In an effort to improve parenting assessments for mothers with mental illness, this study examined the relationship between caregiving attitudes and maternal behavior. Participants included 44 mothers with major mental illness who were involved with the child welfare system and their young children. The Parenting Opinion Questionnaire (POQ) was administered to assess caregiving attitudes. Maternal behavior was assessed directly in a videotaped observation. Unrealistic maternal caregiving attitudes, especially attitudes that a child should provide a parent with support and comfort, were associated with at-risk maternal behavior. The findings support the application of the POQ for use in multimeasure, multimethod parenting evaluations.