The perspectives of individuals with intellectual disabilities (ID) about family relationships are underrepresented in the literature. The topic of family relationships emerged in a grounded theory exploratory focus group study that involved thirty dually diagnosed participants with moderate or mild intellectual disabilities and histories of challenging behaviors. Because of the dearth of existing information and the salience of the topic, this analysis explored properties of the participant's disclosures associated with family relationships. The aims were to offer treatment providers empirically based information that may inform service provision and increase the availability of ID-specific, psychological supports for dually diagnosed individuals. Participants reported different types and statuses of family relationships. Transactional processes described in positive family relationships included properties such as reciprocity, flexibility, accommodation, trusting, and expressing affection. Conversely, participants described transactional relationship barriers (e.g., victimizing, behavioral dys-control, and substance abuse) that involved dysregulated behaviors of both the participants and family members in conflicted and severed family relationships. These factors appeared to lead to co-dysregulation versus co-regulation within the family relationships. These findings are relevant given the consensus in the literature that environmental factors are associated with challenging behaviors. Not only do treatment providers need to understand potential family relationship patterns to provide individual supports, but these multilayered factors may warrant seeking additional treatment modalities that address emotion regulation deficits of the participants and family members, trauma-informed treatment, and family therapy. Additionally, conceptualizing family relationships as transactional may help families and collateral supports co-construct positive, collaborative transactions with dually diagnosed individuals that improve the quality of life of all involved.