others as “abnormal,” encompassing not only those with disabilities, but also those of other races and cultures (Banerjee, 2025; Garland-Thomson, 1997; Lock & Nguyen, 2010; Olkin, 2002). While the moral model is often perceived to be relegated to past ignorance, forced sterilization laws—one product of a moral model of disability and body difference—persisted well into the 20th century (Kafer, 2013). Positioned as necessary for public health and social welfare, forced sterilization targeted not only disabled women, but poor women, women of color and immigrant women (Ko, 2016). The moral connotations of disability and deservingness abound; people who receive federal disability benefits are often stereotyped as shirkers or malingerers unwilling to work due to moral deficit (Russell & Rosenthal, 2019). Disability is seen as a signifier of moral virtue (or its absence) (Mitchell & Snyder, 2000).

The medical model persists as the predominant conceptualization of disability in the United States (Taylor, 2017). In the medical—or individual—model, disability is defined as an individual condition or impairment addressed by medicine (Kafer, 2013). Disability is defined in opposition to the expectations of a “normal” nondisabled body or mind, and disability has no relationship to politics or power (Garland-Thomson, 1997; Taylor, 2017). The medical model’s focus on treatment and cure obscures recognition of potential risks involved in medical treatment; “fixing” disability is demanded for social inclusion (Kim, 2017). Yet, a focus only on those able to overcome incites “inspiration porn”, or “cripspiration.” “Inspiration porn,” a form of objectification not intended for disabled audiences, glorifies stories of disabled people as inspirational or heroic, erasing systemic challenges rooted in ableism. Instead, insider experiences are co-opted and disabled people unable to “overcome” challenges through their own individual will are villainized as malingerers (Dunn, 2019; McRuer 2018). Issues of access, success, and acceptance are consigned to an individual project of hard work rather than broader access for all (Clare, 2017). Associations of disability with impairment, rehabilitation, improvement, and cure shape how we, as a society, understand disability far beyond healthcare. The need for change in the medical model is clear: entrenchment of disability as impairment, limitation, and deficit casts the lives of disabled people as impaired, limited, and deficient.

The social model of disability emerged in Britain in the 1970s and 1980s as a counter to the medical model (Oliver, 1996). Spearheaded by disability activists, the social model identifies disability as primarily the result of inaccessible physical and social environments (Shakespeare, 2013). In this social model, the environment—built for nondisabled bodies and minds—is disabling rather than the impairment itself (Taylor, 2017). Importantly, the social model expands notions of disability beyond disease to recognize the oppression and exclusion of disabled people. The social model distinguishes impairment from disability; impairment refers to a physical or mental limitation while disability refers to social exclusion and stigma (Kafer, 2013). Feminist scholars have problematized the social model for failing to consider the lived reality of disability beyond environmental constraints and reinforcing a white, masculine view of disability as a singular axis of oppression to be overcome (Crenshaw, 1989; Kafer, 2013; Taylor, 2017). The social model’s distinction between impairment and disability erases the realities of those living with disabling conditions, such as chronic fatigue, pain, or illness, that persist regardless of environment. Strict social models, in identifying disability as the product of the environment, foreclose the possibility of medical intervention to alleviate suffering and improve peoples’ everyday lives (Kafer, 2013). The social model can marginalize disabled peoples interested in medical interventions or cures by focusing on disabling barriers.

Closely related to the social model, the minority or diversity model of disability perceives disability as a natural part of human variation. Disability represents its own identity; it is a demographic rather than an outcome (Dunn and Andrews, 2015). While the minority model recognizes the importance of social and cultural identity and personhood, its focus on personal identity and individual civil rights can obscure systemic ableism (Sins Invalid & Tataryn, 2017). What is a right and how that right is granted is culturally constructed; rights may be based on ableist values. While ensuring rights extend to all is often thought to be essential, it can inadvertently promote assimilation of ableist values to disabled people, rather than reenvisioning what rights might look like in an anti-ableist world (Mitchell & Snyder, 2019).

