There is an increasing body of evidence demonstrating the psychological and social challenges that afflict school-age children in sub-Saharan Africa. In spite of widespread calls to provide counselling and guidance services in schools, efforts at expanding these services remain fragmented and under-resourced. Grounded in both empirical and theoretical literature, this article calls for integration of counselling and guidance through a whole-school approach. Utilizing critical aspects of child and adolescent developmental theory, we summarize the current state of counselling and guidance in the region, evaluate attempts at integration, and propose adoption of a comprehensive guidance and counselling model into school curricula.