The standard western theoretical approach to mental health counseling is not applicable to the views held by Native American clients. Consideration must be given to their unique differences, if the therapist is to provide maximum effectiveness. Several perspectives offer alternative counseling procedures. For instance, Indians place great importance in the "higher being" and use the medicine man as an intermediary. Therefore, the medicine man should be considered by therapists if other strategies have failed. The Indian holistic approach to past, present, and future must be kept in mind because it is in conflict with the western approach of placing emphasis on past happenings as causes for one's problems. The therapist must also remember that Indians will first seek aid from their family and extended family and that the last place they will seek aid is from a formal health care institution. Similarities and differences in attitudes, beliefs, etc. among Indians should be considered by looking at the characteristics of the family lifestyle pattern, whether traditional, bicultural, or pan-traditional; and how that lifestyle affects the client's behavior. A 1972 study by Dr. Carolyn Attneave seems to suggest that their poor economic situation must be seen as a major cause for many Indian problems existing today, including the problem of mental illness. (Author/AN)