Given these disparate models, how can we recognize the need for medical intervention and systemic change? Drawing on feminist disability studies and queer theory, Alison Kafer’s (2013) political/relational model offers a means of reconciliation. A hybrid of the social and minority frameworks, the political/relational model emphasizes the importance of understanding disability through social and political relationships, while also recognizing the potential need for medical intervention and the lived realities of impairment. Unlike the social model, both impairment and disability are social. Like the social model, the challenges associated with disability lie in built environments and social patterns necessitating social change and political transformation.

In the political/relational model, disability is inherently political, meaning it is associated with power and can be negotiated and contested (Kafer, 2013). While the political/relational model critiques depoliticization of disability as individual impairment, the model also recognizes the possibility that people want and need treatment or cure. Rather than dismissing medicine, the political/relational model calls for renewed interrogation to understand the biases and limitations within medical approaches. Disability is more capacious, defined by collective affinity, including those with temporary impairment, chronic illness, learning disabilities, and mental illness, as well as others with shared experiences of bodily stigmatization and discrimination. In understanding disability and impairment as political and relational, produced and reproduced through sociality, we can recognize the need for both social activism and medical care (Kafer, 2013).

There are many models of disability, each heralding a different conception of what it means to be disabled and what action should be taken to address it. Work remains to be done in health professions to decenter the medical and social models, move beyond individual experience, and think about broader structural factors that influence, and, at times, determine, not only the health outcomes of disabled people, but the very ways we are able to live our lives.

Cripping Rehabilitation

Cripping rehabilitation applies a disability justice lens to reimagine the field without ableism as an intrinsic project of health equity. Rehabilitation psychology’s fundamental outlook differs from other health professions mired in a medical model of disability focused on impairment and cure. Rehabilitation psychology has long embraced a psychosocial or ecological approach interested in promoting holistic well-being based on the myriad ways that disabilities interact with social environments (Dembo et al., 1956; Wright 1983). Rehabilitation psychology’s person-centered perspective accompanies the understanding that disabled people live meaningful, worthwhile lives, a perspective counter to a strict medical model that demands cure.

Given rehabilitation’s fundamental outlook regarding disability, it is poised to take up the mantle of disability justice within the health sciences. At the same time, many of the unconscious assumptions associated with rehabilitation based on its connection with the health sciences harken to a medical model, at times leaving little room to address the profound psychosocial and structural factors that impact the lives of disabled people (Perrin, 2019). Of course, rehabilitation psychologists are often forced to rely on at least a partial medical model due to the nature of their clinical roles as they are forced to comply with billing requirements and institutional policies. Despite these challenges, we must continually re-examine our own assumptions, including our own complicities in inaccessibility, marginalization, and the reproduction of ableist stereotypes and values in our roles as educators, clinicians, and researchers and consider what opportunities do exist to push back against the medicalization of disability (Maier et al., 2020). Rather than looking to build cultural competence, we encourage clinicians and researchers who have not personally experienced disability to develop disability humility. Disability humility recognizes disabled people as those with expert knowledge; nondisabled clinicians and researchers must recognize disabled people as experts and seek to educate themselves on the medical and social components of disability (Andrews, 2020; Garland-Thomson, 2019; Reynolds, 2018). Building on the work of other disability scholars, researchers, and activists (Forber-Pratt et al. 2019; Kafer, 2013; Maier et al., 2020; Saia et al., 2024; Sins Invalid, n.d.), we propose the following considerations and example applications to clinical practice and research (Table 1) to crip rehabilitation and help build disability humility as we strive towards disability justice:

