Treatment integrity (TI) refers to the degree to which an intervention is implemented as intended. We analyzed 67 youth intervention studies published in "Professional School Counseling" from 1997 to 2018. More than half (55%) of the interventions were operationally defined and 16.4% of the studies monitored TI, but only 6% systematically evaluated TI. Results provide insight into school counseling interventions with implications for practicing school counselors.