The concept of quality of life (QOL), as a psychosocial construct, process, measure, goal, and outcome, has gained much popularity in the rehabilitation literature during the past 35 years. As both a goal (i.e., assisting clients with chronic illnesses and disabilities (CIDs) to attain a better QOL) and a process-outcome indicator (i.e., assessing both subjective and objective levels of QOL during and following rehabilitation interventions), QOL has become one of the most prominent and central concepts in the field of rehabilitation. This chapter familiarizes the reader with the conceptual and temporal parallelism underlying the domains of community interventions and personal coping, of which rehabilitation services are an essential component, as part of their joint goal to improve QOL. It provides examples from the field of psychosocial rehabilitation, and more specific coping with CID, that address the temporal nature of QOL-improving coping strategies.

This chapter provides the reader with an overview of (a) the dynamics (i.e., process) of psychosocial adaptation to chronic illness and disabilities (CID), (b) methods commonly used to assess psychosocial adaptation to CID, and (c) intervention strategies applied to people with CID. The chapter groups the psychosocial adaptation to CID under three headings: basic concepts such as stress, loss and grief, and quality of life, CID-triggered reactions, and CID-related coping strategies. The literature on CID-related coping strategies is vast. The chapter describes only a cursory overview of the most commonly reported strategies, directly related to coping with CID. It first briefly discusses the concept of coping and illustrates its relevance to CID. Over the past half century, a large number of measures of psychosocial adaptation to and coping with CID have been reported in the literature. The chapter reviews only those psychometrically sound measures most frequently reported in the literature.

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.

This chapter offers (a) a description of the empathy fatigue construct as it relates to other professional fatigue syndromes, (b) a recently developed tool (Global Assessment of Empathy Fatigue [GAEF]) that may be useful for screening and identifying professionals who may be experiencing empathy fatigue, and (c) resources for self-care of empathy fatigue and building resiliency. The chapter’s author hypothesizes that empathy fatigue may be different from other types of counselor impairment and fatigue syndromes. The experience of empathy fatigue is both similar and different from other types of counselor impairment or professional fatigue syndromes. Thus, it is hypothesized that the cumulative effects of multiple client sessions throughout the week may lead to a deterioration of the counselor’s resiliency or coping abilities. Developing a clearer understanding of the risk factors associated with empathy fatigue is pivotal in developing self-care strategies for the professional counselor.

The first experiences of supportive and social units come, most often, from the family. This chapter discusses the impact of disability on 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 cultural influence on family adaptation to disability. 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. This involves understanding numerous differences in family reactions and functioning based on the resilience of the family, who in the family has the disability, the extent of the disability, the resources available, and cultural beliefs and practices.

Identity arises out of the sum of our experiences. This chapter traces the developmental concept of identity through its manifestations at different levels of community, revealing a complex and systemic context for rehabilitation counseling. Each level of identity (personal, social, and collective) denotes a potential point of counseling exchange with the family. The authors of this chapter consider family identity in relation to disability and interaction with the community. They discuss personal identity versus family identity and social identity within a social movement. The McMaster model of family functioning and the three dominant tasks of family are explored as are the International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) domains of health conditions, activities and participation, and functions affected. Finally, the chapter presents methods of family coping (both negative and positive strategies), family resiliency, and strategies that counselors can use to effectively assist families.