School counseling incorporates a variety of direct and indirect student services that focus on academic achievement, success, and personal development of students. CACREP and American School Counselor Association standards guide school counselors in upholding ethical practice and the delivery of counseling services. Short-term individual school counseling can aid in student success and achievement. This chapter examines individual counseling theory and its application to empirically based practice in the school. The efficacy of person-centered counseling, solution-focused brief therapy, cognitive behavioral therapy, reality therapy, narrative therapy, and gestalt/expressive therapies are demonstrated through case studies. Practical applications and interventions are provided through case studies.

As with any profession, the roles, responsibilities, and foci areas will evolve as the technological and societal needs change. This chapter begins by providing foundational knowledge about the school counseling profession and its historical pathway. Key events in the United States have shaped the profession in recent years, leading to identification of the current trends affecting school counselors. Advancements in technology, increasing responsibilities, and future directions will be discussed.

According to the American School Counselor Association, school counselors have both an ethical and professional responsibility to help all students meet or exceed academic standards by supporting them with academic, career, and social-emotional development, with consideration for both the strengths and challenges that result from working with students with disabilities or other special needs. However, students receiving special education services are often excluded from school counseling interventions. The purpose of this chapter is to address the need for school counseling interventions related to exceptional students. This chapter will highlight this issue and provide recommendations for school counselor collaboration with special education staff to ensure appropriate service delivery to all.

The American School Counseling Association (ASCA) published a list of appropriate and inappropriate school counseling duties to serve as a guide for PK–12 education related to the intended role and focus of the school counseling profession. School counseling practicum and internship students, as well as recent graduates, are often surprised and frustrated with what they experience as an incongruency between their training focused on an aspirational model and real-life counseling practice. The reality of school counseling practice is that contracts almost always include an “other duties as assigned” clause for both classroom teachers and professional school counselors that require activities that seem unrelated to the training or role of school counseling. This chapter will provide a framework for understanding how these “inappropriate duties” can be embraced by practicing school counselors (while at the same time advocating for change) in order to make connections with students, encourage collaboration, and demonstrate creative approaches to various duties.

This chapter addresses gender and identity issues in PK–12 education, including gender fluidity, students who identify as transgender and the transitioning process, students who identify as LGBTQ+, and general school-based advocacy and safety issues. This chapter offers ways to create safe and affirming spaces for LGBTQ+ students in schools. It serves as a foundation for seeking more knowledge to best serve these affinity groups. Scholarly support and practitioner recommendations for school-based support including student-led groups, staff training, parent education, and safe school culture curriculum are presented.

While the community mental health profession has provided online counseling interventions regularly in the form of telehealth counseling, this counseling platform is not as frequently offered, nor explored, in the scholarly literature related to school counseling. With the onset of online PK–12 instruction throughout the United States in response to the COVID-19 pandemic, school counselors were forced to adjust their reach to align with the virtual platform. This chapter explores the best practice recommendations related to providing school counseling interventions in an online/virtual format.

Classroom engagements and lessons are an important part of the role of school counselors. Classroom guidance allows for systemic change and collaboration with the teachers. Classroom guidance should be implemented in PK–12 settings and focus on academics, career, and personal/social domains consistent with a comprehensive school counseling program. This chapter will focus on developmentally appropriate and culturally relevant classroom guidance lessons/presentations for each level of school counseling. A discussion of relevance, scholarly support, best practice, classroom management strategies and practical application will be provided.

This chapter serves as an introduction to building a comprehensive school counseling program (CSCP). In a CSCP, school counselors serve as collaborative leaders advocating for systemic change using data and incorporating an equity lens with every decision made. CSCPs are developed, delivered, and maintained to promote student success in academic, career, and social/emotional domains. Examples of how varying school districts throughout the United States approach school counseling programs are included. This chapter also provides guidance for school counselors through the process of developing a CSCP. Scholarly support for the benefits of a CSCP are presented, and practical application of the model, including the benefits of a CSCP for multiple stakeholders, are discussed.

Implementing data-driven school counseling interventions helps ensure school counseling program efficacy. School counselors benefit from being knowledgeable regarding the various types of data available in schools and having the skills to appropriately analyze assessment results to drive school counseling interventions and implement systemic change. Data can be used to advocate for equity and inclusion and identify opportunities for engagement.

We present the benefits of collaborations with school staff to support student success from research-based and applied perspectives. We make recommendations for staff engagement regarding presentation of data, professional development training opportunities, and school community-building strategies. We discuss school counselor self-advocacy, specifically regarding situations in which school policy may conflict with ethical guidelines.

This chapter focuses on the role of professional school counselors as related to the importance of collaborating with the school and local community to promote family engagement. Systems theory is applied, and research addressing the positive academic implications related to family engagement is presented. Specific strategies and useful tips are discussed. The American School Counselor Association (ASCA) National Model carefully outlines the role of school counselors in consultation and collaboration engagement with families and community stakeholders. Additionally, ASCA tasks school counselors with addressing barriers to these partnerships, such as communication and access (2016). Ideally, school counselors in training gain knowledge and skills in this area during their graduate training programs, but many gain most of their preservice experience in this area during their field experiences (i.e., practicum and internship). This is because, in large part, CACREP standards do not currently require a graduate-level course in family–school collaboration, although some programs instill this content into other courses. As PK–12 student needs increase and school counselors must partner with families and communities more than ever, it is advantageous for counselor educators to add specific family-community-school coursework into graduate training programs. The authors of this chapter will use the terms parent, family, and caregiver to describe a variety of constellations that include caregivers, guardians, home environments, and other words used in related research and broader conversations as it relates to systems in which our students live.

There are two key foci of the ASCA Student Standards. The first focus is the ASCA Student Standards: Mindsets & Behaviors for Student Success: K-12 College-, Career-, and Life-Readiness Standards for Every Student, which are standards used by school counselors to support students’ academic success, social and emotional learning, and college and career readiness. The second focus is the ASCA School Counselor Professional Standards and Competencies, which delineates standards for school counselors’ professional development and promotes the planning, delivery, and evaluation of comprehensive school counseling programs. Moreover, the authors provide examples of school counseling interventions and ways to overcome potential roadblocks for successful implementation, as well as recommendations for integrating social justice advocacy when using the ASCA Student Standards.

