To implement care that is suitable and valuable, that resonates with patients and families, it is crucial to consider various personal, environmental, and practice considerations that influence psychiatric treatment. This Clinical Case Conference uses a case focusing on an 11 year-old African American girl as a foundation to review family, cultural, religious, and ethical influences relevant to the practice of child and adolescent psychiatry. This presentation discusses how these relevant influences upon the lives and treatment of children and adolescents can be conceptualized and incorporated into psychiatric work with children and adolescents. Recognizing, understanding, and managing family, religious, cultural, and ethical beliefs and practices is an essential knowledge and skill set for practicing child and adolescent psychiatrists.