This chapter considers the concepts of losses, and the central role of theories of loss in informing the medical model of disability has attracted wide criticism for a failure to acknowledge the repercussions of living within a society that historically has contained a set of beliefs and practices about disabled people. It discusses counselling approaches which have been advocated as being appropriate for counsellors to utilise when working with disabled clients who require counselling support. The chapter examines the development of counselling models for use when working with women, feminist counselling and therapy aimed primarily to make the counselling process both accessible and comprehensible with a simultaneous commitment to an egalitarian relationship rather than one embedded in hierarchical mode. The use of cognitive approaches have been contrasted with the use of behavioural approaches which Lenny strongly rejected for use with disabled clients.