The counseling profession has experienced a great deal of change, especially during the 1990's. Several of those changes occurred in 1992; these include the changing of the AACD's name to the ACA (American Counseling Association), the adding of counseling as a primary mental health profession into the health care human resource statistics of the Center for Mental Health Services and National Institute of Mental Health, and the writing of the multicultural counseling standards and competencies, which was done by Sue Arredondo and McDavies. Another major change that occurred in the 1990's was the inclusion of counselors as providers for managed health care organizations. .

             Two of the major trends being faced by counselors in the new century include having to serve an increasing number of clients recovering from violence, crisis situations, and trauma, and helping clients cope with loneliness and isolation. The negative characteristics of the first trend are that crisis situations and acts of violence have become more deadly and prevalent in society since the 1990's, examples of these being the Columbine massacre and the 9/11 terrorist attacks, and incidences of post-traumatic stress disorder have also become prevalent as a result of these terrible events. The positive characteristics to emerge from this trend are that counselors have begun receiving specialized training in crisis counseling in order to better serve clients, and they have been able to develop practical and well-focused action plans and strategies towards helping clients of all ages to recover. The negative characteristic of the second trend is that more individuals today are experiencing extreme loneliness and isolation than ever before. The positive characteristic is that counseling relationships have helped these individuals significantly overcome their loneliness. For their part, counselors can rise to the challenge by realizing how important they are in their clients' lives and by coming to regard their profession as a "calling" that they are willingly answering.