Target four of the National Agenda for Achieving Better Outcomes for Children and Youth with Serious Emotional Disturbance focuses on collaborating with families to improve service delivery and results for their children. Moving toward this goal has necessitated the continuation of a paradigm shift that brought out this target as an important one in the first place, and that has highlighted the difference between family-focused and family-driven approaches. We discuss the history of the paradigm shift, the progress that has been made toward this goal of making families full collaborative partners in the care of their children, the elements and examples of effective systems of care, and the distance still to traverse toward fully realizing the goal of this strategic target.