Exposure to adverse childhood experiences is a risk factor for the development of serious
psychiatric and somatic illness. Although trauma-focused therapy is effective in reducing
symptoms, not all children benefit from it. To improve treatment efficacy, the children’s
perspective on what they perceive as helpful versus hindering is necessary. This study
aimed, retrospectively, to explore how children exposed to family violence experienced
treatment at the Child and Adolescent Mental Health Service. Seventeen children and youths
were interviewed 4–5 years after treatment. The thematic analysis resulted in five themes:
confusion, the need to feel heard, fear of consequences, feelings of pain, and identifying
oneself as an agent. The results emphasize the importance of the therapeutic relationship,
and that trust, genuine interest, and reciprocity are necessary for the child to engage in
treatment. However, neither the child’s own agency nor external obstacles such as
continuous exposure to abuse should be underestimated in terms of the child’s
engagement.