Objective: Multi‐family therapy (MFT‐AN) is a promising group‐based treatment for adolescent anorexia nervosa. This study aimed to explore how young people and parents perceived change to occur during MFT treatment. Methods: Young people (10–18 years) diagnosed with anorexia nervosa or atypical anorexia nervosa and their parents who completed MFT‐AN alongside family therapy for anorexia nervosa within the preceding 2 years were eligible for this study. Semi‐structured qualitative interviews were conducted. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. Results: Twenty‐three participants (8 young people, 10 mothers and 5 fathers) completed interviews. Five main themes were identified; (1) Powerful connection, (2) Intensity, (3) New learning and perspective shifts, (4) Comparisons, and (5) Discharge is not recovery. There was a strong sense that being with others in a similar position in an intense environment were key factors in promoting change. Comparisons were inevitable and could promote insight and foster motivation, but could also be unhelpful at times. Participants spoke about how recovery continues beyond service use and requires ongoing attention and support. Conclusions: Through the mechanisms of connection, intensity, new learning and comparisons change is perceived to occur in MFT‐AN. Some of these are considered unique to this treatment format. Key points: Multi‐family therapy is perceived as a unique, challenging and helpful treatment for young people with anorexia nervosa.The combination of connecting with others in a similar position, the treatment intensity, new knowledge obtained in the group and the impact of comparisons between group members was described as leading to hope, increased mentalisation and change.Participants described how recovery continues beyond service use and that the end of treatment is not the same thing as recovery from anorexia nervosa. [ABSTRACT FROM AUTHOR]