Health care professionals' ratings of their perceptions and practices of the components of family-centered care were examined to determine possible barriers to practice at a western Canadian children's hospital. A significant and large difference was found between health care professionals' perceptions and practices of family-centered care using the Family-Centered Care Questionnaire-Revised (FCCQ-R; Bruce, 1993)(p<.001). Older participants had higher scores on the Practices scale. Participants with post--secondary education as their highest level of education-predominately registered nurses--and physicians also scored lower on the Perceptions scale of the FCCQ-R. In contrast, nurses has higher overall scores on the Perceptions scale of the FCCQ-R. Professionals in staff positions as opposed to educational or administrative positions also scored lower on the Perceptions scale. Bachelor's-and master's-prepared health care professionals had significantly higher perceptions scores on the FCCQ-R. Perceptions were found to account for the majority of the variance in the regression equation of practices of family-centered care, as measured by the FCCQ-R. The findings suggest that education, knowledge, experience, and employment position influence health care professionals' abilities to practice family-centered care. The 'dilemma of helping' (Dunst, Trivette, Davis, & Cornwall, 1988) is proposed as an explanation for these findings.