Home life and environment outside of school have a great impact on student wellness (socially and emotionally), academic success, and career trajectory. This chapter will highlight and address the impact home life and caregivers have on the social-emotional learning, academic success, and career and college readiness of PK–12 students. Substance abuse, poverty, homelessness, immigration and incarceration, and deployment will be addressed. Supportive and practical interventions for the professional school counselor will be provided.

Although culturally relevant interventions and social justice advocacy will be integrated throughout the text, this chapter focuses on marginalized communities, antiracism practices, and the Black Lives Matter movement as it relates to serving BIPOC students and discusses the impact of cultural mismatch and culturally incompetent school-based interventions. Resources for cultural awareness, knowledge, and skill development will be discussed, as well as the opportunities for addressing the school-to-prison pipeline, historically underserved populations, and the opportunity gap.

This chapter provides an introduction to group counseling in schools. The American School Counselor Association Position Statement related to school counseling group interventions is presented and discussed specific to application and best practice recommendations. The basics of group counseling are outlined to guide those entering the profession, including considerations for this time-effective intervention. Multicultural and social justice advocacy opportunities within group work are highlighted. Developmental considerations for running groups as the elementary, middle/junior high, and high school levels are discussed.

The chapter will serve as an overview of the ASCA National Model and provide a clear connection with the translation from an aspirational ideal of school counseling to the reality of school counseling practice. The four main components of the National Model will be presented, including define, manage, deliver, and assess. This chapter will address and provide examples as to how these components are often offered in current models of PK–12 education—both in brick-and-mortar schools and online academies.

The legal requirements and ethical obligations of professional school counselors clearly state our responsibility to the welfare of children. However, the mandated reporting process can be intimidating for both counseling students and seasoned professionals. This chapter will define the classifications of mandated reporter, guidelines for professional practice will be presented, and a framework for gathering information and documenting the report will be suggested. Other important aspects that are covered in the chapter include confidentiality, ethical and cultural implications, and the necessity for maintaining professional boundaries with colleagues following a mandated report. The authors share personal experiences throughout the chapter, omitting information and using pseudonyms to protect the privacy of our former students.

In this chapter, students will explore the concept of strengths-based counseling and related interventions as the various roles and specific interventions are applied through this lens as the very foundation to the work of school counselors. Research-based support for this perspective and practitioner guidance is included. Case studies and scenarios demonstrating the difference between a traditional “deficit-based” perspective where a clinician or counselors initial view of a student is considering a “what’s wrong” approach will be compared to a “what’s going well” approach where school counselors collaborate with school staff and partner with students to build on student strengths to ensure academic success and improvement.

Considering the documented increase in mental health concerns, violence and trauma, the role of the school counselor related to prevention and response to these and other school crisis will be discussed. Trends in current scholarly literature point to the increase in student/family depression and anxiety related to the current pandemic which scholars suspect will result in a significant increase in student suicidal ideation and mental health concerns.

In this chapter, we provide an overview of career and college readiness initiatives in the United States. We also briefly review counseling and career development theories that are useful for conceptualizing P–12 career and college readiness interventions. Finally, we discuss inequities that exist across specific student populations and how those affect career and college outcomes.

In this chapter, we discuss second and third grade students with emphasis on the development of career and college readiness capital. We explore the importance of social emotional learning for the development of prosocial behavior and employability skills and the benefits of service learning. Parent involvement in career readiness is included with strategies for assisting parents to build skills for helping their children explore careers.

Late childhood is a pivotal time in career and college readiness. We examine the role and influence of cognitive development as well as peer support and gender identity development. We also explore the development of efficacy, self-regulation, and executive functioning and discuss their connection to career and college readiness. Finally, this chapter culminates with a discussion of how to support students during the fifth- to sixth-grade transition.

Middle school students love to learn about themselves including their interests, values, and aptitudes. In this chapter, we review developmental milestones occurring in middle school, the impact of social media use, middle school career interventions, and the integration of technology in the career counseling curriculum. In addition, we explore ways to engage parents and faculty and introduce career and technical education.

Students’ postsecondary preparation is a K–12 endeavor and involves learning about oneself, career pathways, and the many options for future work and lifestyle choices. School counselors can help students and their families understand the complexity and nuance of making a postsecondary choice. In this chapter, we address some of the intricacies of the postsecondary choice process and provide resources to help students and families.

In this chapter, we review career development strategies specific to PreK–first grade. Special attention is given to students psychosocial, cognitive, and gender development related to career. We focus on play therapy techniques in classroom lessons and innovative content integration such as the use of problem-based learning and design model thinking to promote career efficacy. Finally, we highlight techniques for helping teachers develop career strategies for the classroom and for parents to begin to develop career and college mindsets in the home.

In this chapter, we focus on helping students narrow down their future plans and engage in exploratory activities to more concretely prepare for their postsecondary transitions. We review Social Cognitive Career Theory and the Theory of Career Construction as frameworks for designing career and college readiness interventions. Finally, we highlight interventions to help students identify and hone in on strengths as well as to gather more information about themselves and details associated with potential future options.

In this chapter, we review unique career and college readiness considerations related to a variety of subpopulations of students. We share career and college-related statistics and focus on identifying personal and systemic barriers and inequities that students from these diverse populations might encounter. Finally, we offer suggestions for how to identify, advocate for, and address the unique career and college readiness needs of diverse students.

The focus of this chapter is designing curriculum to meet the career and post-secondary readiness needs of P–12 students. In this chapter we discuss how school counselors develop school specific curriculum plans using national and state standards, data summaries, and the school and district improvement and strategic plans as guide posts. Finally, we conclude by reviewing methods for assessing student learning outcomes.

Eighth grade is a time of distinct change and transition. In this chapter, we discuss the significant decisions eighth graders are asked to make regarding careers and how they can be supported to make these choices. Information on high school secondary track options, how to work with parents, and examples from a school counselor and district leaders are provided.

