Resistance to treatment is not only seen in the therapeutic dyad of patient and therapist. It can also be manifest in the interaction between the family, the patient, and the clinicians providing treatment. Psychodynamic and family systems perspectives can be useful in understanding the systemic and unconscious dynamics that comprise this form of resistance. Family therapy may be an effective modality for addressing family resistance, can be integrated with a psychodynamic approach, and may facilitate establishing a working alliance that allows therapeutic change and growth.