Families attending child and adolescent mental health (CAMH) services are often assumed to have problems in key areas such as communication, belonging/acceptance and problem‐solving. Family therapy is often directed towards addressing these difficulties. With increasing emphasis in family therapy and human services fields over the last decade on identifying and building from strengths, a different starting point has been advocated. This paper describes a large survey of the self‐reported pre‐therapy functioning of children and families using a public CAMH service (n=416). Before commencing family therapy parents identified family strengths across a range of key areas, despite the burden of caring for children with moderate to severe mental health problems. This evidence supports theoretical and clinical work that advocates a strengths perspective, and highlights how resilience framed in family (and social) rather than individual terms enables a greater appreciation of how strengths may be harnessed in therapeutic work.

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In the consumer satisfaction literature, there is little exploration of the relationship between change and satisfaction and the two are often conflated. This qualitative study interviewed parents a year after using child and adolescent mental health services. Eliciting an account of their experiences enabled the development of ‘grounded theories’ about what constitutes satisfaction for parents. The outcomes suggest that in addition to the expectable stories of ‘high change and satisfaction’ or ‘no change and low satisfaction’, considerable numbers of people are satisfied with a service despite experiencing little or no change, while others who experience positive change are not satisfied. Understanding these alternative stories helps address critical issues that affect the way therapists respond to people's needs and provide services — these matters are often within the capacity of therapists and services to address, even when working with limited resources.

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