Brain injury can have a profound impact on people’s abilities, lifestyle and sense of self. One of the most challenging issues to address in rehabilitation is how to manage impaired self-awareness. Clinicians are often concerned about the impact of developments in self-awareness on psychological well-being. In particular, heightened awareness of deficits is associated with negative self-appraisals and emotional distress. Although recognised as a key issue to attend to in brain injury rehabilitation, there are few guidelines on how best to manage impaired self-awareness as part of a broader approach to supporting people to re-establish a positive self-identity. Drawing on contemporary theories and research, this chapter outlines client-centred practices for addressing impaired self-awareness and identity issues in rehabilitation. The evidence base for awareness and identity-oriented interventions is discussed, along with the importance of establishing sustainable support networks to maintain therapy gains.