Recent studies indicate that the majority of school psychologists' time continues to be dedicated to SPED related activities. Despite ongoing calls for school psychologists to expand their roles, why many practitioners do not deliver more comprehensive services is not well understood. This qualitative study investigated facilitators of and barriers to comprehensive and integrated services using the "National Association of School Psychologists Model for Comprehensive and Integrated School Psychological Services" as the guiding framework. Thirteen full-time, school-based practitioners from across the US participated in semi-structured interviews. Constant-comparative analysis was used to generate themes. Results indicated that practitioners experienced a number of systemic barriers to (e.g., heavy caseload; inconsistent district policies, priorities, and role definitions; lack of stakeholder involvement) and facilitators of (e.g., resources, graduate training and professional development) comprehensive and integrated service delivery. Participants' perspectives regarding changes needed to expand their services focused on systemic issues as well. Implications for research and practitioners' efforts to advocate for systems change are discussed.