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Adults with episodic neurological disabilities (e.g., epilepsy) and their families are likely to encounter a number of psychosocial difficulties for which family counseling is sought. Although previous research has identified broad categories of family difficulties, we continue to lack basic information about the specific types, range, and severity of these family problems. Furthermore, we have only limited knowledge about the relationships among the specific types of problems, family background characteristics, and the family members involved in specific problems. The primary objectives of the study were to determine (a) the kinds of problems reported by adults with episodic neurological disabilities (n = 25) and their families (n = 34) in counseling, (b) the relationships between types of problems and demographic/medical factors, (c) the family problems reported in counseling that are most severe, and (d) members of the family system and significant others in the community who are involved in specific problems. The findings provide valuable information for designing family counseling interventions for this population.