Little information exists regarding mental health and special needs related to American Indian and Alaska Native (AI/AN) families. In this article we emphasize the use of oral tradition during the Circles of Care initiative, which was essential in understanding cultural history and historical trauma of AI/ANs while giving a greater understanding of an AI/AN-based definition of serious emotional disturbance. The success of these methods serves as a template for improving systems of care and may be useful in evaluation among a wide range of ethnic communities.