Families provide foundational contexts in which most children develop and grow. For families of children with special health care needs (CSHCN), interdisciplinary supports can build family participation capacities, beyond individualistic child supports. This single-group pretest–posttest quasi-experimental study sought to determine the preliminary effects of the Healthy Families Flourish Program (HFFP), a telehealth occupation-based parent coaching intervention to promote participation, cohesion, adaptability, and communication for families of CSHCN. Eleven families, including 17 parents and 27 children, completed the 10-session intervention consisting of parent education and individualized coaching. Participants completed the Canadian Occupational Performance Measure, Goal Attainment Scaling, and the Family Adaptability and Cohesion Evaluation Scales pre-/post-intervention. Within-group comparisons showed improvements in family participation, cohesion, adaptability, and communication with Cohen’s d effect sizes ranging from 0.55-3.32. Researchers found positive relationships between family participation and cohesion as well as participation and adaptability. Findings provide considerations for supporting families within socioecological contexts.