This chapter reviews the current scope of practice in rehabilitation counseling and the impact that counselor licensure legislation has on the field concerning eligibility for counselor licensure and becoming an independent rehabilitation practitioner. It defines the foundational skills and scope of practice required for effective, competent, and ethical rehabilitation counseling practice. The chapter explains a psychosocial model for rehabilitation counselors (RCs) who want to structure therapeutic interactions with clients who have chronic illnesses and disabilities. The counselor uses the counseling relationship to help clients draw from their personal history, knowledge, coping abilities, resiliency skills, and overall life experiences to derive meaning. Counselors across a variety of work settings and theoretical orientations must be proficient, competent, and ethical in working with a range of people with disabilities who may be culturally different. There are both universal and specific counseling approaches, programs, and services used during therapeutic interactions for people with disabilities.

This chapter explores a range of topics related to obesity, including its prevalence, medical aspects, and associated complications. Other relevant areas include the psychosocial factors pertaining to societal attitudes and individual mental health issues, vocational implications concerning work/wage discrimination, Social Security regulations, and Americans with Disabilities Act (ADA) protections. The chapter also discusses the implications for rehabilitation counselors regarding vocational and mental health counseling. The implications of working with persons who are obese or overweight may be broken down into mental health counseling and/or vocational counseling. Obesity and related medical complications have soared to the forefront of medical conditions that lead to premature death, discrimination in employment, compromised quality of life, and negative psychosocial implications. Counselors who are aware of the medical, psychosocial, and vocational implications of obesity can assist clients in a variety of ways, keeping Olkin’s (1999) recommendations in mind regarding disability-affirmative therapy.

Acceptance of disability, for most people, evolves gradually over a span of years filled with instructive experience. This chapter pursues the lifelong process of acknowledging disability, physically, intellectually, emotionally, and spiritually, further than usually is done, beyond the range of normalization to higher levels of self-actualization that are fostered by the disability experience. Different variants of denial are evident in the shock, expectancy of recovery, and defense stages. Nancy Kerr’s stages of adjustment to disability are a model of psychological development focused on a particular segment of the population in a limited aspect of their lives. The continuity of the rehabilitation process of disabled people with the human development of people in general is stressed. As a result of the spiritual renascence taking place in current times, more and more people are coming to value and seek the transcendence of lower consciousness, and this includes increasing numbers of disabled people.

This chapter emphasizes the psychological and tangible benefits of belonging to a group with a solid, political powerbase. Lawmaking is a basic power approach designed to give freedom and equity to groups of people. Limitations on the ability to foresee have long created socioeconomic problems for disabled people, and these, in turn, generate difficulties in psychological adjustment. In recent years, however, the confluence of many forces has led to the articulation of a new understanding of disability and the creation of protective legislation. Building upon the energy and vision of the civil rights and women’s movements, a disability rights movement began to coalesce and advocate for needed legislation. The basic survival programs for individuals with disabilities are contained in the Social Security Act. Both the federal education for all handicapped act and parallel state statutes have mainstreaming as a prime goal.

There is power in revisiting the underlying foundational principles of our past and looking at how they can inform our present and future functioning. This chapter looks back at the historic foundational principles of rehabilitation psychology (RP) and shows the links to current research on the psychology of well-being and explores implications for providing meaningful interventions that could improve the lives of persons with disability and chronic illness. It reviews how positive psychology (PP) approaches have been used for people with disabilities (PWD), presents an overview of the development and structure of well-being therapy (WBT), including a literature review, and then demonstrates how it could be applied to people with spinal cord injury (SCI). The chapter concludes with a discussion of the broader implications for utilizing these approaches more widely in RP as well as a cautionary note.

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.