Significant numbers of people now receive mental health services in managed health care settings (HMOs). The growth of HMOs, and with them, the need to provide quality cost-efficient mental health treatment have served to challenge the HMO clinician to develop more parsimonious, time-efficient and effective mental health treatment approaches. In the current paper, the author describes the application of a brief therapy model in working with children and families in a HMO. Principles and illustrative case examples are presented and support the idea that the family psychotherapies are especially well-suited for mental health practice in managed care settings. The model discussed is relevant to clinicians in other settings which emphasize time-efficient mental health practice.