In this article, I will explore how parentfication, in which children take on parental roles, develops within the context of insecure attachments. I argue that parentification is more prevalent than is generally supposed. Adaptive parentfication is differentiated from destructive parentification, which is associated with a range of childhood problems. In this article, attachment theory is placed within a family systems framework and family concepts are described, such as a secure family base and family scripts, which can help to understand parentification. The ways in which two attachment relationships—insecure/ambivalent and insecure/controlling—contribute to parentification processes are delineated. Transgenerational patterns are discussed. Family therapy can provide a preventive intervention aimed at reducing current parentification and interrupting transgenerational transmission. A central aim is to reduce the need for a parent to turn to a child for care. To this end, work can be done to resolve conflicts between parents, thus freeing them to provide sufficient mutual support to each other. Children need to be detriangulated from the parental relationship. Working with transgenerational patterns, including work with grandparents, is recommended. Therapy with a family with a preschool child illustrates these issues as well as the prevention of the establishment of destructive parentification.