U.S. consumers are spending billions on complementary and alternative medicines, and nearly half of those consumers on psychiatric prescription drugs also use herbal remedies. Clients may take herbaceuticals, over-the-counter drugs, and dietary supplements instead of, or in combination with, prescription drugs. This frequently occurs without the input or knowledge of prescribers, which can create significant problems for clients. There is a growing need for counselors to be familiar with herbal remedies, over-the-counter drugs, and dietary supplements. It is vital that counselors understand the potential interaction of these substances with prescribed medications, as well as their impact on clients' emotions, thoughts, and behaviors. This article reviews relevant research and professional publications in order to provide an overview of the most commonly used psychoactive non-prescription products, counselor roles, client concerns, associated counseling ethics, diversity and cultural considerations, and counselor supervision concerns.