From its very inception, pediatric psychology has been committed to involving the whole family in the service of treating children. Yet, in many respects family-based interventions are still in their infancy. Recently, Kazak and colleagues presented a model of family systems practice in pediatric psychology (Kazak, Simms, & Rourke, 2002). They introduce their article with the statement "We write this article reflecting on the lack of established family intervention approaches in pediatric psychology" (p. 133). In the same issue of the Journal of Pediatric Psychology, Brown's presidential address calls for greater attention to social ecologies and the reciprocal influence of children and families (Brown, 2002). Clearly, the need for family-based interventions in pediatric psychology has been endorsed. Why is it taking so long to heed the call from so many fine scholars? On the one hand, a marriage between family-based interventions and pediatric psychology makes sense. There are strong theoretical models suggesting that families affect children's well-being and that children's health affects family functioning (Fiese, 1997;Fiese & Wamboldt, 2001;Patterson & Garwick, 1994;Wood, Klebba, & Miller, 2000). There is a relatively large body of descriptive research linking family interaction styles, disease management practices, family belief systems, and communication patterns with children's health and well-being (Kazak, Rourke, & Crump, 2003). Like most marriages, the relationship between family-based interventions and pediatric psychology is a work in progress and the best of intentions take time to materialize.