This article describes the brief treatment of a Mexican American teenager who presented for family therapy to address major depressive disorder (MDD) and comorbid binge-purge behaviors. Treatment was brief and integrated components of family-based therapy (LeGrange, 2010) and narrative therapy with an overarching multicultural lens. Progress was measured through self-report (Children's Depression Inventory), parent-report, and concrete behavioral markers (e.g., reduced number of purging events). By the end of treatment, there was a reduction of depressive symptoms (e.g., elimination of suicidal ideation and cutting behaviors, reduction of fatigue, anhedonia, and low mood) as well as disrupted eating behaviors. By supporting the teenager and family to identify and leverage their individual and family strengths, treatment also strengthened family communication, increased shared positive family experiences (e.g., family meals), and supported the teenager in engaging in community activities consistent with the family's values. This case adds to the existing literature by reviewing ways in which treatment was modified across multiple domains to provide culturally sensitive care, as well as by identifying weaknesses in the approach, which may serve to illuminate gaps in the existing literature and highlight areas where clinicians may want to adapt their treatment so as to strengthen client outcomes.