Ninth grade is a critical transition year where students’ academic habits and choices set the stage for future possibilities. In this chapter we address the importance of career and college advising as well as assisting students in developing individual learning plans to map how they will approach preparing for their future. Interventions focus on self and career exploration as well as the development of strong academic habits and dispositions.

In this chapter, we focus on career development and environmental influences for 10th graders and we highlight how Super’s Life-Span Life-Space theory and Social Cognitive Career Theory can be useful for conceptualizing these students. We also discuss factors that influence students’ career and postsecondary decision-making and goal-setting. Finally, we offer suggestions for addressing many of the internal and external factors that can negatively affect career and college readiness.

In this chapter, we provide an overview of professional competencies that are important for school counselors or others who plan to engage in career-related work in P–12 schools. We identify relevant professional documents that address these competencies in addition to ethical and professional responsibilities related to career counseling and development. We also discuss specific knowledge and skill areas as they relate to career and college readiness counseling and provide information about professional credentials related to career counseling.

In this chapter, we discuss interventions to help students take the final steps needed for their postsecondary transitions. Also, we reference the Theory of Career Construction in conceptualizing the career developmental needs of 12th-grade students in addition to focusing on the importance of values clarification. Interventions we highlight target summer opportunities, self-advocacy, and final career and college preparation.

In this chapter, we discuss the purpose of career and college readiness assessment in P–12 schools and review numerous factors that should be considered when determining which assessments to use. We provide a selected list of formal and informal assessments related to a variety of career and college readiness constructs. Finally, we provide considerations for interpreting assessment data and using it for school counseling program planning.

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 provides a backdrop to our current social security program and an overview of some models for social security programs in Europe and Canada. It explores the genesis of the social program in the United States. The chapter also explores contents of the original social security act (SSA) and compares the titles and programs mandated through the current SSA. It offers some guidelines for the current administration of the program, examines the debate around current proposals for revision, and reviews why these proposals are current issues for consideration. The chapter then presents the current social security system, which provides for older adults, but has also grown to cover dependent women and children. Although many people have argued for their vision to privatize the system, the reality is that there is much more political support to maintain the program as a safety net program rather than a means-tested program.

This chapter helps the reader to understand the history of the Elder Justice Act (EJA). It provides specific components of the EJA and how programs and services flow for older adults and people with disabilities. The chapter discusses the limitations in programs and services within the EJA. The EJA requires the oversight and the appropriation of federal funding to protect people growing older and people with disabilities from abuse. It addresses legal issues with a special emphasis on the concept of a power of attorney. The chapter explores several legal issues that face older adults. It also address elder abuse, power of attorney, and a differentiation made between the types of power of attorney and the healthcare power of attorney. In addition, the chapter explores legal services provided to older adults as a result of the Older Americans Act, and outlines the challenges within the realm of legal issues.

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 explores health promotion frameworks, to showcase their role vis-à-vis health policy and programs, and discusses three specific frameworks. Health promotion frameworks are theoretical conceptions of how health behavior can be addressed. These frameworks are conceives for the purpose of program and policy development. The health promotion frameworks are the health belief model (HBM), the theory of reasoned action, the transtheoretical model of stages of change. This chapter addresses these three questions; however, prior to discussing these questions and answers, it is essential to understand some well-known health promotion frameworks. Although a number of health promotion frameworks exist in the literature. It focuses on three that can be specifically applied to older adults. The chapter showcases use of health promotion frameworks in the program planning process for older adults can have a number of positive outcomes.

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 be familiar with the role coalitions play in advocacy and policy development and to understand the various types of coalitions that affect the policy landscape. It also helps the reader to be familiar with the various roles that exist within groups and coalitions that contribute to the success or non-success of the group process. A number of strategies can be used to develop initiatives to impact one’s advocacy efforts. These strategies can be used to promote the development of new programs and services and can include the use of and/or development of coalitions, the media and media advocacy, and consumer advocates. The chapter addresses each of these strategies in greater depth. It outlines a variety of issues related to coalitions, group development, and coalition building for aging policies and programs.

This chapter address a number of areas that will affect the lives of people as they age or people who are older adults. Philosophical paradigms, statistics, evidence-based approaches, dealing with the media, making people aware of new technologies, and preparing for communities to best deal with issues of aging are all major issues of concern. It provides a range of issues; however, the chapter provides an overview of the most significant ones to be addressed or to require intervention. It cites 10 major challenges that the future will bring, in reality, policy advocates will have to be prepared to address and deal with these challenges by using innovative strategies for policy development and policy change. The chapter addresses policy development and program design to meet the needs of an aging and ability-challenged society are unique challenges.

Aging policy is shaped by a variety of demographic, social, and economic factors. However, these factors are not the only influences on the development of public policy or aging/disability policies. Philosophical paradigms and theoretical frameworks also influence the actual development of policy and play a strong implicit role in how public policy is drafted. Values and philosophies guide the development of specific philosophical paradigms and shape how aging and disability policy is developed and implemented. This chapter explores how these realities play a role in the development and implementation of public policy and aging/disability policy. It showcases some of the realities that may prevent the implementation of the policy or program as envisioned. As a safeguard against a subjectively devised policy and program base, objective evidence and empirically driven initiatives can be developed by aging and disability policy advocates.

This chapter helps the reader to understand how to use tools such as health behavior models, the media, coalitions, and needs assessments to bring a vision to fruition and how to use advocacy tools for policy and program development. It also helps them to understand how to use advocacy tools to influence the practice arena for older adults and people with disabilities. The chapter reviews the various tools and strategies, along with policies that have been addressed thus far, and integrate these issues and skills with one’s vision for either program planning or policy development. When considering program development, all tools and strategies related to policy development apply equally. Some additional strategies or tools to use for program development include the health behavior models. This chapter attempts to integrate the theories and concepts and suggest how a program planner or policy advocate can apply them.

