Although caregiver burden is not a direct cause of elder abuse and neglect, research in Japan indicates that stressful caregiving relationships can lead to mistreatment and abuse of frail elders by their families. At the present time, there is no formal notification system for elder abuse in Japan. The purpose of this paper is to discuss crisis intervention strategies that are implemented by social workers at Home Care Support Centers when encountering cases of mistreatment, neglect, and abuse in family caregiving situations. We present the demographic background of elders and their families and review findings of elder abuse studies conducted by Japanese researchers. We then offer three cases to illustrate intervention strategies employed by social workers who work at Home Care Support Centers in an agricultural area in northeastern Japan, including (1) ongoing monitoring, (2) arrangements for formal services, and (3) institutionalization. Cultural issues unique to family caregiving situations are also discussed. [Brief Treatment and Crisis Intervention 5:203-211 (2005)] KEY WORDS: Japanese elders, elder abuse and neglect, family caregiving. The task of caring for elders in traditional Japanese society belonged solely to the family. The rapid growth in the elderly population who require care, however, has led to changes in policies regarding the provision of formal geriatric services. Although families continue to provide the majority of care for frail elders, during the last decade there has been an increase in services, such as in-home health care, to augment family caregiving. Local governments in Japan are now mandated by the national government to establish Home Care Support Centers to assist families that provide care for elders in their homes. Home-based services such as visiting nurse care have led to increased contact between professional care