As best friends in a small Midwestern town, Jon and Stephen, both extremely bright and inquisitive, often talked with each other about their dreams of jobs they would have as adults. Throughout childhood, made alive through imaginative play, their wide-ranging ideas about careers were inspired largely by television and movie characters. They were enthralled with the idea of “special powers” to save the universe, but soon realized that “superhero” wasn’t a career. A few years later, they considered becoming crime scene investigators, lawyers, emergency room doctors, and, briefly, even astronauts. Jon and Stephen were inseparable and were regarded by the elementary school’s Gifted and Talented (G/T) coordinator as the most academically advanced students in her memory. They loved to learn, had vivid imaginations, and inspired their classmates and each other to “dream big” about the future. They were big fish in a little pond (e.g., Marsh, 1987; Salchegger, 2016).

Then Jon’s family relocated to an affluent suburban neighborhood on the West Coast after his father took a position in Silicon Valley. Jon, in middle school, had to adjust to a new set of expectations and found the adjustment quite challenging—in fact, far more so than he had imagined. Surrounded by a large group of intense and extremely driven students, who all seemed to aspire to top-tier universities, and struck by the harsh realization that he was no longer one of the very best students, Jon now felt as if he were a fish out of water. He was plagued with self-doubt about his abilities and future educational and career prospects. Compared to the other students, who had long positioned themselves to earn coveted spots in the local STEM-oriented magnet high school, Jon felt inadequately prepared to compete and felt his excitement for learning fading quickly. Once a confident and enthusiastic student, Jon was immobilized by his fear of making mistakes, especially in the presence of his new peers, and he began to retreat from others both at school and at home. He had difficulty dealing with even minor setbacks and grew to resent the students who seemed ambitious and competitive. Adopting a defensive posture, Jon downplayed the importance of thinking about future goals; in his own words, it was “stupid” to worry too much about college and career. Although he generally maintained respectable grades (mainly to make his parents happy and to keep their anxieties at bay), he refused to take the most challenging courses at school and stopped taking academic risks. Since he was getting mostly As and Bs and an occasional C on his report card, Jon’s parents were not alarmed by the changes in his behavior and failed to notice that he had turned away from learning. His academic self-concept had taken a major hit.

In contrast to Jon, Stephen remained in the same small Midwestern school district for the remainder of his precollege years and continued to feel passionate—about everything! Stephen’s parents encouraged him to indulge his intellectual curiosity and explore every subject that captured his interest. But Stephen had difficulty narrowing his interests for the sake of establishing career direction. When he was first exposed to chemistry, for instance, he quickly memorized the periodic table and spent many nights at the dinner table teaching his younger brother everything he had learned about each element. Later, when introduced to physics, he could hardly contain his excitement about quantum field theory, cosmic inflation, fluid dynamics, and a host of other topics. Of course, he also loved math and was eager to learn computer languages. Adept not only in STEM subjects, Stephen also excelled in and enjoyed writing, history, and politics. However, because the school district was small and lacked resources, he often learned advanced content on his own by reading books and searching the Internet. The local public high school he attended offered few Advanced Placement (AP) courses, and school officials believed they could not justify offering additional AP courses just for him. Without his friend Jon, he had no intellectual peer with whom he could share ideas and interact meaningfully. As his precollege years progressed, Stephen did not gain sufficient clarity about educational and career direction to focus his efforts on developing any particular interest to a high level outside of the classroom.

This chapter focuses on conceptualizing addiction in relationship to the experience of trauma. It briefly covers some of the major theoretical orientations used to understand how addiction develops in individuals with diagnosable substance use disorders and co-occurring trauma. The chapter highlights the importance of social neuroscience and identifies stigma-related obstacles to recovery. The chapter concludes with discussions of treatment approaches and strategies as well as the counseling implications of co-occurring substance use and trauma disorders.

Substance users have substantially reduced rates of use of preventive health care services, and reduced rates of compliance with prescribed medical treatment. Primary care providers are frequently overwhelmed and may be reluctant to address substance-related problems given few resources. Direct collaboration with a behavioral health specialist (BHS) co-located within the primary care clinic results in increased efficiency and better treatment outcomes. There are excellent resources available for the BHS who will provide tobacco abuse interventions in the primary care setting. A number of behavioral factors should be considered in effectively addressing substance use and abuse in the primary care setting. Primary care providers should also be alert to unexplained vague symptoms, somatic complaints, difficulty with sleep, anxiousness, frequent life disruptions or chaotic lifestyle, and a family history of mental health problems or substance abuse.

Counselors serve an important role in the lives of youth. They provide safe spaces for children to express their emotions, fears, thoughts, and worries. Supporting children and adolescents of special populations and marginalized statuses requires that counselors (a) recognize how personal bias may impact the counseling process; (b) utilize culturally competent, theory-based techniques in counseling; (c) understand how socioeconomic status, poverty, race, gender, and sexual orientation impact children and adolescents; and (d) utilize practical, strength-based approaches to counseling. Counselors remain committed to the work of building strength-based, culturally competent, and inclusive practices. The counselor’s efforts to provide culturally responsive strategies and interventions will greatly influence the success of counseling diverse populations of children and adolescents. With this in mind, clinicians must remain critically reflective of their worldviews and biases and commit to the life-long process of cultural competence.

For professional school counselors and clinical mental health counselors to serve students with disabilities and adequately advocate within the comprehensive school and community contexts, they must first understand the legislation that exists. Congress set these legislations in place to protect the rights of students with disabilities and assure them access, inclusion, and a free and appropriate public education. This chapter helps to identify the disability categories under the Individuals with Disabilities Education Act and the common characteristics of giftedness. It recognizes legislative mandates that apply to education of children and adolescents with disabilities and giftedness in grades Pre-K through 12. The chapter describes postsecondary transition issues for adolescents with disabilities entering postsecondary institutions. It expresses the connection between identity and disability. The chapter explains the role of the professional school counselor and clinical mental health counselors when working with students with disabilities and those classified as gifted.

Trauma work with children and adolescents remains challenging on all levels and becomes increasingly complex when violence permeates various domains of life. Counselors must also consider the reciprocal relationships between trauma and neurological, psychological, social, cultural, and systemic factors that alleviate or exacerbate the experience of trauma. Early identification, assessment, and intervention remain critical components of trauma recovery. The inclusion of trauma-informed interventions such as emotional awareness and regulation, as well as mindfulness skills can help children and adolescents diminish symptoms that overwhelm internal coping mechanisms. This chapter helps readers to distinguish the complexity and range of trauma experienced by children, identify the neurobiological, social, psychological, and academic impact of trauma causing events on children, and recognize various trauma-informed and creative interventions when working with children and adolescent clients, as well as important considerations for school counselors.

This chapter informs readers of major concepts in Adlerian theory, with an emphasis on the contemporary relevance of Adlerian approaches for rehabilitation counselors and related professionals. It highlights the importance of a holistic understanding of individuals, as well as the significance of one’s social context. The chapter helps the reader to develop an understanding of key concepts, including holistic understanding of individuals, the significance of social context in Adlerian approaches, and the importance of goal-directed behavior and ‘lifestyle’. It also helps the reader to understand the counseling process in Adlerian approaches and the role of the counselor in providing encouragement while facilitating change, consider the level of evidence-based support for Adlerian approaches and appreciate the relevance of Adlerian theory in rehabilitation counseling, including the significance of the environment, the need to address problems in the environment, and implications for social justice.