Diabetes self-management education (SME) programs are holistic approaches to support people living with chronic conditions to improve their health status, clinical outcomes, and quality of life. SME interventions are enhanced when coupled with chronic disease self-management support (SMS). SMS comprises ongoing services provided by the program or health care provider to promote sustained improvement to outcomes in the long term. Counseling vulnerable populations is a challenge for many healthcare providers. This presentation will address contextual influences on chronic disease as well as comparing and contrasting motivational interviewing (MI), guided self-determination (GSD) and illness integration support as a means to counsel vulnerable groups. Additionally, this presentation will include case studies that provide practical application for bridging contextual influences or barriers with patient counseling to promote improvements in their health outcomes.