Abstract Patients receiving a diagnosis of catastrophic illness are expected to choose among treatment options fairly quickly. Brief therapists can facilitate the process of decision making by assisting patients to overcome common deterrents, including 1.) cognitive overload, 2.) failure to fully comprehend treatment options, 3.) inability or refusal to process information in the presence of a denial defense, 4.) hurried presentation of information by the physician, and 5.) self-imposed time constraints to get decisions made. Many patients later regret the treatment choices they made under those circumstances. From a medical perspective, the best treatments offer a physical cure; however, from a psychological perspective, the best treatments maximize a patient’s ability to heal emotionally, socially, intellectually, and spiritually. Therapists in medical settings can make a difference for such patients by assisting them to systematically consider their options, and can educate clinic staff about ways to minimize framing bias. The involvement of therapists in decision making applies to various diagnoses. However, each diagnosis presents its own unique factors.