Social workers often help clients make decisions that they experience as “difficult” because of the stressful and challenging circumstances involved (Gibelman, 2005). However, despite extensive clinical exploration of the helping process by social work authors, the process of assisting clients with difficult decisions is not currently much explored in the literature. Because this area of practice is of significant interest to the profession, it is clearly a topic that needs further exploration. This article examines some of the current literature on the topic of difficult decision making, drawing on research in clinical medicine, psychiatry, nursing, psychology, and social work. WHAT ARE DIFFICULT DECISIONS?