As the growth of grandparent-headed families continues, increasing numbers of social workers will find themselves dealing with the multitude of issues that these families face. Understanding the needs and concerns of these families is critical for the development of appropriate interventions, which include counseling, support groups, working with schools, and case management. This article discusses specific interventions social workers can use in working with these families. In addition, because their needs and problems are often systemic and not the result of any individual pathology, it stresses (a) the importance of working with grandparents to help them become self-advocates and (b) the role of social workers in changing unresponsive and insensitive policies and systems.