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.

Counseling people with disabilities has evolved in its constructs from medical models that focus on pathology within the individual, to functional models that focus on economic viability of the individual, to sociopolitical models that focus on the handicapping dynamics of the external environment. We have evolved science and practice sufficiently to understand that disability is a social construction. The meaning of disability emerges from the interaction between the person and the society; it varies across groups and changes over time. The sociopolitical lens highlights the issue of power, its use, and its abuse; the minority experience under a dominant culture; and the role of culture as a context for empowerment, research, and the development of more effective practice. This chapter considers the changeable nature of disability from this postmodern, multicultural perspective and explores its implications for serving diverse populations in diverse cultural settings.

The topic of ethics is vast and impossible to cover comprehensively in any single work. This chapter presents some of the relevant and controversial topics in this arena. It focuses on common ethical dilemmas, factors that influence counselor ethics, counselor competence, and current and debated ethical issues. Some ethical dilemmas seem inherent in the counseling process and are as likely to be encountered in the present day as they were in earlier generations. Others occur due to societal advancements and trends, new technologies, or catastrophic events or diseases that lead to increases in prejudice and discrimination. The chapter covers current and debated ethical issues related to AIDS/HIV and duty to warn self-injuring clients, biotechnology advances, wrongful birth and wrongful life actions, decisions related to choosing disability, ethics and private sector rehabilitation, online and Internet counseling, end-of-life counseling, and assisted suicide.

This chapter discusses the impact of disability on a family by examining the reactions of family members to disability, factors that influence adjustment to disability in the family, adjustment models, parenting reaction perspectives, effective family coping, the impact of disability based on the family role of the person with a disability, and the cultural influence on family adaptation to disability. Understanding the role of the family and how it functions to enhance or to detract from the lives of people with disability is imperative because this basic social unit can provide a lifetime of love, support, encouragement, and care. It is important to assess family needs and support services so that the family does not become overwhelmed or feel isolated in their endeavors to assist their loved one and to integrate into the larger community.

Rehabilitation counseling (RC) recognized family impact on service outcomes decades ago (Power & Hershenson, 2003; Westin & Reiss, 1979), but failed to develop substantive research (Bryan, 2009), practice, or policy (Kneipp & Bender, 1981) on their behalf. The cursory overview of family counseling approaches presented in this chapter is informative as a gestalt of theories and as a collection of unique tools. From the Community-based Rehabilitation Counseling (CRC) perspective, the therapeutic tools of family counseling can be repurposed for inclusive community development outcomes through community processes in all of the nested and networked communities that populate our lives. Thinking about counseling in systems and inclusive community development provides the backdrop for a CRC consideration of the models and tools of family counseling. The chapter describes models that align with social justice and integrated author’s own thinking in the hypothetical discipline of the CRC.

The identity of rehabilitation counseling is rooted in the constructs of counseling psychology and is expressed through current best practice. This chapter provides a brief description on which counseling theories and techniques work best with different disability populations and why. It traces the emerging threads of rehabilitation counseling through counseling theories and techniques. Next, it focuses on the relevance of theory and an accounting of successful applications of theory to practice. It then moves outward from the roots of counseling, from common factors to schools of thought, to describe how counseling fits into our community-based world. Career counseling is a signature venue for rehabilitation counseling. The chapter describes three of the most popular and useful approaches (Minnesota Theory of Work Adjustment, Holland’s Theory, and Super’s Life Span, Life- Space Theory) to providing a sense of the spectrum of service possibilities.

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).