Children reared by alcoholic parents, especially those with co-occurring psychopathology, are at risk for dysfunction involving behavioral and affect self-regulation, interpersonal relationships, cognitive functioning, and value structures. These are preliminary findings from the Michigan State University-University of Michigan (MSU-UM) Longitudinal Study of 300 families over a 20-years period in which about one-third of the children of alcoholics were exposed to two parents with alcohol abuse/dependence diagnoses, and one-half exposed to parents with some kind of co-occurring psychopathology in at least one parent. In their effort to isolate pathways to alcoholism, the authors consider the determinants to those pathways and the impact of risk load both on boys and girls reared in those families. They further elaborate on the intervention program targeting families with especially dense child risk factors. Designed to be delivered over 10 months and 28 sessions, the intervention developed, rather than focusing strictly on the child, has incorporated a marital problem solving protocol. Also the intervention made no direct attempt to modify parental drinking behavior, all efforts being focused instead on attempting to reduce familial violence by modifying antisocial behavior in children and authoritarian parenting behavior and parenting styles in mothers and fathers.