OBJECTIVE: Family strain, which reflects the overall function of the family system, could play an important role in routine posttraumatic stress disorder (PTSD) care. We examined how high/low family strain influences perceptions of a family-involved intervention for Veterans with PTSD to inform the design and implementation of family-centered interventions in routine PTSD care. METHOD: Sequential explanatory mixed methods study that analyzed qualitative exit interview data from a three-session family-involved pilot study stratified by Veteran baseline scores of family strain (Veteran RESULTS: Eleven Veterans (nine associated SPs) were classified as experiencing high and five Veterans (three associated SPs) were classified as experiencing low family strain. While nearly 50% of Veterans reported belonging to a non-White racial group, all of the Veterans were men. Themes reflected preintervention expectations, intervention experiences, and postintervention changes. Differences in intervention experiences were observed with different family strain levels. Participants in the high strain group articulated concrete goals for the intervention and provided more details about benefits, including an enhanced understanding of PTSD, improved family communication, and increased social support. Participants in the high strain group reported more discomfort with the intervention process, especially the conjoint sessions. CONCLUSIONS: Family-involved interventions for Veterans with high family strain are feasible and may have even greater benefits than for Veterans reporting low family strain. Future research is needed to empirically test this hypothesis and to understand the experiences of female Veterans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).