We surveyed Canadian psychological practitioners (N 137) who offer services to children and youth, using real-time sampling to obtain a profile of services offered to a specific child or adolescent client. Our sample included practitioners with a master’s degree and those with a doctorate. Practitioners provided services in both publicly funded agencies and in independent practice, working with an ethnically and socioeconomically diverse clientele with multiple psychosocial risk factors and a range of presenting problems and comorbidities. Clients were referred by parents, schools, and other health professionals for services including assessment, intervention, and consultation. In the majority of cases, psychological services involved not only the target client, but also parents or school personnel. Almost one third of clients had been prescribed psychotropic medication, and one quarter of practitioners indicated that their clients were receiving services from another health care practitioner for the same problem. The results paint a portrait of the complexity of the context in which psychological services are provided to young people. Implications for training and professional practice are discussed.