Providing individual and group counseling has become an identified role for school psychologists working in the school setting. There is an extensive research base that highlights positive outcomes and supports the use of a variety of counseling methods when working with children and adolescents. However, there may exist a host of other outcomes, including deleterious effects, when counseling school-age children and adolescents. This article looks to identify and summarize some of the possible deleterious effects in school-based counseling across a variety of disorders and to make school psychologists cognizant of possible negative outcomes when designing and implementing treatment plans.