The neurobehavioral family therapist is often confronted with unusual circumstances when treating families with a brain-compromised member. These circumstances make the family therapy process categorically different from more traditional forms of family treatment. Although any number of therapeutic challenges can occur, major practical concerns typically involve confusion regarding the referral for family treatment, utility of including the compromised member in sessions, responding to questions outside of one's expertise, conduct of the session, and termination of treatment. In this chapter, some of these concerns and related problems will be addressed. Reimbursement issues are also discussed. Additionally, we will address future training and ethical issues that are likely to emerge as this growing profession develops.