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.

It is clear that laypersons, health professionals, and researchers are interested in addressing the importance of religion in society and in health care. However, if we are to use religion effectively to improve the health of individuals, there is a need to better educate current rehabilitation professionals and students about religion, to critically evaluate the existing literature on disability and religion, and to develop practical suggestions for rehabilitation professionals to appropriately use religion to promote positive health outcomes. Rehabilitation professionals need to collaborate with faith-based organizations to improve the physical and mental health of persons with disabilities, as well as their ability to reintegrate back into their communities. Such collaborations are particularly important given the resources that are available in most community churches (e.g., church vans, counseling services) to assist persons with disabilities with transportation and provision of social support.

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.

Family caregiving and support are perhaps the most essential elements in their disabled loved ones’ adjustment for response to disability. This chapter first explores the prevalence of caregiving in America, including demographic information about who the typical caregiver is and what the situational circumstances are for these individuals. It is followed by providing a definition of the types of caregiving support generally provided by loved ones, as well as the nuanced differences between unpaid family care versus paid formal care. This segues into a brief exploration into the significant family role caregiving entails and its impact on each member. The chapter then discusses caregiver abuse as well as the often painful decision to place a loved one in a long-term care facility. Finally, it explores strategies for counselors to be able to support family caregivers in caring for their loved one while maintaining their own mental and physical health needs.

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.

Women with disabilities constitute one of the largest and most disadvantaged populations in the United States. This chapter helps rehabilitation counselors understand the myriad factors that affect the psychological and social health of women with disabilities. After giving some background on the historical roots of the rehabilitation response to women and a description of the demographic and health characteristics of this population, the chapter presents a heuristic, holistic model for understanding the reality of our lives and strategies for helping us achieve optimal health. It first discusses the pivotal construct of self-esteem, followed by social connectedness, its polar opposite abuse and the consequences of disparities stress and depression. The chapter ends with recommendations on strategies that the rehabilitation researchers and practitioners can use to include gender in their examination of individual and program outcomes, and thereby advance the field.

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.

The skills of working with the psychosocial aspects of grief, death, dying, and loss are essential, particularly in working with persons who have acquired chronic illness and disability. This chapter helps elucidate important psychosocial issues in death and dying as it relates to how individuals experience and express grief within the context of the person’s physical, psychological, cognitive, emotional, social, cultural, and spiritual well-being. Recognition in the new Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) of the Persistent Complex Bereavement Disorder diagnostic category provides legitimacy for the individual’s sense of loss and mourning based on multiple events related to death and dying. It is essential that counselors address such psychosocial concerns clients because of the added therapeutic value and ethical obligation to guide the individual and his or her family in important decisions regarding death and dying.