Recognition of the critical role that family factors play in the etiology of AOD, mental health and other behavioural health problems, combined with the ongoing role that families can potentially play in supporting adolescents, indicates that some form of family involvement is an important component of developmentally appropriate practice. Early and middle-stage adolescents also tend to be reliant on care-givers for resources, thus securing care-giver involvement, or at least support, may often be essential to the task of engaging younger adolescents in health and social care services.

A critical role for legal guardians (most often parents) is to regulate the experiences of the young people in their care through the application of appropriate boundaries (limit setting). This is of central importance for early and middle stage adolescents but still applies for clients in late adolescence. Enhancing the capacity of parents and caregivers to fulfil this parental role of regulating the experiences of their adolescents, or to contribute to this role in some way, is a key goal of family-focused interventions, particularly family therapy. Practitioners might help a family identify one or more forms of support that they can provide to support that enables the young person in their care to move away from problematic behaviours and contexts and maintain a pro-social lifestyle.

Assessment and intervention planning with young people needs to be family inclusive or at least family sensitive in the sense of considering whether and how the family system as a whole, or unilateral relationships between the adolescent and particular family members may be shaped and strengthened to diversify and enrich the social supports available to the adolescent. Family inclusive assessment and care planning would involve direct communication with those family members, whereas family sensitive assessment and care planning would involve consideration of how family connections can be improved but stop short of directly involving them if that is the limit of what is possible or the preference of the adolescent.

If immediate family members are unavailable, the potential contribution of other significant adults should be considered. Whether or not families are involved or supportive, other social systems such as schools, alternative education organisations, sports clubs and other social institutions are also vitally important to building a viable network of social supports around adolescents.

As clients begin to take on more responsibility for their own health and well-being they also have more agency regarding the nature and degree of the contact they have with families and significant others. Practitioners need to assist clients to work through these decisions.