The discussion of treatment practice is prefaced with an exploration of three pivotal issues in incest treatment: the definition of the problem, the role of the larger system, and the potential for doubt and deception. Regarding the definition of the problem, the authors' view is that "individual" variables and "systems" variables are inseparable. The role of the larger system has to do with attitudes toward the legal and social service systems, which are almost always involved in incest cases during their treatment. Regarding doubt and deception, the authors believe the therapists can make an assessment of the risks of remolestation and the incentive for and against deception with each family. Following an overview of these three issues, the article identifies changes in the family structure due to the removal of the incestuous father from the home and notes under what conditions, from a therapeutic perspective, the removal of the father is most effective. The article then turns to a discussion of common themes and progressions in work with family subsystems at various stages: the crisis stage, loss and grief/family reorganization stages, father's re-entry, father's return home, and the termination of treatment. A case description is provided, and three pitfalls for the larger system are identified. 25 references and 3 figures