This article highlights the importance of incorporating Transactional Analysis (TA; Berne, 1961) as a counseling intervention into the clinical work with Bhutanese-Nepali refugees. The authors of this article explored the existing literature on the experience of transitioning to a new country and the mental health challenges experienced by Bhutanese-Nepali refugees during their transition. An overview of the effectiveness of TA is provided using a theoretical case vignette with an 18-year-old Bhutanese-Nepali male. The vignette demonstrates conceptualization through ego state contamination and counseling intervention through co-creative TA. The article concludes with limitations, directions for future research, and implications.