In this paper, we address the phenomenon of clients who present their concerns in the medicalised discourse of the "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition" ("DSM-5"). We contextualise this phenomenon, highlighting how a "diagnose-and-treat" logic increasingly pervades everyday understandings and informs people's efforts to make sense of their concerns. We relate these cultural ways of sense-making to discursive counselling practice, noting possibilities for circumventing "discursive capture" through reflective and generative dialogues. We then turn to two common ways in which clients present their concerns in counselling: (1) arriving self-diagnosed or diagnosed by another professional and (2) as a family in which parents present a child as having a mental disorder. We suggest ways of moving beyond medicalised discourse via resourceful and critically reflective conversations with clients.