This chapter focuses on Buddhist approaches to the work of pastoral counseling and the role of the counselor. It explores the topics of Buddhism and pastoral counseling as separate entities, looks at how they can be joined, and presents unique elements of working with Buddhist and non-Buddhist clients. The chapter introduces the notion of the Buddhist pastoral counselor as the kalamitra, or spiritual friend. In Mahayana Buddhism, the teacher is often termed kalamitra, Sanskrit for spiritual friend. The kalamitra as counselor is one who has worked with his or her own mind and therefore knows the workings of the mind and how the mind creates suffering. Similar to all counseling, the Buddhist pastoral counselor will rely on the relationship with the client as the main process and intervention of counseling. Buddhism and mindfulness will continue to influence psychology, and therefore Buddhist pastoral counseling as a discipline will continue to grow.