“The only disability I have is other people” – Navigating stigma: the changing role of friendship in people with acquired physical disabilities

Background Stigma is considered to be the main barrier to friendships in people with acquired physical disabilities. Occupational Therapy as a dynamic, client-centred process is well positioned to address stigma. Whist the process of stigmatisation in intellectual disability has been thoroughly examined in literature, there is a lack of research examining stigma associated with acquired physical disabilities, and the role it plays in the trajectory and function of friendship. The UN Convention on the Rights of Persons with Disabilities aims to minimise the attitudinal barriers to engagement and promote inclusion. However, this is yet to be ratified in Ireland. Objectives The purpose of this study is to explore the experiences of stigma in adults with acquired physical disabilities specifically investigating the impact of stigma on the role of friendship. Methods Semi-structured interviews were completed with three adults (25-45) with acquired physical disabilities, recruited through local disability organisations as part of a longitudinal navigating stigma study. Results Thematic analysis explored experiences of stigma participants encountered after acquiring their physical disability. It also yielded sub-categories describing the strategies participants employed to navigate stigma to create and sustain friendships: 1) Disrupting societal norms, 2) Ableism, 3) Invisibility versus hyper-visibility of stigma, 4) Segregation versus Inclusion. Conclusion These findings highlight the role occupational therapists can play facilitating people with acquired physical disabilities re-establish their occupational identity. Through establishing peer mentoring programmes, engagement in meaningful activities can be achieved allowing friendships to be created and sustained through meaningful occupations, minimising the lived experience of stigma.