Researchers project a threefold increase in substance abuse, inclusive of alcohol, prescription, and illicit drugs, for adults aged 50 or older by 2020, when an estimated 5 million older adults will need treatment for substance abuse problems (Gfroerer, Penne, Pemberton, & Folsom, 2003). This suggests a need for heightened awareness among clinical mental health counselors as they treat this population. This article (a) discusses the prevalence, vulnerabilities, and consequences of misuse and abuse of alcohol, prescription drugs, and illicit substances; (b) reviews age-specific counseling considerations and approaches to assessment, diagnosis, and intervention; and (c) calls for more attention to the subject in training and research.

Most empirical investigations with Black clients have focused on the multicultural competence of practitioners who work with them. Little attention has been given to the needs of Black clients. This phenomenological inquiry explored Black practitioners' perceptions of Black clients' mental health needs and identified five common themes: (a) mental health literacy, (b) family and parenting counseling, (c) advocacy, (d) trauma and grief work, and (e) self-efficacy enhancement. Implications for counseling and future research are discussed.

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