Home-based counseling is increasingly an alternative mode of providing counseling services for children and families, reduces barriers to accessing traditional counseling services, and has also been shown to be effective. As such, the purpose of this qualitative study was to explore and describe the competencies needed to provide such counseling services. This study yielded five categories of competencies—necessary knowledge sets, case conceptualization, counseling behaviors, flexibility in session, and professional dispositions and behaviors. We also outline implications for counseling practice, counselor education, and public policy.