As the population of the United States ages, and the lifspan increases, so does the number of living generations. The mental health care delivery system therefore faces new challenges. The United States is heading into the 21st century with multigenerational families now commonplace, with up to four or five generations co-existing at the same time. And each generation is forced to deal with its own developmental transitions as well as complex cross-generational issues. When a therapist steps into this situation, his or her role has to take on board the complexity of the whole family system.