Although it is not apparent from the practice literature, clinical wor
k with midlife women can differ significantly from clinical work with
younger or older women. Although many women are satisfied with their l
ives at midlife and find these years to be the prime of life, there is
a subgroup of midlife women who are not happy at this time. In this p
aper, factors that discriminate women who have a strong sense of well
being at midlife from those who do not are presented. Treatment consid
erations related to five areas (disability, marital relationship, iden
tity, self esteem, and loss) found to be problematic for women are pre
sented. Social work practice implications are discussed in terms of th
e benefits of focusing on the issues of identity, connectedness to oth
ers, and spirituality.