This study examined how youth-reported satisfaction with specialty mental health services was associated with youths' symptom and functioning change. Change in clinical functioning was assessed prospectively on the basis of parent, youth, and interviewer report for 369 youths (aged nine to 18 years at study entry) receiving mental health services. Satisfaction was assessed at two-year follow-up. The results indicated that satisfaction was only minimally associated with clinical change, and only in the case of youth-reported clinical change. Parent- and interviewer-reported change were not associated with consumer satisfaction. These results suggest that consumer satisfaction is not a good indicator of effectiveness of treatment in changing clinical functioning.