The impacts of the terror attacks of September 11, 2001, were observed in Student Assistance and Prevention Counseling programs in New York schools. Methods: A mixed-method study of programs across the state, consisting of interviews (N = 14) and record reviews (N = 407), was conducted in New York State in 2002. Standardized state forms were used for quantitative data collection and frequencies were analyzed. Results: An analysis of referral source before and after September 11, 2001, showed that self-referrals were slightly higher after September 11, 2001. Using data from students admitted before September 11, 2001, as a baseline, there were some shifts observed in reason for admission following the terrorist attacks. Increase of services was typical for the schools closest to the World Trade Center site and in the New York metropolitan area. Discussion: Due to the flexible nature of Student Assistance and Prevention Counseling services, programs were able to redirect both staff and resources to attempt to meet the need brought about by this tragedy.