Difficulties on interpersonal and familial functioning are significantly associated with depression in women. However, there is a paucity of work addressing gender-sensitive marital and family therapy with depressed women. This article reviews the literature on depressed women's family functioning and discusses a gender-sensitive object -relational approach to marital and family therapy with depressed women. In work with depressed women and their families, the central themes that emerge are the imbalance in power and the lack of intimacy. Characteristic interactional patterns are marked by negative affect, coercion, and rejection. Thus family interventions should emphasize altering family interactional patterns to promote a more adaptive balance of intimacy and power in which the depressed woman, her spouse, and her children feel empowered, interpersonally connected, and affectively integrated.Researchers have documented increased risk, higher incidence, and greater frequency of recurrent episodes of unipolar depressive disorders in women as compared to men (McGrath, Keita, Strickland, & Russo, 1990;Nolen-Hoeksema, 1990). Difficulties in interpersonal and familial functioning are significantly associated with depression in women, and women more often report that interpersonal conflicts precipitated their depressive episodes. Additionally, interpersonal experiences related to loss and unresolved mourning; physical, emotional, and sexual abuse; neglect; and rejection and abandonment are family-of-origin issues typically associated with depression in women (Stiver & Miller, 1988). Women with these interpersonal histories are often involved in the recapitulation of these dynamics in their family of creation. Thus they may feel oppressed and rejected by an alcoholic or abusive spouse, a troubled child, or a demanding parent. Acutely depressed women evidence impairments in social roles such as wife, mother, worker, and community member, and these interpersonal difficulties persist evenWe would like to thank the members of the family therapy study group that the first author attended for their thoughtful comments on this material: