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.

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 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.

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.

Assistive technology (AT) has a profound impact on the everyday lives and employment opportunities of individuals with disabilities by providing them with greater independence and enabling them to perform activities not possible in the past. Self-esteem, self-efficacy, and motivation are described as central elements in increasing a consumer’s confidence and belief in self. Good outcomes and efficacy expectations, as well as strong motivation, help lead to successful adaptation to AT. This chapter presents the human component of technology, the relationship between consumers and technological devices/equipment, and the acceptance and use by consumers. It offers recommendations to assist rehabilitation professionals in helping consumers with accepting, utilizing, and benefiting from technology. There needs to be a close and appropriate fit between the technological device and consumer. Therefore, the need for the counselor to actively listen and engage the consumer in the process is essential to the effectiveness and outcome of AT success.

Accepting the handicapped person as a full human being means accepting him or her as having the full range of human needs. The location of institutions and the houses in which handicapped people can live becomes important because their location within communities enables participation of the handicapped in community offerings. Architectural barriers become an issue because their elimination enables people with a wide range of physical abilities to have access to events within buildings at large. The lives of handicapped people are inextricably a part of a much wider socioeconomic political and ethical society affecting the lives of all people. It is therefore essential for all of us to remain vigilant to protect and extend the hard-won gains of recent decades and to be ready to counter undermining forces. Vigilance requires thoughtful action guided by continuing reevaluation of the effectiveness of present efforts and alertness to needs of changing conditions.

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.

Athletes are believed to be at greater risk for eating disorders than the general population. When examining the rates of autism spectrum disorder (ASD) among those with or without an eating disorder, an ASD diagnosis was found to be more common among those with an eating disorder. Accurately identifying older adults who may have an eating disorder has its challenges. Eating disorders understood in the context of physical disabilities reveal not so much an issue with respect to effectively and accurately diagnosing an eating disorder but in regard to the degree that body image issues can be pronounced among those who have a physical disability. Refusing to eat or engaging in fasting for spiritual reasons was a common practice during medieval times. The difference between those who benefit from having a religious faith and those who do not may lie in the difference between religion and spirituality.

This chapter describes the development and impact of federal legislation on the disability services environment in the United States, with a focus on the impact of federal legislation on the daily lives of people with disabilities, including the multiple legal frameworks that people with disabilities may encounter in social services as they overlap—sometimes imperfectly—with employment and community services and supports. In focusing on the disability services environment and relevant legislation, it engages with topics ranging from: social insurance and means-tested disability entitlements; the provision of quality rehabilitation, community supports, and services; access to services, including the purpose and impact of “order of selection” rules; legislation mandating and supporting equal participation in work and society; the rise of “employment first” initiatives and outcomes-based employment legislation and policy; and the shift in the emphasis of disability as a social construction as opposed to a medical construction.

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.

The proper diagnosis and the delivery of quality services do not change because the veteran has military culture–related experiences. This chapter explores how rehabilitation services can be an integral part of the veteran’s overall plan of care, whether directed by the Veterans Administration or community, state, or other human services providers. It presents information on multiple trauma, military culture, military cultural competence, and unique challenges the military culture creates for veterans and their family members during transition. The chapter gives special attention to the needs of women veterans, especially military sexual trauma. Finally, the chapter focuses on specific, evidence-based strategies that can be utilized to support transition and reintegration of veterans with disabilities into their families, communities, and work spaces. Service members’ needs are best served when practitioners have military cultural competence and are able to work across disciplines to delivery evidence-based practices.

This chapter presents a review of adaptive behavior assessment from conceptual, technical, and practical perspectives. Although adaptive behavior is a construct with relevance across multiple disability populations served by rehabilitation professionals, its greatest relevance concerns persons with intellectual disabilities (ID). This chapter presents adaptive behavior assessment within an ID context. It begins by describing the population of persons with ID and how they are defined through federal legislation and professional associations. Specific focus is placed on the growing importance of adaptive behavior in the process of identifying persons with this disability. The chapter then presents a review of standardized and informal approaches to adaptive behavior assessment. To illustrate its professional importance and use of best-practice approaches, the chapter then addresses three practice areas where adaptive behavior assessment plays a key role in contemporary practice with persons with ID, including death penalty evaluations, community-based habilitation, and culturally responsive assessment.

Assistive technology (AT) provides powerful tools used to diminish disability, enable activities of daily living (ADLs), and promotes recreational and vocational pursuits. This chapter serves as an introduction to AT tools, patient assessment, person-centered application of AT and resources for patients, and clinicians alike. AT can increase independence, improve quality of life, and aid persons with disabilities in accomplishing educational and vocational pursuits. Although there are an increasing number of commercial technology and fee-based “add-on” programs available to meet the needs of persons with disabilities, this chapter emphasizes emerging technologies and basic complementary computer-based commercial applications, which are commonly found as part of standard operating systems. Computer technology, including Internet applications, serves as an indispensable tool to enhance vocational reentry and personal satisfaction. The chapter has a major emphasis on profiling specific AT solutions that enhance prognostic efficacy of vocational rehabilitation programs.

Poverty and disability are interconnected and are cyclical in nature. That is, persons with disabilities and chronic illnesses are disproportionately represented among those living in poverty and poverty disproportionately affects individuals with disabilities. Socioeconomic status is the most powerful predictor of chronic disease, disability, and mortality. The intersection between poverty and disability and chronic illness is influenced by a host of factors including employment status, educational attainment, lack of insurance, lack of access to medical care, race, ethnicity, sexual orientation, and gender identity. Persons with disabilities living in poverty may have to contend with multiple risks associated with limited resources, high stress, neurobehavioral effects, and exposure to various traumas. This chapter examines how poverty, disability, and chronic illness influence one another, describes the impact of poverty, contributing factors that precipitate and result from living in poverty, and the relationship between poverty and disability, and discusses implications and strategies for counseling.

This chapter discusses clients who have severe personality disorders (PDO’s) and techniques that tend to work with them. Individuals with severe personality disorders, according to the most recent psychological and neurological findings, frequently had an abysmal childhood that included verbal, physical, and sexual abuse. Personality disordered individuals also frequently have low frustration tolerance about their handicaps. One form of personality disorder that is frequently neglected is that of clients who are intensely and frequently angry. Some of the people with the most severe personality disorders are termed psychopaths or sociopaths. Rational Emotive Behavior Therapy (REBT) sees most people who engage in serious addicting behaving as having either one or two serious problems. First, they may have abysmal low frustration tolerance and think that they absolutely need what they want such as they absolutely need alcohol, drugs, gambling, smoking, compulsive sex activities, and other behaviors to which they addict themselves.

The annual American Community Survey conducted by the U.S. Census Bureau is considered the most current and accurate measure of disability prevalence rates. Social work practitioners are uniquely positioned to work in different settings and at the intersection of multiple systems to address the needs of disabled persons. This chapter emphasizes social work’s contributions throughout the lifespan, in work with children and adolescents, as well as adults and older adults to ensure that each receives age-appropriate, holistic, and disability-competent care that is increasingly self-driven and determined. The financing of healthcare and social services, as well as limited coordination of services across the continuum both continue to be in need of greater advocacy. Social workers must direct substantial efforts toward advocacy interventions that ensure that these issues are addressed, and can do so by partnering with disability self-advocates and their families to continue to advance the policy agenda of disability movement.

Rehabilitation counselors have long played a central role in helping persons with disabilities achieve their independent living and employment goals. Although the profession of rehabilitation counseling evolved from the state-federal vocational rehabilitation (VR) program, the professional practice of rehabilitation counseling is no longer restricted to state VR agencies. This chapter helps the reader understand rehabilitation and the impact of related legislation on rehabilitation counseling practices and the inclusion and participation of people with disabilities. The chapter explains the evolution of rehabilitation counseling and professional issues related to the profession, including certification and licensure. The chapter also provides the basic principles of ethics, ethical behavior, and risk management related to the professional practice of rehabilitation counseling.

People with disabilities are one of the most stigmatized and marginalized groups in the United States. Traditionally, rehabilitation counselors use a supply-side employment approach to provide employment services for people with disabilities, with a focus on medical, psychological, social, educational, and vocational services to improve functioning, stamina, and job skills of people with disabilities. Demand-side employment, on the other hand, has a focus on workplace culture and disability inclusion practices (and the interaction of employer demands and the environment [e.g., the job economy]) as predictors of high-quality employment outcomes for people with disabilities. This chapter reviews the literature related to demand-side employment approaches to create employment opportunities and improve the quality of employment for people with disabilities. It also discusses employers’ perceptions about hiring people with disabilities. The chapter concludes with a discussion of effective disability inclusion policies, procedures, and practices that increase employment opportunities and quality of employment for people with disabilities.

This chapter provides an overview of the salient psychosocial aspects of chronic illness and disability. It reviews the models of chronic illness and disability; psychosocial, environmental, and attitudinal aspects of chronic illness and disability; culture, chronic illness, and disability; adjustment to disability models and concepts; and sexuality, gender identity, chronic illness, and disability. In addition, the chapter provides readers with an in-depth review of specific psychological constructs relevant to living with a chronic illness and disability as well as social factors that encompass a wide array of interpersonal, environmental, and attitudinal factors, such as social support, access, accommodations, and ableism. The chapter also discusses how culture influences the experience of living with chronic illness and disability, reminding readers to consider the individual’s cultural factors and the impact of both their culture and Western culture on their experience.

This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.

This chapter briefly discusses the history of the Caregiver Support Act and its specific components and explains how the Caregiver Support Act provides resources to older adults and people with disabilities. It provides an overview of the current status of family members serving as caregivers, with special attention to grandparents raising grandchildren. It then discusses a current profile of relative caregivers raising children in the United States; reasons for the increase in relative caregiving; and issues facing grandparents raising grandchildren. It also provides some background into the literature and promotes an awareness of issues that grandparents face as primary caregivers. A literature review examines some of the current issues and services needed. The chapter discusses resources and services designed to meet the needs of grandparents raising grandchildren, and reviews programmatic responses through the national resources. Finally, the chapter outlines some best practice interventions for review in the text.

This chapter helps the reader to understand the history of the Americans with Disabilities Act (ADA), specific components of the ADA and how the ADA provides resources to older adults and people with disabilities. The ADA, while groundbreaking, was not initially intended for people with disabilities rather than for older adults. As time progressed, however, the benefits of the ADA were much more far-reaching than originally intended, especially for aging adults with disabilities. The individual titles of the ADA have had some dramatically positive and specific impact for older adults wishing to remain in their homes or in their communities as long as possible. Although the ADA is still in its young adulthood, the benefits of the ADA have only grown as new and further linkages, such as the ADRCs, have developed in all regions of the United States.

This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.

This chapter briefly discusses the history of the Affordable Care Act (ACA) and community and presents specific components of the ACA in relationship to community prevention. The chapter deals with specific aspects of the legislation that impact older adults and people with disabilities. It presents a short review of the ten titles: Title one: quality, affordable health care for all Americans; Title two: role of public program; Title three: improving the quality and efficiency of health care; Title four: prevention of chronic disease and improving public health; Title five: health care workforce; Title six: transparency and program integrity; Title seven: improving access to innovative medical therapies; Title eight: Class Act; Title nine: revenue provision; Title ten: strengthening quality, affordable health care for all Americans. The chapter explains some of the legislative highlights, policies, and programs that have been articulated within each of the specific titles of the ACA.

This chapter discusses the history of the Medicare in the United States; specific components of Medicare Parts A, B, C, and D; and how Medicare provides healthcare resources to older adults and people with disabilities. Medicare, a healthcare program perceived to be a universal program rather than one based upon a needs test, currently provides healthcare to people who reach the age of 64. Comprised of four parts, it can provide hospital care, general healthcare, hospice care, home healthcare, and prescription drug coverage. The chapter provides an overview of the Medicare program, its various components, and aspects of healthcare that are covered through its component parts. Although there are currently no needs tests or limitations as to who qualifies for services, the chapter concludes with some dilemmas for the future of healthcare coverage, including “an empty pot at the end of the rainbow” and rationing of healthcare services and procedures.

