Psychological distress and mood disorders are commonly experienced by people with acquired brain injury (ABI). Cognitive behavioural therapy (CBT) is an influential and evolving psychotherapeutic field that is also well established for managing psychological distress for people with ABI. Here, we focus broadly on CBT interventions used in brain injury rehabilitation, including ‘third wave’ cognitive and behavioural therapies. Chapter 26 more comprehensively covers Compassion Focused Therapy, Acceptance and Commitment Therapy, and Positive Psychotherapy. This chapter initially reviews the prevalence and aetiology of psychological distress in the context of ABI. The theoretical foundations and main assumptions of CBT are then summarised. Process issues such as therapy engagement and the therapeutic relationship are outlined in the context of models guiding practice in brain injury rehabilitation. The techniques of CBT are described along with the adaptations often necessary to support people with physical, cognitive and behavioural impairments to engage in and benefit from psychotherapy. In the final section, the evidence base for the efficacy of CBT in people with ABI is appraised and future research directions are outlined.