This chapter explores a range of topics related to obesity, including its prevalence, medical aspects, and associated complications. Other relevant areas include the psychosocial factors pertaining to societal attitudes and individual mental health issues, vocational implications concerning work/wage discrimination, Social Security regulations, and Americans with Disabilities Act (ADA) protections. The chapter also discusses the implications for rehabilitation counselors regarding vocational and mental health counseling. The implications of working with persons who are obese or overweight may be broken down into mental health counseling and/or vocational counseling. Obesity and related medical complications have soared to the forefront of medical conditions that lead to premature death, discrimination in employment, compromised quality of life, and negative psychosocial implications. Counselors who are aware of the medical, psychosocial, and vocational implications of obesity can assist clients in a variety of ways, keeping Olkin’s (1999) recommendations in mind regarding disability-affirmative therapy.

This chapter reviews the history of treatment toward people with disabilities (PWDs) in the United States. Early immigration literature and the apparent attitudes and treatment toward PWDs, as well as certain other immigrant populations, were blatantly prejudiced and discriminatory. Antidisability sentiment became more evident with immigration restriction, which began as early as the development of the first North American settlements. The eugenics movement essentially died down after World War II, primarily because of Social Darwinism and the Nazi extermination of an estimated 250,000 German citizens and war veterans with disabilities. The survival-of-the-fittest concept and natural selection in the 21st century appear to have morphed into a survival of the financially fittest ideology. With the aging of America and millions of baby boomers moving into their golden years, the financial portfolios of these individuals dictate what the quality of their lives will be, like at no time before in American history.

In this chapter, the book’s editors, Marini and Stebnicki presents a compelling and provocative reflection on the counseling profession. They summarize salient aspects of dealing with culture and disability that reflect how services are provided in an evidence-based practice environment. Each editor offers opinions and considerations for counseling professionals in the 21st century. Together, they hypothesize an inconvenient and potentially frightening future for Americans, particularly those of lower socioeconomic status, many of whom are minorities with disabilities. The chapter explores the ramifications of social class and classism, whereby social injustice perpetuates and exacerbates classism. In particular, Marini and Stebnicki call on counselors and related helping professionals to take a more active role in advocating beyond their traditional narrowly focused job duties of working almost exclusively with the client to adapt and survive in an able-bodied world.

This chapter explores one of the most profound and important empirical questions that researchers have regarding the psychological and sociological impact of disability: How do persons with disabilities react to their situation, and why do some actually excel, whereas others become indefinitely incapacitated both mentally and physically? The chapter explores seven common theories of adaptation to a traumatic physical disability. Some proposed theories have stronger evidence-based empirical support, whereas others rely on more qualitative and case study accounts, as well as clinical observation. The chapter first explores persons born with a congenital disability, and questions whether such individuals actually experience any type of adjustment process since they have no preinjury, nondisabled experience with which to compare their situation. It then explores the seven theories of adjustment: stage models, somatopsychology, the disability centrality model, ecological models, recurrent or integrated model, transactional model of coping, and chaos theory.

Family caregiving and support are perhaps the most essential elements in their disabled loved ones’ adjustment for response to disability. This chapter first explores the prevalence of caregiving in America, including demographic information about who the typical caregiver is and what the situational circumstances are for these individuals. It is followed by providing a definition of the types of caregiving support generally provided by loved ones, as well as the nuanced differences between unpaid family care versus paid formal care. This segues into a brief exploration into the significant family role caregiving entails and its impact on each member. The chapter then discusses caregiver abuse as well as the often painful decision to place a loved one in a long-term care facility. Finally, it explores strategies for counselors to be able to support family caregivers in caring for their loved one while maintaining their own mental and physical health needs.

The root causes of social injustice are in part centralized around wealth inequities, politicians, and legislation favoring the wealthy, discrimination, and a Darwinian mentality. This chapter explores the ramifications of social injustice in America focusing on those with disabilities. It discusses the ripple effect of poverty, oppression, and disability, and its subsequent deleterious impact for equitable treatment and opportunity. Beginning with prevalence statistics regarding poverty in general and disability specifically, the chapter segues into an exploration of the domino and vicious cycle effect of inequitable education, employment, health care, and health. The resulting psychosocial impact on minorities and those with disabilities is a reciprocal occurrence between these populations interfacing with an arguably apathetic societal and political populace. Finally, the chapter discusses a dialogue regarding the social justice counselor and strategies for counseling and advocating for this most ignored and disenfranchised population in America.