The role of the family in recovery from brain injury is of central importance. Family members provide emotional and practical support, advocate for the patient and assist in rehabilitation. The experience of observing a family member following a traumatic injury is extremely challenging and families can experience high levels of distress, anger, guilt and denial in the early post-traumatic phase. These features are followed, in the longer term, by increasing social isolation, depression and anxiety about the future1–3 and can persist for many years after discharge from hospital. Cognitive and personality changes in the individual with the brain injury are reported as the main causes of family distress than other consequences.