1. Reflect on conceptualizations of disability and challenge accompanying assumptions. Models of disability-related language signal how we understand the world. We should recognize disability as part of human variation. Normalizing disability remains an important and necessary first step not yet fully realized (Andrews et al., 2019). Disability is typically viewed as a deficit, a fate worse than death defined by limitation (Kafer, 2013). Of course, recognizing disability as part of what makes us human does not mean we should engage in “denying necessary health care, condoning dangerous working conditions, or ignoring public health concerns (thereby causing illness and impairment)” (Kafer, 2013, p.4). Rather than projecting your expectations of someone’s capacities or limitations, ask the person. While some of this is common disability etiquette—for instance, it is considered rude to touch someone’s wheelchair, as an extension of their body, without their permission—it entails a deeper unlearning of internalized ableism. Similarly, the need for an assistive device or adaptive equipment is often misinterpreted as dependence; however, it can be a welcome tool for greater independence with mobility, eating, driving, communication, and more. We all depend on devices that make our lives easier; why is it different when it is related to disability? Questioning our own assumptions of what disability is and what it means to be disabled demands acknowledgment also of the diversity within disabled lives. We must challenge assumptions that the primary challenge is someone’s life is their disability. Moreover, someone need not identify as disabled to experience discrimination because of it (Kafer, 2013).

   Application to practice and research: Counter to the goals of researchers and clinicians, continuing to rely on definitions of disability that inadvertently reinforce ableist assumptions only harms disabled people. In clinical practice, it is paramount to actively identify and challenge one’s own internalized biases around disability and chronic illness (e.g., a disabled life is inherently one of suffering; disability is the patient’s only or primary concern; disabled people need help). This vigilance is essential for a building a strong therapeutic alliance and preventing misdiagnosis or pathologizing systemic issues. Relatedly, practitioners are encouraged to support patients³ in working with their own internalized ableism. Forber-Pratt and colleagues (2019) offer practical tools for rehabilitation practitioners to support their patients in developing their disability identity. In research, lack of representation of disabled people in clinical trials compromises generalizability, undermines trust, hinders innovation, and compounds the health inequities experienced by disabled people (Bibbins-Domingo and Helman, 2022; Spong and Bianci, 2018). People with disabilities should not be excluded to create more convenient research procedures. For instance, from the outset, researchers should consider how to create procedures for participants who may be blind or low vision, how to help people with difficulties speaking to engage in interviews or focus groups, and have alternate consent procedures for people with impaired consent capacity. Utilizing principles of universal design—the concept that a product, environment, or procedure should be designed to be accessible by all people—originated in architecture (NC State University College of Design, 1997). Since then, universal design has been applied in learning settings and can also inform research design, methods, and procedures (Meyers and Andresen, 2000; Williams and Moore, 2011). Failing to engage with disabled people as research participants threatens the generalizability of study results (Shariq et al., 2023). Designing accessible procedures is not merely more ethical, it’s better science.

2. Understand and work to address the ways that disability is shaped by structural violence and the ways in which that violence impacts individuals. Disability is political, meaning it relates to power, authority, and access (Kafer, 2013). Disability justice requires we recognize and confront systemic injustices based on ableism, racism, sexism, classism, capitalism, and regionalism, among others. Forces such as poverty, gender inequality, political violence, racism, and ableism can determine who becomes disabled, who access care, and what kind of care they receive (Farmer et al., 2006). Structural violence refers to these systemic arrangements, often embedded in social and economic policy, that expose people to harm (Galtung, 1969; Farmer, 2004). Ableism—discrimination in favor of nondisabled people—includes not only overt prejudice, but also encompasses many American values, such as individualism and independence, that devalue disabled lives (McRuer, 2018; Shildrick, 2019). Structural violence limits the rights and protections afforded to disabled people. For instance, disabled people face barriers in attaining education and employment; the poverty rate for disabled adults is more than twice the rate for nondisabled adults (27% versus 12%) (Goodman et al., 2019). Amid the fight for disability justice, many disabled people are surviving in vulnerable and devalued social positions across the world. Beyond individual challenges and needs, we must understand the systemic forces that promote suffering and seek to include them in clinical practice and research. We must fight for individual improvement of people’s lives and the broader mission of collective disability justice.

