Pediatric acquired brain injury (BI) not only affects the child with the injury, but also greatly impacts their family. Studies suggest there are higher rates of caregiver and sibling psychological distress after a child in the family has sustained a BI. Also, family functioning after BI impacts the child's recovery. In reviewing the literature, we identified seven theoretical clinical guidelines for working with families of children and adolescents with BI. These clinical guidelines are as follows: (1) select developmentally appropriate interventions, (2) match the intervention to the family, (3) provide advocacy, (4) provide injury education, (5) focus on family realignment, (6) appropriately adjust the child's environment, and (7) provide skills training to the family and child. The existing research on family interventions for BI is reviewed within the context of these theoretical guidelines, and the empirical support for each guideline is subsequently evaluated using specific criteria for empirically supported treatments. Unfortunately, very few randomized controlled studies exist, and continued research is needed to classify all clinical guidelines as "efficacious." In addition, continued research will aid in informing professionals of specific approaches to utilize when working with a family of a child with BI. Currently, clinicians and researchers can turn to the existing clinical guidelines to help address the numerous barriers posed by implementing and studying family interventions for pediatric BI.