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OBJECTIVE: Although the importance of family caregivers' involvement in their children's mental health treatment is increasingly recognized, factors that influence caregivers' participation are not clearly understood. This study examined the views of family caregivers whose children received out-of-home treatment to determine the amount and types of family caregivers' participation in their children's treatment, the caregivers' perceptions of barriers and supports to participation, and the relationship of barriers and supports to caregivers' participation and satisfaction with care. METHODS: As part of a national survey, a subsample of 102 family caregivers from 31 states whose children were in a residential treatment center, psychiatric unit, or group home answered a questionnaire that included questions about their participation in their children's treatment and about barriers and supports to their participation. RESULTS: Family caregivers identified as barriers concrete factors such as cost of transportation and distance from service providers as well as more intangible factors such as lack of communication between staff members of different programs and negative attitudes of staff members. CONCLUSIONS: Programs seeking to create a more supportive environment for family caregivers' involvement in out-of-home care will need to seek out family members' perceptions of their experience with their children's treatment and their views about factors that would help increase their participation.