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 focuses on sources of evidence for evidence-based policy development. It explores some of the dilemmas with developing an evidence base and provides a range of empirical sources within the aging and disabilities arenas that can be used in building an evidence-based approach to policy development. The journey, however, will not be without struggle—since philosophical paradigms, and social and economic factors will interface and play a role in the development of evidence-based policy. The chapter helps the reader to be aware of healthy people 2020 benchmarks that are used to guide program planning and policy development. Benchmarks currently have been established in order to identify where health goals for the nation and individual states should be, and the program is evaluated routinely by local and state health departments. Healthy people 2020 is also used to gauge the impact of health policy.

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 deals with one subset of these strategies, namely using media as a part of the advocacy process. The chapter reviews a number of specific media advocacy strategies and provides some innovative approaches to sending a message relevant to program or policy development. Media advocacy is the strategic use of any form of media to help advance an organization’s objectives or goals. Media advocacy explores a number of key issues and serves to present strategies that can be helpful in the development of innovative human service opportunities and educate the general public. These strategies can be used as stand-alone methods or in combination with each other. These strategies build on understanding one’s health and help-seeking behavior and enable advocates to influence a wide number and array of people with limited resources and energy.

This chapter discusses Older Americans Act (OAA). In the original act, the principles are defined through six specific titles. Title one: outlines the objectives and defines the administrative oversight for the OAA. It provides definitions for the administrative structure to carry out the OAA. This organization includes the secretary, commissioner, and the role that individual states will take on in the administration of the act. Title two: administration on aging establishes the infrastructure for the administration of aging services and outlines the main activities of this administrative structure. Title three outlines the authorization process of appropriations for the purpose of community planning, services, and training. Title four is about research and development projects. Title five: training projects outlines the provision of funds for training projects to benefit individual states. Title six outlines the advisory committees that govern the administration of the OAA.

This chapter presents a brief overview of some legislative efforts within the mental health (MH) arena and examined their limitations and application with respect to older adults and people living with mental illness. The chapter also takes us through a journey to examine the current status of MH and older adults, with a particular emphasis on depression, anxiety, and schizophrenia. It discusses and reviews the programs, services and issues still outstanding within the MH arena. The chapter helps the reader to understand specific components of the Community Mental Health Act and other MH-related legislation. Many of the community day hospital programs and community MH programs administered through the Community Mental Health Act are based on the deinstitutionalization paradigm since the goal is to treat people outside the institution and within community settings. It concludes with laying out some challenges for the future in the area of MH and older adults.

This chapter helps the reader to understand what a needs assessment is and be acquainted with a framework within which to conduct a needs assessment. and to be familiar with the core concepts of a needs assessment. It helps the reader to be familiar with strategies that encompass a needs assessment. Needs assessments can be carried out by a wide cast of people. Social workers and public health workers, as well as city planners, can carry out needs assessments, as can government organizations. Local citizens or groups of people can also be responsible for carrying out a needs assessment. The chapter provides an overview of strategies to develop a needs assessment. When used in combination with a health behavior framework, a needs assessment can help one determine the needs of a community and attempt to build community support for this resource or policy change through media advocacy and coalition building.

This chapter helps the reader to understand the history of housing and long-term care for older adults and people with disabilities and specific components of the Long-Term Care Reconciliation Act. The chapter discusses how legislation related to housing and long-term care provides resources to older adults and people with disabilities. It explains community-based care options such as home health, seniors congregate living, assisted living options, skilled nursing facilities, and long-term care facilities. Although differences may exist from state to state relative to who qualifies for these options and when they qualify, these will be discussed in some detail specifically providing an overview of these as options for care management of older adults. The chapter describes different residential models of care for people as they require community-based settings or settings with supports and examines issues that will face the long-term and community-based care settings in the future.

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 revisits the issues constituting the main causes of homelessness among the geriatric population, with special attention to people who became homeless due to economic factors, substance abuse, mental illness, or all of these reasons. It begins with a description of a general distinction within the geriatric homeless population followed by an overview of housing, shelter, and community programs that are available in most major cities. Not every region or city will have all cited resources available, and some might be called a different name. The chapter ends with a series of case studies. Each one demonstrates a different social issue facing a geriatric homeless person and how it impacts an older adult in locating housing and/or social services. During the discussion, examples of services and cases from several cities are cited.

Depression is common in older adults and associated with poor medical and mental health outcomes, including increased risk for suicide. Homeless older adults are at increased risk for developing depression. The clinical presentation of depression in older adults and younger adults often differs. Having an appreciation for these differences allows clinicians to better diagnose and treat this vulnerable population. This chapter provides case example highlighting the common themes of the presentation, diagnosis, and treatment of depression in the homeless older adult population. Research and advocacy are warranted to ensure that older homeless individuals with a major depressive disorder receive optimal assessment and treatment of their depression. The chapter discusses barriers to adequate detection and treatment of depression in older homeless adults, as well as assessment and treatment strategies. It covers identification and treatment of grief. The chapter reviews promising directions for future strategies to decrease depression among older homeless adults.

This chapter provides brief description on malnutrition and aging, and nutrition and homelessness. It discusses nutritional impact of substance abuse, and nutrition assessment and intervention. The chapter explores the impact that homelessness and food insecurity has on the nutritional status of older adults. Interventions must be tailored to accommodate the patient’s financial resources, medical conditions, and ultimately his or her own personal goals in order to be effective. Patients may be completely disengaged from nutrition education and focused on other priorities, which are essential for survival, that is, shelter and safety, thus making nutrition education the least effective intervention for that patient at that moment in time. Ideally, the homeless geriatric person would be monitored and re-evaluated; however, follow-up may be unrealistic. What does nutrition assessment look like in action? The chapter provides a case study to describe this question.

Skin problems are one of the most common presenting complaints of homeless persons to emergency departments and community clinics, estimated at 20% of such visits. Adult homeless suffer the usual skin diseases common to nonhomeless adults, but in addition can suffer more frequent infections, dermatitis, and wounds related to their compromised living status. This chapter focuses on the diagnosis, treatment, and triage of common skin complaints in homeless adults. Hospital admission should be considered whenever fever, chills, tachycardia, hypotension, or severe or rapidly progressing infection or other admission criteria are present. Additionally, if outpatient treatment is unrealistic given limited social or logistical challenges, admission may be appropriate even without the aforementioned standards, in order to ensure appropriate critical treatments and resolution. The chapter provides case example for infestations, bites and infections, wounds, neoplasms, and rashes.