   Application to practice and research: While rehabilitation psychologists, like many in the allied health sciences, are fundamentally concerned with individual treatment, we must also seek out opportunities to support systemic change. This can be as simple as recognizing those forces within treatment as a common ground with patients or research participants but should also include participating in equity, diversity, and inclusion efforts at your institution and supporting disabled causes in your local community. For instance, if you recognize someone you work with may have a harder time accessing healthcare, whether due to their health insurance status, health literacy, demographic characteristics, or other factors, help bridge the gap by considering referrals and warm hand-offs to other services (e.g., patient navigators, case managers, social workers) who can provide support. Often, those working professionally with disabled people are considered the disability “experts” rather than disabled people themselves. Not only must we question who really holds disability “expertise,” we must also use our positions of privilege within the medical field to confront ableist systems. We can start by engaging in community-based research that centers the priorities of disabled people and ensuring that both research participants and community advisors are adequately compensated for their time and knowledge. Also, consider using research theories, designs, and methods that acknowledge and incorporate social determinates of health.

3. Reimagine understandings of treatment and cure as rehabilitation educators, clinicians, and researchers who often work within or adjacent to medical or health systems. Cure alone is not justice, but neither is failing to engage with disability prevention and management. We can recognize opportunities for treatment alongside the very real possibility that many disabled people neither want nor need it. True disability justice prevention requires us to seek justice – to dismantle racism, poverty, environmental injustice, classism, and capitalism, many of which contribute directly and indirectly to illness and impairment (Clare, 2017; Kafer, 2013). While disability studies interrogates and challenges cure as a singular goal and framework, we must also acknowledge cure is a very real goal for many disabled people and is a normative desire for an individual in an ableist society (Kafer 2013).

   Application to practice and research: A focus on alleviating or eliminating symptoms for the sake of treatment or “cure” can reinforce a medical model without recognition of the many things people can do regardless of disability. Consider a focus on individual goals without imposing the necessity of cure, and encourage other health professional to follow your lead Watch for common ableist beliefs related to a “cure” or a “fix”, including assuming someone’s is presenting concern is solely due to their disability, or assuming that people with disabilities are unhealthy or ill. Also, when working with other providers, share your expertise about working with disabled people based on the principles of disability justice. In research, carefully consider if your research topic, methods, and measures further disability justice or reinforce a medical model of disability. For instance, while quality of life measures are intended to evaluate overall well-being, quality of life is inherently subjective (Ginsburg et al., 2020; Pennacchini et al., 2011). Quality of life measures typically include items related to health, relationships, social life, independence, personal development, and recreation, but offer no means to understand how someone experiences joy, pleasure, and fulfillment (Jacinto et al., 2023; Kafer, 2013). Quality of life research is often the result of ableist assumptions about what it means to live a good or meaningful life and is often inaccessible for people with intellectual or developmental disabilities.

4. Embrace the complexity of disabled people who are often multiply marginalized. While disabled people are united by their common social and political experience, there is no singular experience of disability (Kafer, 2013). There lies diversity not only within the experiences and impacts of various conditions, diseases, and impairments, but also within other identities that intersect with disability, such as race or ethnicity, age, sex/gender, socioeconomic status, citizenship status, geographic location, and other factors. Too often, disability studies focus on disability to the exclusion of intersectional subject identities and their multiplicative interaction (Bell, 2006; Crenshaw, 1989). Moreover, people who are multiply marginalized are more likely to have worse health outcomes alongside limited access to healthcare (Baah et al., 2019). Intersectionality identifies the ways in which cross-hatching oppressions function together, such that the experience of a Black disabled woman is fundamentally different than that of a Black disabled man and is different than simply understanding experiences of race- and disability-based discrimination separately. The specific oppressions experienced by those who are multiply marginalized are often sublimated for the sake of broader causes as people are forced to choose a singular identity, erasing certain aspects of marginalized people marginalized for the sake of the larger disability community (Crenshaw, 1989). Understanding systems of oppression as interlocking means its fight must focus on their specific oppression, while also seeking opportunities to mobilize for social change based on common ground (Nash, 2018).

