The family's perception and expectation of child psychotherapy was evaluated. A modified version of a survey of expectations was administered to children (and their accompanying parent) before and after their initial intake interview. Generally the child and parent anticipated that the therapist would raise psychiatric issues, while being supportive in approach. Child and parent, however, perceived that the therapist raised fewer medical and psychiatric issues than expected. Approximately 50% of the children felt that their behavioral problems were integrally related to family psychodynamics. Parents, however, often perceived that the problems involved one person and were not a family issue. Although many children did not recall the specific reasons for referral for therapy they conceptualized the problem as one related to some “difficulty” they were having. It appears that children often begin treatment with sophisticated and perceptive notions of the therapy process and the need for getting help.