The ethical and legal issues that arise in the care of the geriatric homeless population are complex not only because they involve nuances unique to either population, but because the combination of being undomiciled and aged leads to significant unique vulnerability. The usual dilemmas in geriatrics of creating an acceptable process for informed consent, judging adequate decision-making capacity for treatment acceptance and refusal, determining appropriate substitute decision makers, preserving privacy and confidentiality, promoting advance care planning, and allocating healthcare resources are made more challenging in the homeless. Complicating factors include ongoing psychiatric comorbidities and serious medical illnesses, which change a patient’s mentation and cognitive capacities. Therefore, appropriate assessment and treatment in these complex cases no doubt requires input from an interprofessional team. This chapter presents a case with changing psychiatric, ethical, and legal issues to illustrate how such complex tensions arise and may be resolved in a homeless geriatric patient.

Diabetes mellitus (DM) is one of the most common chronic conditions in older, homeless adults. This chapter provides brief description on DM and prediabetes, and discusses post-hospital admission and clinical manifestations of DM. Careful and deliberate data gathering must take place to understand current health behaviors. Importantly, the patient’s health literacy, memory, and performance of activities of daily living and instrumental activities of daily living will help assess functional status. The chapter covers topics such as nutrition status and food security, fall risk assessment, depression, cognitive impairment, vision, social history, and polypharmacy. It discusses physical exam, diagnostic tests, further work-up, patient education and self-management, prevention, and treatment of DM. The chapter finally provides description on noninsulin versus insulin and oral versus injection, oral noninsulin medications, and strategies to reduce common diabetic complications.

Neurocognitive disorders are life-disrupting disorders that complicate the lives of those who have them, as well as those who care for them. Speaking about neurocognitive disorders among the geriatric homeless populations is further complicated by the fact that not only is the existing research inconsistent, research on this topic in general is relatively sparse. Much of the research that exists in this area examines homeless populations in general, rather than geriatric homeless populations specifically, but examining this research is still useful for the purposes of better understanding this issue within the geriatric homeless population. This chapter endeavors to do so in order to highlight relevant research and clinical issues. It provides case example illustrating the complex nature of caring for an older homeless adult with probable cognitive deficits, the barriers to fully assessing neurocognitive deficits, and the difficult interactions this can create for staff.

Geriatric homelessness (GH) is a significant and growing social, political, economic, and humanistic issue throughout the United States. This chapter presents case studies that will highlight the GH in four urban areas and among veterans. It defines geriatric homelessness, outlines its general dimensions, explicates its two primary etiologies (loss of employment and the lack of affordable housing in the areas where most homeless persons are located), and gives examples of the diversity of the problem and attempts at solutions in four cities and among veterans. The case examples show that the solution to the medical and psychological issues in the GHP involves much more than traditional medical practices and therapies. The solutions, involving among others politics, economics, and housing, are those of communities and localities acting to positively affect the lives of individuals and families of all ages, particularly the growing population of GHPs in the United States.

Cardiovascular disease (CVD) remains the leading cause of death in older homeless people. Traditional CV risk factors, such as hypertension, diabetes, smoking, and hyperlipidemia, and nontraditional CV risk factors, such as substance abuse, psychological stress, and lack of diagnostic and preventative medical care, contribute to CVD in this population. Barriers to CV prevention and treatment in homeless individuals include their environment, lack of access to care, substance dependence, mental illness, food insecurity, and medication non-adherence. Healthcare models that provide Housing First and just-in-time care by non-judgmental multidisciplinary teams have been shown to improve the CV health of people who are homeless. CV health requires prevention, as well as prompt intervention, and close follow-up. CV healthcare practice adaptations for homeless clients include ascertaining living conditions, improvising the physical exam, scheduling longer clinic appointments with frequent follow-up, prioritization of the plan of care, and simplification of the medication regimen.

Perhaps end-of-life considerations for homeless elderly could be considered a topic of fictional creation, a sociomedical unicorn. Because, depending on one’s perspective, the curse or blessing of homelessness is the failure to even reach an age that is generally acknowledged as “geriatric”. Advance care planning is the process by which one decides what types of treatment one prefers at the end of life, but also who can speak on his or her behalf should the person become unable to speak for himself or herself. This chapter discusses advance care planning with aging homeless at end of life. It provides brief description on challenges in accessing healthcare for homeless aging, perceptions of dying of the aging homeless, and spiritual and religious consideration at end of life. The chapter then discusses palliative and hospice care delivery for the geriatric homeless. It also discusses innovative palliative care delivery models.

Homelessness is a rising healthcare problem. Secondary to poor living situations and limited access to healthcare services, homeless people are at increased risk for exposure to various communicable diseases. The diseases found in the homeless population include viral infections, hepatitis A, hepatitis B, hepatitis C, HIV/AIDS, and influenza. Homelessness, on one hand, increases the prevalence of infectious diseases, and aging, on the other hand, makes the elderly more vulnerable to infections. Homelessness is associated with numerous behavioral, social, and environmental risks that expose persons to many communicable diseases, including viral infections, which may spread among the homeless, and aside from posing a threat to individuals’ health can lead to outbreaks that can become serious public health concerns. Homeless populations may be at higher risk for West Nile virus and other mosquito-borne diseases due to their increased exposure to the outdoors and their limited access to preventive measures.

Homelessness is a rising healthcare problem. Secondary to poor living situations and limited access to healthcare services, homeless people are at increased risk for exposure to various communicable diseases, including viral and bacterial infections, tuberculosis, and arthropod carried diseases. This chapter briefly discusses infectious diseases such as bacterial infections, tuberculosis, and arthropods infestation in homeless geriatrics population. The bacterial infections covered in the chapter are urinary tract infections, bacterial pneumonia, and foot infections. The arthropods infestations include lice, scabies mites, bed bugs, delusional parasitosis. There are other causes of bites and lesions aside from lice, scabies mites, and bed bugs. Spiders, mosquitoes, ticks, fleas, and ants also pose risks for homeless people, particularly those who live outdoors. Homeless people can have a difficult time avoiding bites from mosquitoes and ticks, which can carry diseases.

