Substance use in families results in detrimental parent/child dynamics that can increase a child’s vulnerability to later drug use. This article reviews the research on parent/child processes that moderate or mediate a child’s personality, social skills, values, attitudes, behaviors, and subsequent vulnerability or resilience to substance misuse. Research is presented on behavioral and emotional precursors in children of alcohol or drug abusers and then transactional process mechanisms that contribute to developmental trajectories leading to dysfunction and substance abuse disorders. The article concludes by discussing the need to provide families with evidence-based, effective parenting or family strengthening intervention to increase resilience to drug use for high-risk youth. Resources are presented for finding effective family interventions and examples of a family intervention based on principles, specifically the Strengthening Families Program. Increased research is recommended for family interventions that are effective in increasing resilience characteristics in children by improving parent/child transactional processes. There is also a need for better dissemination of effective family interventions to improve adoption by practitioners in the field. References