This chapter focuses on the differential family reunification issues experienced by Cuban Marielitos and balseros upon entrance into the United States. Treatment recommendations, aimed at ameliorating the emotionally laden reunification issues, are presented within a family systems and ecological context. The chapter explores mental health practitioners in their therapeutic work with members of a relatively small but distinct Hispanic ethnic group. The "Mariel boatlifts" or the "Marielitos" represented the third migration wave of Cuban immigrants. In contrast to previous Cuban immigrants, the Marielitos were classified as "socially undesirable" because of the prevalence of individuals with a history of incarceration and mental illness. The chapter addresses the family reunification issues of Cuban Marielitos and balseros via an ecologically based family treatment approach. The content and process distinction is crucial in treating maladaptive family reunification issues often found in Cuban patients who have entered the United States via the Mariel or balsero migration wave.