The authors present the systemic intergenerational family therapy approach to adolescent substance abuse problems. This model considers the following factors as important: (1) the transgenerational process from the husband's and wife's extended families; (2) the level of anxiety in the family; (3) individual characteristics of family members; (4) the peer relationships of family members; and (5) the school and/or work systems of family members. Following a thorough overview of this treatment approach, a case illustration of the therapeutic methods is provided.