The purpose of this paper is to review the dynamics and functioning of families with a severely head-injured member. In order to stress the unique problems faced by persons with brain damage and their families, a comparison with spinal cord-injured persons is presented. The review's major conclusion is that a head injury exposes the family to a complex of problems that are unique to this disability and, therefore, necessitates the delivery of special family support services focused on the family, rather than on the head-injured person.

The purpose of this paper is to review the dynamics and functioning of families with a severely head-injured member. In order to stress the unique problems faced by persons with brain damage and their families, a comparison with spinal cord-injured individuals is presented. The review's major conclusion is that a head injury exposes the family to a complex of problems that are unique to this disability and, therefore, necessitates the delivery of special family support services focused on the family, rather than on the head-injured person.

Traumatic brain injury (TBI) is both an acute and a chronic impairment, with long-term difficulties affecting both the patient and members of the patient's family. The impact of TBI may be different for spouses, parents, children, and siblings, and they can be portrayed as the other and often neglected victims of the trauma. Family members are a potentially high risk group, often requiring intensive intervention services and support, not just as caregivers but also as a treatment target population in their own right. The provision of these services should help the family members and the person with the TBI to cope with and adjust more adequately to the sequelae of the disability in the least restrictive environment.

A human sexual response format was used to describe possible sexual dysfunctions after TBI. Additional material was also included to qualify the information drawn from the above format. A number of possible conclusions were drawn, indicating that the causes and effects of sexual functioning after TBI are very confusing and that the literature does not clarify this confusion. One cannot accurately differentiate between primary and secondary sexual problems and, therefore, cannot evaluate the contribution of each problem to the presented sexual dysfunction.

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