This article discusses the importance of a systems approach to working with adolescents who have offended sexually. Literature concerning family backgrounds of these youths is reviewed, highlighting histories of family violence, parental depression and child maltreatment, problematic communication patterns, parental psychological inaccessibility, inconsistent discipline, and failure of the family to acknowledge the youth’s offending behavior. Such issues and other special challenges presented by parents of these adolescents, particularly as the issues impact caregiver support and supervision, can be significant barriers to a youth’s successful treatment. However, when these barriers are addressed through a systems approach that actively involves parents in assessment and therapeutic phases of intervention, treatment of an adolescent who sexually offended is likely to be enhanced. The importance of offering parents multiple intervention strategies at various stages in the therapeutic process is emphasized; interventions might include individual, family, and multi-family group therapy, and psychoeducation and support groups.