Medication therapy management (MTM) remains a challenging endeavor to optimally implement in the homeless population. Working in various settings in collaboration with other health professionals, pharmacists are spearheading patient-centered efforts to optimize MTM and assist the homeless with attaining health insurance and continuity of care. In the case of MTM, homeless persons may face significant hardship in not only procuring and using effective drug therapy, but also in following-up with their providers and establishing provider–patient relationships that will help them to meet their target therapeutic goals. This chapter enumerates a review of the more common barriers to MTM in the homeless population, followed by a number of practical applications of MTM in optimizing the health of the homeless. In order to appreciate the value and role that stable MTM can offer the homeless, the chapter briefly discusses perspectives on homeless health and the concept of MTM.

The population of geriatric homeless individuals diagnosed with serious mental illness is a largely underrepresented subpopulation in the research literature despite the notion that this population is one of the most vulnerable to negative outcomes due to physical, mental, and psychosocial factors. This chapter briefly summarizes the separate impact of each of these three factors: being homeless, being in the geriatric population, and being diagnosed with a serious mental illness (SMI). In addition, the chapter illustrates how these three factors combined impact overall subjective quality of life and poor outcomes for mental health through the use of a case vignette of a homeless, geriatric individual with a severe mental illness. It also provides case example illustrating that high comorbid substance abuse along with an SMI (i.e., dual diagnosis) associated with complex medical conditions create seemingly insurmountable challenges for the interdisciplinary care team.

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 concluding chapter presents brief summaries of the chapters of the book. The chapters in the book have covered a wide range of theories, concerns, and perspectives. Chapter content has implications for policy and practice. School professionals can incorporate the information and recommendations in them into their current services to ensure that gifted students receive needed support. School counselors respond every day to students who feel different, perhaps painfully different, from those around them—at home, at school, or in the community. Those counselors are distinguished in the school context by rare skills and perspectives that can be used to help gifted students make sense of themselves, value their differentness, and embrace their complex feelings and sometimes perplexing behaviors. Change can happen in either direction because of life events or circumstances. Moving out of impasse and accomplishing developmental tasks can contribute to increased motivation for underachievers.

Samantha has been the middle school counselor in a small rural district in the Midwest for the past 3 years. She has spent most of her time in program development and building relationships with students, parents, staff, and community partners. Currently, she is working with community and district administrators to increase access to Internet and other technology in her building for more program options; unfortunately, the district’s increasingly tight budget precludes upgrades to current systems. As the academic year comes to a close, she talks with Rachel, a veteran teacher with considerable experience in differentiation. Rachel is concerned about some of her math students. By year’s end, due to her differentiated curriculum, at least seven will have completed Algebra 1, the most advanced math class at the school. Rachel wonders what can be planned for them for next year. A few parents have expressed concerns about future classes as these students progress. She asks to meet with Samantha about this situation.

School counselors collaborate, consult, and coordinate resources. They partner with community agencies, empower parents and families, advocate for students, and are probably part of the leadership team in their schools. Every day school counselors probably make lists of tasks that must be accomplished and then prioritize those according to level of urgency. When prioritizing student needs, the needs of gifted students may not rise to the top in the mind of the school counselor. Most educators equate "gifted" with high-achieving, perfectionistic, perhaps slightly eccentric students who have helicopter parents. School counselors work with gifted students regularly. These students come with a variety of different concerns ranging from typical developmental needs to mental health concerns that warrant immediate attention and service. While gifted students are no more or less likely to experience concerns tied to mental health, they do experience the world differently by nature of being gifted.

An experienced, progressive superintendent is new to a large school district, and at her first meeting with all teachers, she describes ambitious goals, one of which is to reconceptualize and reorganize the program for gifted students. She wisely does not speak negatively of the present program; instead, she explains that an administrative transition is simply an opportunity to look at existing programs. Regarding gifted education, she wants to examine current thought in the field about giftedness, what residents in the district think about those perspectives, whether criteria used for identification of eligible students in the district match the programming offered, which programming models are available, which kinds of goals might be appropriate for local programming, which community resources might supplement and enhance programming, and whether the “whole” gifted child is adequately attended to.

The district she left had experienced individual and family tragedies and disturbing student behavior in recent years involving gifted scholars, gifted athletes, gifted musicians, gifted visual artists, gifted leaders, and gifted underachievers. She says she has already begun her own personal exploration of pertinent literature, and she wants the district to be proactive and strategic regarding preventing poor outcomes for gifted and talented students—at all school levels, beginning at the elementary level. She promises to organize a task force of representative classroom teachers, school counselors, gifted-education personnel, parents, and possibly students to study pertinent literature, explore various models, and make recommendations. She encourages individuals interested in being on the task force to contact her.

Ben, a middle school counselor, immediately expresses interest. He has been frustrated with not being able to connect adequately with some gifted students who have concerns—both high and low achievers. He was always a high achiever himself, but he has realized that gifted students are highly idiosyncratic, with many not fitting common stereotypes. He wants to understand them better and help them understand themselves better as well. He is glad the superintendent seems interested in their well-being, not just their academic performance.

Ben suspects there are many counseling needs in this population, but he has never heard a local or state counseling peer refer to these needs at professional meetings. He also has wondered about the identification process and the fit of his most complicated gifted counselees with the current programming. In fact, he has met with brilliant thinkers who have not been deemed eligible and assumes that learning disabilities affect the test scores used for screening. Last, since he has worked with a number of referred gifted underachievers, he has wondered which kind of program would engage them in school and academics—and even whether academic achievement should be the sole goal.

Ben believes that being on the task force, if he is selected, will be informative and helpful as he considers how to be more effective with this special population. In fact, he is selected. The superintendent is wise to include a counselor on the task force.

