This article surveys the past, present, and future trends of counseling in China. Historically, mental health problems were addressed within the family. Currently, psychotherapy from trained practitioners is available on a limited basis, at least in urban settings. The challenge of mental health in China is tremendous, and the efforts to meet that challenge are encouraging. The authors recommend that in the future, prevention and intervention services be offered that are ecosystemic, strengths-based, and culturally appropriate.