   Application to practice and research: For clinical practice, spend time learning about the patient’s identities. As a starting place, you can use the ADDRESSING framework —which helps therapists incorporate multidimensional combinations of Age, Developmental and Acquired Disabilities, Religion, Ethnicity, Socioeconomic Status, Sexual Orientation, Indigenous Heritage, Native Origin, and Gender— as a guide (Hays, 2008). Integrate the patient’s intersecting identities into the conceptualization and treatment plan. Also, seek additional training to meet the clinical needs for multiply marginalized patients and develop disability humility. For clinical supervisors and educators, incorporate intersectionality when working with trainees, which may include supervising clinical work as well as considering your trainees’ own experiences to consider the complex interaction between privilege and oppression (Chan et al., 2018). For instance, help your students and trainees navigate the unwritten rules, expectations, and behaviors—often referred to as the “hidden curriculum”—of their chosen career. Those without familial ties to higher education, such as first-generation students, are often at a significant disadvantage. If you feel you are not equipped to provide guidance related to your mentees’ identities, whether related to disability or otherwise, offer to connect them with another mentor with similar experience. In research, the coexistence and interaction of multiple subject positions should be considered in all aspects of research design, methods, data collection, interpretation, and dissemination. For instance, in research with a community advisory board, your board members should reflect the characteristics of the population you hope to recruit. Consider how to recruit a diverse participant population, create research studies and procedures that are accessible for diverse populations, and understand the limits of generalizability if you are unable to recruit a diverse sample.

5. Recognize the coexistence of strengths and resources alongside challenges for disabled people and communities. In the health sciences, disability is defined sometimes as a negative health outcome rather than recognizing disability as a demographic or identity and the possibility for disabled strengths. Depictions of disability too often focus on only the good—success stories of overcoming incredible odds—or the bad—poor health outcomes, discrimination, and systemic ableism. Both portrayals, whether focusing only on the good or only on the bad, are killer stories—they destroy the possibility of other, more complex experiences. Rather than telling killer stories that destroy the chance to recognize disabled people’s complex personhood, we need to think about life stories that encompass the good and bad alongside possibilities for dignity, agency, and change. This applies not only to disabled people, but also marginalized communities typically described by poor health outcomes, low income, and healthcare and resource shortages. Asset-based approaches embrace a community’s strengths and goals rather than focusing on deficit (Cassetti et al., 2020). Asset-based approaches make use of existing community resources for health interventions and promotion, such as by connecting individuals and organizational assets (Cassetti et al., 2020). While not always suitable depending on the community or research focus, we must reconsider the impact of damage-centered research and narratives that focus on individual trauma recognition of systemic violence, particularly when working in regions or communities that have been previously exploited, including disabled people, as well as indigenous communities and other marginalized groups (Tuck, 2009).

   Application to practice and research: As disabled people and disability allies, we must speak up against one-sided portrayals of disabled life. In clinical practice and research, let us recognize and tell life stories that recognize the humanity of disabled people and center agency, while also recognizing harm and its sources, rather than focusing on the killer stories of inequities (Jegathesan, 2010; Le Guin, 1989). Rather than assuming disability is a negative experience, consider also the possibilities for disabled joy (Kafer, 2013). We must disavow killer stories of disability as the end of life, the end of possibilities, and instead recognize possibilities for treatment and support alongside the recognition that disabled people are already living meaningful, fulfilling lives with or without our assistance. When possible, make use of asset-based approaches that prioritize community strengths and desire-based approaches that center the goals of marginalized communities (Tuck, 2009). Cripping rehabilitation entails a reframing and reimagining of research methods and topics, incorporating an asset-based research framework that centers complex personhood and the goals of those who work alongside us.

6. Listen and follow the recommendations of disabled people as we join them in seeking justice. The disability rights mantra “Nothing About Us Without Us” demands disabled people be included in all decisions that impact their lives. Embracing a disability justice approach in rehabilitation psychology demands we stand in solidarity with disabled people rather than speaking for them (Andrews, 2020). Center the voices of disabled people, whether by asking and respecting preferences for treatment and language or through community-engaged research. Seek crip wisdom, such as national disability collectives like Sins Invalid (Sins Invalid, n.d.), as well as the wisdom that comes from the lived experiences of disabled people in the communities and settings in which you work (Maier et al., 2020). A disability-inclusive approach necessarily incorporates disabled people in the matters that affect their lives (Banerjee, 2025).

