The 2013 publication of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) marked the reemergence of issues related to the appropriateness of diagnosis and the uses of the DSM-5 within the counseling profession. Concerns focus on the implications of the DSM-5 for counseling professionals whose professional identity is grounded in a prevention and wellness model, and the impact of the diagnostic process on counseling ethical practice. In this article, the authors explore the use of the DSM-5 in counseling training and practice. The authors also discuss integrating DSM-5 diagnosis into a counselor training framework while maintaining a wellness orientation. Multicultural and strength-based considerations are recommended when using the DSM-5 in counseling training and practice, while maintaining consistency with a philosophical orientation focused on development and wellness and delivering services that are indicative of a unified counseling professional identity.