One of the great challenges (and rewards) in treating children is the frequent discovery that the patient is not really sick at all, but simply reacting to pathology in the family constellation. The author conceptualizes treatment in structural terms of the family. He describes a therapeutic process in which the therapist helps members of a family system to agree on the problem they need to solve, to identify the participants in the family structure to whom the problem is related, and to make pledges to work on changing the structural basis of the newly clarified problem.