Lois Pitman was admitted to a psychiatric unit in a university hospital because she was depressed and suicidal. She is a divorced 41-year-old African American mother of three adolescents. She says she has been using an increasing amount of cocaine in the preceding weeks, because cocaine makes her "feel numb so that nothing matters." This escalation in drug use and thoughts of suicide coincided with an investigation of the family by child protective services, initiated after Ms. Pitman's older daughter made charges of sexual molestation against her mother's live-in boyfriend. The boyfriend denied the charges. Ms. Pitman was devastated by the accusation and unsure about whom to believe. She did not understand how her boyfriend could have done such a thing.