Mental health practitioners working with children and families must attend to several ethical concerns that do not typically come into play with adult clients. The challenges for practitioners usually involve attention to four subsets of concerns that all begin with the letter c: competence, consent, confidentiality, and competing interests. Using the 4-C model, this article focuses on ethical aspects of practitioner competence, consent and assent, confidentiality, and the incongruence of interests that occurs when different people organize and set goals for psychological services. After explicating these issues, I provide recommendations for addressing them in the course of clinical practice. © 2008 Wiley Periodicals, Inc. J Clin Psychol:In Session 64 : 1–12, 2008.