Treating suicidality is one of the most challenging situations managed by college and university counseling centers. The first edition of Bongar's (1991) "The Suicidal Patient: Clinical and Legal Standards of Care," a compendium of empirical knowledge and clinical research regarding standard of care in the treatment of suicidality, was soon considered a valuable resource in the field. The volume was pivotal in the arena of clinical practice because, in addition to compiling state of the art information, it also positioned itself as a benchmark for determining whether standard of care has been met in treatment of suicidal people. Now in its third edition (Bongar & Sullivan, 2013), this resource continues to inform clinical practice. This article examines several noteworthy changes across the three editions of this seminal work. What has changed, possible trends suggested by the changes, and resulting implications of these changes are examined. Of particular importance are changes that represent significant developments in the field or make relatively new assertions of what constitutes sound practice. These trends, changes, and assertions regarding standard of care are discussed in terms of their relevance to the counseling center setting. In the third edition there are several instances in which Bongar and Sullivan (2013) clearly extended beyond reporting observations about clinical practice and arguably moved into the realm of attempting to set norms for standard of care. Even though these new assertions may essentially be the authors' opinions, they may be treated as fact by regulators, expert witnesses, attorneys, and others in determining whether standard of care has been met in specific cases.