An empirical integrative framework, developed in Belgrade, Yugoslavia and which is called the ecosystem approach to alcoholism (ESTA) is described in this article. This model draws on a range of theoretical approaches, namely, general systems, ecology, communication, and cybernetics, together with developmental and other related approaches. The fundamental principle is that alcoholism is a problem of the whole context, involving the index patient, the family and wider systems, including the work system. Results of numerous research investigations and a consideration of recent trends in the literature indicate that the ecosystemic approach is a highly effective, economical and ethical way of working with alcohol and other drug and mental health problems in the family, social and work contexts in Yugoslavia. The treatment program, which integrates contemporary principles of the treatment of alcoholism with family-systems ideas covering biomedical-psychological- sociocultural levels, is also described and illustrated by a detailed case example.