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.

The chapter explores the history from the middle ages to the present day, noting the trials and tribulations of a population that continues to remain poorly understood and misperceived by the general public. Conditions for people with psychiatric disabilities did not fare much better in the American colonies. Similar to the circumstances during the Middle Ages, care for this population was the family’s responsibility if they had a family to care for them. Moral treatments began to decline in the second half of the 19th century in favor of somatic therapies and behavioral control techniques. Although psychiatrists initially scoffed at the notion that the quality of the care they provided in mental hospitals was subpar, research was conducted in the treatment of mental illness that brought about improvements. Physicians continued to develop and work toward improvement of somatic treatments for psychiatric disabilities in the early part of the 20th century.

The International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2001), and its predecessors the International Classification of Impairments, Disabilities and Handicaps (ICIDH and ICIDH - 2; WHO, 1980, 1999) have been influential in the conceptualization of the construct of disability in the United States and internationally for more than three decades. This chapter begins with a brief overview of the history of classification of health and illness, and the role that different conceptualizations of disability have played along the way. It then reviews the development of the ICF within the context of these conceptualizations and introduces its key concepts, conceptual framework, and a brief orientation to its use. It concludes with consideration of the current and future impact of the ICF on conceptualizing psychological and social aspects of illness and disability.