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.

The conceptualization of disability as an attribute located solely within an individual is changing to a paradigm in which disability is thought to be an interaction among the individual, the disability, and the environment. This chapter draws both theoretical and practice implications, which may assist practitioners and educators in gaining a clearer understanding of counseling clients who have disabilities, from four broad models of disability. Intended as a broad overview of the major models and an introductory discussion of ways in which these models can affect the profession of counseling, the chapter presents several different ways of conceptualizing the experience of disability. The four broad models are: (a) the biomedical model, (b) the functional model, (c) the environmental model, and (d) the sociopolitical model. The functional model and the environmental model are presented together because both are interactive models; stated differently.

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.

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.

Substance abuse treatment programs and clinical counseling approaches are designed to treat a variety of substance use disorders (SUDs). Treatment approaches may include a combination of medical (e.g., pharmacotherapy) and psychosocial approaches. Counselors apply a variety of evidence-based treatments, counseling theories, and approaches to substance abuse problems. With continued care, successive treatments, and continual monitorng, individuals with SUDs can increase the interval between abusive episodes until the individual achieves either full abstinence or more responsible substance use, as well as a more stable life-fulfilling recovery. Successful long-term recovery requires the adoption of a healthy lifestyle and continued mindfulness that SUDs can rear their ugly heads if one becomes distressed or negligent in maintaining life-enhancing attitudes, beliefs, and behaviors. With patience, persistence, tolerance, empathy, and compassion, counselors can help individuals and their families successfully recover from this devastating and potentially life-threatening disorder.

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.