The purpose of this qualitative study was to explore counselors’ efforts to implement a culturally responsive counseling practice in mainland China. Twenty-two counselors were interviewed about their perceptions of cultural discrepancies between Western-based counseling theories and approaches and the Chinese counseling context, as well as about the participants’ attempts to address these discrepancies in practice. Grounded theory was used as the method for data analysis, resulting in the identification of two main themes: Awareness of Cultural Discrepancies and Culture-Related Practice Strategies. For the latter theme, six subthemes were found: (a) relationship-oriented accommodation, (b) skill integration, (c) internal focus, (d) identifying commonalities, (e) employing accommodative approaches, and (f) theoretical integration. Implications for counselor education and practice in China, as well as further directions for research, are presented.