Objective To present a case study illustrating the application of parent–child interaction therapy (PCIT) for management of a child’s externalizing behaviors related to a severe traumatic brain injury (TBI). Methods An 11-year-old boy’s history and injury are described, followed by a description of PCIT and the course of therapy. Results After 9 sessions of PCIT, the child displayed fewer negative behaviors, and his mother’s distress was reduced. Conclusions This case demonstrates the feasibility of using PCIT with a child older than the recommended age range to address behavior problems associated with TBI.