The topic of missing data has been receiving increasing attention, with calls to apply advanced methods of handling missingness to counseling psychology research. The present study sought to assess whether advanced methods of handling item-level missing data performed equivalently to simpler methods in designs similar to those counseling psychologists typically engage in. Results of an initial preliminary analysis, an analysis using real-world data, and a series of simulation studies were used in the present investigation. Results indicated that available case analysis, mean substitution, and multiple imputation had similar results across low levels of missing data, though in data with higher levels of missing data and other problems (e.g., small sample size or scales with weak internal reliability) mean substitution produced inflation of correlation coefficients among items. The present results support the use of available case analysis when dealing with low-level item-level missingness.