The chapter reviews the occurrence of sexual aggression and incest in families, taking into consideration both individual psychopathology and family dysfunction. It examines the literature on the prevalence and incidence rates of incest, and discusses assessment and treatment considerations. Incest can best be understood and treated within the context of the family. Incestuous relationships are a sign of disturbances in family relationships in which family members are unable to negotiate their basic needs for nurturance, trust, affection, sexuality, and aggression. It has been a major contextual misperception to treat incestuous behavior as a manifestation of the perpetrator’s personality deficiencies. One must look not only at the perpetrator’s role but also at the parents’ contributions and the vulnerabilities in the victim that make her or him particularly vulnerable to exploitation. However, even this expanded view does not recognize the powerful impact of family organization and rules in the promotion of incestuous behavior. References