This chapter helps the reader to understand the history of the legislation related to substance use and misuse. It provides specific components of the Controlled Substances Act. The chapter discusses how legislation related to substance use and misuse provides resources to older adults and people with disabilities. Since substance use/misuse is often perceived as “blaming the victim”, models of care and rehabilitation are often not taken into serious consideration. Prevention, screening, detection, and intervention strategies to meet the needs of baby boomers as they age will be another challenge. Evidence suggests that substance use has been on the rise for the population in general among people living in the community. The chapter reviews programs and services and issues. The chapter concludes by laying out some challenges for the future in the area of substance use and abuse among older adults and people with disabilities.

This chapter presents some of the opportunities and challenges faced by people with physical disabilities in obtaining employment consistent with their career aspirations, interests, and capabilities. It helps the reader recognize employment issues related to people with physical disabilities. The chapter discusses the human capital theory and the dualistic theory of labor markets. It describes how education affects lifetime earnings and employability. The chapter explains the impact of the great recession and be familiar with successful employment strategies for people with physical disabilities. Although there has been significant amount of research conducted over the past 50 years in rehabilitation counseling and job placement, most of this has been descriptive in nature, with many of these efforts attempting to determine relationships among existing data rather than a purposeful approach to define what types of intervention or services appear to work best with what specific populations, under what specific conditions.

This chapter describes the landscape of federal mandates for serving transition-age youth and students with disabilities as outlined in the Individuals with Disabilities Education Act (PL 101-476) and the Rehabilitation Act of 1973 (PL 102-569) as amended by the Workforce Innovation and Opportunity Act (PL 113-128). It explains the overlap between secondary education and rehabilitation counseling services in secondary transition preparation and planning to improve coordination for better postsecondary outcomes. The chapter describes strategies for sharing responsibilities among key transition stakeholders to facilitate positive outcomes for youth and students with disabilities. The assumption that collaboration will just happen across agencies in transition-related efforts is not realistic. For a growing number of youth and students with disabilities transitioning from secondary education, rehabilitation counseling is the bridge to post-school environments such as employment and education.

Poverty can be defined as economic deprivation. This chapter provides an explanation of the process through which a poor individual is at higher risk for acquiring a disability or chronic health problem. This chapter is divided into two parts. The first part focuses on the connection between poverty and disability: poverty as a risk factor for disability; the impact of poverty-related psychological factors on career development and health; and the impact of social role devaluation on individuals who are poor and have a disability. The second part discusses how poverty and disability affect career counseling and job placement and what counselors can do to assist persons who are poor and disabled to make effective career decisions and obtain employment. The chapter enables the reader to implement counseling strategies that can ameliorate the impact of disability and poverty on career counseling and job placement.

The topic of work analysis is frequently given very limited coverage in textbooks related to occupational development, vocational behavior, rehabilitation counseling, and other rehabilitation healthcare fields; this is truly unfortunate. A comprehensive understanding of the requirements of work is essential to the career development and employment of individuals with disabilities; work analysis provides the foundation for building organizational processes that are effective, inclusive, and legally defensible. This chapter provides the reader with a thorough understanding of work analysis through coverage of its definition, history, methodological considerations, and applications. The workplace of today is a very different entity from what existed just a decade ago. Work analysis is a systematic process used to understand the nature of work. Although there are many methodological considerations to be contemplated and numerous existing work analysis tools available to the practitioner, the methods chosen must be appropriate for the purposes at hand.

Work is the primary organizing structure of life, and the significance of work in the lives of individuals with disabilities has been radically altered over the past half a century. This chapter introduces the centrality of work and discusses the role and importance of work in meeting basic human needs. It identifies specific outcome domains for the three human needs of survival and power, social connection, and self-determination and well-being. The chapter describes the Illinois Work and Well-Being Model and discusses how it can be used to guide rehabilitation counseling case conceptualization. When the centrality of work is the core value guiding vocational rehabilitation services for individuals with disabilities, the rehabilitation counselor is working to increase the individual’s power, social connection, and self-determination. These outcomes can be operationalized by multiple outcomes and cannot be measured by the traditional dichotomous outcomes of employed versus unemployed.

