Background: Most studies on the mental health of Palestinians are on the prevalence of PTSD, anxiety and depressive disorders among survivors of Israeli violence. Diagnosis is usually based on a one-time interview using standardized tests built on Western models of mental illness and is often undertaken shortly after periods of heightened Israeli aggression. Whereas such studies are crucial to understanding the psychological consequences of colonial violence, they obscure nuances of symptoms and present an incomplete picture of mental health concerns in Palestine. This study utilizes the data of a major counseling center to understand who seeks counseling/therapy in three regions in the West Bank and for what reasons. The aim is to examine patterns of formal help seeking and concerns that depend on patients’ self-reports and in-depth assessment by practitioners over a long period of time; knowledge that is both lacking and crucial. Methods: The pre-existing data of approximately 900 adult service users who came to the Palestinian Counseling Centre between 2008 and 2018 will be extracted from the database for analysis. Non-inferential statistics and Chi-Square will be used to describe previous and current service users and search for statistically significant patterns across the selected variables. Results: Results will include demographic information (age, gender, education, occupation, type of residence and economic status), reasons for approaching therapy, diagnosis by counselor/therapist, duration of psychotherapy and how it was terminated. Discussion: Findings will be compared to studies on Palestinian mental health that mainly use standardized diagnostic criteria and tools. Patterns of mental health utilization will also be compared to those found elsewhere, both regionally and globally. The implications of the results will be discussed in relation to research, practice and theory in the Palestinian context.