School counselling has the potential to deliver significant support for the wellbeing of children. However, much of the research on school counsellors has been conducted in developed Western countries, with very limited research into factors influencing the effectiveness of counsellors in lower middle-income countries or in Asia. The aim of this qualitative study was to investigate the perceptions of Filipino counsellors about their roles, and factors that supported or impeded their effectiveness. Seventeen school counsellors in the Philippines were interviewed, and the data were analysed thematically. Our findings suggest that Filipino school counsellors often carry out dual roles, experience a lack of role clarity, and are systemically disempowered in their schools. Relationships with school principals have a significant influence on counsellors' roles and positioning in schools, and therefore on their effectiveness. The ability of principals to foster a school ethos supportive of counselling is essential in enabling counsellors to leverage the multifunctional nature of their work, become embedded and centrally positioned in the school community, and enhance their effectiveness. Doing so can enable counselling to be more culturally accessible to young people.