   Application to practice and research: Recognizing and following the expertise of disabled people is the central tenet underlying all disability justice efforts. In practice and research, recognize disabled people as experts in their own lives and learn from their experiences, while also recognizing that each disabled person has unique experiences and perspectives and cannot speak for all disabled people. We must deprivilege academic and clinical knowledge to seek out, engage with, and cite the work of disabled scholars, activists, and organizations or collectives led by disabled people. Not all disability organizations or collectives are working towards disability justice. Many disabled people and others with marginalized identities have been excluded from positions of power, whether in social movements or academia, due to ableist structures. When considering organizations or resources to engage with and rely upon, evaluate their mission, leadership and focus. Does it reinforce a medical model of disability and efforts for cure to the exclusion of other possibilities? Is it led by disabled people? Does it follow the principles of disability justice (Sins Invalid, n.d.)? Does it recognize and confront the challenges of multiply marginalized disabled people? Consider also if there are organizations or groups in your community and investigate local challenges. Disabled people should be included as decision-makers in community advisory boards for research and for clinical practice and should be compensated for their expertise (Collins et al., 2019). Community-based participatory research should promote the full inclusion of disabled people to promote true collaboration and knowledge exchange (Hassouneh et al., 2012).

Table 1:

Summary of Principles of Disability Justice and Example Applications for Rehabilitation Clinical Practice and Research

