Huntington disease (HD) has major psychosocial implications. Many of the psychiatric symptoms of the disorder have been attributed to the HD gene, but systems factors may also account for the disorder’s manifestations. 3 issues – patient preselection, denial of symptom onset & suicide induction are discussed. Recently developed capacity for presymptomatic testing makes it likely that family therapists increasingly will be involved in clinical work with individs & families in which HD occurs.