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As No Child Left Behind continues to impact public K-12 education, educators continue to seek new ways in which to reach out to at-risk students. Many school administrators and school interventionists are using in-home interventions to assist families in facilitating their child’s success. These interventions range from simply bringing instructional materials to the home of a frequently absent student, to facilitating the delivery of mental health services in the home. While school officials are taking on additional roles and responsibilities to try and meet the growing expectations placed on the public K-12 educational system, many feel that they are doing so without the proper education and training to truly be effective in meeting the ever growing demands of their positions. The purpose of this study was to determine the specific factors that contribute to successful in-home interventions as perceived by interventionists working within the three-county Appalachian region of Maryland. These factors included the determination of student issues of need to be addressed through the in-home intervention, protocol/procedures for conducting the in-home intervention and the competencies necessary to successfully serve as an in-home interventionist and the implications for educator training programs at the higher education level, as perceived by those in-home interventionists working in the three most western counties of Maryland. The population for this study was 22 public K-12 school personnel, serving in the capacity of in-home interventionist, across the three-county Appalachian region of Maryland. The data from the study were analyzed using a qualitative approach which allowed the researcher to produce high quality results which were rich in detail. Emergent themes discovered included a six-prong best practice model for in-home intervention, issues of student/family need which can be addressed through in-home interventions, and the skills, competencies and dispositions which should be promoted within the higher education programs that train education candidates to be interventionists. The study also identified challenges that the interventionists face in implementing the identified best practices and addressing the respective issues of student/family need.