Acquired Brain Damage (ABD) causes immense difficulties for individuals and families and is increasingly recognised as a serious community issue. This paper focuses on the burden placed on family members with a head injured relative. The authors propose that when working with families with a member with a neuropsychological condition, the family therapist may be required to embrace a more flexible role. Depending on the developmental needs of the family, the family therapist may at times: provide educational information about brain damage and its effects arrange family support groups or wider network meetings be the family's advocate in the context of complex legal and financial bureaucracies or undertake marital, sexual or family therapy when required. Whatever the role played, a ‘family sensitive practice’ approach by family therapists is advocated. It is also deemed useful to develop a theoretical assessment model which helps the therapist locate where individual family members are in their negotiation of the tasks of grieving, restructuring, identity reformation and achieving a sense of growth after head injury. Further implications for clinical practice are outlined.