This chapter examines racial and ethnic differences in disability in the United States with a focus on their patterns, trends, and determinants. Disability is responsible for massive social and economic costs to individuals, families, and health care systems. Racial and ethnic differences in health are one of the most widely studied topics in U.S. health disparities research. The risk of disability among older Asians is an understudied area, despite the growth of this population subgroup in recent years due to increased volume of immigration from Asia to the United States. There is an ongoing interest in measuring and understanding the patterns and causes of racial/ethnic differences in disability in the United States. Rising obesity may play an important role in the findings for Hispanic women and for the trend in disability for all race/ethnic groups.

The multicultural movement in counseling and psychology has begun to provide scholars and practitioners with contextually relevant, systems-based ecological approaches to counseling as alternatives to the traditional theoretical models of human behavior and intervention that are based on Western dominant culture. This chapter provides awareness of the complexity of multicultural issues among individuals with disabilities and discusses culturally sensitive strategies to work with people with disabilities (PWDs). It reviews legislative mandates related to diversity and multiculturalism in rehabilitation and addresses the relationship between disability and culture in the scope of rehabilitation practice. The chapter introduces multiculturalism and multicultural counseling models as a therapeutic framework and provides guidelines to help psychologists increase their cultural sensitivity. It also provides strategies to work with individuals with disabilities from minority backgrounds.

As diverse student populations gain visibility in colleges and universities across the United States, higher education counselors and student affairs professionals aim to effectively serve and meet the needs of these students. Individuals with disabilities (IWDs) represent one of these previously segregated diverse voices and perspectives that have recently experienced positive developments from inclusive college experiences. College students with disabilities represent an important segment of the growing student population. In 1997, Gill proposed a Disability Identity Integration Model (DIIM) for people with disabilities at the individual and group levels. The DIIM model aims to understand the integration process for people with disabilities into society in a process that involves identity development as part of the disabled minority group. The DIIM offers four types of integration: (a) coming to feel we belong, (b) coming home, (c) coming together, and (d) coming out. This integration process promotes personal empowerment and disability rights.

This chapter focuses on the role that Adult Protective Services (APS) and related service systems play in protecting vulnerable older adults and adults with disabilities from abuse, neglect, and exploitation. It articulates policy issues connected to elder justice. The chapter also explores human rights issues related to elder abuse, aging, and disabilities, particularly how to balance rights to self-determination and safety when working with abused, neglected, and exploited older adults. APS operate within a continuum of services that challenge social workers in their efforts to respond effectively to elder abuse. In addition to knowledge of aging, disabilities, the dynamics of family violence and care giving, and community resources and skills in capacity assessment, working in multidisciplinary teams, advocacy, and systems navigation, social workers need commitment to values of self-determination and empowerment to guide their work in this system.

This chapter explores a paradigm shift in policy and practice related to the delivery of services and supports to older adults or adults of any age with disabilities-the growth of person-centered (PC) and participant-directed (PD) practice initiatives. It discusses new theoretical approaches, particularly the Consumer-Directed Theory of Empowerment (CDTE), which are salient to explaining the growth and impact of PC and PD initiatives as an evolving practice model that represents a paradigm shift from past approaches to working with older adults and persons with disabilities. Research is needed on recent practice and policy changes that have implications for the continued development and examination of theories that support PC and PD care. With both the aging and the increasing diversity of the US population combined with federal policy initiatives related to LTSS, the demand for PC and PD initiatives will continue to grow.

This chapter overviews social work services from public health and boundary spanning perspectives. Social workers work to prevent negative long-term outcomes for persons with disabilities and to optimize the habilitation of the person with residual disabilities. The chapter is based on biopsychosocial framework for understanding the broad range of needs of people with disabilities and will present the epidemiology of disability in American adults. It discusses the policies that underlie disabilities support and services. Using an ecological approach, a multilevel, problem-solving approach to social work services will be defined, with special attention to services that are delivered within a family-centered perspective, which optimize use of policies, benefits, and financial resources to promote optimal rehabilitation and inclusion of the disabled person, and that integrate physical and behavioral health issues in viewing the whole person in a person-centered care approach.

This chapter covers the developmental stage of adolescence and a relatively recently conceptualized development stage of emerging adulthood, comprising a total of 12 years of life. It discusses topics such as crime and violence against individuals with disabilities, substance abuse among IWDs, the “thrills and chills” personality, and traumatic onset disabilities. While experiencing biological changes and gaining more individuation, adolescents and emerging adults begin vocational exploration, decide upon higher education, and initiate romantic, sexual relationships. For both adolescents with and without disabilities, body image and physical attractiveness become very important. Traumatic onset disabilities are more common during the adolescent years, and, in particular, spinal cord injuries, traumatic brain injuries, and alcohol and substance abuse are typically acquired in adolescence.

This chapter discusses the difference between medical models of disability and psychosocial models of disability. It addresses the environmental and psychosocial influences on relationships of individuals with disabilities and explains how people with disabilities can achieve and maintain optical health and functioning. The chapter describes the current health care systems in the United States and reviews alternative ways to improve weaknesses of the health care system. There are two ways to access to health care in the United States. The first is by having private health insurance purchased from a for profit health insurance company by your employer, yourself, or a family member. The second is by being eligible for Medicare or government-funded programs, most commonly Medicaid, the Veterans Health Administration, or the Indian Health Service. An organization of activist people with disabilities called ADAPT is dedicated to creating a priority on home-based services over institutionalization for people with disabilities.

Rehabilitation counselors (RCs) work with “persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals in the most integrated setting possible”. In rehabilitation counseling practice, there are three models that construct disability from three different points of view: the medical or disease model, the functional limitations or economic model, and the sociopolitical or minority model, also known as the social model as posited by the Disability Rights community. This chapter discusses some of the complexities of the Disability Rights community, including the emergence of the independent living movement, disability studies, and disability culture, in order to prepare practitioners to locate rehabilitation within the broader experience of disability. It also talks about the services provided by centers for independent living (CILs). Individual advocacy supports the self- determination of individuals to obtain necessary support services from other community agencies, such as state-federal vocational rehabilitation.