This chapter discusses the psychosocial influences of environmental and natural disasters on individuals and communities. Environmental and natural disasters are envirobiopsychosocial by nature. Many times there are contributing factors involving substantial interaction effects between the person and the environment with which he or she lives. Thus, it is of paramount importance for mental health professionals to recognize that disaster survivors do in fact have some degree of control and responsibility over their internal and external environment for healing traumatic experiences. The chapter addresses commonly occurring environmental and natural disasters and offers disaster mental health counselor’s important issues for consideration based on the typology of each disaster. Four major events are discussed: earthquakes, floods, hurricanes, and tornadoes. Mental health counselors may best serve clients involved in environmental and natural disasters by being culturally attuned.

There are significant mental health challenges for individuals who have acquired a medical–physical disability during a disaster or trauma experience. This chapter discusses some of the more major prevalent medical conditions that are acquired from exposure to person-made and natural disasters. These conditions include traumatic brain injury (TBI), blast wounds, amputation, spinal cord injury (SCI), and musculoskeletal and chronic pain conditions. The chapter describes and discusses the major health conditions that are most prevalent and have the greatest challenges for individuals who have acquired an acute medical–physical injury during extraordinary stressful and traumatic events. It highlights the fact that acquired medical-physical disability, as a direct result of trauma and disaster, has a pervasive effect on the individual, which imposes chronic and persistent mental health conditions. The medical aspects of chronic illness and disability are critical to address clinically during a disaster mental health response.

The root causes of social injustice are in part centralized around wealth inequities, politicians and legislation favoring the wealthy, discrimination, and a Darwinian mentality (Greenwald, 2011; Marini, 2012b; Warren, 2014). 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 among 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.

Caregiving in America is perhaps one of the most misperceived, underappreciated, sometimes stressful, and otherwise rewarding acts of unconditional love. Yet, depending on which study or author you are reading, caregiving is often described at one of the two contradictory ends of the spectrum; "a curse or opportunity". This chapter delves into caregiving for loved ones with a specific type of disability, including Alzheimer’s disease, neuromuscular disorders, traumatic brain injury, psychiatric disabilities, spinal cord injury, and congenital disabilities, such as muscular dystrophy (MD) and cerebral palsy (CP). Ellenbogen, Meade, Jackson, and Barrett (2006) indicate there are significant group differences in caregiving responsibilities and demands between disability types. The chapter explores the dynamics of caregiver abuse and the often painful decision to place a loved one in a long-term care facility and also explores the significance of having social support in caring for a loved one with a disability at home.

This chapter explores the impact that societal attitudes can have on persons with disabilities, both psychologically and socially. Affect, perceived self- esteem, and self- concept are largely influenced not only internally by our own thoughts and actions but also by input from our environment regarding how we perceive what others think of us and how we are treated by others. It focuses generally on empirical and conceptual studies pertaining to the views or perspectives of specific occupational and special interest groups. Stubbins (1991) advised the importance for rehabilitation psychologists and other counseling professionals to gain an understanding of or insight into the motivations, perspectives, or paradigms with which other groups view, treat, and interact with persons with disabilities. These insights provide rehabilitation professionals with relevant others’ perspectives as to how to better understand and work with these groups to facilitate better care for clients with disabilities.

Perhaps the most crucial and significant question rehabilitation researchers have sought to answer over the past several decades is: How is it that some persons with disabilities appear to excel and succeed in life beyond all expectations, whereas others seemingly succumb or yield to the limits imposed by their disabilities and society? This chapter explores the multiple factors that contribute to this dichotomy. It focuses on disability from a salutogenic orientation (focusing on the traits of healthy and successful persons) as opposed to the traditional pathological approach (focusing on the reasons and treatment of those beleaguered with ongoing mental and physical health problems) (Antonovsky, 1987). The chapter briefly explores several of the more common disabling conditions in the United States, specifically substance use disorder (SUD), depression, anxiety, and suicide. It also explores the literature behind positive psychology and also the environmental and social barriers that obstruct wellness.

This chapter explores perhaps the most profound and important empirical question researchers have regarding the psychological and sociological impact of the disability. The terms adjustment, adaptation, reaction, and response are used interchangeably despite the fact they may be different concepts but have overlapping definitions. The chapter first explores people born with a congenital disability, and questions whether such individuals experience any adjustment process as they have no preinjury, nondisabled experience with which to compare their situations. The remainder of the chapter explores the following seven theories of adjustment: stage models (Livneh, 1991), somatopsychology (Lewin, 1935; Trieschmann, 1988; Wright, 1983), the disability centrality model (Bishop, 2005), ecological models (Livneh & Antonak, 1997; Trieschmann, 1988; Vash & Crewe, 2004), recurrent or integrated model (Kendall & Buys, 1998), transactional model of coping (Lazarus & Folkman, 1984b), and chaos theory (Parker, Schaller, & Hansmann, 2003).

The history of treatment and attitude toward people with disabilities has often been marked by societal fears, intolerance, ambivalence, prejudice, and ignorance regarding disability. The independent living movement essentially evolved as people with disabilities learned from the social activist movements concerning minority civil rights, consumerism, and women’s rights. Ironically, because of medical advances, the life expectancy and quality of life for people living with disabilities in industrialized nations continue to improve from a medical perspective for those who can afford health care. To this end, the United States continues to arguably have a "survival of the economically fittest" mentality if universal health care is not soon realized. For the estimated 76 million baby boomers presently transitioning to retirement, the golden years may not be something to look forward to given the increasing health care costs.