This chapter presents a psychotherapy designed to help brain injured children learn about their injury and rehabilitation needs and communicate with their family over these. The psychological therapy uses a narrative approach that is highly structured and adapted for young person’s acquired needs. Central to the therapy is the co-creation of a document that the child keeps after the therapy is finished. The psychotherapy pays attention to particular psychological needs that arise for children following a severe ABI. Firstly, it accommodates trauma by using principles from narrative therapy for traumatised children developed by Michael White. Secondly, it protects the child’s identity by fostering the key developmental properties of the self-construct: self-awareness, self-agency, self-continuity and self-cohesion. It does this by maximising child’s authorship and control, developing narratives of their strengths and resources, situating events within the full lifespan and detailing those roles of most importance to the child. Through supporting their identity, the child becomes curious to learn about their injury and rehabilitation needs and what they discover is added to their document. This chapter presents a case study in which structured narrative therapy is provided for a child with severe acquired brain injury and very significant communication difficulties.