Although marriage and family therapists are being called on to help at-risk families, some say that clinicians have insufficient knowledge about the impact of policies on families involved in the foster care system. The purpose of this qualitative investigation was to identify how the Adoption and Safe Families Act informs decision making, to recognize trends in decisions regarding termination of parental rights of parents with mental health issues, and to explore treatment issues of families involved in the foster care system. Results indicate that court cases decided after the implementation of the Adoption and Safe Families Act are likely to result in termination of parental rights. Implications for clinicians and researchers are discussed.