The patient suffered significant acute brain damage just before his fifth birthday. His neurological rehabilitation was fairly successful, but two years after the event he exhibited numerous symptoms derived from anxiety, depression, and neurotic conflict. Since the family lived far from any source of mental health services, treatment consisted of episodes of brief intensive psychotherapy for the young patient and casework for other members of his family. The author served as primary clinician and case manager for a treatment that lasted between ages seven and ten. Despite his neurological deficits, the patient was able to work in an expressive, insight-seeking mode. He resolved his oedipal conflicts and entered latency. Subsequently, there were brief contacts to deal with common developmental crises. Long-term follow-up indicated the treatment had been successful. The author concludes with a coherent exposition of a model of psychotherapy for brain-injured children, and with a comprehensive bibliography.