Statistics show that two thirds of American Indians and Alaska Natives (AIs/ANs) live outside of tribal areas, and 50% of those individuals who seek counseling services will not use tribal resources. There is a strong likelihood that counselors will have the opportunity to provide services to AI/AN clients. The review of the academic literature focused on counseling services for AIs/ANs revealed three primary themes. These themes include issues regarding cultural competency, awareness of different levels of acculturation, and the appropriateness of utilizing Eurocentric counseling theories with AIs/ANs. Perhaps more importantly, these themes often emerge within the context of family and tribal unity. These issues, as well as some general guidelines for counseling indigenous families, are addressed within this article.