Tosha and Erik are the two school counselors in a large suburban elementary school. For 5 years, they have worked to create a school counseling program aligned with their state’s framework, which was developed with the ASCA National Model in mind. This year, they are hosting a school counseling intern, Tony, from a program in the school of education at a local university. Although the school counselors are grateful to have an intern with fresh eyes and new ideas, they wonder whether the supervision will require too much time and divert their attention from the report they must write prior to a visit by the state department of education later in the year. At the initial interview, Tosha and Erik learn that because Tony had already had several education classes, his program advisor suggested that he take some electives in areas of interest. During his student-teaching experience, he had been intrigued by creative and artistic students and therefore opted to take a few courses in gifted education. He is excited to be working with Tosha and Eric and wants to know if he might work with gifted students and find out how the gifted-education program is currently serving them.

Thomas (pseudonym for a composite student profile), in his final K–12 year, participates in five components of a multidimensional program for gifted students in a large school: Future Problem Solving (FPS), Advanced Placement (AP) courses, a noon-hour philosophy course taught by a retired professor, after-school lectures by community members, and small discussion groups focused on nonacademic development. He has an extremely high IQ, is known as an excellent musician, and recently was named a semifinalist in the Preliminary SAT (PSAT) merit-scholar competition. However, his only-average academic record has long frustrated teachers, who seem offended by his seemingly limp investment and who see an “attitude problem” in his lack of oral engagement and absent homework. Thomas has a quiet personality, typically avoids eye contact, and seems older than his age. He has taken no steps toward postsecondary education, and he will need financial aid if that is his direction. One of his teachers asks the school counselor to meet with him to assess needs and concerns, including those related to college applications. Before she meets with Thomas, the counselor arranges conversations with his current teachers, his single-parent mother, the orchestra teacher/conductor, and the gifted-education program coordinator. Only the one teacher has ever referred Thomas to the counselor.

The AP American Literature and AP American History teachers both focus mostly on the missed assignments but note his serious alertness during class and brilliant insights on the papers he has submitted. The chemistry teacher expresses concern about Thomas’s sad demeanor but notes that he pays attention in class and does “OK” academically. The orchestra director, who has worked with Thomas since elementary grades, calls him one of the most gifted and highly invested musicians he has known. He reacts emotionally when he listens to classical music.

The gifted-education teacher has learned that Thomas struggles with perfectionism—with essays stalled after he has discarded several eloquent thesis statements. He has told her that he doubts he can follow through worthily. About eye contact, Thomas once said he could not hear peers’ comments when distracted by the visual stimuli of faces. He despairs over circumstances in distressed countries. Nevertheless, he is a quiet leader on his FPS team. His mother describes her acrimonious divorce and the depression Thomas has struggled with since middle school. She worries about him, especially now, with his inertia about applications. She hopes, given the PSAT results, that he will now invest in the process, securing a scholarship. She feels incapable of helping him.

In a rural school district, Abby is responsible for creating and delivering gifted-education programming across all school levels. She wants to develop a comprehensive K–12 affective curriculum for it. Though the majority of students are from middle-class families, others come from families that are struggling economically due to unemployment, military deployment, parental incarceration, single parenting, and addictions. Teachers and administrators are concerned about student well-being. Bullying has been a school concern, and the community has been shocked by three student suicides among the “best and brightest” over the past 2 years. Abby believes that attention to the social and emotional development of gifted students during all school years might make a difference. She wants to collaborate with Jack, the one K–12 school counselor, in possibly cofacilitating two proactive small discussion groups of gifted students. She wants to observe his listening and responding skills and share information with him about giftedness. In the past, Jack has not thought of organizing small groups for gifted students, but agrees to the collaboration. He says they should conduct a needs assessment among students identified as gifted and organize a group of high achievers around a common concern, such as bullying or bereavement—an approach he used in the past with the general population. Abby has something different in mind, but is hesitant to advocate for her view, since group work is in Jack’s “territory.” After she learns some skills from Jack, she wants all identified students to have a small-group experience at some point. She also understands that programming should address needs of more than just high achievers, including highly intelligent academic underachievers, who currently are not viewed as eligible for it. Abby needs to have a clear rationale for both the group format and mixing achievers and underachievers in the groups before she talks with the counselor again.

A speech/theater teacher at a large urban high school refers Andrew (pseudonym for a composite profile), 16, to the school counselor because “he’s out of control and living dangerously.” The counselor, who routinely examines the student’s school file before such a meeting, finds standardized test percentiles in the high 90s, a good attendance record, and regular participation in the arts, but also a high incidence of lateness to class and an academic record that has deteriorated in high school. Family information shows an older brother attending a distant university, parental divorce when Andrew was 5, and, at age 12, Andrew relocating with his brother and mother when she remarried.

Andrew presents as personable, verbal, socially smooth—and somewhat arrogant. He claims he can raise his current low grades before the semester ends. Missed assignments are the key. He says he adds provocative comments to class discussion, and teachers like him.

His best friend lives 2000 miles away, where Andrew lived prior to his move at age 12. Andrew has gravitated toward dramatic females locally, and his current girlfriend is in high conflict at home. His grades deteriorated after becoming involved with her. He has run away several times and now has thoughts of running away with her. He mentions a special relationship with a male friend. When he drinks, he drinks too much, and his friends worry about him.

Andrew believes the psychologists he saw in the past did not understand him. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and depression, but was noncompliant with medication. He recognizes that he makes poor choices. He claims not to be suicidal currently, but has been in the past. He has self-harmed. He says his father has almost no contact with him, but his father does have a close relationship with his brother. Andrew says his own problems resemble his highly intelligent father’s. Andrew has been exploring anarchic and white supremacist groups online.

The counselor plans to meet with him in a week, but will informally check on him daily and then meet with him and his mother together, a meeting Andrew quickly agrees to. Regardless of whether a referral will be made eventually, the counselor hopes to build a therapeutic relationship with Andrew to be able to provide ongoing support at school as needed.

