This chapter describes an ecological approach to behavioral intervention with families of children with developmental disabilities and severe problem behavior that is designed to promote survivable interventions in family contexts. The approach, ecological family centered positive behavior support, is based on an ecological unit of analysis, coercive processes in family routines. The unit of analysis represents a synthesis of behavioral theory, coercion theory, and ecocultural theory. The approach aims to transform coercive into constructive processes in family routines. The chapter discusses the challenges faced by families raising a child with a developmental disability. It describes the components of the ecological unit of analysis and their contributions to tertiary level behavioral intervention with families. Results of a longitudinal intervention study that investigated the efficacy of the approach are presented. Implications are offered for assessment and intervention with families of children with developmental disabilities who may need tertiary level behavioral intervention services.