This paper describes the development of a consumer-based program in rural Essex County (New York) for families with children with emotional disorders. Initially, in-depth, in-home interviews were held with 24 families who had children with serious emotional disturbances concerning their service needs and desires. The following needs were expressed by the families: respite, information and referral, an advocate, community friend/mentor for their child, support for caregivers, siblings, and the identified child; crisis services; concrete assistance; and family centeredness. The interviews led directly to development of 32 program recommendations in the development of the Families First in Essex County program. These included: preference for parents of children with special needs in hiring; inclusion of participants in all training as both attendees and trainers; no interagency meetings about families without their presence; a family's assertion that the child has emotional/behavioral problems and requires help as the only criterion for receiving services; and immediate service responsiveness (no waiting lists). The program has served 250 families in 39 months and an evaluation survey of consumers indicated a high degree of satisfaction. (DB)