This chapter reviews the history of treatment toward people with disabilities (PWDs) in the United States. Early immigration literature and the apparent attitudes and treatment toward PWDs, as well as certain other immigrant populations, were blatantly prejudiced and discriminatory. Antidisability sentiment became more evident with immigration restriction, which began as early as the development of the first North American settlements. The eugenics movement essentially died down after World War II, primarily because of Social Darwinism and the Nazi extermination of an estimated 250,000 German citizens and war veterans with disabilities. The survival-of-the-fittest concept and natural selection in the 21st century appear to have morphed into a survival of the financially fittest ideology. With the aging of America and millions of baby boomers moving into their golden years, the financial portfolios of these individuals dictate what the quality of their lives will be, like at no time before in American history.

In the past quarter of a century, several attempts have been made to categorize the different sources of negative attitudes toward individuals with disabling conditions. This chapter integrates the major approaches in the domain of attitudinal sources toward people with disabilities and offers a new classification system by which these attitudes can be better conceptualized and understood. Some of the major categories included are: (a) conditioning by sociocultural norms that emphasize certain qualities not met by the disabled population; (b) childhood influences in which early life experiences foster the formation of stereotypic adult beliefs and values; and (c) psychodynamic mechanisms that may play a role in creating unrealistic expectations and unresolved conflicts when interacting with disabled persons. Parental and significant others’ actions, words, tone of voice, gestures, and so forth, are transmitted to the child and tend to have a crucial impact on the formation of attitudes toward disability.

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 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.