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.

A dramatic shift has occurred in the field of long-term care in recent decades in how providers talk about those they serve. This chapter explains what consumer rights are and suggests how they might apply in long-term care. It considers obstacles that older consumers with physical and cognitive disabilities may face as well as barriers imposed by the markets themselves, such as the failure of healthcare to respond to market forces that are supposed to drive prices down and lead to new and improved products. It acknowledges the special rights of users of medical care, nursing homes, assisted living facilities, and health plans as articulated in patients' rights and residents' rights declarations and agreements. The chapter finally makes the case that consumers' rights should be a component of elder justice and that elder justice advocates and the public need to understand how to exercise and protect them.

Perhaps nowhere are the challenges to preserve individual rights and justice greatest than in the face of illness, disability, and death. This chapter calls attention to common violations of individual rights at the end of life such as the disregard of advance directives like “living wills” and “do not resuscitate” orders. It highlights the perils of these instruments, which were created to preserve autonomy but can be weaponized to exploit. The chapter then explores highly controversial rights of individuals to control their own deaths and enlist others to help them. It suggests how the “right to life” takes on new meaning in light of technological innovations that seek to extend life to previously unimaginable lengths and their implications for individual and collective rights. Finally the chapter also explores the implications of its corollary the “right to die”.

Elder justice has emerged from multiple fronts. It comes from researchers who are discovering that chronic illnesses, disability, and elder abuse are linked to poverty, discrimination, and social exclusion. This chapter calls for a new paradigm of elder justice that is based on the principles of human rights and social justice as they apply to older people. It builds on and reinforces past progress, revisits old assumptions and unfulfilled promises, and identifies new needs and challenges. The chapter then lays the groundwork for an elder justice agenda by suggesting the need for a new conceptual framework and elements to include. It builds upon principles of human rights and justice and employs public health methods to identify needs and suggest solutions. Finally the chapter connects the dots among existing policies and practices, building on those that have proven successful and rejecting those that have not.

The authors of this chapter are tasked with reviewing the dos and don’ts of interacting with people with disabilities as human beings. A collection of suggested behaviors, a disability etiquette, has emerged from the collective experience of people with disabilities and is widely available in brochures and on the Internet. Although disability etiquette is an important read for anyone in the field, it is not a sufficient guide for the rehabilitation counselor. The authors are a value-driven profession. They share allegiance to the fundamental mission of full community inclusion for people with disabilities. They act with their clients and on their behalf to help individuals achieve standing in their communities and to advance a more inclusive world for all people with disabilities. Disability etiquette is only the superficial expression of professional values that have much deeper roots and higher aspirations.

The topic of ethics is vast and impossible to cover comprehensively in any single work. This chapter presents some of the relevant and controversial topics in this arena. It focuses on common ethical dilemmas, factors that influence counselor ethics, counselor competence, and current and debated ethical issues. Some ethical dilemmas seem inherent in the counseling process and are as likely to be encountered in the present day as they were in earlier generations. Others occur due to societal advancements and trends, new technologies, or catastrophic events or diseases that lead to increases in prejudice and discrimination. The chapter covers current and debated ethical issues related to AIDS/HIV and duty to warn self-injuring clients, biotechnology advances, wrongful birth and wrongful life actions, decisions related to choosing disability, ethics and private sector rehabilitation, online and Internet counseling, end-of-life counseling, and assisted suicide.

The root causes of social injustice are in part centralized around wealth inequities, politicians and legislation favoring the wealthy, discrimination, and a Darwinian mentality (Greenwald, 2011; Marini, 2012b; Warren, 2014). 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 among 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.

Counseling people with disabilities has evolved in its constructs from medical models that focus on pathology within the individual, to functional models that focus on economic viability of the individual, to sociopolitical models that focus on the handicapping dynamics of the external environment. We have evolved science and practice sufficiently to understand that disability is a social construction. The meaning of disability emerges from the interaction between the person and the society; it varies across groups and changes over time. The sociopolitical lens highlights the issue of power, its use, and its abuse; the minority experience under a dominant culture; and the role of culture as a context for empowerment, research, and the development of more effective practice. This chapter considers the changeable nature of disability from this postmodern, multicultural perspective and explores its implications for serving diverse populations in diverse cultural settings.