This article proposes ways in which the theories, philosophies, and techniques of Gestalt therapy can assist rehabilitation counselors to better understand traumatic brain injury (TBI). The article describes the central tenets of Gestalt therapy and its unique fit to TBI. Discussion focuses on how an appreciation of Gestalt therapy can assist rehabilitation counselors to understand and address the psychological, familial, and service system implications of TBI. A conceptual framework is presented on the pathways of maladjustment and adjustment to living with TBI from a Gestalt perspective. A central assumption of this model is that without intervention, the onset of TBI activates a process of maladjustment for many persons with TBI and their family caregivers expressed by fragmentation, unfinished business, and lack of self-awareness. The model underscores the importance of rehabilitation counselor attention on both individual and contextual levels.