A review of the literature provides the conclusion that individuals with a disability versus those without a disability are more likely to have a substance abuse problem and less likely to get effective treatment. Data suggest 10-40% of all individuals in treatment for substance abuse have a coexisting physical or mental disability. Alcohol rates for certain disabilities such as spinal cord or head injury exceed 50%. This paper discusses risk factors, and provides substance abuse incidence and impact data for several disability groups. Service barriers related to these individual disability groups are identified. Barriers across all groups include: denial on the part of the client since the stigma associated with substance abuse keeps individuals with disabilities from seeking service; inaccessible treatment facilities; and treatment staff who do not want to work with or do not know how to work with individuals with disabilities. Given these barriers, counselors should work with providers to resolve architectural, attitudinal, and communication barriers, and discriminatory policies and procedures. They should get to know providers, effectively coordinate referrals to appropriate treatment facilities, and provide follow-up as needed. Also included is a facilitator's manual which is a practical guide for teaching content through guided experiential projects. Two objectives are listed, and four student exercises are provided. (Contains 74 references.) (MKA)