This chapter reviews how the practice of Vocational rehabilitation (VR) counseling has facilitated or encouraged employment of people with disabilities since the establishment of a national policy on employment of people with disabilities. It examines the intent and the impact of Ticket to Work and Self-Sufficiency Program of the Ticket to Work and Work Incentives Improvement Act of 1999. The chapter presents an overview of key legislation with implications for employment to provide a cursory understanding of the purpose and significance of these laws for people with disabilities. It presents basic information on the Ticket and amendments to its regulations and program components. The chapter provides a labor force characteristics of people with disabilities. It presents a discussion of policy and practices of one state VR agency and reviews the impact of the Ticket and implications. The chapter discusses the recommendations for future directions.

There are currently six primary government systems of occupational classification used to classify civilian work in the United States. This chapter discusses the systems most pertinent to vocational guidance and Transferable skills analysis (TSA). To improve cross-references from one system to another, the Federal Office of Management and Budget requires that each system directly relate to the standard occupational classification in some way TSA is a time-honored and time-tested method for reasonably identifying similar or new jobs for people following illness or disability, for those seeking alternate work opportunities for “change”, advancement, or transition to a new employment setting. The most critical ingredient in the determination process is the activity and preparation of the practitioner. In cases where the online O*NET or a commercial computer program is used, information that is input to the program is determined by the practitioner.

The state–federal Vocational rehabilitation (VR) system addresses employment disparities faced by people with disabilities by offering services to target individuals’ employment needs and promote consumer choice and empowerment. Vocational rehabilitation can play an important role in enhancing the psychosocial and vocational outcomes of people with disabilities. This chapter provides an overview of the state–federal VR program and the rehabilitation process and services associated with the public rehabilitation system. It reviews the best practices and outcomes of VR within the context of evidence-based practice. The chapter discusses the role and qualifications of VR professionals. There is empirical evidence demonstrating the effectiveness of state VR services in returning people with disabilities to competitive employment. Central to the effective delivery of VR services is the rehabilitation counselor, with support found for counselors with graduate training in rehabilitation counseling being more effective than counselors without degrees in rehabilitation counseling.

Employment is central to one’s identity, sense of achievement, and the overall quality of life. This chapter explains how and why employment is central to an individual’s life. It defines career counseling and explains the role of the rehabilitation counselor in the career counseling process. The chapter describes the stages of change and interventions that are commonly used in the career-counseling process. The role of the rehabilitation counselor in the career-counseling process is critical in assisting individuals with disabilities as they navigate through their journey in the pursuit of competitive employment. Rehabilitation counselors who embrace an active role in addressing these concerns, which are often perceived as barriers by the individual with a disability, will have a greater chance of increasing their likelihood of successful outcomes and growth. Strategies to facilitate change as well as frameworks that are more conducive to the diverse needs of individuals with disabilities are introduced.

The work of Rehabilitation professional (RP) is complex, spanning a wide range of competencies and practices. This chapter considers the practice of job development across several key professional processes. It identifies environmental trends that impact job development and explains how to develop collaborative relationships with employers in the community. The chapter discusses the importance of matching the job seeker to the employment outcome they achieve. It ends by pointing out that the work of the RP is important, not just to people with disabilities but also to businesses, employers, policy makers, and communities. Although this work can be at times demanding, frustrating, and perplexing, it is always worthwhile to return to this main truth: What RPs do contributes significantly to improving the employment outcomes and the lives of people with disabilities.

Social cognitive career theory (SCCT) is designed to promote an integrative understanding of career behavior. This chapter briefly describes SCCT’s interest and choice models and reviews research that has applied the theory, or some of its constructs, to the career behavior of people with disabilities. It focuses on the interest and choice models both because of space limitations and because these two models, which are interwoven, have so far drawn the most attention in SCCT-related research on the career development of people with disabilities. The findings of a number of studies suggest that self-efficacy beliefs are related to the interests, goals, and employment experiences of persons with a variety of disabilities, both in the United States and abroad. Additional directions for future research and practice can be drawn both from within the literature on disability and from the larger literature on SCCT, including its applications to other forms of diversity.

