This study analyzed the risk of burnout for school counselors in rural Appalachia by surveying school counselors in West Virginia. The specific research questions delved into the areas that may predict a higher risk of burnout. These areas were clinical supervision, self-care engagement, levels of education, experience, caseloads, intensity of cases, and peer relationships. Utilizing a quantitative, predictive research design, the researcher asked participants in West Virginia to complete the Professional Quality of Life, version 5 and the Self-Care Assessment for Psychologists instruments as well as a demographic questionnaire to see if those areas could impact the potential risk of burnout. The findings provide concrete answers to these areas and school counselor burnout and implications for addressing these areas. Administrators who were not former school counselors will see how a school counselor's need for clinical supervision can impact the potential for burnout.