Disability resource offices are seeing a rapid expansion of students requesting services based on psychological conditions. The impact requires service professionals to innovate processes, adjust communication strategies, and consider standards for determining reasonable modifications that do not fundamentally alter courses. Existing frameworks inform best practices for communication with faculty and campus stakeholders and center the intersection of course design and disability as both social justice priorities and an ADA mandate. However, differentiating between qualifying for complex accommodation and implementing them and oppositional attitudes can strain our capacity to ensure access. In this webinar, we will discuss the characteristics often associated with psychological conditions that may warrant participation modification, accommodation decision-making, and the balance between reasonable accommodation and fundamental alteration.