During adolescence, some young people may experiment with both licit and illicit substances (alcohol, tobacco, cannabis and other drugs). This can have an impact on their behaviour, their relationships with others and how they function in society. For those who develop substance use disorders, family has a vital role to play in addressing this issue. This EMCDDA Paper focuses on a form of inclusive therapy that involves the young person, their family and their environment. Based on five studies carried out in the United States and the EU, the holistic approach encapsulated by Multidimensional family therapy delivers promising results that are visible both during therapy and after it has ended. However, the approach requires family engagement which cannot always be obtained, and may come at a higher cost than other therapeutic options.