This paper investigates general practitioners’ (GP) self-reported practices for psychologically distressed patients with sexually transmissible infections (STI). A cross-sectional postal survey was conducted among a 15% random sample of GP practising in New South Wales. The main outcome measures were self-reported strategies to deal with psychologically distressed STI patients, priority of counselling, and perceived need for training in counselling. The great majority (82%) of GP reported that they extended their consultation time to deal with psychologically distressed patients, whereas 49% reported being likely to refer distressed patients to a counsellor. Just over half (54%) considered counselling to be a high priority in STI care, whereas 49% acknowledged benefits of further training in counselling. Overseas medical graduates were more likely to refer patients in distress to counsellors compared with Australian graduates (odds ratio = 1.80, P = 0.008). Female and metropolitan GP were more likely to consider counselling a high priority in STI care (odds ratio = 1.56, P = 0.038; odds ratio = 1.62, P = 0.028, respectively). GP appreciate the need to deal with psychological distress of STI patients; however, referral to counselling services is not a widespread priority. Further research is needed to examine practitioners’ actual practice in caring for psychological distress among STI patients and barriers to referral for counselling.