Systemic lupus erythematosus (SLE) is an increasingly common chronic medical condition that affects not only patients but also their families. Because this condition has significant psychosocial impact, effective treatment requires an integration of psychosocial treatment—including individual, couples, and family counseling—with conventional medical treatment. Individual psychological dynamics as well as couple and family dynamics that can influence the treatment process are described along with implications for couples counseling. An illustrative case example is included.