A few days after the school counselor’s meeting with Andrew, his mother contacts the counselor because of the girlfriend. She says Andrew struggles with impulse control, is easily distracted and affected emotionally, has difficulty managing emotions, and escalates conflict quickly when sad or angry. He resists authority at home, and his arguments with her leave her worn out and sad. She says her husband, Andrew’s stepfather, ignores Andrew and does not understand giftedness.

Ben, the middle school counselor from Chapter 5, continues to work with the district’s task force. There, he also meets Julie the district’s coordinator of gifted and talented services. Based on the superintendent’s concerns, Julie wants to re-imagine the district’s identification and programming for gifted youth. Ben’s experiences have given Julie new insights into potential roles of school counselors when working with high-ability learners and their parents. Julie was particularly drawn to Ben’s discussions of talking with parents about why their students were not identified. Ben’s frustrations with the gifted services have also included the pervasive mythology that the program is a “cookie” program used as a reward for “good” students with “good” behavior and even better grades—a myth that disenfranchises diverse populations in the school district, including underachieving students, and doesn’t accurately identity those students who may need services. Historically, because the district has implemented identification procedures in third grade, Julie has contacted several of the elementary school counselors in her district to get their perspectives. She is surprised by the range of their knowledge about identification and the degree of the school counselors’ involvement in this process. While Ben has informed her that all practicing school counselors have training in testing and assessment, not all have connected this with identification practices for gifted learners—until they meet with their first parent.

Stewart and Tray are the seventh- and eighth-grade school counselors in a new middle school in a large urban district with a diverse student population. Wintercrest Middle School has been a magnet school for science, technology, engineering, and mathematics (STEM) for only 3 years. Currently students can take Algebra I, Geometry, Honors Biology, and semester classes in Advanced Computing, Introduction to Physics, Robotics, and Trigonometry. Logistically, the magnet school functions as a school within a school, with students attending classes in one wing of the school building. Teachers and students who are not involved in the magnet school are located in two other wings on the opposite side of the school. During the past school year, Tray and Stewart have sensed tensions in the school in various relationships, including within, between, and among teams of teachers, between parents and teachers, among students, and between administrators and teachers. Mr. Wallace, their building principal, has seen the explosive outcomes of some of these tensions and has encouraged the counselors to investigate the current school climate.

Michael is a 12-year-old Black male in the seventh grade in a remote rural farm community. He recently relocated to this community from a large metropolitan area, where he was a sixth-grader in a culturally diverse elementary school. He is the oldest of three children with parents who have become pillars in the community despite being new there. Identified as gifted in his previous elementary school, Michael took science and math classes in higher grade levels by single-subject acceleration. He had to work much harder in his language arts classes, but he loved his school and was liked by his peers and teachers.

While Michael’s new school is culturally diverse, the school and community norms for students are different. The emphasis is on community fellowship, service, and helping one’s family. Little is said about college; instead, jobs in agriculture and manufacturing are emphasized. Michael has been invited several times to participate in the 4H club. Upon arriving at his new school, despite providing his previous years’ school records, he is placed in the traditional seventh-grade classes. He complains to his parents that his math and sciences courses are a repeat of information from his previous school. Michael is also encountering difficulties in his language arts classes, which require more traditional essay-writing than his last school did.

In a six-week progress report, Michael’s teachers noted that he seems unengaged and withdrawn in class. His parents believe he has become apathetic about school, and they are worried he might lose his love of math and science. In addition, Michael’s language arts homework frequently leads to anger and frustration at home.

Michael’s parents have requested meetings with his teachers, with the school counselor, Brenda, also attending. Prior to the meeting, she evaluates Michael’s cumulative file. Based on his grades, standardized test scores, and teacher comments, she determines that he is extremely bright and very talented in math and science, but has challenges in language arts and social sciences. His teachers’ comments include “Handwriting continues to be a challenge, but he is working very hard,” “Michael is a very hard worker, but writing paragraphs or persuasive essays requires much more effort,” “He is quick at multiple-choice questions and short-answer questions are okay,” “His reading comprehension is fantastic, but writing brings out frustrations,” and “I realized Michael was much more at ease with oral book reports than written. His love of learning really shines through when he gets to talk about what he knows, in all subjects. He even manages to get his peers interested.”

Brenda makes a phone call to the school counselor at Michael’s former middle school and the elementary school he attended. She hears wonderful things about Michael, as well as about his challenges with written work. Many of his former language-arts teachers allowed Michael to demonstrate his mastery of content and skills orally or via multiple choice or computerized testing. The middle school counselor reported that he and Michael’s parents had discussed talking to their school psychologist about more testing for Michael because they were concerned about the increased requirements for writing in middle school. But that conversation did not lead to changes before the end of the school year, when Michael’s family moved.

Angela was extremely excited to begin school as a kindergarten student and was matched with a supportive teacher for her first year in the rural community in which her family lived. She was lively and talkative around adults, and her parents worked hard to find opportunities for Angela to connect with kids her own age. However, in their small community there were limited possibilities for connection, and Angela often retreated physically behind her parents in public.

During the first parent–teacher conference for Angela, her parents were surprised at the teacher’s observations that Angela was reading well beyond the level of her peers. Not knowing many other children with whom to compare Angela’s abilities, they had assumed she was on par with most other kids her age. While there were no services available in their school system until the third grade, the kindergarten teacher remarked that the Lees might want to look into additional enrichment opportunities for Angela elsewhere. However, the teacher was eager to provide additional reading opportunities. Because reading was one of Angela’s favorite activities, this arrangement seemed to be a good fit.

It was during Angela’s third-grade year that challenges began for her at school. She often came home upset that she was reprimanded at school, and she rarely talked about positive interactions with her peers. She shared with her parents that she did not have much in common with many of the girls in her class, and that they often teased her about her friendship with a boy in the class they all thought was “weird.” This social tension was exacerbated when she was reprimanded for not showing her work in math class. She expressed her frustration with “Why do I need to write out all the steps for something when I just know the answer!” A friend of Angela’s parents worked in the school Angela attended and shared with them that contacting the school counselor might be the best next step.