Characterological defects secondary to brain injury tend to disrupt normal family interaction patterns and create adjustment problems for the patient's close family members. Social and psychological ties, expectations, and vulnerabilities make caretaking spouses and dependent children particularly susceptible to emotional stresses. Unrealistic expectations often compound these problems. Almost all family members experience some depression. Counseling family members can improve the quality of their adjustment and their care of the patient. Counseling goals include helping the family readjust expectations, providing practical management advice, and alerting family members to their own needs. Specific recommendations for dealing with common family problems are offered.