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.