This chapter explores families who are trying to adapt to a change in the family structure. While there are a number of similarities between couple and family therapy—the need for leadership, the heavy focus of the family on content rather than process—there are some differences important to note. The dynamics of families are different because the children, unless they are adults, lack the equal power status that is part and parcel of clinician's concern when seeing couples. Seeing siblings together without parents is often helpful and is an efficient use of time when one sibling is shy and difficult to engage, or when the sibling group is struggling with a common issue. The chapter talks about teens who are falling into addictions, cutting behaviors, aggressive or anti-social behaviors, eating disorders, suicidal talk and/or gestures. The most obvious and frequent one is the inclusion of children and teens in the process.