Principles of Disability Justice	Example Applications to Clinical Practice	Example Applications to Research
Reflect on conceptualizations of disability and challenge accompanying assumptions.	Identify and challenge internalized ableist views and assumptions (e.g., disabled life is inherently one of suffering; disability is the patient’s only or primary concern; disabled people need help). Consider and monitor how internalized ableist views can negatively affect clinical practice. Support patients in identifying and challenging their own internalized ableism. Support patients in developing their disability identity.	Create inclusive research procedures (eligibility criteria, consent procedure, multiple methods for data collection), that accommodate disabilities, particularly those common in the research population, rather than excluding disabled people from research. Use principles of universal design to create flexible research procedures that meet a variety of needs.
Understand and work to address the ways that experiences of disability are shaped by structural violence and the ways in which that violence impacts individuals.	Recognize systemic forces that impact your patients’ lives. Refer and connect your patients to other services (e.g., patient navigators, case managers, social workers) to support with issues of healthcare access, especially for specialty services. Participate in equity, diversity, and inclusion efforts at your institution. Support disabled causes in your community. Use your privilege as a provider to support and advocate for your disabled patients’ concerns. Take disabled patient concern about access or accommodation seriously. Instituting change helps not only that person, but others. Refer patients to specialists who can help with necessary accommodations (e.g., vocational rehabilitation counseling, assistive technology specialists, patient navigators, social work).	Consider research theories, designs, and methods that acknowledge and incorporate structural violence or social determinants of health. Be careful your research does not incidentally contribute to extractive or harmful research practices that further stigmatize and/or extract knowledge and labor from marginalized groups. For instance, community advisors and participants should be adequately compensated for their time and expertise. Educate yourself on unethical research done on marginalized communities in your region and field to prevent replication of past harms. Adopt diverse citational practices, being mindful to intentionally cite underrepresented scholars.
Reimagine understandings of treatment and cure as rehabilitation educators, clinicians, and researchers who often work within or adjacent to medical or health systems.	Recognize when the focus of treatment imposes the necessity of a “cure” or “fix”. Be on the lookout for common ableist beliefs related to a “cure” or a “fix” (e.g., assuming someone’s presenting concern is solely their disability.) Both providers and patients can be focused on curing a condition to the exclusion of other meaningful goals. Work with patients to understand their goals. Explore goals that are unrelated to a “cure” or “fix.” Encourage other providers to adopt this perspective. When working with other providers, take advantage of opportunities to share your expertise about working with disabled people based on the principles of disability justice.	When choosing a research topic or measure, consider it within the context of disability justice. Does it further disability justice or reinforce a medical model of disability? Move beyond disability or diagnosis as a health outcome to consider other outcomes that may be more meaningful and relevant to your research population (e.g., pain or fatigue management, sleep quality, depression, anxiety). Engage with scholars in other health disciplines to educate them on the principles of disability justice and their application.
Embrace the complexity of disabled people who are often multiply marginalized.	Learn about patients’ intersecting identities. The ADDRESSING framework can be a helpful guide (Hays, 2019). Incorporate patient’s intersecting identities into the conceptualization and treatment plan. For example, consider how a patient’s intersecting identities inform their experiences and perspectives within and beyond disability. Seek training as a practitioner to ensure you can meet the unique needs of multiply marginalized patients and develop disability humility. Incorporate intersectionality when working with trainees. Seek to understand your students’ own experiences to consider the complex interaction between privilege and oppression (e.g., teach the hidden curriculum, connect them to other mentees as needed).	Consider the use of theories that include intersectionality (e.g., Levine and Breshears, 2019) as key to disability experience to inform all aspects of research. Consider how to recruit a diverse participant population to ensure representative research. Be mindful of which experiences of disability your research does and does not speak to: who is not represented? Consider if and how to include a positionality statement in your work.
Recognize the coexistence of strengths and resources alongside challenges for disabled people and communities.	Rather than assuming all experiences of disability are negative, ask your patients for their own perceptions and recognize possibilities for disabled joy. Conceptualize patients not as people to be “cured” or “fixed,” but as complex human beings with strengths and concerns. Build upon the strengths and resources of your patients.	Tell life stories that honor the personhood of disabled people. Reflect on how we write about disability, including language, but also depictions of disability that are limited (e.g., too positive or negative). Make use of asset- and desire-based approaches that recognize and build upon community strengths and resources.
Listen and follow the recommendations of disabled people as we join them in seeking justice.	Recognize disabled people as experts in their own lives and learn from them. Understand each disabled person has their own unique experiences and perspectives and does not speak for all disabled people. Ask people if they prefer person-first or disability-first language, if there are other specific words they prefer you use related to their disability, or if there are words they do not want you to use (even if they use them).	Deprivilege academic and clinical knowledge to recognize the expert knowledge of disabled people regardless of education. Cite the work of disabled scholars, activists, and organizations intentionally, including work in peer-reviewed journals, but also in other sources given barriers to academic publishing. Engage in community-based research practices that center the expertise of disabled people and adequately compensates them as community experts throughout the research process, including when choosing the research topic to ensure it fits community needs.

Conclusion

Rehabilitation psychology’s holistic focus on the entire web of factors that impact well-being aligns well with the principles of disability justice and offers a starting place to reimagine a crip rehabilitation (Dembo et al., 1956; Wright 1983). To crip means to continually unsettle and question ableist standards that have become standardized. The recommendations we offer are intended as a starting place. Disability justice should be central to rehabilitation, impacting not only inclusive language, but as a fundamental component of clinical treatment and practice. Rather than offering a set endpoint, we encourage rehabilitation researchers and clinicians to consider: what would it mean to crip rehabilitation? While this paper has attempted to answer this question and explore implications for rehabilitation research and practice, consistent with the ethos of crip theory, we aim to start a conversation that continually questions expectations of normativity and centers disability justice. Cripping rehabilitation is a step towards broader adoption of disability justice principles within the health sciences as we continue to question: what would a crip future centering disability justice look like?

Impact and Implications.

As disabled people in the United States experience the withdrawal of social services and civil rights protections, affirming our disciplinary commitment to disability justice is vital. Bringing together rehabilitation psychology and critical and feminist disability studies, we propose principles for a crip rehabilitation. “To crip,” or to apply a disability justice lens, entails a reimagining not only of the language we use, but how we conceptualize disability and disabled life. As part of this crip reimagining, we offer practical recommendations and strategies for prioritizing disability justice in rehabilitation research and practice.