The vocational rehabilitation profession in the United States has existed for a century. In that time, the focus on improving vocational functioning toward employment for Persons with disabilities (PwD) has consistently been a priority in the quest to maximize independence. This chapter offers essential knowledge needed to successfully improve employment among ethnic minority populations of PwD. It discusses the importance of conducting race- and ethnicity-related research and describes the working-age population of ethnic minorities with disabilities. The chapter explains the triple threat phenomena of race, poverty, and disability along with the concept of intersectionality. It discusses the differences in employment outcomes of persons with disabilities based on ethnicity and describes the role of ethnicity in employment discrimination due to disability. The chapter helps the reader identify several strategies that vocational professionals can use to work effectively with ethnic minority populations of individuals with disabilities seeking employment.

Disability is experienced by Americans in every corner of America. This chapter provides and discusses national statistics on the educational, employment, and financial experiences of people with disabilities in the United States (U.S). The statistics presented are calculated from the American Community Survey (ACS), a large, annual, nationally representative dataset collected by the U.S. Census Bureau. The chapter provides a description of the ACS, including how it measures disability and employment. It presents the findings on heterogeneity in disability prevalence, heterogeneity in employment rates, heterogeneity in broader socioeconomic outcomes, and occupational and industrial composition of workers with disabilities. The chapter examines overall differences between individuals with and without disabilities. It concludes with a discussion of the implications that the ACS data have for the state/federal vocational rehabilitation program as well as an overview of the ACS data products that are available to provide national and local statistics.

Entering or reentering the workforce can be a challenging task for individuals following disabilities. Appropriate use of vocational interest measures in career counseling, however, can facilitate this process. This chapter reviews and familiarizes the readers with the construct of vocational interests, to update them with the most recent advances and new findings in interest research, especially with regard to gender differences in interests and the relationship between interests and performance. It provides a brief description of appropriate interest measures for rehabilitation counseling, their psychometric properties, and their usage. The assessment of interests is the starting point and a critical component in career counseling for clients with disabilities. Following interest assessment and assessments of other important individual characteristics, such as work values, aptitudes, and skills, additional information and resources are provided based on clients’ needs to facilitate their career entry or reentry after disabilities.

Women who have disabilities face many challenges that, in combination, can have a unique impact on workforce entry, career decision-making, and employment outcomes. In light of these direct outcomes and the critical roles that work can play in alleviating poverty and increasing quality of life, this chapter adapts a client-focused considering work model to highlight the barriers to work for women with disabilities; discuss ways to assess these barriers; and provide a framework for evaluating the considering work process and incorporating varied interventions to address the unique psychosocial, financial/legal, vocational, and medical barriers to employment for women with disabilities. The chapter provides a broad overview of the demographics of women with disabilities. The client-centered considering work model provides a solid framework for exploring and assessing the career decision-making process for women with disabilities.

Today, society is seeing and hearing about individuals with significant disabilities working in their local communities. For many individuals with disabilities, this goal has been achieved with a vocational rehabilitation service option called supported employment and its extension called customized employment. This chapter presents the definitions of both supported employment and customized employment as characterized by Workforce Innovation and Opportunity Act. The chapter presents two models: supported employment, which is an evidence-based practice backed by decades of empirical research; and customized employment, a promising practice gaining more momentum as a viable vocational service option. Both offer opportunities for real jobs for real pay for individuals with severe disabilities. Despite the empirical evidence for these models and against segregated services, we have far to go before real work for real pay is an option for the majority of individuals with severe disabilities.

Cognitive information processing (CIP) theory applies cognitive psychology and information-processing strategies to making career decisions. The client’s career concern is defined as a gap between the current situation and their ideal state. This chapter enables the reader to be familiar with key elements and research supporting cognitive information processing theory. It describes the Career Thoughts Inventory (CTI) and applies it to a case example. The chapter discusses relevant research on CIP and CTI as applied to people with disabilities. It summarizes research on dysfunctional career thinking and the CTI and applies concepts and elements of CIP to a case example of an individual with disabilities. Having empirically based theories and tools is a requisite for effective career counseling. The CIP theory and the CTI have yielded substantial research supporting their utility and application to the career decision-making process for people with and without disabilities.

This chapter describes aging with respect to people with acquired versus congenital disability. There is an emphasis on people with lifelong developmental disability, including intellectual disabilities, Down syndrome, and cerebral palsy. General aging issues for this population are described, and then specific aging issues that are more prevalent and problematic are identified. The need for more vigilant health promotion and education is discussed.