What is strengths-based clinical work in the 21st century? Will it survive, will it scatter and become something else, or will the pathology driven mental health paradigm persist and push strengths work away again? In Chapter 2 of this book, Kelly and Gates presented a useful interdisciplinary historical account of strengths-based clinical work. As has been noted throughout this work, psychologists, counselors, marriage and family therapists, and recently positive psychologies have taken to using the name of strengths-based. It is evident to us that the push for a different sort of clinical effort has had its ups and downs.