This book discusses how counselling, a profession known for diverse and innovative practices, has recently been influenced by scientific, marketplace, and administrative developments corresponding with a medicalized focus on psychiatric diagnoses and related evidence-based treatments. Tensions associated with this medicalized focus refer to competing logics and accountabilities regarding how to understand and address concerns brought to counselling. Tom Strong reviews such tensions as they relate to counsellors’ approaches to practice experienced as incompatible with a medicalized approach. The role of media and technology, therapy culture, and counsellor education, are examined with respect to medicalizing tensions that professionals and clients of counselling increasingly face. The book will interest readers who share concerns regarding the potential for a mental health monoculture grounded in the diagnose and treatment logic of medicalized counselling.