Dialectical Behavior Therapy (DBT) is based on a transactional model of the etiology of borderline personality disorder (BPD). It assumes that the associated emotional dysregulation is not simply biological or family induced but the result of a dynamic interaction between the biology and characteristics of an individual with the individual's social environment. This paper discusses the theoretical issues and empirical research relating to a synthesis of family therapy and DBT with adolescents. A review of the literature identifies support for a greater understanding and inclusion of families in treatment, attention to relational aspects of affect, and a dialectical framework for synthesizing individual-oriented and systemic-oriented theories and practice. Some implications for the development of a DBT family therapy model are discussed.